If you’re a guy interested in sexual intimacy and you happen to be a rabid health news follower, you might be eating lots and lots of blueberries and citrus fruits these days. That’s because increased fruit intake (particularly citrus fruits and blueberries) was recently reported to be associated with a reduced risk of erectile dysfunction ED.

Researchers followed about 25 thousand men for 10 years, and found that those with the highest intake of fruit had a 14% reduced risk of reporting erectile dysfunction^[1]. They found that flavonoids, a specific class of antioxidants rich in fruits and vegetables, were linked to reduced risk of ED^[1]. This is supported by animal research showing that quercetin (a specific type of flavonoid) administration improves erection ‘firmness’ in diabetic rats^[2]. Because I know you were concerned about erection pressures in diabetic rats.

Given the recent good news about fruit and flavonoids, let me take this opportunity to highlight several important points regarding erections. They can be the source of endless middle school humor, but, as you’ll see, good erectile function is quite a serious matter.

1. There’s a reason that it seems every third commercial is about erections. Erectile dysfunction is extremely common.
• One survey^[3] found about 50% of men aged 40 and up had ED and another^[4] found that 33% of men aged 50 and up complained of having ED in the past 3 months.
2. Older age, heart disease, high blood pressure, obesity, diabetes, smoking, alcohol and drug abuse, stress, sedentary lifestyle all increase your risk of ED^[5]
3. Blood vessel disease, the same process that causes heart disease, is one of the most common causes of erectile dysfunction (there are many causes, including psychological issues like depression and anxiety, medications, and nerve problems, to name a few).
4. As much as 70% of all erectile dysfunction caused by non-psychological factors is due to blood vessel problems and diabetes^[6].
5. If you just got ED, you may be headed for the hospital for something much more serious in 2-5 years.
• 50%-90% of men with coronary artery disease ‘events’ (heart attacks, for example) had erectile dysfunction prior to any heart symptoms or events. In these men with heart disease events after erectile dysfunction, heart problems were diagnosed 2-5 years after onset of erectile dysfunction^[7].
6. If you have ED you are 70% more likely to die prematurely than men without ED^[8]
7. In a 2 year study, men with ED placed on a Mediterranean diet richer in fiber, beans, fruits, vegetables, nuts and unsaturated fats had better erections^[9].
8. Weight loss^[10] and exercise^[11] also have been shown to improve erection quality in men with ED

What do I take away from this? Think of the manliest scenes in American culture: downing meat, eggs, and protein to ‘bulk up’ or sitting in front of a TV with chicken wings and pizza, watching the game, or grilling a steak while pounding beers, . These ‘manly’ activities may actually be the exact opposite of what your penis needs to be functional over time.

Instead, to prevent and treat erectile dysfunction, step away from the steak, hot dogs, and chicken wings and try some beans, fruit, and vegetables and get off your butt and get your heart rate up regularly. When we look beyond pop culture, and the dangerous stereotypes of masculinity, science tells us that those are actually the factors that make for the best sexual function over your lifetime.

References

1. Cassidy A, Franz M, Rimm EB. Dietary flavonoid intake and incidence of erectile dysfunction. Am J Clin Nutr 2016.
2. Zhang W, Wang Y, Yang Z, et al. Antioxidant treatment with quercetin ameliorates erectile dysfunction in streptozotocin-induced diabetic rats. Journal of bioscience and bioengineering 2011;112:215-8.
3. Grover SA, Lowensteyn I, Kaouache M, et al. The prevalence of erectile dysfunction in the primary care setting: importance of risk factors for diabetes and vascular disease. Arch Intern Med 2006;166:213-9.
4. Bacon CG, Mittleman MA, Kawachi I, Giovannucci E, Glasser DB, Rimm EB. Sexual function in men older than 50 years of age: results from the health professionals follow-up study. Ann Intern Med 2003;139:161-8.
5. Shabsigh R, Anastasiadis AG. Erectile dysfunction. Annual review of medicine 2003;54:153-68.
6. Goldstein I. Male sexual circuitry. Working Group for the Study of Central Mechanisms in Erectile Dysfunction. Scientific American 2000;283:70-5.
7. Jackson G, Nehra A, Miner M, et al. The assessment of vascular risk in men with erectile dysfunction: the role of the cardiologist and general physician. International journal of clinical practice 2013;67:1163-72.
8. Loprinzi PD, Nooe A. Erectile Dysfunction and Mortality in a National Prospective Cohort Study. The journal of sexual medicine 2015;12:2130-3.
9. Esposito K, Ciotola M, Giugliano F, et al. Mediterranean diet improves erectile function in subjects with the metabolic syndrome. International journal of impotence research 2006;18:405-10.
10. Esposito K, Giugliano F, Di Palo C, et al. Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial. JAMA 2004;291:2978-84.
11. Lamina S, Okoye CG, Dagogo TT. Therapeutic effect of an interval exercise training program in the management of erectile dysfunction in hypertensive patients. Journal of clinical hypertension 2009;11:125-9.