Can A Poor Diet Cause Erectile Dysfunction And Libido Problems?
Because if you don’t provide your body with the nutrients (think building materials and fuel) it needs in order to function optimally, then it will operate sub-optimally.
And when operating sub-optimally, your sexual functions are very often the first to break down.
You Are What You Eat
You are what you eat. Your hair, your eyes, your right thumb, your kidneys – have all been created from foods and drinks you have ingested.
Every single part of you has been assembled from stuff you have put into your mouth and swallowed.
You are what you eat.
Nutrition is something that has interested me since I was a kid. It has fascinated me since I first understood that food can have an impact on how I feel and who I become.
I have now learned that eating right is of paramount importance to the quality of my life, feeling good as well as a long and healthy life.
Not only do I feel that eating properly makes me better of physically, but it also gives me lots of energy and an upbeat mood.
Athletes generally take nutrition extremely seriously. For many athletes, what they eat is just as important as the physical training they do.
They have learned that in order for their bodies (and minds) to perform at an optimal level, they need to supply their bodies with the right foods containing the right kinds of energy, vitamins, minerals, oils, etc.
I am not a professional athlete, but why should I not eat like one?
If this can help to keep my body in an optimal condition, why should I not be as serious about nutrition as the professional athletes?
Our Diet Has Changed Dramatically
What we eat has changed dramatically over the last few thousands years, and particularly during the last 100 years.
We have introduced several new foods to our diets, we have significantly altered many of the traditional foods. And we now eat more of certain foods, such as meat, and less of others, such as vegetables.
Can this be good?
What have human beings eaten throughout history?
The first humans (Homo Habilis) are believed to have appeared around 2.1 million years ago.
Homo Erectus arrived about 1.9 million years ago.
And then, Homo Sapiens, which is believed to be our direct ancestor, is estimated to have entered the scene around 200,000 years ago.
And we believe that these different versions of the human beings ate more or less the same kinds of foods.
Needless to say, the diet of these early humans probably varied from geography to geography, however:
They ate vegetables, fruit, berries, nuts, seeds, roots, leaves, mushrooms, meat, seafood and other foods they could either gather or kill.
It is also likely that a large proportion of this food would have been consumed raw, and also consumed immediately after sourcing it.
Our diet probably did change towards consumption of more meat as we became more intelligent and advanced, and hence were capable of catching more living prey.
Also, as we mastered fire, some of our food was cooked or otherwise prepared with the use of fire.
However, although our diet evolved as we evolved during our time as humans, it has also probably remained relatively stable.
Until very recently.
About 10,000 years ago, our lives took a dramatic turn. And this caused a big shift in our diet.
We went from being nomadic hunters and gatherers, to settle down in permanent or semi-permanent villages.
We had become intelligent enough to domesticate plants and animals, and it therefore made sense to stay put at the same place for longer.
By doing this, we had access to more food, we spent less time sourcing the food, life became less uncertain, we had more leisure time, and life generally became easier.
However, when we domesticated plants and animals, we:
- Started consuming large quantities of certain foods we had not consumed much of before
- We were able to change these plants and animals by selecting and reproducing the traits in these plants and animals that were desirable, and
- It became common to store food for later consumption.
For instance, it is believed that we only ate small quantities of grains such as wheat and oats before these grains were domesticated.
We also replanted the grains, vegetables and fruits that produced the largest or sweetest kinds of foods, and we were therefore able to increase the yield of these harvests over time.
Animals that had desirable traits were also allowed to mate, so that these traits were preserved.
And we begun storing grains, seeds, and other foods that did not perish quickly.
A beginning of what were to become a startling transformation of our diet had begun.
And where are we today, 10,000 years later?
French fries, tofu, ice cream, cheese, pasta, yoghurt, liver-pate, sauerkraut, sausage, chocolate, smoked salmon, microwave popcorn, pickled cabbage, frozen pizza…
Today our diet hardly contains any raw food at all. Rather, most of what we eat is one or several steps removed from where it originally grew or lived.
