Diet and Erectile Dysfunction: What Studies Report

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Short answer: Published studies on the worst foods for erectile dysfunction mostly look at whole eating patterns, not single foods. In the Health Professionals Follow-up Study of 21,469 men, those under 60 with the highest Mediterranean diet scores had a lower risk of developing ED than those with the lowest scores (hazard ratio 0.78) (Bauer 2020). NIDDK lists foods high in saturated fat, refined carbohydrates, sodium and added sugars, plus alcohol, among those to “avoid or limit” (NIDDK); talk to a licensed provider about ED itself.

This page reports what the cited studies and health agencies say. It is not a diet plan, and it does not present any food as a treatment for erectile dysfunction.

What are the worst foods for erectile dysfunction, according to studies?

A 2010 review of the research said “Only few studies assessed the role or the effect of diet on ED” (Esposito 2010). The same review reported that a dietary pattern “high in fruit, vegetables, nuts, whole grains, and fish but low in red and processed meat and refined grains is more represented in subjects without ED” (Esposito 2010). That is a pattern seen in groups of men, not a test of any one food.

NIDDK, part of the National Institutes of Health, says “Foods and drinks that increase the risk of diabetes, heart disease, and obesity can also increase the chance of having ED” (NIDDK). Its page lists these to “avoid or limit” (NIDDK):

• foods high in saturated fats, such as red meat and fried foods
• full-fat dairy foods, including whole milk, cream, butter and cheese
• refined carbohydrates, such as pastries, chips, white rice and candy
• foods and drinks high in sodium and added sugars
• packaged foods, such as lunch meats and snack bars
• drinks that contain alcohol

NIDDK cites the Health Professionals Follow-up Study analysis below as one of its references (NIDDK).

What does the Health Professionals Follow-up Study report?

The Health Professionals Follow-up Study (HPFS) is a long-running US cohort of male health professionals. Two analyses from it looked at diet and new cases of ED. Both are observational: they show associations, not cause and effect.

Diet quality scores and ED

Bauer and colleagues followed 21,469 men from 1998 to 2014, using food questionnaires every 4 years (Bauer 2020). Men were aged 40 to 75 at enrollment, and those who already had ED, a heart attack, diabetes, stroke or genitourinary cancer were excluded. Over a mean follow-up of 10.8 years, there were 9,464 new ED cases across all age groups (Bauer 2020). The reported results:

Group	Comparison	Hazard ratio (95% CI)
Men under 60	Highest vs lowest Mediterranean Diet score category	0.78 (0.66 to 0.92)
Men 60 to under 70	Higher Mediterranean Diet score	0.82 (0.76 to 0.89)
Men 70 and older	Higher Mediterranean Diet score	0.93 (0.86 to 1.00)
Men under 60	Highest vs lowest fifth of Alternative Healthy Eating Index 2010	0.78 (0.63 to 0.97)

A hazard ratio below 1 means a lower rate of new ED in that group over the study period. The authors concluded that adherence to healthy dietary patterns “was associated with a lower risk for erectile dysfunction” (Bauer 2020). For how ED rates change across age groups in other studies, see erectile dysfunction rates by age.

Flavonoids and fruit

Cassidy and colleagues studied 25,096 HPFS men over 10 years; 35.6% reported new ED (Cassidy 2016). Comparing the highest and lowest intakes, after adjusting for heart disease risk factors, they reported lower ED incidence with three flavonoid groups: flavones (relative risk 0.91), flavanones (0.89) and anthocyanins (0.91). Higher total fruit intake was associated with a 14% lower risk (relative risk 0.86) (Cassidy 2016).

The associations were significant only in men under 70, not older men, and the authors wrote that “Intervention trials are needed” (Cassidy 2016).

What did the Mediterranean diet trials find?

Three studies from one research group in Naples, Italy, looked at diet and ED, each in a different group of men.

Study	Design and men studied	What was compared	Reported finding
Esposito 2004, JAMA	Randomized trial; 110 obese men aged 35 to 55 with ED, without diabetes, high blood pressure or high cholesterol	Detailed advice to lose 10% or more of body weight by eating fewer calories and exercising more, vs general healthy-living information	After 2 years, 17 men in the intervention group and 3 controls had an IIEF score of 22 or higher
Esposito 2006, Int J Impot Res	65 men with ED and metabolic syndrome, drawn from earlier lifestyle trials	Mediterranean-style diet (35 men) vs control diet (30 men)	After 2 years, 13 vs 2 men had an IIEF score of 22 or higher (P=0.015)
Giugliano 2010, J Sex Med	Questionnaire study of 555 men with type 2 diabetes	Highest vs low adherence to a Mediterranean diet	ED in 51.9% vs 62%; severe ED in 16.5% vs 26.4%

IIEF is the International Index of Erectile Function questionnaire; the 2004 trial enrolled men scoring 21 or less (Esposito 2004). Two points matter when reading these results:

• The 2004 trial tested weight loss and exercise together, so it does not isolate diet. Its authors concluded that lifestyle changes “are associated with improvement in sexual function in about one third of obese men” with ED at baseline (Esposito 2004).
• The diabetes study measured diet and ED at one point in time. Men with the highest adherence also had lower body weight and more physical activity, so the authors reported an association: “greater adherence to Mediterranean diet is associated with a lower prevalence of ED” (Giugliano 2010).

