Comparing the effects of meal replacements with reduced-fat diet on weight, sexual and endothelial function, testosterone and quality of life in obese Asian men

Abstract

Sexual dysfunction is more prevalent in obese than in normal-weight men. Meal replacements (MRs) are useful weight-loss strategies. We randomized obese (body mass index 27.5 kg m(-2), waist circumference (WC) 90 cm) Asian men (mean age 40.5 years, range 30-61) to a conventional reduced-fat diet (CD) (n=24) or MR-based plan (n=24) to reduce daily intake by 400 kcal for 12 weeks. There were significantly greater reductions in weight (4.2 ± 0.8 kg), WC (4.6 ± 0.7 cm), calorie and fat intake in the MR group, compared with the CD group (2.5 ± 0.4 kg, 2.6 ± 0.5 cm). Erectile function (International Index of Erectile Function 5-item score) improved comparably in the MR (3.4 ± 0.7 points) and CD (2.5 ± 0.5 points) groups, as did the Sexual Desire Inventory score (5.5 ± 2.3 vs 7.7 ± 2.1 points), quality of life (36-item Short Form survey score), plasma testosterone and endothelial function (Reactive Hyperemia Index). Subjects were switched to or continued CD for another 28 weeks. Weight, WC and erectile function were maintained at 40 weeks. MR induces greater reductions in weight and abdominal obesity than conventional diet, and comparable improvements in sexual and endothelial function, testosterone and quality of life.

Long-Term Effects of a Randomised Controlled Trial Comparing High Protein or High Carbohydrate Weight Loss Diets on Testosterone, SHBG, Erectile and Urinary Function in Overweight and Obese Men

“…Our findings are in contrast to prior reports [6,7,35,36] where improvements in the SDI or IPSS occurred following weight losses of 2-6-12.3 kg over 8–52 weeks. We note that an improvement in the storage LUTS score occurred for those with the presence of features of lower urinary tract symptoms relating to storage symptoms at baseline.…”

Lifestyle and lower urinary tract symptoms

“…While some studies have shown that comprehensive lifestyle changes that included weight loss but not as the sole intervention improved LUTS symptoms, none studied weight loss alone and none included a group of men who specifically had symptomatic LUTS. [18–20] While in general the studies showed that dietary interventions that induce weight loss may improve LUTS with greater weight loss correlating with greater improvements, these studies suffer from multiple limitations. First , none of the studies specifically targeted men with symptomatic LUTS.…”

Relationship among diet habit and lower urinary tract symptoms and sexual function in outpatient-based males with LUTS/BPH: a multiregional and cross-sectional study in China

“…Additionally, Oksuz and Malhan30 reported that men without diet-based lifestyle changes are at higher risk for MSD, and Khoo et al 15 found that a reduced-fat diet in obese Chinese men enhances male sexual function. In this study, however, vegetables and milk and dairy products were risk factors for MSD.…”