Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial.

By K. Esposito, F. Giugliano, C. Di Palo, G. Giugliano, R. Marfella, F. D’Andrea, M. D'armiento, D. Giugliano. Journal of the American Medical Association (JAMA), 2004

850 citations recorded by the source corpus.

CONTEXT Healthy lifestyle factors are associated with maintenance of erectile function in men. OBJECTIVE To determine the effect of weight loss and increased physical activity on erectile and endothelial functions in obese men. DESIGN, SETTING, AND PATIENTS Randomized, single-blind trial of 110 obese men (body mass index > or =30) aged 35 to 55 years, without diabetes, hypertension, or hyperlipidemia, who had erectile dysfunction that was determined by having a score of 21 or less on the International Index of Erectile Function (IIEF). The study was conducted from October 2000 to October 2003 at a university hospital in Italy. INTERVENTIONS The 55 men randomly assigned to the intervention group received detailed advice about how to achieve a loss of 10% or more in their total body weight by reducing caloric intake and increasing their level of physical activity. Men in the control group (n = 55) were given general information about healthy food choices and exercise. MAIN OUTCOMES MEASURES Erectile function score, levels of cholesterol and triglycerides, circulating levels of interleukin 6, interleukin 8, and C-reactive protein, and endothelial function as assessed by vascular responses to l-arginine. RESULTS After 2 years, body mass index decreased more in the intervention group (from a mean [SD] of 36.9 [2.5] to 31.2 [2.1]) than in the control group (from 36.4 [2.3] to 35.7 [2.5]) (P<.001), as did serum concentrations of interleukin 6 (P =.03), and C-reactive protein (P =.02). The mean (SD) level of physical activity increased more in the intervention group (from 48 [10] to 195 [36] min/wk; P<.001) than in the control group (from 51 [9] to 84 [28] min/wk; P<.001). The mean (SD) IIEF score improved in the intervention group (from 13.9 [4.0] to 17 [5]; P<.001), but remained stable in the control group (from 13.5 [4.0] to 13.6 [4.1]; P =.89). Seventeen men in the intervention group and 3 in the control group (P =.001) reported an IIEF score of 22 or higher. In multivariate analyses, changes in body mass index (P =.02), physical activity (P =.02), and C-reactive protein (P =.03) were independently associated with changes in IIEF score. CONCLUSION Lifestyle changes are associated with improvement in sexual function in about one third of obese men with erectile dysfunction at baseline.

Subfields: Emergency Medicine, Endocrinology, Diabetes and Metabolism, Psychiatry and Mental health

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Citations in the corpus

Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation. (2010, neutral): “The risk of ED may be reduced by modifying these risk factors, particularly exercising or losing weight [4].”
Exercise as medicine – evidence for prescribing exercise as therapy in 26 different chronic diseases (2015, background): “Obesity is also frequently associated with erectile dysfunction, which physical training can contribute to prevent (Derby et al., 2000; Esposito et al., 2004).”
Evidence for prescribing exercise as therapy in chronic disease (2006, methodology): “In a randomized-controlled trial (Esposito et al., 2004) in which 55 obese men aged 35–55 years with erectile dysfunction were instructed in weight loss through dietary modification and physical activity, the erectile function index 2 years later was significantly better in the intervention group…”
2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults (2013, background): “The remaining 51 trials (72 articles) were rated good or fair quality (22,23,69-138), and included in the evidence base that was used to formulate the ESs and recommendations.”
Effects of exercise and diet on chronic disease. (2005, background): “Furthermore, risk of several other chronic diseases may be ameliorated by physical activity and diet, including musculoskeletal diseases such as sarcopenia (352), osteoporosis (398), and arthritis (253), as well as stroke and congestive heart failure (238), chronic renal failure (66), Alzheimer’s di”
The medical complications of obesity. (2006, background): “In men, there is a link between impotence and increasing infertility, with abdominal obesity a particular risk.(127,128) Polycystic ovary syndrome (PCOS), the most common endocrine disorder in women of reproductive age, is characterized by a combination of chronic anovulation, polycystic ovary morph”
Association of Mediterranean diet with Mild Cognitive Impairment and Alzheimer’s disease: A Systematic Review and Meta-Analysis (2014, background): “Higher adherence to MeDi has been shown to be associated with low level of C-reactive protein and lower interleukin levels [33–35].”
Erectile Dysfunction: AUA Guideline (2018, background): “hypertension, diabetes, or hypercholesterolemia to a weight loss and increased physical activity intervention group or to a general information group.(100) After two”