Can A Poor Diet Cause Erectile Dysfunction And Libido Problems?
By Johnathan P Cumberwell
A poor diet can indeed cause erectile dysfunction and libido problems.
In order to grow and repair itself, your body needs the right building materials. And in order to power itself, your body needs the right fuel.
Where do these building materials and fuel come from? From the foods and drinks you consume.
If you don’t give your body the foods and drinks it needs in order to function optimally, what happens?
It will operate sub-optimally. And when it operates sub-optimally, dysfunctions are likely to appear.
Two of the first to come knocking on your door, are often erectile dysfunction and a poor libido.
You Are What You Eat
You are what you eat. Your hair, your eyes, your right thumb, your kidneys – have all been built 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.
And every day, more than 50 billion of your cells die. And every day you need to replace these cells.
What are these new cells created from? From foods and drinks.
You are what you eat.
Nutrition has interested me since I was a little kid. It has fascinated me since I first understood that it could impact how fast I could run. 
I have now learned that eating right is important not only to run fast, but also for being healthy and live long.
And also for being happy. Eating healthy also improves my mood, makes me positive and gives me lots of energy.
Lets talk about athletes for a moment.
Most athletes take nutrition extremely seriously. For many, what they eat is just as important as the actual training they do.
They know that in order for their bodies and minds to perform at an optimal level, they need the right foods and drinks containing the right nutrients.
I am not a professional athlete, but why shouldn’t I eat like one?
If this can help me towards optimal physical and mental condition, why shouldn’t I be as serious about nutrition as professional athletes?
Let’s understand why proper foods and drinks are crucial for sexual functions.
Why Is A Proper Diet So Important For Sexual Functions?
Your body is a very sophisticated and complex system consisting of millions of parts. One system depends on another. It’s thousands of times more delicate than the most advanced high performance engine out there.
And this delicate system needs great fuel in order to operate well.
Not OK fuel, great fuel.
In other words, your body and mind need certain vitamins, minerals, fatty acids and other nutrients to function optimally.
If you don’t consume adequate amounts of these essential nutrients, your body and mind will not be able to function as well as they could.
These nutrients are essential to every organ and process in your body.
They are the building blocks of life – without them your cells are not be able to do their tasks properly.
This also applies to sexual functions.
The process of getting an erection for instance, is incredibly complex.
And in order to consistently get and maintain hard erections, you need a certain set of nutrients. If you lack these, your erections are in trouble.
In fact, weak erections can be the first problem to show up when your diet is no good. Maybe you have noticed?
This is also true for your libido. Because in order to have a strong libido, your body and mind also need a constant supply of tip top nutrients.
But, it’s not only important to eat and drink the proper foods and drinks.
It’s also super important to stay away from the damaging foods and drinks.
Because if you eat lots of fast food, candy and processed ‘stuff’, you will pollute your insides with excess glucose, fats and toxins. As a result, your erections will probably be in trouble.
Therefore, a proper and healthy diet is paramount in order to function well sexually.
Let’s take a look at the wild changes we have made to our foods.
Our Diet Has Changed Dramatically
What we eat and drink have changed dramatically during the last 100 years or so.
We have introduced several new foods to our diets, we have significantly altered many traditional foods. And we now eat more of certain foods, such as meat, and less of others, such as vegetables.
Can this be good?
Let’s look at what we have eaten throughout our history:
We have been ‘humans’ for about 2.1 million years (Homo Habilis, the first human, appeared around 2.1 million years ago).
Homo Sapiens, our direct ancestor, entered the scene around 200,000 years ago.
In-between, there were several sub-species of humans. But:
We believe that these different versions of human beings, ate more or less the same kinds of foods.
Well, almost. Their diet probably varied significantly depending on geography. Some had access to lots of berries, other lived where fish was plentiful.
However:
They ate vegetables, fruit, berries, nuts, seeds, legumes, roots, leaves, mushrooms, meat, seafood, and other foods they could either gather or kill.
Most of this food would have been consumed raw, and also consumed immediately after sourcing it.
We did eat 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 heated.
However, although our diet evolved as we evolved, it has also remained relatively stable.
Until very recently.
About 10,000 years ago, our lives changed forever. And this caused a big shift in our diet.
From being nomadic hunters and gatherers, we started settling down in permanent and 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 living this way, we had access to more food, we spent less time sourcing the food, and the food supply became more certain.
We now had more leisure time and life became easier. 
