Physical screening for erectile dysfunction risk should include the assessment of weight circumference and physical activity level in addition to body mass index
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Erectile dysfunction (ED) is a frequent comorbidity in cardiometabolic states such as obesity and the metabolic syndrome, and is considered a surrogate marker of endothelial dysfunction as well as sentinel predictor of new-onset macroangiopathic events. A high waist circumference (WC) and low levels of physical activity may predict ED independently of body mass index (BMI). The study was designed to investigate the independent relationship between BMI, WC, and physical activity with ED in 3941 adult men without prostate cancer history from the 2001-2004 National Health and Nutrition Examination Survey. After controlling for potential confounders, men with either a high WC or an obese BMI had approximately 50% higher odds of having ED as compared to men with a low WC or a normal BMI, respectively. After entering all three predictors into the same logistic regression model, both a high WC and low physical activity level were independently associated with greater odds of ED, but BMI was not. Thus, maintaining a WC level below 102 cm and achieving the recommended amount of moderately intense physical activity (≥150 min/week) appears to be associated with maintenance of proper erectile function, regardless of BMI level. Clinical screening for ED should therefore include assessment of WC and physical activity level in addition to BMI.
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