The association between comprehensive dietary antioxidant index and erectile dysfunction in adult men: a cross-sectional study from the 2001-2004 U.S. National Health and Nutrition Examination Survey.

Background: Increasing evidence suggests that a diet rich in antioxidants may prevent erectile dysfunction (ED), but the impact of comprehensive dietary antioxidants on ED has been little studied.

Aim: To investigate the association between the composite dietary antioxidant index (CDAI) and ED risk in adult men.

Methods: The study performed a cross-sectional analysis using data from the 2001-2004 National Health and Nutrition Examination Survey to investigate the association between the composite dietary antioxidant index (CDAI) and ED. The connection between the CDAI and ED was assessed using univariate and multivariate weighted logistic regression models, as well as the restricted cubic spline.

Outcomes: Association between the CDAI and the prevalence of ED.

Results: The study included a total of 3699 participants, among whom 1042 were diagnosed with ED, resulting in a prevalence of 28.17%. Multivariate weighted logistic regression consistently showed a negative association between the CDAI and ED (OR = 0.95, 95% CI: 0.92-0.98,  = .005). The group with the highest CDAI (Q4) had a 33% reduced risk of ED than the group with the lowest CDAI (Q1) when the CDAI was regarded as a categorical variable (OR = 0.67, 95% CI: 0.49-0.91,  = .014). Restricted cubic spline analysis showed that the CDAI was linearly related to the risk of ED (non-linearity  = .652). Furthermore, subgroup analysis indicated that the inverse relationship between CDAI and ED was more pronounced in individuals under 60 years of age, those with diabetes, and those without hypertension.

Clinical Implications: Dietary strategies to increase antioxidant intake might offer a potential approach to reducing ED risk and supporting men's sexual health.

Strengths And Limitations: This is a large-scale study investigating the association between the CDAI and ED. However, as a cross-sectional study, the timeliness of the dataset and the recall bias inherent in dietary data somewhat limit the reliability of the results.

Conclusion: This study identified a significant inverse association between the CDAI and ED risk among adult men in the United States; however, as a cross-sectional study, this research cannot establish causation, and further longitudinal studies are needed to validate these findings and provide more definitive evidence.