title: Adherence to Mediterranean diet and sexual function in women with type 2 diabetes.
abstract: BACKGROUND
  There are no reported studies assessing the relation between diet and sexual function in women with diabetes.
  
  
  OBJECTIVE
  In the present study, we explored the relation between consumption of a Mediterranean-type diet and sexual function in a population of type 2 diabetic women.
  
  
  METHODS
  Patients with type 2 diabetes were enrolled if they had a diagnosis of type 2 diabetes for at least six months but less than 10 years, age 35-70 years, body mass index (BMI) of 24 or higher, HbA1c of 6.5% or higher, treatment with diet or oral drugs. All diabetic patients were invited to complete a food-frequency questionnaire and self-report measures of sexual function. A total of 595 (90.2%) of the 659 women completed both questionnaires and were analyzed in the present study.
  
  
  METHODS
  Adherence to a Mediterranean diet was assessed by a 9-point scale that incorporated the salient characteristics of this diet (range of scores, 0-9, with higher scores indicating greater adherence). The Female Sexual Function Index (FSFI) was used for assessing the key dimensions of female sexual function.
  
  
  RESULTS
  Diabetic women with the highest scores (6-9) had lower BMI, waist circumference, and waist-to-hip ratio, a lower prevalence of depression, obesity and metabolic syndrome, a higher level of physical activity, and better glucose and lipid profiles than the diabetic women who scored <3 points on the scale. The proportion of sexually active women showed a significant increase across tertiles of adherence to Mediterranean diet (from 54.2% to 65.1%, P = 0.01). Based on the FSFI cutoff score for female sexual dysfunction (FSD) of 23, women with the highest score of adherence had a lower prevalence of sexual dysfunction as compared with women of lower tertiles (47.6%, 53.9%, and 57.8%, higher, middle, and lower tertile, respectively, P = 0.01). These associations remained significant after adjustment for many potential confounders.
  
  
  CONCLUSIONS
  In women with type 2 diabetes, greater adherence to Mediterranean diet is associated with a lower prevalence of FSD.
authors.affiliation: Division of Urology, Department of Geriatrics and Metabolic Diseases, Second University of Naples, Naples, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Giugliano
authors.forename: Maria Ida
authors.initials: MI
authors.lastname: Maiorino
authors.forename: Carmen
authors.initials: C
authors.lastname: Di Palo
authors.forename: Riccardo
authors.initials: R
authors.lastname: Autorino
authors.forename: Marco
authors.initials: M
authors.lastname: De Sio
authors.forename: Dario
authors.initials: D
authors.lastname: Giugliano
authors.forename: Katherine
authors.initials: K
authors.lastname: Esposito
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy* / Q000523:psychology; D038441:Diet, Mediterranean / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D055105:Waist Circumference; D049629:Waist-Hip Ratio