Study: "Robust link" between inflammatory diet and erectile dysfunction

Erectile dysfunction (ED) is one of the most common types of sexual dysfunction in men and is predicted to affect approximately 322 million men​ worldwide by 2025.

Diet is a potential source of chronic low-grade inflammation which is related to the pathogenesis of ED. Previously, some dietary patterns, especially anti-inflammatory diet, have been linked to ED​. 

Existing studies focus on the protective effect of specific anti-inflammatory nutrients or diet patterns on ED yet the impact of the dietary inflammatory potential on ED is still unclear.  

The dietary inflammation index (DII) is a novel method to quantify the inflammatory potential of a diet but the association between the level of dietary inflammation potential and ED has not been reported before.

To best understand the influence of dietary inflammation on ED and provide clues for its prevention, this cross-sectional study explored the association between DII and ED among US adults, using data from the National Health and Nutrition Examination Survey (NHANES) 2001– 2004.

The authors conclude: "This nationally representative study found robust association between DII and ED in US adult males...Since a pro-inflammatory diet may be a modifiable risk factor of ED, we expect more studies on this field."

Findings

This cross-sectional study included 3,693 males, aged 20–85. Multivariable-adjusted logistic regression models were used to assess the association between the DII and ED.

DII score was calculated based on 27 food parameters extracted from the NHANES 2001–2004 by a 24-h dietary recall interview.

The survey included the question “How would you describe your ability to get and keep an erection adequate for satisfactory intercourse?”. In the present study, those who responded “sometimes able” or “never able” to maintain an erection were considered as having ED.

A total of 1,011 of participants were found to have ED - 33.7% of all participants.

The researchers found, after adjusting for the baseline imbalance, participants in the top third DII had an approximately 1.5-time higher odds of having ED. This relationship remained stable in the fully-adjusted model that adjusted for a large set of confounders (age, race/ethnicity, education, BMI, several health conditions, smoking and drinking status, and fitness level).

The authors note that the cross-sectional nature of this study means causal inference about the association between DII and ED could not be established.

They also note that there could be a recall bias when participants answered the survey and the 24-h dietary recall interview.

Mechanism of action

Although previous studies​ have noticed an elevation of inflammatory biomarkers in both animal models and humans with ED, the exact mechanism is still unclear. A possible explanation is that the pro-inflammatory diet mediated ED by increasing the vascular endothelial injury.

It is known that endothelial nitric oxide is a molecule that regulates vascular tone and can protect endothelial cells from oxidative damage. Previous studies​ showed that inflammatory biomarkers, such as TNF-α, can inhibit endothelial nitric-oxide synthase (eNOS) gene expression in endothelial cells, leading to vascular endothelial injury and a higher risk of ED. In addition, a proinflammatory diet can contribute to the pathogenesis of diabetes and cardiovascular disease. Both are potential risk factors of ED.

Source: Frontiers in Nutrition​

https://doi.org/10.3389/fnut.2022.930272​

“Association between dietary inflammation and erectile dysfunction among US adults: A cross-sectional analysis of the National Health and Nutrition Examination Survey 2001–2004”​

Zhijie Ruan, Xiaoping Xie, Haoyang Yu, Ruimin Liu, Wenjuan Jing and Tao Lu*