It is normally cooked, fried, boiled, extracted, temperature treated or processed in one way or another. Often, foods have gone through processes where sugar, salt, fat or other ingredients are removed or added.
The foods we eat today are very different from the foods we ate thousands of years ago.
It goes without saying that this could cause our bodies to throw tantrums.
Let me tell you about the moment of my food epiphany..
My Food Epiphany
For most of my life, I have eaten a normal western diet.
This has typically meant having bread with cheese, ham or jam, or cereal + milk for breakfast.
Lunch would normally consist of bread with the same spreads, or potentially some dish made of meat.
Dinner would typically always be meat and cooked vegetables (potatoes as the staple).
This diet would contain only a small proportion of vegetables, fruits and nuts. It would be heavy in meats and grain-based foods as well as dairy products.
As a kid, I was told this was a healthy diet.
This diet probably wasn’t terribly bad. It just wasn’t optimal.
However, it wasn’t until the day the quality of my diet was drastically downgraded, that I discovered how important what I eat really is.
Or rather, it wasn’t until my diet was downgraded and then significantly upgraded again, that I fully understood the importance of eating well.
Here is my story:
I once left my job because I wanted to try something different. I didn’t have much income at this time, so I needed to be thrifty with money.
One of the things I saved money on was food. Therefore, I would normally eat a sugary cheap cereal with milk in the morning, bread with peanut-butter for lunch, and pasta and pasta-sauce for dinner.
This was cheap, easy and quick. For a few months, this was by and large all I ate. I would hardly eat any vegetables, nuts or seeds, and fruits only occasionally.
For most of this period, I was sexually almost dead.
I also had very little desire for sex. Sex just wasn’t on my mind much. My libido was gone.
I didn’t at the time imagine that the foods I ate (or rather the foods I didn’t eat) had anything to do with this.
This all changed almost instantaneously one day.
Because I met a lovely woman who was vegetarian and who also liked making food.
As a result, we made lots of food together, and I also switched to a diet that was by and large vegetarian. Nutrition-wise, this was a significant improvement.
And I could feel a difference almost immediately. The first remarkable change was that I would all of a sudden get erections when I kissed her!
At the time it almost felt like a miracle, and I could hardly believe it!
At first I didn’t get it. Why was it happening?
But it didn’t take too long until I realized that the food played a big part in what was happening.
I realized that proper nutrition was important! I realized that I needed the right foods to function well sexually.
And it turned out to not just be a lucky one-time coincidence. But for as long as I maintained this healthy diet, I was also able to function much better sexually.
In addition, my sex drive also increased.
After this epiphany, I stayed faithful to this diet for a long time. And during this time I consistently worked better sexually than before.
But given this startling discovery of how important food turned out to be for my health, I also wanted to experiment further.
I was incredibly intrigued and I wanted to know more.
So I decided to try out different diets.
My first experiment was with a vegan diet. This meant no meat and no dairy. The diet basically entails eating vegetables, fruits, nuts, fungi, berries, legumes, seeds, etc.
The only minor issue I had, was that it was slightly difficult practically, and particularly so when going out to eat.
But it worked very well for me health-wise. It gave me lots of energy, I felt totally sharp and good, my libido was strong and I was able to function well sexually.
In other words, the vegan diet seemed to support my sexual health.
This means eating fruits, vegetables, berries, nuts, fungi, meats, etc., and also eating it fresh, unprocessed and, if possible raw.
This diet cuts out anything with added salt or sugar, anything frozen, pasteurized, processed or with preservatives.
This diet also worked really well for me healthwise. I felt totally fine physically and mentally, had lots of energy, felt sharp and focussed. My libido was strong and I functioned well sexually.
Therefore, this diet also seemed to support my sexual health.
Because I was curious..
