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Urology Practice Management - February 2016, Vol 5, No 1 - Erectile Dysfunction
Rosemary Frei, MSc

A new study suggests that boosting the consumption of flavonoid-containing foods, such as blueberries, may help stave off erectile dysfunction (Cassidy A, et al. Am J Clin Nutr. 2016 Jan 13. Epub ahead of print).

The questionnaire-based study of more than 25,000 men participating in the Health Professionals Follow-Up Study indicated a 9% lower risk for erectile dysfunction among men who had a higher intake of flavones and an 11% lower risk with a higher intake of flavanones.

“This is a large observational study and provides some novel and interesting associations on the potential protective effects of fruits, and hints that some fruits may be better than others, particularly berries and citrus,” lead investigator Aedín Cassidy, PhD, MSc, Professor, Department of Nutrition, Norwich Medical School, University of East Anglia, England, told Urology Practice Management.

“The data also suggest that the flavonoid content may be a key constituent for the effects, given our current understanding of how they work, including effects on improving blood flow,” said Dr Cassidy.

However, the study relied on the Food Frequency Questionnaire, which leaves room for question about its reliability, considering it is based on patient-reported outcomes. Dr Cassidy agreed that further research is needed on this subject, and randomized trials would be the optimal form of evidence.

“That would be the obvious next step, and certainly a number of trials are ongoing looking at these compounds and heart disease and diabetes already,” Dr Cassidy said. However, the study involved a large cohort over a long period.

Study Details

The study involved 25,096 men who at baseline in 1998 did not have a diagnosis of erectile dysfunction, cardiovascular disease, or prostate, bladder, or testicular cancer. The men completed the questionnaire regarding their dietary intake every 4 years through 2010. They also rated their ability to have and maintain an erection without treatment in 2000, 2004, and 2008.

During the 10-year follow-up, 35.6% of the men reported incident erectile dysfunction. The investigators adjusted for classic cardiovascular disease risk factors and other confounders, and found that those in the highest versus the lowest quartile of flavone intake had a 9% reduced risk for erectile dysfunction, whereas those in the highest versus the lowest quartile of flavanone intake had an 11% reduced incidence of erectile dysfunction.

High anthocyanin intake was also associated with a 9% lower risk for erectile dysfunction.

Strongest Association Found in Older Men

The investigators also analyzed the intake of the top 6 sources of the 3 plant components of anthocyanin, flavone, and flavanone, including:

  • Strawberries
  • Blueberries
  • Red wine
  • Apples
  • Pears
  • Citrus fruits.

They found men in the highest quintile of intake of these groups had a 14% reduced risk for erectile dysfunction compared with men in the lowest quintile. Citrus fruit and blueberry intake were the most strongly associated with a reduced risk for erectile dysfunction.

It is interesting to note that the strongest relationship between the 3 plant components and a reduction in erectile dysfunction was found in men aged ≥70 years.

“We need trials to further understand these data, but these data suggest that we should start to refine our dietary recommendations, as the benefits of specific fruits vary, with some more beneficial for erectile dysfunction than others,” concluded Dr Cassidy.

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Last modified: March 4, 2016
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