What do NIDDK and the AUA say about diet and ED?

NIDDK says “Research shows that a healthy diet can lower the risk of developing erectile dysfunction (ED) and improve ED symptoms,” and that “Studies have shown that certain diets, such as the Mediterranean diet, help decrease the chance of getting ED” (NIDDK). Those are NIDDK’s words, based on the studies it cites. NIDDK also says a health care professional may suggest working with a registered dietitian (NIDDK).

The American Urological Association (AUA) guideline, Statement 7, says: “Clinicians should counsel men with ED who have comorbidities known to negatively affect erectile function that lifestyle modifications, including changes in diet and increased physical activity, improve overall health and may improve erectile function” (AUA guideline). The AUA rates this a Moderate Recommendation with Grade C evidence, and its discussion says lifestyle interventions “may have small positive effects on erectile function” (AUA guideline).

What are the limits of this research?

• Self-reported diets. The HPFS analyses used food frequency questionnaires (Bauer 2020; Cassidy 2016).
• Observational designs. The cohort and diabetes studies report associations (Bauer 2020; Giugliano 2010). The Cassidy authors call for intervention trials (Cassidy 2016).
• Specific groups. HPFS enrolled US male health professionals aged 40 to 75 (Bauer 2020). The trials enrolled obese men or men with metabolic syndrome in Italy (Esposito 2004; Esposito 2006).
• Few studies. The 2010 review said only a few studies had looked at diet and ED (Esposito 2010).

Diet, testosterone and other ED factors

NIDDK’s list of possible contributors to ED goes beyond diet. It lists lifestyle behaviors that “may contribute to ED,” including not getting enough physical activity, drinking too much alcohol, smoking and using recreational and illicit drugs, and separately lists mental health or emotional issues such as anxiety, depression or stress (NIDDK). For the research on those, see what studies report about psychological ED. If you came here from testosterone research, our page on foods studied for testosterone covers a different question, and what exercise does to testosterone covers activity.

Can food interact with ED medicines?

This is a separate question from causes of ED. MedlinePlus says to talk to your doctor about eating grapefruit and drinking grapefruit juice while taking sildenafil or tadalafil (MedlinePlus: sildenafil; MedlinePlus: tadalafil). For general background on ED medicines, see our ED safety information.

When to talk to a doctor

The AUA guideline says the presence of ED “indicates the likely presence of other conditions, particularly cardiovascular risk factors” (AUA guideline). NIDDK lists diabetes, obesity and overweight, and heart and blood vessel diseases such as atherosclerosis, high blood pressure and stroke among the most common conditions that can lead to ED (NIDDK).

Talk to a licensed provider

A licensed provider can review your health history, other conditions and medicines, and decide whether any treatment is appropriate. Read about online ED treatment.

Sources

1. Bauer SR, Breyer BN, Stampfer MJ, et al. Association of Diet With Erectile Dysfunction Among Men in the Health Professionals Follow-up Study. JAMA Netw Open. 2020;3(11):e2021701. PubMed. pubmed.ncbi.nlm.nih.gov. Accessed Oct 2026.
2. Cassidy A, Franz M, Rimm EB. Dietary flavonoid intake and incidence of erectile dysfunction. Am J Clin Nutr. 2016;103(2):534-41. PubMed. pubmed.ncbi.nlm.nih.gov. Accessed Oct 2026.
3. Esposito K, Giugliano F, Di Palo C, et al. Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial. JAMA. 2004;291(24):2978-84. PubMed. pubmed.ncbi.nlm.nih.gov. Accessed Oct 2026.
4. Esposito K, Ciotola M, Giugliano F, et al. Mediterranean diet improves erectile function in subjects with the metabolic syndrome. Int J Impot Res. 2006;18(4):405-10. PubMed. pubmed.ncbi.nlm.nih.gov. Accessed Oct 2026.
5. Giugliano F, Maiorino MI, Bellastella G, et al. Adherence to Mediterranean diet and erectile dysfunction in men with type 2 diabetes. J Sex Med. 2010;7(5):1911-7. PubMed. pubmed.ncbi.nlm.nih.gov. Accessed Oct 2026.
6. Esposito K, Giugliano F, Maiorino MI, Giugliano D. Dietary factors, Mediterranean diet and erectile dysfunction. J Sex Med. 2010;7(7):2338-45. PubMed. pubmed.ncbi.nlm.nih.gov. Accessed Oct 2026.
7. Eating, Diet, & Nutrition for Erectile Dysfunction, last reviewed October 2024. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). niddk.nih.gov. Accessed Oct 2026.
8. Symptoms & Causes of Erectile Dysfunction, last reviewed October 2024. NIDDK. niddk.nih.gov. Accessed Oct 2026.
9. Burnett AL et al. Erectile Dysfunction: AUA Guideline (2018). American Urological Association. auanet.org. Accessed Oct 2026.
10. Sildenafil and Tadalafil. MedlinePlus, NIH National Library of Medicine. medlineplus.gov (sildenafil); medlineplus.gov (tadalafil). Accessed Oct 2026.

This article is for general information. It is not medical advice and it is not a recommendation for any particular treatment. Whether a treatment is appropriate for you is a decision for a licensed clinician who has reviewed your health history and current medications.