I also wanted to switch back to the diet I had for most of my earlier life, just to see what happened.
So for a few weeks, I tried to go back to my normal western diet, which entailed eating lots of bread and meat.
Did it work for me?
Not really. It worked less well for me than the other diets.
When on this diet, I would typically have periods in the afternoons where I would get drowsy and tired and just wanted to take a nap. Generally I had less energy.
I didn’t however notice a big impact on erectile functioning or libido, but the experiment might have been too short for an effect to show up. However, given my lack of energy, I changed this diet after about three weeks.
I have now settled on a diet that is basically vegan.
My diet now consist mostly of vegetables, fruits, nuts, seeds, legumes, berries, roots, leaves and fungi.
I stay away from meat, fish, and dairy products. I also try to avoid anything that is processed, or at least heavily processed.
I am really happy with this diet. It gives me lots of energy and I feel very alert and alive. I can feel that it impacts my mood positively.
Also, it is not a regime I have given myself that I need to follow, it’s rather what I feel like eating. I simply start craving vegetables, fruits and nuts, etc., if I don’t get them in adequate quantity on a regular basis.
So what is my conclusion from trying a number of diets?
The traditional western diet with lots of meat, bread, cereal and processed food did not work very as well for me.
So I have learned through experimentation that what I eat is incredibly important for how my body works.
Therefore, I try to provide my body (and mind) with everything it needs in order to function optimally (or at least super well).
As a result, my diet is rather extreme.
However, I don’t think it’s necessary to be super extreme with your diet to function well sexually. But I believe in common sense.
In a minute, I will tell shed more light on what I would recommend eating in order to support your sexual functions.
Hippocrates once said “Let food be your medicine and medicine your food”.
I believe there is much truth to this, because after I started eating very healthy, I have hardly gotten sick at all. Before, I would get several colds and sore throats throughout the year.
In fact, I can’t remember the last time I had a cold. Nor the last time I had a sore throat. Not only that, but I often have so much energy I hardly know what to do with myself. I particularly get a huge boost of energy after my breakfast.
Although I still experiment with my diet and therefore what I eat does change, the below is what I eat on an average day (as this is being written):
Breakfast: One avocado (or half if it’s large), one small banana, one or two cloves of garlic, a thumb-size of ginger (with peel), one small beetroot (or carrot) (with peel), one radish (with peel), one kiwi (with peel), half a lemon (with peel), half a stick of celery, a handful of spinach, a tablespoon of apple cider vinegar, a tablespoon of ground flax seeds, a tablespoon of bee pollen, a tablespoon of Maca powder, 1/4 tablespoon of matcha green tea powder, 1/4 tablespoon of turmeric powder, and water.
I mix this in a food processor and out comes about 700 ml of green / red-ish stuff with the consistency of porridge. The taste may not be the greatest to the average person, but I have gotten used to it and I quite like it.
(I eat it with a spoon.)
Pre-lunch: A salad containing one avocado (or half if its large), half a red bell pepper, five small tomatoes (or half a large tomato), a small cucumber, a stick of celery, half a pomegranate, and a handful of spinach.
Lunch: Typically a homemade vegan dish, and often this is leftover from dinner. If not a leftover dinner, it could be lightly fried rice and vegetables, quinoa salad, porridge, or baked vegetables.
Dinner: When I make dinner, I normally make a large dish, something that is enough for about 4 meals. This way, I have 4 dinner and lunch meals.
I like to cook in a large pot, because it’s easy. So what I often do is to put onion, garlic, tomato sauce, vegetables (broccoli, cauliflower, aubergine or sweet potatoes), mushrooms, tomatoes, olives, dried tomatoes, beans or quinoa and chia seeds all in a pot, and slow cock for about 3 hours.
It can also be cooked on higher heat for about 45 minutes.
I also add about a table spoon of each of the following spices: turmeric, oregano, paprika and cumin.