However, when we domesticated plants and animals, this also brought about changes:
- We started consuming large quantities of certain foods we had not consumed much of before
- Plants and animals that had desirable traits were reproduced. Hence, over time we started manipulating our foods
- It became common to store food for later consumption
For instance, we probably 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. Hence, these traits were preserved.
And we begun storing grains, seeds, and other foods that did not perish quickly.
This was the beginning of a startling and incredible transformation of our diet.
And where are we today, 10,000 years later?
French fries, tofu, ice cream, cheese, pasta, yogurt, liver-pate, sauerkraut, sausage, chocolate, smoked salmon, microwave popcorn, pickled cabbage, frozen pizza..
What a change!
Today our diet hardly contains any raw food at all. Rather, most of what we eat is several steps away from where it originally grew or lived.
First of all, the food on your plate has probably traveled hundreds, if not thousands, of kilometres. And it was probably sourced several weeks ago, if not months. Potentially even years.
Secondly, your food is normally frozen, cooked, fried, extracted, pickled, bleached, deodorized, concentrated, pasteurized or processed in one way or another.
Often, your food has gone through processes where sugar, salt, fat, stabilizers, preservatives or other ingredients are removed or added.
Some of your foods may even be genetically modified! Or fortified with vitamins and minerals.
And let’s not forget about all the unintended ‘things’ that end up in our foods: Herbicides, pesticides, hormones, antibiotics, pharmaceutical drugs, and even microplastic.
The foods we eat today are very different from the foods we ate thousands of years ago.
Why is this not good?
Because we are no longer consuming the foods and drinks our bodies are designed for.
And when we don’t get the building materials and fuel our minds and bodies need, things start to slow down. Then break down.
Imagine trying to run a petrol engine on diesel? Not going to work well.
Let me tell you about my food epiphany.
My Food Epiphany
Throughout my childhood and adolescence, I ate and drank what people around me ate and drank.
For breakfast, this meant bread with cheese, ham or jam, or a cereal + milk.
Lunch normally consisted of bread with the same spreads. Boring, I know. 
For dinner, there was always meat. Always. And typically boiled potatoes and some other stuff.
This diet contained very little vegetables, fruits, nuts, seeds, legumes, etc. Rather, it was heavy in meats and dairy products.
As a kid, I was told this was a healthy diet.
This diet didn’t kill me. It just wasn’t optimal.
But little did I know back then..
It wasn’t until much later that I had my food epiphany.
It wasn’t until the day the quality of my diet was drastically downgraded, that I discovered how important what I eat and drink 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:
For a period of my life, I felt I needed to be very thrifty with money.
One of the things I saved money on was food. Therefore, I ate a sugary and 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 hardly ate any vegetables, nuts or seeds, and fruits only occasionally.
For most of this period, I was sexually almost dead.
I had severe difficulties obtaining and keeping my erections. I would sometimes get an erection, but it would normally fade very quickly. Morning erections were practically non-existent.
My desire for sex was also practically non-existent. Sex just wasn’t on my mind much. My libido was gone.
I didn’t at the time imagine that the foods and drinks I consumed (and didn’t consume), 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 felt a difference almost immediately. All of a sudden I got erections when we kissed!
And my erections continued as we started getting intimate! All of a sudden, my erections didn’t just come and go, but they lasted much longer than before!
One day kissing ended with sex. And it worked – sex worked! Normally and without pills! (At the time I had to take ED pills to have sex.)
It almost felt like a miracle, and I could hardly believe it!
At first I didn’t get it. Why was it happening? Why did my erections come back all of sudden?
But it didn’t take too long until I realized that food played a big part in what was happening.
I realized that proper nutrition was super important in order to function well sexually!
By the way, this experience wasn’t just a lucky one-time coincidence. Rather, I noticed a shift, a significant upgrade, in my sexual abilities.
In addition, my sex drive also increased.
After this epiphany, I stayed faithful to this diet for a long time. And I consistently worked much 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. Could I improve even further..?
So I decided to try out different diets.
My first experiment was to try the vegan diet. Vegan means no meat and no dairy. The diet entails eating vegetables, fruits, nuts, fungi, berries, legumes, seeds, etc.
For the 4 months I tried being vegan, I really liked it! I felt super good and it gave me lots of energy. My libido was strong and I functioned well sexually.
The only minor issue I had, was that it was difficult to maintain when I went out to eat.
For me, going from vegetarian to vegan produced no noticeable change in how i felt, or in my state.
