title: Comparing effects of a low-energy diet and a high-protein low-fat diet on sexual and endothelial function, urinary tract symptoms, and inflammation in obese diabetic men.
abstract: BACKGROUND
  Abdominal obesity and type 2 diabetes mellitus are associated with sexual and endothelial dysfunction, lower urinary tract symptoms (LUTS), and chronic systemic inflammation.
  
  
  OBJECTIVE
  To determine the effects of diet-induced weight loss and maintenance on sexual and endothelial function, LUTS, and inflammatory markers in obese diabetic men.
  
  
  METHODS
  Weight, waist circumference (WC), International Index of Erectile Function (IIEF-5) score, Sexual Desire Inventory (SDI) score, International Prostate Symptom Scale (IPSS) score, plasma fasting glucose and lipids, testosterone, sex hormone binding globulin (SHBG), inflammatory markers (high-sensitivity C-reactive protein [CRP] and interleukin-6 [IL-6]) and soluble E-selectin, and brachial artery flow-mediated dilatation (FMD) were measured at baseline, 8 weeks, and 52 weeks.
  
  
  METHODS
  Over 8 weeks, 31 abdominally obese (body mass index ≥ 30 kg/m(2) , WC ≥ 102 cm), type 2 diabetic men (mean age 59.7 years) received either a meal replacement-based low-calorie diet (LCD) ∼1,000 kcal/day (N = 19) or low-fat, high-protein, reduced-carbohydrate (HP) diet (N = 12) prescribed to decrease intake by ∼600 kcal/day. Subjects continued on, or were switched to, the HP diet for another 44 weeks.
  
  
  RESULTS
  At 8 weeks, weight and WC decreased by ∼10% and ∼5% with the LCD and HP diet, respectively. Both diets significantly improved plasma glucose, low-density lipoprotein (LDL), SHBG, IIEF-5, SDI and IPSS scores, and endothelial function (increased FMD, reduced soluble E-selectin). Erectile function, sexual desire, and urinary symptoms improved by a similar degree with both diets. CRP and IL-6 decreased with the HP diet. At 52 weeks, reductions in weight, WC, and CRP were maintained. IIEF-5, SDI, and IPSS scores improved further.
  
  
  CONCLUSIONS
  Diet-induced weight loss induces rapid improvement of sexual, urinary, and endothelial function in obese diabetic men. A high-protein, carbohydrate-reduced, low-fat diet also reduces systemic inflammation and sustains these beneficial effects to 1 year.
authors.affiliation: Department of Endocrinology, Changi General Hospital, Singapore, Singapore. furrina_2000@yahoo.com
authors.forename: Joan
authors.initials: J
authors.lastname: Khoo
authors.forename: Cynthia
authors.initials: C
authors.lastname: Piantadosi
authors.forename: Rae
authors.initials: R
authors.lastname: Duncan
authors.forename: Stephen G
authors.initials: SG
authors.lastname: Worthley
authors.forename: Alicia
authors.initials: A
authors.lastname: Jenkins
authors.forename: Manny
authors.initials: M
authors.lastname: Noakes
authors.forename: Matthew I
authors.initials: MI
authors.lastname: Worthley
authors.forename: Kylie
authors.initials: K
authors.lastname: Lange
authors.forename: Gary A
authors.initials: GA
authors.lastname: Wittert
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D031204:Caloric Restriction; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D018752:Diet, Fat-Restricted; D019040:E-Selectin / Q000097:blood; D006801:Humans; D007249:Inflammation / Q000178:diet therapy*; D015850:Interleukin-6 / Q000097:blood; D007989:Libido / Q000502:physiology; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy*; D010410:Penile Erection / Q000502:physiology; D011467:Prostate / Q000503:physiopathology; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013739:Testosterone / Q000097:blood; D014570:Urologic Diseases / Q000188:drug therapy*; D055105:Waist Circumference
chemical_list: D001786:Blood Glucose; D019040:E-Selectin; D015850:Interleukin-6; D008055:Lipids; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D002097:C-Reactive Protein