For dinner, I could also make a large pot of rise and mix with cooked beans, vegetables and herbs.
I sometimes also make vegetable lasagna, quinoa salad with vegetables, and occasionally a veggie pizza.
Throughout the day, I also eat about 150 grams or more of nuts, 2-3 apples and other fruits such as oranges, plums, dates, cherries, blueberries, drink a cup of matcha green tea or hibiscus tea (both from powder (not tea bags)) and I also drink lots of water.
I also take a vitamin B12 supplement because this vitamin is not found in the foods that I eat. Vitamin B12 would have normally been found in bacteria that come with vegetables / in the dirt that comes with vegetables, but today the vegetables are so clean and often treated with pesticides and herbicides that kill this bacteria.
That’s it. That’s what I typically eat during a day. Not only does it give me an incredible amount of energy, but it is also easy to maintain and relatively inexpensive.
What Should You Eat In Order To Function Optimally Sexually?
In order to give your body and mind the best possible chance to function optimally sexually, what should you eat?
These foods are not only the ones that will help you function optimally sexually, but also the ones that will provide you the best overall health and give you the most energy.
These are also the foods that will help you reduce the chances of getting heart problems, stroke, diabetes, cancer, Alzheimer’s, dementia, and many other health problems.
So what are these foods?
In short, they are plant based, whole foods.
Plant based meaning foods that come from plants such as vegetables, fruits, legumes, seeds, nuts, mushrooms, berries, leaves, etc.
Whole foods refers to foods that are as they are, meaning not processed.
Which means you would be smart to stay away from meat, fish, dairy and foods that are heavily processed.
This is not just my personal opinion, this is all backed up by science.
To learn more about this, I would recommend an excellent book called ‘How Not To Die’ by Dr. Michael Greger.
Diet And Sexual Function
If we do not consume adequate amounts of these essential nutrients, our bodies will not be able to function properly. These nutrients are essential to every organ and process in the body.
They are the building blocks of life – without them our cells would not be able to function properly.
These nutrients are also incredibly important for sexual functions. In fact, sexual functions are often the first to stop working when the body is out of balance.
The body simply cannot experience proper sexual desire or enjoy great sex if it doesn’t have the proper nutrients to support these functions.
A balanced diet will not only deliver key nutrients to keep sex drive and sex function high, but it will also help you look better and feel more confident.
Smoking And Erectile Dysfunction
These chemicals will typically accumulate in the body over time, and will be particularly prominent in the lungs and blood vessels.
These chemicals are not supposed to be in the body (at least not in these amounts), and can cause significant harm (in several ways) to the fine-tuned system your body is.
Nitric oxide is a component that is essential for a man to get and sustain an erection as it allows the penis to be filled with blood and be engorged. In addition, nicotine has itself been shown to have a negative effect on nitric oxide production.
You can learn more about nitric oxide on Truelibido here.
Smoking is also associated with heart disease, insulin resistance and increased blood pressure, all of which will normally have a negative long-term impact on bloodflow, and may therefore also cause erectile dysfunction.
Studies have shown that men that smoke are up to 30% more likely to suffer from erectile dysfunction than non-smokers.
Studies have also shown that smokers with erectile dysfunction that quit smoking, are significantly more likely to regain erectile functioning than those that continue to smoke.
And studies have concluded that there is a strong correlation between the intensity of cigarette smoking and the degree of erectile dysfunction.
Alcohol And Erectile Dysfunction
Although research is less conclusive on the impact of alcohol consumption on erectile dysfunction and libido (some studies show no impact or even a positive short-term effect), a large body of research indicates that excessive alcohol consumption is likely to have negative long-term consequences.
Some people report that alcohol increases their libido and erectile functioning in the short-term. This is likely because alcohol can function as a vasodilator, (help expanding blood vessels) and thereby increase bloodflow.
