Dietary flavonoid intake and incidence of erectile dysfunction

Aedin Cassidy, Mary Franz, Eric B. Rimm (Lead Author)

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Background: The predominant etiology for erectile dysfunction (ED) is vascular, however limited data are available on the role of diet. A higher intake of several flavonoids reduces diabetes and cardiovascular disease (CVD) risk but no studies have examined associations between flavonoids and erectile function.  

Objective: To examine the relationship between habitual flavonoid sub-class intakes and incidence of ED.  

Methods: We conducted a prospective study among 25,096 men from the Health Professionals Follow-up Study. Total flavonoid and subclass intakes were calculated from food frequency questionnaires collected every 4 years. Participants rated their erectile function in 2000 (with historical reporting from 1986) and again in 2004 and 2008.  

Results: During 10 years of follow-up, 35.6% reported incident ED. After multivariate adjustment, including classic CVD risk factors, several sub-classes were associated with reduced ED incidence; specifically flavones (RR 0.91:95%CI=0.85,0.97; p-trend=0.006), flavanones (RR 0.89;95%CI=0.83,0.95; p-trend=0.0009), and anthocyanins (RR 0.91;95%CI=0.85,0.98; p-trend=0.002) comparing extreme intakes. The results remained significant after additional adjustment for a composite dietary intake score. In analyses stratified by age, a higher intake of flavanones, anthocyanins and flavones was significantlyassociated with a reduction in risk of erectile dysfunction only in men <70 years old and not older men (11-16% reduction in risk (p - interaction 0.002, 0.03, 0.007 for flavones, flavanones and anthocyanins respectively). In food-based analysis, higher total fruit intake, major sources of anthocyanins and flavanones, was associated with 14% reduction in risk of ED (RR 0.86;95%CI=0.79,0.92; p=0.002).The American Journal of Clinical Nutrition AJCN/2015/122010 Version 3.   

Conclusions : These data suggest that a higher habitual intake of specific 24 flavonoid-rich foods are associated with reduced ED incidence. Intervention trials are needed to further examine the impact of increasing intakes of commonly consumed flavonoid-rich foods on men’s health.   

Original languageEnglish
Pages (from-to)534-541
Number of pages8
JournalAmerican Journal of Clinical Nutrition
Issue number2
Early online date13 Jan 2016
Publication statusPublished - Feb 2016


  • anthocyanins
  • erectile dysfunction
  • flavanones
  • flavones
  • flavonoids

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