June 22, 2004 -- You may be willing to walk the ends of the earth to find true love. But when it comes to maintaining good sex, the trek is much shorter. A new study shows it takes just two miles a day.
"In our study, about one-third of obese men with erectile dysfunction regained their sexual function after two years of adopting healthy behaviors, mainly regular exercise and reducing weight," they write in this week's Journal of the American Medical Association.
And the workout to help iron out problems below the belt? According to the researchers, "sedentary men may be able to reduce their risk of erectile dysfunction by adopting regular physical activity at a level of at least 200 calories a day, which corresponds to walking briskly for two miles."
Dual Approach Is Best
The researchers wanted to determine how healthy lifestyle interventions could help improve erectile dysfunction in obese, middle-aged men who did not have heart disease, diabetes, hypertension, or other conditions known to cause erectile dysfunction.
Along with exercising two hours a week, half of the 110 men studied were placed on a calorie-restriction diet in which their average caloric intake dropped from 2,340 to 1,950 calories daily. Their prescribed diet boosted their fiber intake and they substituted saturated fats with monounsaturated and polyunsaturated fats.
The other half were given general information about healthy food choices and exercise, but not placed on any specific regimen.
After two years, the men advised to lose weight saw little improvement -- in either weight loss or sexual function. But the men who ate less and exercised more lost about 15% of their weight. What's more, one in three regained sexual function.
"We must say that the program which the obese subjects agreed to enter in was based on an integrated approach, so, we don't know if adopting one aspect only (diet or exercise) could be effective," says study researcher Katherine Esposito, MD, of the Center for Obesity Management at Second University of Naples.
"Our feeling is that diet and exercise are both important," she tells WebMD. "Our advice to such a man would be, eat well and move more."
Exercise Delays Problems
Her findings follow a study by Harvard researchers published last year touting exercise, in particular, as a powerful prevention measure against ED. After studying some 31,000 men between ages 55 to 90, the researchers show that men who regularly exercised typically had a 10-year delay in erectile dysfunction compared with more sedentary guys.
Erectile dysfunction occurs more commonly as men age, affecting about 12% of men before age 60. About 20% of men in their 60s are afflicted, and about 30% of men after age 70 suffer from erectile dysfunction.
Results from neither study surprise Martin Resnick, MD, past president of the American Urological Association and chairman of urology at Case Western Reserve University School of Medicine. After all, obese men are especially prone to erectile dysfunction.
"We certainly recommend overweight patients with erectile dysfunction to lose weight, for several reasons," he tells WebMD. Often, erectile dysfunction results from poor circulation, and good blood flow is necessary for achieving and maintaining an erection. And even losing a little weight with diet and exercise can translate to significant cardiovascular health and blood circulation.
But there's also the psychological aspect to fuel the fires down below. "As they lose weight, they become more physically active, and that improves body image and they feel better about themselves," says Resnick, who was not involved in either Esposito's or the Harvard study.
"I think the psychological component of weight loss can be very important, and often is at least as effective as medication, if not more so."
In an accompanying editorial to Esposito's study, Christopher S. Saigal, MD, MPH, of the University of California, Los Angeles, cautions that diet and exercise are not necessarily a cure-all for erectile dysfunction, which affects some 30 million Americans.
"The population studied may differ from obese patients typically seen in primary care clinics in that these patients did not have known coronary heart disease, diabetes, or hypertension, all commonly seen in obese patients in practice," he notes. "The presence of these (other) diseases may lessen the impact of the effect of exercise and weight loss on ED."