Therefore, both the vegan and the vegetarian diet enabled me to function well sexually.
I also tried the paleolithic diet. This diet tries to copy the diet of people during paleolithic times, or rather our diet as ‘cavemen’.
This means eating foods that were available then, such as nuts, fruits, vegetables, fish, etc. And foods that are completely unprocessed and not tampered with.
The paleo diet also worked well for me health wise. I had lots of energy, felt sharp and happy. My libido was strong and I functioned well sexually.
I also didn’t notice any major changes in libido, erectile functioning, energy or mood from switching from the vegan to the paleo diet.
At this point, three different diets had worked well for me. Out of curiosity, I wanted to try something..
I wanted to switch back to my old diet, just to see what happened.
So I changed back to my normal western diet, which entailed eating lots of bread, dairy and meat. And little fruits and vegetables.
What happened? Did it work for me?
Not really. Because I felt heavier and more tired. I had less energy.
For instance, I often got super tired in the middle of the day and felt the need to nap. This was less common for my three other diet experiments.
It also made me fart more than usual. I seemed to have significantly more gas production than normal.
I didn’t however notice a big impact on erectile functioning or libido.
But this experiment might have been too short for this effect to really play out. Because, given my lack of energy and how I felt, I decided to scrap this diet after about two weeks.
Today I am vegan. A very happy vegan. Actually, confession: I sometimes use honey, which supposedly makes me a ‘honey-tarian’. 
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, and I also avoid anything that is processed (to the extent possible).
For me, this diet is amazing. It gives me all the nutrients I need (almost: I do take a couple of supplements), it gives me loads of energy, if makes me feel light, alert and also positive. 
Also, the foods I have chosen are simply what I feel like eating. Meaning, I am not vegan because Dr. Nutrition says I should be vegan.
I simply crave vegetables, fruits and nuts, etc. It’s what I want. I no longer crave meat or potato chips.
Because I now know how I feel and how I function when I eat and drink this way. Eating meat and potato chips makes me feel off.
So what is my conclusion from trying a number of diets?
For me, the vegetarian, vegan, and the paleo diet worked really well. Energy-wise as well as sexually.
The traditional western diet did not work as well for me.
So..
From my food epiphany and my diet experiments, I learned something super useful: What I eat and drink is incredibly important not only for how I feel and my health, but also for my sexual health.
Therefore, today I try very hard to provide my body and mind with everything they need in order to function optimally, or very close to optimally.
As a result, my diet is perhaps a bit extreme. 
However, I don’t think it’s necessary to be super extreme with your diet in order to function well sexually. Just almost.
Hippocrates once said: “Let food be your medicine and medicine your food”.
How true! After I started eating super healthy, I have hardly gotten sick at all. Before, I normally got at least a cold or a flu each year. No more.
In fact, I can’t remember the last time I had a cold. Nor the last time I had a sore throat. That said, I did catch the Corana virus. 
Let tell you exactly what I eat and drink.
My Diet
Although I still experiment with my diet and hence what I eat changes, this is what I eat currently:
Breakfast: 1/2 avocado, one banana, two cloves of garlic, a thumb-size of ginger (with peel), one radish (with peel), one small beetroot (or carrot) (with peel), one kiwi (with peel) or half a stick of celery (I alternate), 1/3 lemon (with peel), a handful of spinach, a tablespoon of apple cider vinegar, a tablespoon of coconut oil, one drop of oregano oil, two tablespoons of ground flax seeds, a tablespoon of Maca powder, 1/4 tablespoon of matcha green tea powder, 1/4 tablespoon of turmeric powder, 1/4 tablespoon of amla powder, a little bit of ground pepper, 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 quite like it.
I call it my morning smoothie, but it’s too thick to drink, so I eat it with a spoon. 
Pre-lunch: A salad containing 1/2 avocado, 1/2 red bell pepper, 1/2 large tomato, a small cucumber, a stick of celery, half a pomegranate, and a handful of spinach.
Lunch: Normally leftovers from yesterday’s dinner. If not a leftover dinner, often porridge or cereal.
Dinner: When I make dinner, I normally make a large one so I have enough for at least two meals. This way, I have lunch for tomorrow also.
What I often do, is to put a lot of ‘stuff’ in a big pot, and let it cook for a few hours. It’s easy, healthy and requires little of my time.
