Benefits of movement-based Behaviors on improving erectile function in American men: a nationwide survey study.

Abstract

Background: Erectile dysfunction (ED) is a prevalent condition with significant psychological and physiological impacts. Recently, a new concept called movement-based behaviors (MBB) has been proposed, which includes four types of PA: vigorous PA (VPA), moderate-intensity PA (MPA), walking/cycling, and muscle-strengthening activities (MSA), and uses an MBB index (range 0-4) to estimate the combined effects of these activities on health outcomes.

Aim: This study aims to evaluate the relationship between different types of physical activities (PA) and ED using the MBB index in a nationally representative sample of U.S. men.

Methods: We analyzed data from the National Health and Nutrition Examination Survey (NHANES) 2001-2004, including 3435 male participants. Multivariate logistic regressions were performed to explore the associations, supplemented with subgroup analysis and sensitivity analysis.

Outcomes: The assessment of PA in this study is based on four self-reported questions from the NHANES Mobile Examination Center interview, including VPA, MPA, walking/cycling, and MSA. The MBB index, ranging from 0 to 4, was used to assess combined PA types. ED was evaluated using a single-question self-assessment.

Results: Higher MBB index values were associated with lower ED risk. Participants with an MBB index of 2 had a significantly lower risk of ED in Model 3 (OR = 0.65, 95% CI: 0.43-0.97, P = 0.04). Those with an MBB index of 3 or 4 had the lowest risk of ED across all models, with OR_Model1 = 0.29 (95% CI: 0.21-0.40, P < 0.0001), OR_Model2 = 0.52 (95% CI: 0.37-0.73, P < 0.001), and OR_Model3 = 0.61 (95% CI: 0.41-0.90, P = 0.02). However, this relationship was not significant in subgroups with severe ED or comorbid conditions.

Clinical implications: Our findings can provide clinicians with guidance to help patients personalize their selection of different exercise combinations.

Strengths and limitations: We explored the impact of different exercise combinations on reducing ED risk and innovatively proposed the MBB index for a comprehensive assessment of exercise benefits, supported by a large sample size and multivariable adjustments. However, the limitations of cross-sectional design and recall bias cannot be overlooked.

Conclusion: The MBB index effectively demonstrates that combined PA can reduce ED risk, supporting tailored exercise recommendations for patients.