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The Mediterranean diet (MD) has received much attention recently as one of the world’s most recognized healthy dietary structures. Studies have shown that the Mediterranean diet can reduce the incidence of cardiovascular disease by 30%. In addition, adherence to the Mediterranean diet can also reduce the risk of diabetes, metabolic syndrome, and Alzheimer’s disease.
As a result of recent research, ED has been widely recognized as an independent risk predictor for cardiovascular disease, revealing an inextricable pathogenetic link between ED and cardiovascular disease and highlighting the potential consistency of preventive measures.
What is the Mediterranean diet?
The Mediterranean diet refers to the traditional food culture of Greece, Italy, Spain, and other countries in the Mediterranean region. The Mediterranean diet is characterized by diverse and balanced foods rich in omega-3 fatty acids, antioxidants, and phytochemicals.
It is a dietary pattern based on vegetables, fruits, nuts, and grains, and cooking with olive oil is considered one of the best dietary patterns for human beings.
Mediterranean Diet Pyramid
Benefits of the Mediterranean diet
Long-term adherence to the Mediterranean diet is considered to have significant nutritional value and a very healthy diet. Studies have found that ED patients who adhere to the Mediterranean diet have relief from the symptoms of erectile dysfunction.
Researchers from the University of California, San Francisco, reviewed data from a survey of 21,469 men’s diet quality at Harvard University between 1986 and 2014 to explore the effects of the Mediterranean diet on erectile dysfunction in men and found that men on a long-term Mediterranean diet were less likely to experience erectile dysfunction at any age.
Also, the probability of sexual dysfunction was lower among those who regularly consumed berries and citrus fruits. Studies have shown that these fruits contain a higher percentage of anthocyanins, flavonoids, and flavonoids, which are more commonly found in those fruits that are blue-purple and red, such as various berry berries.
Such fruits include strawberries, blueberries, blackberries, grapes, apples, cherries, and citrus. Fruit flavonoids have antioxidant and anti-inflammatory effects, which may explain why they can reduce the probability of men suffering from erectile dysfunction.
In addition, the Mediterranean diet can also reduce the risk of cardiovascular disease and regulate blood sugar.
Most foods in the Mediterranean diet are rich in vitamins and polyphenolic compounds, which are thought to have antioxidant properties and inhibit oxidative stress by inhibiting reactive oxygen species (ROS) or by affecting specific ROS-producing enzymes. Fighting oxidative stress slows down atherosclerosis, reduces platelet activity, decreases the coagulation cascade, and ultimately inhibits atherosclerotic thrombosis.
At the same time, the Mediterranean diet is rich in vegetable fats, which can control blood glucose by reducing late glycosylation end products and regulating metabolism. This dietary pattern increases plasma antioxidant levels and is effective in reducing fasting blood glucose (FBG), 2h postprandial glucose (2hPG), and glycated hemoglobin (HbA1c) levels in patients with type 2 diabetes.
The Mediterranean diet and ED
Erectile dysfunction (ED), defined as the inability of a man to obtain or maintain a sustained erection sufficient for satisfactory sexual intercourse, is one of the most common sexual dysfunctions in men.
Studies have shown that normal human semen contains many minerals (such as sodium, potassium, calcium, zinc, etc.) besides fructose, glucose, cholesterol, testosterone, many proteases, and more than 20 amino acids. It can be seen that semen is very rich in nutrients. Changes in its amount can indirectly reflect the level of sex hormones and affect fertility.
The relative lack of these substances in the semen of ED patients, as well as unhealthy diet-induced hypertension, obesity, fatty liver, and a series of glycolipid metabolism problems, may lead to ED, so reasonable nutrition is also conducive to the recovery of sexual function in ED patients.
At the European Society of Cardiology, a study entitled “Exercise capacity benefit about endogenous testosterone, coronary and central vascular physiology, and the Mediterranean regime in hypertensive males with erectile dysfunction” showed that the Mediterranean diet was associated with better exercise performance, vascular health, testosterone levels, and erectile dysfunction. The Mediterranean diet is strongly associated with better exercise performance, vascular health, testosterone levels, and erectile function, and both diet and exercise play a key role.
The Mediterranean diet can improve blood pressure levels. High blood pressure makes blood vessels abnormal and erections more complex, and men with high blood pressure are twice as likely to develop erectile dysfunction as ordinary men.
Scholars from Greece studied 250 men with both hypertension and erectile dysfunction. The average age of the participants was 56 years, as men were more likely to have both as they aged.
The researchers used a questionnaire to assess the participants’ dietary habits on a scale of 0 to 55, with higher scores indicating a diet closer to the Mediterranean diet. The participants’ health was tested through exercise, and testosterone levels were measured through blood samples. To check vascular health, each participant underwent an echocardiographic test to detect coronary flow reserve, a parameter that indicates the ability to increase blood flow.