Here is what I do: I caramelize onion, then add tomato sauce (or I make my own sauce), vegetables (for instance broccoli, cauliflower, aubergine or sweet potatoes), mushrooms, olives, dried tomatoes, beans (or quinoa or lentils) and chia seeds all in a pot, and slow cock for about 3 hours.
I also add spices such as turmeric, oregano, paprika and cumin. And if needed, water.
Sometimes, I also make vegetable lasagna, quinoa salad with vegetables, or a veggie pizza.
Throughout the day, I also eat about 150 grams or more of nuts, ideally unsalted.
Normally I also eat 2-3 apples a day, perhaps an orange, a few dates, a plum, and some berries. It also depends on what is in season and available at food stores.
I normally also drink a cup of matcha green tea or hibiscus tea (I use powder not tea bags) in the morning, and lots of water throughout the day. My last water is normally around 19:00, just so that I don’t wake up too many times at night to pee.
And I also take a vitamin B12 supplement because the food I eat contains no or little B12. By the way, vitamin B12 is produced by bacteria that blanket planet earth, but because we wash (and spray) our plant foods (and chemically treat our drinking water), little of this bacteria remain.
I also take an iodine supplement. And vitamin D3 in the winter (when I don’t get much sun).
That’s it. That’s what I typically eat and drink during a day. This gives me an incredible amount of energy, and is also easy to maintain and relatively inexpensive.
What do I recommend that you eat in order to function sexually?
What Should You Eat And Drink 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 and drink?
Well, you should consume those nutrients that your body needs, and stay away from those ‘things’ that cause harm to your body.
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 eat little meat, fish, dairy and foods that are heavily processed.
And you would also be smart to drink lots of water.
These foods and drinks are likely to help you function optimally sexually.
They are also the ones that will provide you with the best overall health, and give you the most energy.
They will also help you reduce the chances of getting heart problems, stroke, diabetes, cancer, Alzheimer’s, dementia, and many other health problems.
This is not my personal opinion, this is all backed up by science.
If you want to learn more, I recommend a great book called ‘How Not To Die’ by Dr. Michael Greger.
Let’s take a look at some of the ‘bad stuff’.
Erectile Dysfunction, Smoking, Alcohol, Fat, Salt And Sugar
In addition to trying to provide my body and mind with all the essential nutrients they need, I also stay away from smoking and alcohol, and I am very careful with saturated fat, trans fat, salt and sugar.
Let’s explore each of these.
Smoking And Erectile Dysfunction
Cigarette smoke can contain more than 7,000 chemicals, such as acetone, ammonia, arsenic, carbon monoxide, lead, nicotine and tar.
Many of these chemicals will accumulate in your body over time, and will be particularly prominent in your lungs and blood vessels.
These chemicals are not supposed to be in your body (at least not in these amounts), and can cause significant harm to the fine-tuned system your body is.
For instance:
Smoking can damage the inner lining of your blood vessels, which can increase the risk of plaque build-up in the arteries. If this becomes severe, it may develop into atherosclerosis.
Advanced atherosclerosis may restrict bloodflow and inhibit the arteries’ ability to produce nitric oxide. Both of which normally make it more difficult to obtain erections.
In addition, nicotine has itself been shown to have a direct negative effect on nitric oxide production.
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.
In short:
Smoking attacks the normal functioning bloodflow from many fronts. Anything that reduces proper bloodflow may lead to erectile dysfunction.
Research studies have shown that men that smoke are up to 40% 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
Excessive alcohol consumption is likely to have negative long-term consequences for your ability to ‘get it up’, as well as for your sex drive.
In the short-term however, alcohol may increase your sex drive and your performance. This is because alcohol thins your blood, and can also act as a vasodilator (help expanding blood vessels). The result is temporarily better bloodflow.
In the long-term however, the story is very different.
Excessive alcohol consumption may weaken your heart (a condition called alcoholic cardiomyopathy).
A weakened heart that cannot contract effectively, will not be as apt as a healthy hart at pumping blood around your body.
This can also damage your organs and tissues, as they may not get enough oxygen and nutrients.
And it can also cause erectile dysfunction, as proper erections are dependent on strong bloodflow.
Too much alcohol may also damage the inner lining of your blood vessels, called the endothelium. When the endothelium gets damaged, it can’t produce as much nitric oxide as before.
Less nitric oxide production in your penis means reduced bloodflow to fill your penis.
