Pistachio Diet Improves Erectile Function Parameters and Serum Lipid Profiles in Patients with Erectile Dysfunction

M Aldemir; E Okulu; S Neşelioğlu; O Erel; Ö Kayıgil


Int J Impot Res. 2011;23(1):32-38. 

In This Article

Materials and Methods

Design and Patients

A total of 17 married male patients (mean age 47.9±6.2, range 38–59 years) with ED for at least 12 months were included in the study. All patients were evaluated using medical history and sexual history with IIEF, physical examination and routine blood analysis. IIEF-5 and IIEF-15 questionnaires were applied to all patients.[12,13] All five domains (erectile function, orgasmic function, sexual desire, sexual intercourse satisfaction and overall satisfaction) of IIEF were recorded. ED domain score was calculated by the IIEF short form (IIEF-5). Subjects were accepted as having ED if the ED domain score was <21. Serum fasting blood glucose, total testosterone levels and lipid profiles were measured in the routine blood analysis for the diagnosis of ED. Lipid profiles of the patients included in our study are presented in Table 2.

The study did not include those patients who had a systemic disease such as malignancy, hepatic or renal failure, coronary artery disease, active infection; those who underwent any operation or cardiovascular intervention within the previous 3 months; and those who underwent any medical treatment such as intake of phosphodiesterase type 5 inhibitors, multivitamin drugs, β-blockers, thiazide diuretics and lipid-lowering drugs in the last 3 months. Patients with secondary hyperlipidemia, hypothyroidism, nephrotic syndrome, dysglobulinemias, Cushing's syndrome, vascular impairments, hypertension and angina were excluded.

After the approval of the local ethic committee, patients were informed about the study and gave signed consent.

Previous studies have used 60–100 g of pistachios per day for a period of 3 to 4 weeks.[6,14,15] Therefore, in this study, our patients received 100 g of pistachio nuts per day for a period of 3 weeks. Patients consumed 100 g of pistachio nuts at lunch every day for a period of 3 weeks. This corresponds to 20% (570 kcal) of the daily calorie intake. The subjects were informed to maintain similar daily dietary intake, similar physical activity and other lifestyle habits. No subjects were reported to have side effects during the pistachio-diet period and no patient dropped out during the study.

Before the pistachio diet, body mass index, systemic systolic and diastolic blood pressures, fasting blood glucose level, lipid parameters and blood testosterone levels were measured. Basal serum prolactin levels of our patients were measured in order to detect presence of hyperprolactinemia as a possible etiological factor of ED. IIEF-5 and IIEF-15 scores were determined and PCDU was performed. At the end of 3 weeks, all of these tests were repeated and the results were compared with the results obtained before the diet.

PCDU Measurements

PCDU was performed using a linear probe (B-K Medical, Herlev, Denmark) with 8 MHz frequency to diagnose the arterial or veno-occlusive pathology. PCDU measurements were performed by the same radiologist. Before the test, papaverine HCl (60 mg) was injected into one of the cavernosal bodies. Thereafter, peak systolic velocity (PSV) and end diastolic velocity (EDV) were taken separately from right and left cavernosal arteries. Measurement of PSV at 20 min of intracavernosal injection was reported to be sufficient.[16] Therefore, we measured PSV following 20 min of intracavernosal injection. The resistive index (RI) of each cavernosal artery was calculated individually using the formula: RI=PSV–EDV/PSV.

Serum Lipid Profile Measurements

Heparinized blood samples were obtained from all subjects after an overnight fast before and after the pistachio diet. The levels of triglyceride (TG), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL) and fasting glucose were determined using a colorimetric method (Advia; Siemens, Erlangen, Germany) with an automatic analyzer (Siemens, Germany).

Statistical Analysis

SPSS version 11.5 software (Chicago, IL, USA) was used for data analysis. Continuous variables were expressed as mean±s.d. Kolmogorov–Smirnov test was used for a normal distribution before analysis. Two-tailed t-test for paired samples was used to compare changes in outcome variables in response to pistachio diet. Because similar parameters of the same patients were measured in different time intervals (that is, before and after the pistachio diet), paired-samples t-test was used in our study. The P-values <0.05 were considered significant.


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