Abstract
Obesity and low serum testosterone (T) levels are interrelated and strongly influenced by dietary factors, and their alteration entails a great risk of hypogonadism. Substantial evidence suggests a bidirectional relationship between nutrient metabolism (e.g., glucose, lipids, and iron) and T levels in men; however, T-related dietary patterns remain unclear. This study investigated the dietary patterns associated with serum total T levels and its predictive effect on hypogonadism and the body composition. Anthropometry, blood biochemistry, and food frequency questionnaires were collected for 125 adult men. Dietary patterns were derived using a reduced rank regression from 32 food groups. Overall prevalence rates of central obesity and hypogonadism were 48.0% and 15.7%, respectively. An adjusted linear regression showed that age, insulin, red blood cell (RBC) aggregation, and transferrin saturation independently predicted serum total T levels (all p < 0.01). The total T-related dietary pattern (a high consumption of bread and pastries, dairy products, and desserts, eating out, and a low intake of homemade foods, noodles, and dark green vegetables) independently predicted hypogonadism (odds ratio: 5.72; 95% confidence interval: 1.11‒29.51, p < 0.05) for those with the highest dietary pattern scores (Q4) compared to those with the lowest (Q1). Scores were also negatively correlated with the skeletal muscle mass (p for trend = 0.002) but positively correlated with the total body fat mass (p for trend = 0.002), visceral fat mass (p for trend = 0.001), and to a lesser extent, subcutaneous fat mass (p for trend = 0.035) after adjusting for age. Randomized controlled trials are needed to confirm that improvement in dietary pattern can improve T levels and reduce hypogonadism.
Highlights
Testosterone (T) is the most important male sex hormone in men and plays key roles in reproductive and sexual functions [1]
Our study found that the male sex hormone, total T, is closely linked to age and nutrition-related biomarkers
Total T-associated dietary patterns, which were characterized by high-frequency consumption of bread and pastries, dairy products, and desserts, eating out, and low intake frequency of homemade foods, noodles, and dark green vegetables, were significantly associated with an unhealthy body composition, low total T levels, and hypogonadism (OR: 5.72; 95% confidence intervals intervals (CIs): 1.11~29.51, p < 0.05)
Summary
Testosterone (T) is the most important male sex hormone in men and plays key roles in reproductive and sexual functions [1]. T is involved in erythropoiesis, bone and muscle formation, the body composition, and iron metabolism. It was hypothesized that adipose tissue-derived aromatase can convert T to estradiol, which in turn suppresses the release of gonadotropin-releasing hormone (GnRH)-luteinizing hormone (LH) from the hypothalamus [3]. Once it enters the circulation, a large proportion (~66%) of T is tightly bound to sex hormone-binding globulin (SHBG) and approximately 33% of T is bound to albumin with lower binding affinities [4]
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