title: A prospective study of risk factors for erectile dysfunction.
abstract: OBJECTIVE
  We examined the impact of obesity, physical activity, alcohol use and smoking on the development of erectile dysfunction.
  
  
  METHODS
  Subjects included 22,086 United States men 40 to 75 years old in the Health Professionals Followup Study cohort who were asked to rate their erectile function for multiple periods on a questionnaire mailed in 2000. Men who reported good or very good erectile function and no major chronic disease before 1986 were included in the analyses.
  
  
  RESULTS
  Of men who were healthy and had good or very good erectile function before 1986, 17.7% reported incident erectile dysfunction during the 14-year followup. Obesity (multivariate relative risk 1.9, 95% CI 1.6-2.2 compared to men of ideal weight in 1986) and smoking (RR 1.5, 95% CI 1.3-1.7) in 1986 were associated with an increased risk of erectile dysfunction, while physical activity (RR 0.7, 95% CI 0.7-0.8 comparing highest to lowest quintile of physical activity) was associated with a decreased risk of erectile dysfunction. For men in whom prostate cancer developed during followup, smoking (RR 1.4, 95% CI 1.0-1.9) was the only lifestyle factor associated with erectile dysfunction.
  
  
  CONCLUSIONS
  Reducing the risk of erectile dysfunction may be a useful and to this point unexploited motivation for men to engage in health promoting behaviors. We found that obesity and smoking were positively associated, and physical activity was inversely associated with the risk of erectile dysfunction developing.
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Channing Laboratory, 665 Huntington Avenue, Boston, MA 02115, USA.
authors.forename: Constance G
authors.initials: CG
authors.lastname: Bacon
authors.forename: Murray A
authors.initials: MA
authors.lastname: Mittleman
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawachi
authors.forename: Edward
authors.initials: E
authors.lastname: Giovannucci
authors.forename: Dale B
authors.initials: DB
authors.lastname: Glasser
authors.forename: Eric B
authors.initials: EB
authors.lastname: Rimm
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D007172:Erectile Dysfunction / Q000209:etiology*; D015444:Exercise; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D011795:Surveys and Questionnaires