In the long-term however, consumption of alcohol may weaken the heart muscle, causing a condition called alcoholic cardiomyopathy.
A weakened heart that cannot contract effectively, will as a result have problems pumping enough blood to sufficiently nourish the body.
This will normally lead to impaired bloodflow as well as potential damage to organs and tissues that don’t get enough oxygen and nutrients.
Excessive alcohol consumption may also damage the inner lining of the blood vessels called the endothelium. When the endothelium gets damaged, it can’t produce as much nitric oxide as before, and bloodflow to the penis is likely to be reduced.
In addition, consumption of alcohol, even in moderate doses, will normally reduce testosterone levels. This happens through four different ways.
Firstly, it causes your testicles to produce less testosterone. In your testicles, you have certain cells called leydig cells that are responsible for producing testosterone. When there is alcohol in your blood, these cells produce less testosterone.
Secondly, alcohol impairs your body’s ability to break down estrogen. This can cause large amounts of estrogen to circle around your body.
Too much estrogen shifts your testosterone / estrogen ratio, which (even if your absolute testosterone level is fine) will cause many of the same symptoms as low testosterone.
This estrogen also binds to your androgen receptors, but is unable to activate them. Hence it leaves the receptors idle as long as estrogen is connected to them.
Also, when you have high estrogen levels, this causes your body to make fewer androgen receptors. The result is that less testosterone can find a receptor to connect to.
Thirdly, alcohol consumption will normally increase your cortisol levels. Cortisol is a hormone that crowds out your testosterone and therefore, more cortisol means less testosterone.
Also, more cortisol has also been shown to stimulate the urge for increased alcohol consumption, which can potentially cause a vicious cycle with more alcohol.
Lastly, alcohol has the ability to deplete zinc levels in your body. Zinc is a very important mineral needed by your body to create testosterone.
First of all, it makes your blood thicker, which means it flows less smoothly through your veins. And don’t forget that the blood vessels in your penis are very narrow, hence thicker blood will have a tougher time to flow smoothly through these.
It will normally also increase triglycerides, increase low-density lipoprotein (LDL) cholesterol, decrease high-density lipoprotein (HDL) cholesterol, and cause build-up of plaque inside the blood vessels.
None of this is good for bloodflow.
Also, build-up of plaque is likely to cause atherosclerosis, which causes blood vessels to narrow and also to stiffen. When these blood vessels stiffen, they break and rapture more easily which in turn causes further disruptions to bloodflow.
Atherosclerosis will also disrupt the blood vessels’ ability to produce nitric oxide, because when the inner linings of the blood vessels are coated in plaque, it’s much harder for nitric oxide to pass through.
Salt And Erectile Dysfunction
Excessive salt ingestion is neither good for sexual functions. And it is estimated that a western diet may contain 10 times more salt than what is ideal.
Too much salt may cause your blood pressure to increase. Your kidneys will start having problems filtering out water in the presence of excess salt, and therefore the body holds on to more water than normal.
This increase in water retention increases blood pressure.
Increased blood pressure can also cause damage to your blood vessels. It can cause them to rupture, to leak and to get deformed. This can impair bloodflow which in turn can cause erectile dysfunction.
Sugar And Erectile Dysfunction
Excessive sugar consumption is not good for proper erectile functioning either.
When you consume too much sugar, you are likely to also get elevated levels of sugar in your blood, or typically elevated levels of the sugar glucose.
Glucose in excess levels causes your blood to thicken which in turn decreases bloodflow.
In order for the cells in your body to use glucose, they need insulin to help absorb the glucose. When there is too much glucose, the insulin often gets exhausted and less effective, and insulin resistance kicks in.
When this happens, less glucose is absorbed by the cells, and blood sugar remains higher than it should be.
Large intake of sugar for a long period of time may also lead to atherosclerosis.
Excess intake of sugar that is being stored instead of being used is also likely to lead to increase in body fat. This increase in body fat is often correlated with lower testosterone.
