The effects of a low carbohydrate diet on erectile function and serum testosterone levels in hypogonadal men with metabolic syndrome: a randomized clinical trial
Tóm tắt
Metabolic syndrome is a risk factor for several diseases. The relationship between metabolic syndrome and hypogonadism is well known. Our objetive is to assess whether a low carbohydrate diet can increase total serum testosterone and improve erectile function in hypogonadal men with metabolic syndrome. An open label randomized clinical trial was conducted comparing a low carbohydrate diet and controls, during three months, in hypogonadal men with metabolic syndrome. Anthropometric measurements were evaluated as well as total serum testosterone levels, and symptoms of hypogonadism, using the ADAM and AMS scores, and sexual function using IIEF-5 score. Eighteen men were evaluated. Anthropometric measures were improved only in low carbohydrate diet group. The intervention group also had a statistically increase in IIEF-5 score and a significant reduction in AMS and ADAM scores (p < 0.001). The increase in serum total testosterone levels was statistically significant in the low carbohydrate group compared to the control group as well as calculated free testosterone (p < 0.001). Low carbohydrate diet may increase serum levels of testosterone and improve erectile function in hypogonadal men with metabolic syndrome. However, larger studies are necessary to strongly prove the effectiveness of low carbohydrate diet in treating male hypogonadism.
Tài liệu tham khảo
Brazilian Government database. https://www.gov.br/pt-br/noticias/saude-e-vigilancia-sanitaria/2020/10/pesquisa-do-ibge-mostra-aumento-da-obesidade-entre-adultos. Accessed 10 Jul 2022.
Flegal KM, Carroll MD, Kit BK, et al. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999 and 2010. JAMA. 2012;307:491–7.
Isidori AM, Buyat J, Corona G, et al. A critical analysis of the role of testosterone in erectile function: from pathophysiology to treatment - a systematic review. Eur Urol. 2014;65:99–112.
Corona G, Forti G, Maggi M. Why can patients with erectile dysfunction be considered lucky? The association with testosterone deficiency and metabolic syndrome. Aging Male. 2008;11(4):193–9.
Stanworth R, Jones TH. Testosterone in obesity, metabolic syndrome and type 2 diabetes. Front Horm Res. 2009;37:74–90.
Rao PM, Kelly DM, Jones TH. Testosterone and insulin resistance in the metabolic syndrome and T2DM in men. Nat Rev Endocrinol. 2013;9(8):479–93.
Malik S, Wong ND. Metabolic syndrome, cardiovascular risk and screening for subclinical atherosclerosis. Expert Rev Cardiovasc Ther. 2009;7(3):273–80.
DeLay KJ, Haney N, Hellstrom WJ. Modifying risk factors in the management of erectile dysfunction: a review. World J Men’s Health. 2019;34(2):89–100.
Hession M, Rolland C, Kulkami U, et al. Systemic review of randomized controlled trials of low-carbohydrate vs. low-fat/low-calorie diets in the management of obesity and its comorbidities. Obes Rev. 2009;10(1):36–50.
Bazzano LA, Hu T, Reynolds K, et al. Effects of low-carbohydrate and low-fat diets: a randomized trial. Ann Inter Med. 2014;161(5):309–18.
Executive Summary of the Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001;285(19):2486–97.
I Brazilian guidelines on diagnosis and treatment of metabolic syndrome. Arq Bras Cardiol. 2005;84 Suppl 1:1–28.
Morley JE, Charlton E, Patrick P, et al. Validation of a screening questionnaire for androgen deficiency in aging males. Metabolism. 2000;49:1239–42.
Heinemann LA, Saad F, Heinemann K, et al. Can results of the Aging Males’ Symptoms (AMS) scale predict those of screening scales for androgen deficiency? Aging Male. 2004;7:211–8.
Rosen RC, Riley A, Wagner G, et al. The International Index of Erectile Function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology. 1997;49:822–30.
Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser. 1995;854:1-452.
Lunenfeld B, Mskhalaya G, Zitzmann M, et al. Recommendations on the diagnosis, treatment and monitoring of hypogonadism in men. Aging Male. 2015;18(1):5–15.
Mavropoulos JC, Yancy WS, Hepburn J, et al. The effects of a low-carbohydrate, ketogenic diet on the polycystic ovary syndrome: a pilot study. Nutr Metabol. 2005;2:35–9.
Grossmann M. Low testosterone in men with type 2 diabetes: significance and treatment. J Clin Endocrinol Metab. 2011;96(8):2341–53.
Westman EC, Feinman RD, Mavropoulos JC, et al. Low-carbohydrate nutrition and metabolism. Am J Clin Nutr. 2007;86:276–84.
Chawla S, Silva FT, Medeiros SA, et al. The effect of low-fat and low-carbohydrate diets on weight loss and lipid levels: a systematic review and meta-analysis. Nutrients. 2020;12:3774–95.
La J, Roberts NH, Yafi FA. Diet and Men’s Sexual Health. Sex Med Rev. 2018;6(1):54–68.
Machado FP, Rhoden EL, Pioner SR, et al. Weight loss through bariatric surgery in men presents beneficial effects on sexual function, symptoms of testosterone deficiency, and hormonal profile. Sex Med. 2021;9(4):100400.
Freedland SJ, Howard LE, Ngo A, et al. Low carbohydrate diets and estimated cardiovascular and metabolic syndrome risk in prostate cancer. J Urol. 2021;206:1411–9.