Comparing effects of a low-energy diet and a high-protein low-fat diet on sexual and endothelial function, urinary tract symptoms, and inflammation in obese diabetic men

Joan Khoo, Cynthia Piantadosi, Rae Duncan, Stephen G. Worthley, Alicia Jenkins, Manny Noakes, Matthew I. Worthley, Kylie Lange, Gary A. Wittert

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138 Citations (Scopus)

Abstract

Introduction. Abdominal obesity and type 2 diabetes mellitus are associated with sexual and endothelial dysfunction, lower urinary tract symptoms (LUTS), and chronic systemic inflammation. Aim. To determine the effects of diet-induced weight loss and maintenance on sexual and endothelial function, LUTS, and inflammatory markers in obese diabetic men. Main Outcome Measures. Weight, waist circumference (WC), International Index of Erectile Function (IIEF-5) score, Sexual Desire Inventory (SDI) score, International Prostate Symptom Scale (IPSS) score, plasma fasting glucose and lipids, testosterone, sex hormone binding globulin (SHBG), inflammatory markers (high-sensitivity C-reactive protein [CRP] and interleukin-6 [IL-6]) and soluble E-selectin, and brachial artery flow-mediated dilatation (FMD) were measured at baseline, 8 weeks, and 52 weeks. Methods. Over 8 weeks, 31 abdominally obese (body mass index≥30kg/m2, WC≥102cm), type 2 diabetic men (mean age 59.7 years) received either a meal replacement-based low-calorie diet (LCD) ∼1,000kcal/day (N=19) or low-fat, high-protein, reduced-carbohydrate (HP) diet (N=12) prescribed to decrease intake by ∼600kcal/day. Subjects continued on, or were switched to, the HP diet for another 44 weeks. Results. At 8 weeks, weight and WC decreased by ∼10% and ∼5% with the LCD and HP diet, respectively. Both diets significantly improved plasma glucose, low-density lipoprotein (LDL), SHBG, IIEF-5, SDI and IPSS scores, and endothelial function (increased FMD, reduced soluble E-selectin). Erectile function, sexual desire, and urinary symptoms improved by a similar degree with both diets. CRP and IL-6 decreased with the HP diet. At 52 weeks, reductions in weight, WC, and CRP were maintained. IIEF-5, SDI, and IPSS scores improved further. Conclusions. Diet-induced weight loss induces rapid improvement of sexual, urinary, and endothelial function in obese diabetic men. A high-protein, carbohydrate-reduced, low-fat diet also reduces systemic inflammation and sustains these beneficial effects to 1 year.

Original languageEnglish
Pages (from-to)2868-2875
Number of pages8
JournalJournal of Sexual Medicine
Volume8
Issue number10
DOIs
Publication statusPublished or Issued - Oct 2011

Keywords

  • Diabetes mellitus
  • Endothelial function
  • Erectile dysfunction
  • Obesity
  • Sexual function
  • Urinary tract symptoms

ASJC Scopus subject areas

  • General Medicine

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