Studies have shown that a diet very rich in sugar is correlated with higher levels of triglycerides, higher LDL cholesterol levels (bad cholesterol) and decreased HDL cholesterol levels (good cholesterol).
What Does Research Say About Diets?
Several research studies have shown a strong relationship between eating habits and prevalence of erectile dysfunction.
In particular, many studies have shown significant improvements in erectile function in men after they switched to the Mediterranean diet.
This diet consists of large amounts of whole grains, fruits, vegetables, nuts, legumes, fish and moderate use of olive oil.
Not only have research seen an improvement in erectile dysfunction from switching to this diet, but also a stronger libido, an increase in nitric oxide generation, improvement in insulin sensitivity, weight-loss and other health benefits.
Adamowicz J, Drewa T. Is there a link between soft drinks and erectile dysfunction? Central European J. Urol. 2011; 64 (3): 140-143. Epub 2011 Oct 6.
Afeiche M, Williams PL, Mendiola J, Gaskins AJ, Jørgensen N, Swan SH, Chavarro IS. Dairy food intake in relation to semen quality and reproductive hormones levels among physically active young men. Hum Reprod. 2013 Aug; 28 (8): 2265-75.
Arackal BS, Benegal V. Prevalence of sexual dysfunction in male subjects with alcohol dependence. Indian J Psychiatry. 2007 Apr-Jun; 49(2): 109-112. DOI: 10.4103/0019-5545.33257.
Boegehold MA. The effect of high salt intake on endothelial function: reduced vascular nitric oxide in the absence of hypertension. J Vasc Res. 2013; 50 (6): 458-67.
Carrera-Bastos P, Fontes-Villalba M, O’Keefe JH, Lindeberg S, Cordain L. The western diet and lifestyle and diseases of civilization. Res Reports Clinl Cardiol 2011: 2 15-35.
Chiu YH, Afeiche MC, Gaskins AJ, Williams PL, Mendiola J, Jørgensen N, Swan SH, Chavarro IS. Sugar-sweetened beverage intake in relation to semen quality and reproductive hormones levels in young men. Hum Reprod. 2014 Jul; 29(7):1575-84.
Derby CA, Mohr BA, Goldstein I, et al. Modifiable risk factors and erectile dysfunction: can lifestyle changes modify risk? Urol. 2000; 56(2):302-306.
Di Francesco S, Tenaglia RL. Mediterranean diet and erectile dysfunction: a current perspective. Cent European J Urol. 2017 Jun 30;70(2):185-187. DOI: 10.5173/ceju.2017.1356. Epub 2017 Jun 11.
Dishy V, Sofowora GG, Imamura H, Nishimi Y, Xie HG, Wood AJ, Stein CM. Nitric oxide production decreases after salt loading but is not related to blood pressure changes or nitric oxide-mediated vascular responses. J Hypertens. 2003 Jan; 21(1):153-7.
Esposito K, Ciotola M, Giugliano F, Maiorino MI, Autorino R, De Sio M, Giugliano G, Nicoletti G, D’Andrea F, Giugliano D. Effects of intensive lifestyle changes in erectile dysfunction in men. J Sex Med. 2009; 6(1):243-250.
Esposito K, Ciotola M, Giugliano F, De Sio M, Giugliano G, D’armiento M, Giugliano D. Mediterranean diet improves erectile function in subjects with the metabolic syndrome. Int J Impot Res. 2006; 18(4):405-410.
Esposito K, Giugliano F, De Sio M, et al. Dietary factors in erectile dysfunction. Int J Impot Res. 2006; 18(4):370-374.
Esposito K, Giugliano F, Di Palo C, Giugliano G, Marfella R, D’Andrea F, D’Armiento M, Giugliano D. Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial. JAMA. 2004 Jun 23; 291(24):2978-84.
