Mediterranean diet improves erectile function in subjects with the metabolic syndrome

Esposito, Katherine; Ciotola, Miryam; Giugliano, Francesco; Sio, Marco De; Giugliano, Giovanni; D’Armiento, Massimo; Giugliano, Dario

doi:10.1038/sj.ijir.3901447

Cited by 136 publications

(98 citation statements)

References 35 publications

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“…The connection between diet and systemic inflammatory tone has often been suggested (70,71). Several studies have investigated potential single-meal effects on markers of inflammation, with most studies using HFMs.…”

Section: Discussionmentioning

confidence: 99%

Magnitude and Timing of the Postprandial Inflammatory Response to a High-Fat Meal in Healthy Adults: A Systematic Review

Emerson

Kurti

Harms

et al. 2017

Advances in Nutrition

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Research findings over the past several decades have shown that inflammation is a prominent feature of many chronic diseases, with poor diet being one likely inflammatory stimulus. Specifically, a single high-fat meal (HFM) has been suggested to increase inflammation, although there is currently no consensus with regard to the specific changes in many of the proinflammatory markers that are frequently assessed after an HFM. The aim of this systematic review was to objectively describe the postprandial timing and magnitude of changes in 5 common inflammatory markers: interleukin (IL) 6, C-reactive protein (CRP), tumor necrosis factor (TNF) a, IL-1b, and IL-8. Ten relevant databases were searched, yielding 494 results, of which 47 articles met the pre-established inclusion criteria: 1) healthy men and women aged 18-60 y, 2) consuming a single HFM ($30% fat, $500 kcal), and 3) assessing relevant inflammatory markers postmeal for $2 h. The only marker found to consistently change in the postprandial period was IL-6: on average, from a baseline of ;1.4 pg/mL, it peaked at ;2.9 pg/mL ;6 h post-HFM (an average relative change of ;100%). CRP, TNF-a, IL-1b, and IL-8 did not change significantly in 79% (23 of 29), 68% (19 of 28), 67% (2 of 3), and 75% (3 of 4) of included studies, respectively. We conclude that there is strong evidence that CRP and TNF-a are not responsive at the usual time scale observed in postprandial studies in healthy humans younger than age 60 y. However, future research should further investigate the role of IL-6 in the postprandial period, because it routinely increases even in healthy participants. We assert that the findings of this systematic review on markers of inflammation in the postprandial period will considerably aid in informing future research and advancing clinical knowledge. Adv Nutr 2017;8:213-25.

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Section: Discussionmentioning

confidence: 99%

Magnitude and Timing of the Postprandial Inflammatory Response to a High-Fat Meal in Healthy Adults: A Systematic Review

Emerson

Kurti

Harms

et al. 2017

Advances in Nutrition

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“…3 Lifestyle, metabolism and erectile function DR Meldrum et al including various combinations of the listed interventions, 50 such as the favorable effects on ED of combining testosterone and sildenafil, 36 or of the Mediterranean diet, which increases intakes of omega-3's, antioxidants and folic acid. 74 …”

Section: Reduction Of Inflammation Improves Endothelial Function and Edmentioning

confidence: 99%

Lifestyle and metabolic approaches to maximizing erectile and vascular health

et al. 2011

Self Cite

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Oxidative stress and inflammation, which disrupt nitric oxide (NO) production directly or by causing resistance to insulin, are central determinants of vascular diseases including ED. Decreased vascular NO has been linked to abdominal obesity, smoking and high intakes of fat and sugar, which all cause oxidative stress. Men with ED have decreased vascular NO and circulating and cellular antioxidants. Oxidative stress and inflammatory markers are increased in men with ED, and all increase with age. Exercise increases vascular NO, and more frequent erections are correlated with decreased ED, both in part due to stimulation of endothelial NO production by shear stress. Exercise and weight loss increase insulin sensitivity and endothelial NO production. Potent antioxidants or high doses of weaker antioxidants increase vascular NO and improve vascular and erectile function. Antioxidants may be particularly important in men with ED who smoke, are obese or have diabetes. Omega-3 fatty acids reduce inflammatory markers, decrease cardiac death and increase endothelial NO production, and are therefore critical for men with ED who are under age 60 years, and/or have diabetes, hypertension or coronary artery disease, who are at increased risk of serious or even fatal cardiac events. Phosphodiesterase inhibitors have recently been shown to improve antioxidant status and NO production and allow more frequent and sustained penile exercise. Some angiotensin II receptor blockers decrease oxidative stress and improve vascular and erectile function and are therefore preferred choices for lowering blood pressure in men with ED. Lifestyle modifications, including physical and penile-specific exercise, weight loss, omega-3 and folic acid supplements, reduced intakes of fat and sugar, and improved antioxidant status through diet and/or supplements should be integrated into any comprehensive approach to maximizing erectile function, resulting in greater overall success and patient satisfaction, as well as improved vascular health and longevity.

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“…15 It is reported that ED may affect obese men, especially both in younger 16 or in those older men with co-morbidities, 17 and that tailored diet is able to restore sexual function when metabolic syndrome is present. 18 Accordingly, the origin of ejaculatory complaints in obese men is poorly investigated. An interesting association between obesity and lifelong PE exists, and some authors reported that patients with lifelong PE were leaner than the healthy control cases, and the prevalence of obesity was lower in the PE group than in the control group.…”

Section: Discussionmentioning

confidence: 99%

A pilot study to evaluate the effects of vardenafil on sexual distress in men with obesity

et al. 2011

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There are no interventional studies on the impact of sexual distress (SD) in men with obesity. We investigated the effects of vardenafil (VAR) on SD in middle-aged (mean age 49±8), healthy, obese men in the absence of premature ejaculation, ED or hypogonadism. After a 4-week run-in period, 20 men with high body mass index (BMI ¼ 40±8) and SD at the Sexual Distress Esteem Questionnaire-Male (mean score 65 ± 20 AU) were randomized to receive either VAR 10 mg on demand (N ¼ 10) or matched-placebo (PLB, N ¼ 10). Primary endpoints were variations from baseline in the intravaginal ejaculatory latency time (IELT) measured by the stopwatch technique; secondary endpoints were variations from baseline in Self-Esteem and Relationship (SEAR) and Male Sexual Health Questionnaire-Ejaculatory domain (MSHQ-EjD) scores. VAR significantly improved IELT (Po0.0001), as well as SEAR (Po0.001) and MSHQ-EjD (Po0.005) scores, wheraes no changes were observed after PLB. Interestingly, an inverse relationship between BMI and IELT was found in all the men studied (r 2 ¼ 0.37, Po0.001). SD in healthy obese men seems to be correlated mainly with inadequate ejaculatory control, especially in men with higher BMI. Our preliminary results suggest that treatment with VAR may improve ejaculatory control, thus ameliorating self-esteem and sexual performance in men with obesity.

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Mediterranean diet improves erectile function in subjects with the metabolic syndrome

Cited by 136 publications

References 35 publications

Magnitude and Timing of the Postprandial Inflammatory Response to a High-Fat Meal in Healthy Adults: A Systematic Review

Magnitude and Timing of the Postprandial Inflammatory Response to a High-Fat Meal in Healthy Adults: A Systematic Review

Lifestyle and metabolic approaches to maximizing erectile and vascular health

A pilot study to evaluate the effects of vardenafil on sexual distress in men with obesity

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