Mediterranean diet improves cardiovascular performance in patients with erectile dysfunction

Erectile dysfunction patients with poor diets have more vascular and cardiac damage

The Mediterranean diet is linked to improved cardiovascular performance in patients with erectile dysfunction, according to research presented at EuroEcho-Imaging 2014 by Dr Athanasios Angelis from Greece. Patients with erectile dysfunction who had poor adherence to the Mediterranean diet had more vascular and cardiac damage.

EuroEcho-Imaging is the annual meeting of the European Association of Cardiovascular Imaging (EACVI), a branch of the European Society of Cardiology (ESC), and is held 3-6 December in Vienna, Austria.

Dr Angelis said: "Erectile dysfunction is not a symptom of ageing, it is a bad sign from the body that something is wrong with the vasculature. In 80% of cases erectile dysfunction is caused by vascular problems and is a warning that patients are at increased risk of a heart attack or stroke."

He added: "The Mediterranean diet is associated with lower cardiovascular events and could be a way to help erectile dysfunction patients lower their risk. We wanted to investigate whether patients with erectile dysfunction who follow this diet have less vascular and cardiac damage."

The study included 75 men with erectile dysfunction, aged 56 years on average, who attended the Department of Cardiology at Hippokration Hospital in Athens, Greece. Adherence to the Mediterranean diet was assessed with the Med-Diet Score1 which ranks patients as high (30-55), intermediate (21-29) or low (0-20) according to consumption of cereals, fruit, vegetables, meat, fish, dairy products, wine and olive oil.

Vascular function was assessed by measuring two aspects of atherosclerosis, namely atheromatosis and arteriosclerosis. Atheromatosis refers to the development of atheroma (plaque), a fatty deposit in the intima (inner lining) of the artery, and was measured by the intima-media thickness (IMT) of the common carotid artery. Arteriosclerosis refers to the stiffening of the arteries and was evaluated with carotid-femoral pulse wave velocity (PWV). Heart involvement was based on diastolic function and left ventricular mass.

The researchers found that a lower Med-Diet Score correlated with significantly worse vascular and heart function. These patients had greater IMT and aortic stiffness as well as higher left ventricular mass and more profound diastolic dysfunction.

Dr Angelis said: "Patients with erectile dysfunction who had unhealthy diets had more vascular and cardiac damage than those who followed the Mediterranean diet. Previous studies have shown that patients with erectile dysfunction have vascular damage but we found that the heart is also damaged. This may help to further explain why these patients are more prone to cardiovascular events. The formation of atheroma, the stiffening of the arteries, and the poor functioning of the heart can eventually lead to a cardiac event."

He added: "Our findings suggest that adopting the Mediterranean diet can improve the cardiovascular risk profile of patients with erectile dysfunction and may reduce their chances of having a heart attack or stroke. This needs to be tested in a larger study."

The Mediterranean diet is characterised by daily consumption of fruit, vegetables, unrefined cereals and pasta, olive oil and nuts. Dairy products are eaten in modest amounts, in the form of yogurt and cheese. Consumption of meat is low, with red meat once a week and poultry once a week considered a healthy level. A modest amount of wine can be consumed, and refined sugar should be avoided in favour of natural desserts like fruit.

Dr Angelis said: "Really simple changes in our diet may help a lot, for example using olive oil which contains monounsaturated fat. If someone doesn't have the money to buy some of the foods they can substitute them with others, for example nuts are a good source of monounsaturated fat. Sometimes it's difficult to adopt something if you consider that it's part of a prescription, but the Mediterranean diet is not a prescription, it's a lifestyle. It's about having an awareness of what foods are healthy or unhealthy."

He concluded: "Patients who have erectile dysfunction and don't adhere to the Mediterranean diet have vascular and cardiac damage and are at increased risk of heart attack and stroke. Our findings suggest that adopting a healthy diet can reduce that risk. We also advise patients to stop smoking, exercise and ensure that they have healthy levels of blood pressure and lipids."