Relative contributions of modifiable risk factors to erectile dysfunction: Results from the Boston Area Community Health (BACH) Survey
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Objectives The objective of this study was to determine the relative contribution of modifiable risk factors (physical activity, smoking, and alcohol consumption) to inter-subject variation in erectile dysfunction (ED). Methods The Boston Area Community Health (BACH) Survey used a multistage stratified random sample to recruit 2301 men age 30-79 years from the city of Boston between 2002 and 2005. ED was assessed using the 5-item International Index of Erectile Function (IIEF-5). Multiple linear regression models and R(2) were used to determine the proportion of the variance explained by modifiable risk factors. Results In unadjusted analyses, lifestyle factors accounted for 12.2% of the inter-subject variability in IIEF-5 scores, comparable to the proportion explained by comorbid conditions (14.7%) and socioeconomic status (9%). Lifestyle factors were also significantly associated with age, comorbid conditions and socioeconomic status (SES). A multivariate model including all covariates associated with ED explained 29% of the variance, with lifestyle factors accounting for 0.9% over and above all other covariates in the model. Analyses repeated in a subgroup of 1215 men without comorbid conditions show lifestyle factors accounting for 2.5% of the variance after accounting for all other variables in the model. Conclusions Results of the present study demonstrate the contribution of modifiable lifestyle factors to the prevalence of ED. These results suggest a role for behavior modification in the prevention of ED.
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In the BACH Survey of 2031 males aged 30-79, lifestyle contributed to 12.2% of clinically validated ED, but when all covariates were considered, lifestyle alone explained only 0.9%.
“For instance in the Boston Area Community Health (BACH) Survey of 2031 males aged 30–79 lifestyle contributed to 12.2% of the total subject with clinically validated ED (295). However, when all covariates were considered, lifestyle alone could only explain 0.9% of the ED.”
From Lack of Exercise Is a Major Cause of Chronic Diseases (2012) · cites this paper as [295]
Several large cross-sectional studies suggest that physical inactivity is a cause of erectile dysfunction.
“Several large cross sectional studies exist to suggest that physical inactivity is a cause of ED.”
From Lack of Exercise Is a Major Cause of Chronic Diseases (2012) · cites this paper as [295]
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Rizzoli, G., Schmid, F. A., Keßler, F., Kalbas, Y., Klingebiel, F. K.-L., Berk, T., Pfeifer, R., Eberli, D., Pape, H., & Halvachizadeh, S. (2025) · European Journal of Trauma and Emergency Surgery · doi:10.1007/s00068-024-02761-y · Cited by 1 · see citing works
Substance Use Disorders in Men Presenting to a Psychosexual Clinic
Rajkumar, R. P. (2014) · ISRN Addiction · doi:10.1155/2014/486383 · Cited by 1 · see citing works
Ünal, A., Şahin, A., Altan, M., Demir, İ. B., Üre, İ., Mazlum, H. A., Cirigliano, L., Preto, M., Falcone, M., & Gül, M. (2025) · International Journal of Impotence Research · doi:10.1038/s41443-025-01135-1 · Cited by 1 · see citing works
Kupelian, V. A., de Araújo, A. B., Chiu, G. R., Rosen, R. C., & McKinlay, J. B. (2011) · Preventive Medicine · doi:10.1016/j.ypmed.2011.03.012
Self-citationHuri, Z., Choo, L., Razack, A., & Azad, H. (2014)
Hark, L. A. (2015) · Journal of Clinical Research and Ophthalmology · doi:10.17352/2455-1414.000025
Introduction to erectile dysfunction
Calderon, L. P., Berg, R. W. V., Stoddard, M. D., Cho, A., & Chughtai, B. I. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-819765-3.00016-9
Erectile dysfunction in men with diabetes (literature review) Part 1
Luchytskyy, E. V., & Luchytskiy, V. (2021) · INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine) · doi:10.22141/2224-0721.17.5.2021.241523
Erectile Dysfunction - Prevention and Treatment with a Plant-Based Diet
Strombom, A. J. (2021) · JOJ Urology & Nephrology · doi:10.19080/jojun.2021.07.555715
Chen, Z., Pang, Z., Wang, K., & Qin, M. (2025) · Medicine · doi:10.1097/md.0000000000044552
- Authors
- Kupelian, V., Araujo, A. B., Chiu, G. R., Rosen, R. C., & McKinlay, J. B.
- Affiliations
- New England Research Institutes (US)
- Venue
- Preventive Medicine
- Publisher
- Elsevier BV
- Published
- 2010-01
- Volume
- 50
- Issue
- 1-2
- Pages
- 19-25
- ISSN
- 0091-7435 (ISSN-L)
- PMC
- PMC2813912
- OpenAlex
- W2047712315
- Cited by
- 62
- References
- 40
- Citations by year
- 2025: 3 · 2024: 3 · 2023: 3 · 2022: 1 · 2021: 6 · 2020: 1 · 2019: 3 · 2018: 4 · 2017: 2 · 2016: 10 · 2015: 4 · 2014: 5 · 2013: 3 · 2012: 6
- FWCI
- 2.89
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Preventive Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Health Sciences › Medicine › Urology › Urological Disorders and Treatments
- Health Sciences › Health Professions › General Health Professions › Male Reproductive Health Studies
- Keywords
- erectile dysfunction, modifiable risk factors, lifestyle factors, physical activity, smoking, alcohol consumption, interindividual variability, comorbidities, socioeconomic status, behavior modification, men's health
- MeSH terms
- Adult, Aged, Boston, Health Surveys, Humans, Erectile Dysfunction, Interviews as Topic, Male, Middle Aged, Risk Factors, Linear Models, Risk Reduction Behavior
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