Dietary flavonoid intake and incidence of erectile dysfunction

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