Consuming pro-inflammatory foods may increase the risk of testosterone deficiency in men, a new study finds.

During the National Health and Nutrition Examination Surveys 2013 to 2016, a total of 4151 men completed a 24-hour dietary history including 27 foods. Overall, 25.7% of the men had testosterone deficiency, defined as total testosterone levels less than 300 ng/dL. Their calculated scores from the Dietary Inflammatory Index (DII) ranged from −5.05 (most anti-inflammatory) to +5.48 (most pro-inflammatory).

The mean total testosterone level was significantly lower in men with the most pro-inflammatory diet (highest tertile of DII) compared with men with the most anti-inflammatory diet (lowest tertile of DII): 410.42 vs 422.71 ng/dL, Shi Qiu, MD, and colleagues from West China Hospital, Sichuan University in China, reported in The Journal of Urology. The odds of testosterone deficiency increased 4.0% for every unit increase in DII. In a fully adjusted model, men in tertiles 2 and 3 had significant 19% and 30% increased odds of testosterone deficiency compared with men in tertile 1.

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Obese men with more pro-inflammatory diets (tertiles 2 and 3) had 15.91 and 26.75 ng/mL lower total testosterone than men with an anti-inflammatory diet (tertile 1). Results showed that obese men in the higher DII tertiles had significant 31% and 59% increased odds of testosterone deficiency, respectively.

“Our results suggest men who eat a pro-inflammatory diet, particularly those who are obese, are more likely to have testosterone deficiency,” Dr Qiu stated in a press release from the journal’s publisher. “Since men with obesity likely already experience chronic inflammation, physicians should be aware of contributing factors, like diet, that could likely worsen this inflammation and contribute to the risk of other health conditions, such as diabetes and heart disease.”

An inflammatory diet is characterized by a higher content of refined carbohydrates, added sugars, saturated fat, and cholesterol, and a lower content of unsaturated fat, fiber, and polyphenols.

In this study, only 27 of 45 foods in the DII could be assessed, which limits interpretation of the data.  In addition, it’s possible that some men in the overall cohort had untreated hypogonadism or prostate cancer.


Zhang C, Bian H, Chen Z, et al. The association between dietary inflammatory index and sex hormones among men in the United States. J Urol. Published online April 21, 2021.doi:10.1097/JU.0000000000001703

Inflammatory diet linked to testosterone deficiency in men [press release]. Wolters Kluwer; April 21, 2021.