In addition:
Consumption of alcohol, even in moderate doses, will normally reduce your testosterone levels. This happens in four different ways:
Firstly, in your testicles, you have certain cells called leydig cells that produce testosterone. When there is alcohol in your blood, these cells normally produce less testosterone.
Secondly, alcohol impairs your body’s ability to break down estrogen. This can cause large amounts of estrogen to accumulate in 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 can also bind to your androgen receptors. Hence it leaves the receptors idle as long as estrogen is connected to them.
Also, with lots of estrogen in your blood, your body may make fewer androgen receptors. The result is that it gets harder for your testosterone to find a receptor to connect to.
Thirdly, alcohol consumption can increase your cortisol production. Cortisol is a hormone that can crowd out your testosterone.
Also, more cortisol can stimulate the urge to drink more, which can potentially cause a vicious cycle of more and more alcohol consumption.
Lastly, alcohol can deplete zinc levels in your body. Your body needs zinc to create testosterone.
Fat And Erectile Dysfunction
Research has shown that excess consumption of particularly trans fat (or trans-unsaturated fatty acids), but also saturated fat, can damage your health.
Trans fats form when certain oils are heated to very high temperatures, for instance when frying foods. They are also found in meat and dairy products.
However, given the health risks, most foods you can buy today have trans fats limits.
According to several research studies, trans fats can cause heart disease, cancers, diabetes, liver disease, among others.
Saturated fats may increase your ‘bad’ cholesterol. However, research is still inconclusive.
Fat in general, makes your blood thicker. This means it will flow less smoothly through your veins.
The blood vessels in your penis are very narrow, hence thicker blood will have a tougher time to flow smoothly through these.
Fat also tends to get stuck to the inner lining of your blood vessels, causing plaque build-up. This causes your blood vessels to become stiffer, narrower and more prone to rupture.
Also, when the inner linings of your blood vessels are coated with plaque, it is much harder for your blood vessels to produce nitric oxide
None of this is good for bloodflow.
Salt And Erectile Dysfunction
Excessive salt ingestion is neither good for your sexual performance.
When you have lots of salt in your blood, your kidneys struggle to filter our water from your blood.
And this increase in water retention increases blood pressure.
High blood pressure can 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.
Elevated blood pressure can also cause damage to your heart.
Excessive salt ingestion has also been shown to decrease nitric oxide production.
In addition, research has shown that high blood pressure can decrease testosterone production.
It is estimated that a western diet easily contains 10 times more salt than what’s ideal.
Salt consists of sodium and chloride, and you normally get enough of both through a normal plant based diet. No need to add any salt.
Sugar And Erectile Dysfunction
Excessive sugar consumption is not going to help you ‘get it up’ either.
When you eat a lot of sugar (glucose), this will be flushed into your bloodstrem. Now you have high blood sugar levels.
Now insulin gets to work. Insulin is the ‘key’ your cells use in order to use glucose as energy.
However, when there is excess glucose to process, your insulin gets overworked. Tired. Then exhausted. And then your insulin gets so exhausted it can no longer do its job properly.
This is called insulin resistance.
Now less glucose is absorbed by your cells, and glucose accumulates in your blood.
This causes your blood to thicken, which in turn makes your blood drift slower though your veins.
But something else scary also happens:
With lots of glucose in your blood, something called superoxide starts to form in larger numbers.
Superoxide is a free radical. It very easily react with nitric oxide (which is another free radical).
When these react, nitric oxide is eliminated. With less nitric oxide, it will be more difficult to get and keep erections.
Also, research has indicated that this excess glucose may directly inhibit the enzyme nitric oxide synthase, in producing nitric oxide.
What happens in the end with the sugar that is not used as energy?
It is stored. As fat. And excess body fat can be dangerous in several ways. One key problem is that it normally makes your testosterone production fall.
Another problem with this stored fat, is the plaque buildup inside your blood vessels that messes with your bloodflow.
As you see, excessive sugar consumption has many of the same negative results as excessive consumption of fat.
What Does Research Say About Diets?
Several research studies have shown that there is a strong relationship between diet and ED.
In particular, many studies have demonstrated significant improvements in erectile function with the Mediterranean diet.
This diet consists of large amounts of whole grains, fruits, vegetables, nuts, legumes, fish, olive oil, and limited red meat.
Research has also shown that men with metabolic syndrome and men with diabetes, have been able to regain erectile functioning after switching to this diet.
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.
Research has also found a similar correlation between both vegan and vegetarian diet, and ED.
Research Studies
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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.
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