The researchers used a central arterial pressure augmentation index to reflect arterial stiffness. Central arterial pressure is a direct response to vascular load, and higher values indicate a higher risk of developing arterial stiffness or heart disease.
Finally, to assess erectile dysfunction, the researchers scored men using the Sexual Health Inventory for Men (SHIM), a scale of five questions about erectile capacity, with final scores ranging from 0 to 25, with higher values indicating better erectile performance.
Sexual Health Inventory for Men
Overall, the researchers found that men with higher Mediterranean diet scores (above 29) tended to have higher coronary flow reserve, testosterone, and better erectile performance (SHIM scores above 14), as well as lower arterial stiffness.
Metabolic equivalent (MET) indicates exercise intensity and can be used to assess cardiorespiratory fitness. Taking these scores into account with health status, the researchers found that patients with greater exercise capacity (MET >10) had higher coronary blood flow reserve, testosterone, and erectile function and were also closer to the Mediterranean diet.
Although this observational study can only show the relationship between dietary habits and health status, it does not prove causality; a healthy and balanced diet and regular exercise are still necessary.
Mediterranean diet plans
Increase the proportion of coarse and mixed grains intake.
These coarse processed cereals are rich in dietary fiber, B vitamins, and trace elements, which are helpful for weight control, gastrointestinal tract regulation, blood sugar stabilization, and increased immunity.
Maintain the excellent habit of eating more vegetables and increasing the intake of fruits.
The Mediterranean diet contains a lot of fresh vegetables and fruits, which are low in energy density and rich in phytochemicals, and are an essential source of micronutrients, dietary fiber, and natural antioxidants, so it is recommended to ensure the intake of vegetables.
Reduce the proportion of red meat intake, and increase the seafood intake.
Red meat and seafood are good sources of high-quality protein and fat-soluble vitamins, but their nutritional values differ. Fish fat content is generally lower and contains more polyunsaturated fatty acids, which have a role in the prevention of dyslipidemia and cardiovascular diseases. In contrast, the fat content of red meat is higher, and mainly saturated fat, too much intake is not conducive to preventing cardiovascular and cerebrovascular diseases, obesity, and other diseases. Therefore, the structure of meat should be adjusted to increase the intake of aquatic products appropriately.
Increase the variety of dairy products, and promote milk, yogurt, and cheese.
The intake of dairy products in the Mediterranean diet is extensive and rich in variety, such as milk, yogurt, cheese, etc. In addition to being rich in high-quality protein and vitamins, milk is a good source of dietary calcium because of its high calcium content and high utilization rate. It is recommended that each person can drink 300g of milk or an equivalent amount of milk products daily.
The rational choice of cooking oil increases the proportion of monounsaturated fatty acid intake.
Olive oil is the main cooking oil in the Mediterranean diet, which is rich in monounsaturated fatty acids. Nowadays, most family cooking oils are mainly vegetable oils, and traditional vegetable oils include peanuts, soybean, sesame, and so on.
In addition to attention to diet, life must be regular; a good work and rest schedule guarantees health.
Regular and quantitative eating, always maintaining the best digestive function, is the maximum beneficial use of nutrients.
Actively adjust their mindset, maintain an optimistic spirit, and pay attention to the combination of work and rest.
Long-term adherence to such habits can allow men to regain sexual confidence and have a more satisfying sex life.
Here is a sample menu for one day on the Mediterranean diet:
Breakfast:
- Greek yogurt with fruit and nuts
Lunch:
- Whole grain pita stuffed with grilled vegetables and hummus
Dinner:
- Grilled fish with a side of roasted vegetables and quinoa
This is just one example of a day on the Mediterranean diet. You can adjust the portions and food choices based on your needs and preferences. The Mediterranean diet typically encourages people to consume more fruits, vegetables, whole grains, legumes, nuts and seeds, heart-healthy fats, and less processed foods, added sugars, and refined grains.
Sources
[1] Feldman HA, Goldstein I, Hatzichristou DG, et al. Impotence and its medical and psychosocial correlates: the Massachusetts Male Aging Study results. J Urol. 1994 Jan;151(1):54-61. doi: 10.1016/s0022-5347(17)34871-1.
[2] Estruch R, Ros E, Salas-Salvado J, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368:1279–1290.
[3] Doumas M, Douma S. Sexual dysfunction in essential hypertension: myth or reality? J Clin Hypertens (Greenwich). 2006;8:269–274.
[4] Panagiotakos DB, Pitsavos C, Stefanadis C. Dietary patterns: a Mediterranean diet score and its relation to clinical and biological markers of cardiovascular disease risk. Nutr Metab Cardiovasc Dis. 2006;16:559–568.