Esposito K, Giugliano F, Mahorino MI, Giugliano D. Dietary factors, Mediterranean diet and erectile dysfuncion. J Sex Med. 2010; 7(7):2338-2345.
Esposito K, Marfella R, Ciotola M, Di Palo C, Giugliano F, Giugliano G, D’Armiento M, D’Andrea F, Giugliano D. Effect of a Mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomised trial. JAMA. 2004; 292(12):1440-1446.
Frias J, Torres JM, Miranda MT, Ruiz E, Ortega E. Effects of acute alcohol intoxication on pituitary-gonadal axis hormones, pituitary-adrenal axis hormones, beta-endorphin and prolactin in human adults of both sexes. Alcohol Alcohol. 2002 Mar-Apr; 37(2):169-73.
Giugliano F, Maiorino MI, Bellastella G, Autorino R, De Sio M, Giugliano D, Esposito K. Adherence to Mediterranean diet and erectile dysfunction in men with type 2 diabetes. J Sex Med. 2010; 7(5):1911-1917.
Gumus B, Yigitoglu MR, Lekili M, Vyanik BS, Muezzinoglu T, Buyuksu C. Effect of long term alcohol abuse on male sexual function and serum gonadal hormone levels. Int Urol Nephrol. 1998; 30:755-9.
Gupta BP, Murad MH, Clifton MM, Prokop L, Nehra A, Kopecky SL. The effect of lifestyle modification and cardiovascular risk factor reduction on erectile dysfunction: a systematic review and meta-analysis. Arch Intern Med. 2011 Nov 14; 171(20):1797-803. DOI: 10.1001/archinternmed.2011.440.
Hoppe C, Mølgaard C, Vaag A, Barkholt V, Michaelsen KF. High intakes of milk, but not meat, increase the insulin and insulin-resistance and 8-year-old boys. Eur J Clin Nutr. 2005 Mar; 59 (3): 393-8.
Hoshiyama M, Li B, Yao J, Harada T, Morioka T, Oite T. Effect of high glucose on nitric oxide production and endothelial nitric oxide synthase protein expression in human glomerular endothelial cells. Nephron Exp Nephrol. 2003; 95(2):e62-8.
Ishizaka N, Ishizaka Y, Toda E, Hashimoto H, Nagai R, Yamakado M. Association between cigarette smoking, metabolic syndrome, and carotid arteriosclerosis in Japanese individuals. Atherosclerosis. 2005 Aug; 181(2):381-8.
Kagota S, Tamashiro A, Yamaguchi Y, Nakamura K, Kunitomo M. High salt intake impairs vascular nitric oxide/cyclic guanosine monophosphate system in spontaneously hypertensive rats. J Pharmacol Exp Ther. 2002 Jul; 302(1):344-51.
Kimura C, Oike M, Koyama T, Ito Y. Impairment of endothelial nitric oxide production by acute glucose overload. Am J Physiol Endocrinol Metab. 2001 Jan; 280(1):E171-8.
Lam TH, Abdullah AS, Ho LM, Yip AW, Fan S. Smoking and sexual dysfunction in Chinese males: findings from men’s health survey. Int J Impot Res 2006; 18: 364-369.
Maiorino MI, Bellastella G, Esposito K. Lifestyle modifications and erectile dysfunction: what can be expected? Asian J Androl. 2015 Jan-Feb;17(1):5-10. DOI: 10.4103/1008-682X.137687.
Meldrum DR, Gambone JC, Morris MA, Ignarro LJ. A multifaceted approach to maximize erectile function and vascular health. Fertil Steril. 2010 Dec; 94 (7): 2514-20.
Musicki B, Kramer MF, Becker RE, Burnett AL. Inactivation of phosphorylated endothelial nitric oxide synthase (Ser-1177) by O-GlcNAc in diabetes-associated erectile dysfunction. Proc Natl Acad Sci U S A. 2005 Aug 16; 102(33):11870-5.
