Lowering blood pressure through Mediterranean diet and fitness may limit erectile dysfunction

By James DuckerReviewed by Emily Henderson, B.Sc.Aug 25 2021

Study demonstrates that a Mediterranean diet and greater exercise ability improves erectile performance in men suffering from erectile dysfunction.

Image Credit: Antonina Vlasova/Shutterstock.com

Exploring the behavioural and dietary factors underling erectile dysfunction

During their lifetime, men have nearly a 50% chance to experience some form of erectile dysfunction, a condition originating from the loss of flow augmentation in the small arteries.  

The likelihood increases with age due to declining testosterone levels, which contributes to the onset of the condition.

In previous studies, findings have shown that fitness and activity levels are linked with improved survival in men with hypertension, which are also known to experience frequent erectile dysfunction.

In addition, dietary research has indicated that a Mediterranean diet lowers blood pressure and prevents heart attacks and strokes in individuals at high cardiovascular risk.

In a new study combining these factors to examine how they affect blood pressure and erectile dysfunction, a new study on middle aged men shows both diet and activity play key roles.

The Mediterranean diet emphasises fruit, vegetables, whole grains and olive oil, modest consumption of dairy products, and limiting red meat using alternative protein sources such as fish. Components of the diet are therefore rich in natural fibre, vitamins, and low in fat as well as sugar.

Researchers in the current study examined whether consuming such a diet was linked with fitness levels, testosterone, blood flow, arterial stiffness, and erectile performance, using a sample group of 250 men with known high blood pressure and erectile dysfunction.

Designing a comprehensive assessment of dietary and behavioural patterns

On average, men were aged 56 years, and their dietary habits were assessed using questionnaires from which they were given a score between 0 and 55 corresponding to their dietary adherence.

Additionally, individuals were assessed on a treadmill test to determine their fitness, and blood was taken to measure their testosterone levels. To examine vascular health, echocardiography tests were performed to determine coronary flow reserve, indicative of the ability to increase blood ow when needed and values of 2 or above are considered normal vascular function.

To measure arterial stiffness, researchers used the augmentation index and central pulse pressure with higher values indicating rigid arteries associated with a higher risk of adverse heart events in men with erectile dysfunction.

Finally, to assess erectile dysfunction, men were ranked using the Sexual Health Inventory for Men (SHIM) that has five questions about erectile ability to allocate a score of 0 to 25, with higher values correlating to better erectile performance.

Mediterranean diet linked to better erectile performance and exercise capacity

Overall, researchers found men with a higher Mediterranean diet score (above 29) was associated with higher coronary flow reserve, testosterone, and better erectile performance (SHIM score above 14) as well as lower arterial stiffness.

When considering these results combined with fitness, researchers found that patients with greater exercise capacity (above 10 METs) had higher coronary flow reserve, testosterone, Mediterranean diet score (above 25) and SHIM score (above 12), and lower arterial stiffness.

In our study, consuming a Mediterranean diet was linked with better exercise capacity, healthier arteries and blood ow, higher testosterone levels, and better erectile performance. While we did not examine mechanisms, it seems plausible that this dietary pattern may improve fitness and erectile performance by enhancing function of the blood vessels and limiting the fall in testosterone that occurs in midlife.”

Dr. Athanasios Angelis of the University of Athens, Greece

He then concluded: “The findings suggest that the Mediterranean diet could play a role in maintaining several parameters of vascular health and quality of life and in middle aged men with hypertension and erectile dysfunction.”

Importantly, the study serves primarily as an observational study with no causational mechanisms at play. Nonetheless, these results provide key support to further determine how dietary as well as behavioural habits, such as exercise, can affect conditions.

Understanding such mechanisms can then lead to the improvement of existing treatments as well as the development of novel therapies that focus on beneficial physical exercises and dietary components.