The following article features coverage from the American Urological Association (AUA) 2019 meeting. Click here to read more of Renal & Urology News’ conference coverage.

CHICAGO—Men who consume a low-fat or Mediterranean-style diet may experience a reduction in their serum testosterone (T) levels, investigators reported at the 2019 American Urological Association annual meeting.

In a nationally representative sample of 3128 men from the National Health and Nutrition Examination Survey (NHANES) database, 14.6% followed a low-fat diet similar to that recommended by the American Heart Association, with 30% or fewer daily calories from fat, 10% or fewer calories from saturated fat, and less than 300 mg cholesterol. Another 24.4% of men adhered to a Mediterranean-style diet, with 40% of calories from fat, and roughly 60% of men ate what they pleased in a non-restrictive diet. Both the low-fat and Mediterranean diets were limited to 1800 calories per day.

Although mean serum T was 435.5 ng/dL for the cohort overall, a proportion of men were actually hypogonadal, with serum T less than 300 ng/dL, Richard Fantus, MD, of the University of Chicago Medicine, and colleagues reported. Men who limited their dietary intake had lower serum T levels than those who did not. Mean serum T was significantly lower among men on a low-fat diet (410 vs 443 ng/dL) or Mediterranean diet (412 vs 443 ng/dL) than men with an unlimited diet. In multivariable analysis, men with non-restrictive diets had higher serum T compared with those on low-fat (parameter estimate -57.2) or Mediterranean diets (parameter estimate -26.2). The findings held true after controlling for comorbidities, diabetes, prostate cancer, age, body mass index, and physical activity levels. Men adhering to a low-fat diet were more likely to be hypogonadal than nondieters.

“Millions of Americans each year trial new diets hoping to lose weight, gain strength, or increase their energy level. While multiple studies have examined the benefits of low-fat and Mediterranean diets, the effects of these diet regimens on serum testosterone are unknown,” Dr Fantus told Renal & Urology News. “We hypothesized that men who restrict their dietary fat intake may be at increased risk for decreased serum T, a steroid hormone with cholesterol precursors.”

Clinicians can help men presenting with testosterone deficiency by initially adjusting their diet and exercise routines, Dr Fantus said. “Our data demonstrate that while restrictive diets remain useful in the overweight and diabetic population, those recommendations may not be as useful in men who are otherwise healthy. Therefore clinicians should individualize recommendations based on patient characteristics rather than giving the same counseling to all patients.”

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Fantus RJ, Halpern JA, Chang C, et al. The Association between popular diets and serum testosterone among men in the United States. Presented at the 2019 American Urological Association annual meeting held May 3-6 in Chicago. Abstract MP46-03.