Mykoniatis I, Grammatikopoulou MG, Bouras E, Karampasi E, Tsionga A, Kogias A, Vakalopoulos I, Haidich AB, Chourdakis M. Sexual Dysfunction Among Young Men: Overview of Dietary Components Associated With Erectile Dysfunction. J Sex Med. 2018 Feb;15(2):176-182. DOI: 10.1016/j.jsxm.2017.12.008. Epub 2018 Jan 8.
Nicholls SJ, Lundman P, Harmer JA, Cutri B, Griffiths KA, Rye KA, Barter PJ, Celermajer DS. Consumption of saturated fat impairs the anti-inflammatory properties of high-density lipoproteins and endothelial function. J Am Coll Cardiol. 2006 Aug 15; 48(4):715-20.
Pourmand G, Alidaee MR, Rasuli S, Maleki A, Mehrsai A. Do cigarette smokers with erectile dysfunction benefit from stopping?: a prospective study. BJU Int. 2004 Dec; 94(9):1310-3.
Rosen RC, Friedman M, Kortis JB. Lifestyle management of erectile dysfunction: the role of cardiovascular and concomitant risk factors. Am J Cardiol. 2005; 96(12B):76M-79M.
Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, Obarzanek E, Conlin PR, Miller ER, et al. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. N Engl J Med. 2001; 344:3-10.
Sartori C, Scherrer U. Insulin, nitric oxide and the sympathetic nervous system: at the crossroads of metabolic and cardiovascular system. J Hypertens 1999, 17:1517-1525.
Shindel A. Effects of Intensive Lifestyle Changes on Erectile Dysfunction in Men. Yearbook of Urology 12/2010; 2010:125-126. DOI: 10.1016/S0084-4071(10)79383-0.
Storlien L, Jenkins A, Chisholm D, Pascoe W, Khouri S, Kraegen E. Influence of dietary fat composition on development of insulin resistance in rats. Relationship to muscle triglyceride and omega-3 fatty acids in muscle phospholipid. Diabetes 1991, 40:280-289.
Toda N, Toda H. Nitric oxide-mediated blood flow regulation as affected by smoking and nicotine. Eur J Pharmacol. 2010 Dec 15; 649(1-3):1-13. DOI: 10.1016/j.ejphar.2010.09.042.
Razny U, Kiec-Wilk B, Wator L, Polus A, Dyduch G, Solnica B, Malecki M, Tomaszewska R, Cooke JP, Dembinska-Kiec A. Increased nitric oxide availability attenuates high fat diet metabolic alterations and gene expression associated with insulin resistance. Cardiovasc Diabetol. 2011 Jul 22; 10:68. DOI: 10.1186/1475-2840-10-68.
Vessby B, Unsitupa M, Hermansen K. KANWU Study. Substituting dietary saturated for monounsaturated fat impairs insulin sensitivity in healthy men and women: The KANWU Study. Diabetologia 2001, 44:312-319.
Vogel RA, Corretti MC, Plotnick GD. Effect of a Single High-Fat Meal on Endothelial Function in Healthy Subjects. Am J Cardiol. 1997 Feb 1; 79(3):350-4.
Wang W, Fan J, Huang G, Zhu X, Tian Y, Tan H, Su L. Meta-Analysis of Prevalence of Erectile Dysfunction in Mainland China: Evidence Based on Epidemiological Surveys. Sex Med. 2017 Mar;5(1):e19-e30. DOI: 10.1016/j.esxm.2016.10.001. Epub 2016 Dec 23.
Wolford ST, Argoudelis CJ. Measurement of estrogens in cow’s milk, human milk, and dairy products. J Dairy Sci. 1979 Sep; 62(9):1458-63.
Zhang Q, Radisavljevic ZM, Siroky MB, Azadzoi KM. Dietary antioxidants improve arteriogenic erectile dysfunction. Int J Androl. 2011; 34(3):225-235.