Purpose: The Mediterranean diet (Med-Diet) assists cardiovascular disease prevention. Erectile dysfunction (ED) reflects functional damage of the small peripheral vessels. Our aim is to investigate whether left ventricular (LV) performance and peripheral vascular parameters associate with adherence to the Med-Diet in men with erectile disorder.

Methods: 150 ED patients (54±12 years) underwent cardiac ultrasound examination. E/ E′ ratio and LV mass index (LVMI) were obtained to asses diastolic performance and myocardial strain respectively. Carotid-femoral pulse wave velocity (PWV) was used to evaluate central arterial stiffness and augmentation index (AIx) as a measure of wave reflections. Dietary habits were evaluated through a special diet score (Med-Diet score, range 0–55). Higher values indicate greater adherence to this pattern. ED severity was assessed by an international questionnaire, the SHIM-5 score.

Results: Population was divided into tertiles according to Med-Diet score (high >30, intermediate: 25–30 and low ≤ 25) with no significant differences in main risk factors between them. Low Med-Diet score patients had significantly higher LVMI and E/E′ compared to intermediate and high score population. Regarding vascular performance, both PWV and AIx were inversely correlated to the Med-Diet score subgroups as well as ED severity (r=−0.245, P=0.005). Associations remained significant in multivariate analysis after adjustment for age, blood pressure and lipid profile.

Conclusion: Low adherence to the Mediterranean type of diet charges unfavourably cardiac structure and diastolic performance as well as peripheral and central vascular physiology. Our data may clinically assist ED patients in preventing further cardiovascular damage by adopting healthier dietary habits.