title: Adherence to Mediterranean diet and erectile dysfunction in men with type 2 diabetes.
abstract: BACKGROUND
  There are no reported studies assessing the relation between diet and erectile dysfunction (ED) in men with diabetes.
  
  
  OBJECTIVE
  In the present study, we explored the relation between consumption of a Mediterranean-type diet and ED in a population of type 2 diabetic men.
  
  
  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 555 (90.8%) of the 611 diabetic men 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). ED was assessed with the International Index of Erectile Function-5.
  
  
  RESULTS
  Diabetic men with the highest scores (6-9) had lower BMI, waist circumference, and waist-to-hip ratio, a lower prevalence of obesity and metabolic syndrome, a higher level of physical activity, and better glucose and lipid profiles than the diabetic men who scored <3 points on the scale. The proportion of sexually active men showed a significant increase across tertiles of adherence to Mediterranean diet (from 65.1% to 74.4%, P = 0.01). Moreover, men with the highest score of adherence were more likely to have a lower prevalence of global ED (51.9% vs. 62%, P = 0.01) and severe ED (16.5% vs. 26.4%, P = 0.01) as compared with low adherers.
  
  
  CONCLUSIONS
  In men with type 2 diabetes, greater adherence to Mediterranean diet is associated with a lower prevalence of ED.
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: Giuseppe
authors.initials: G
authors.lastname: Bellastella
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: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000178:diet therapy* / Q000523:psychology; D038441:Diet, Mediterranean / Q000523:psychology*; D007172:Erectile Dysfunction / Q000097:blood / Q000175:diagnosis / Q000178:diet therapy* / Q000523:psychology; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D010349:Patient Compliance / Q000523:psychology
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D008055:Lipids; C517652:hemoglobin A1c protein, human