Thursday, April 17, 2008

Mr.Harrelson... Aint It A Wonderful World?


Why is there a sudden focus in the media on waist circumferences of 40 inches or greater for men? 36 inches or greater for Asian, Indo-Asian, Pacific-Rim men...

Why is it associated with everything not good for us... Dementia ... Parkinson's Disease... Alzheimer's... Metabolic syndrome... Kidney Disease... Diabetes Mellitus... Heart disease...

And also... erectile dysfunction ? ? It appears that may be the case...

Bacon CG, Mittleman MA, Kawachi I, Giovannucci E, Glasser DB, Rimm EB. A prospective study of risk factors for erectile dysfunction. J Urol. 2006 Jul;176(1):217-21.
Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA.

PURPOSE: We examined the impact of obesity, physical activity, alcohol use and smoking on the development of erectile dysfunction.
MATERIALS AND METHODS: Subjects included 22,086 United States men 40 to 75 years old in the Health Professionals Followup Study cohort who were asked to rate their erectile function for multiple periods on a questionnaire mailed in 2000. Men who reported good or very good erectile function and no major chronic disease before 1986 were included in the analyses.
RESULTS: Of men who were healthy and had good or very good erectile function before 1986, 17.7% reported incident erectile dysfunction during the 14-year followup. Obesity (multivariate relative risk 1.9, 95% CI 1.6-2.2 compared to men of ideal weight in 1986) and smoking (RR 1.5, 95% CI 1.3-1.7) in 1986 were associated with an increased risk of erectile dysfunction, while physical activity (RR 0.7, 95% CI 0.7-0.8 comparing highest to lowest quintile of physical activity) was associated with a decreased risk of erectile dysfunction. For men in whom prostate cancer developed during followup, smoking (RR 1.4, 95% CI 1.0-1.9) was the only lifestyle factor associated with erectile dysfunction.
CONCLUSIONS: Reducing the risk of erectile dysfunction may be a useful and to this point unexploited motivation for men to engage in health promoting behaviors. We found that obesity and smoking were positively associated, and physical activity was inversely associated with the risk of erectile dysfunction developing.

When I first started working as a pharmacist, Viagra had just come out. The NP I was working with asked that I consult one of her patients. She asked me about the drug's indications, side effects and contraindications... and we used scientific terminology... like... plumbing... tent-in-the-pants... morning w**d... Then I went and met with the patient to review how to properly take the medication (yeah... fun). At the time, it was not realized that this class of medications (known as PDE inhibitors) had more serious side effects like rare blindness and (more rare) hearing loss. Oddly, one may also change blue-eyes to brown (unfortunately not the other way around).

Viagra, Levitra, or Cialis typically need to be taken prior to ... uhh... provocation. In other words, they don't just work while standing at the kitchen counter chopping vegetables... particular thoughts need to occur first.

Is it necessary to rely on these medications?

Why not prevent vascular disease early in the 20's and 30's and 40's?

Would you want to wait around for E.D. (erectile dysfunction) and vasculature obstructions to affect the function of reproductive organs? Or brain? Or heart?

Some evidence shows that ED may be equivalent to coronary artery disease and plaque.

Just as we are aware in the TYP program that plaque is modifiable (as Dr. Davis recently presented at the FASEB meeting), several trials have shown that ED is measurably modifiable. I think to myself... what a wonderful world? Solutions for reversible conditions exist in the TYP plan including erectile dysfunction.

Factors that have been shown to improve ED are:
  1. Exercise -- promotes improved circulation, increases the body's inherent antioxidants and reduces systemic inflammation
  2. Smoking cessation
  3. Losing weight
  4. Reducing excessive alcohol
  5. Relaxation
  6. L-Arginine (a special amino acid/protein supplement)
  7. Anything that reverses coronary plaque (ie, the TYP program including all the above)



    • Mallika V, Goswami B, Rajappa M. Atherosclerosis pathophysiology and the role of novel risk factors: a clinicobiochemical perspective. Angiology. 2007 Oct-Nov;58(5):513-22.
    • Francavilla S, Bocchio M, Pelliccione F, Necozione S, Francavilla F. Vascular aetiology of erectile dysfunction.Int J Androl. 2005 Dec;28 Suppl 2:35-9.
    • Jackson G, Rosen RC, Kloner RA, Kostis JB. The second Princeton consensus on sexual dysfunction and cardiac risk: new guidelines for sexual medicine. J Sex Med. 2006 Jan;3(1):28-36; discussion 36.

    • -------------------------------------------
    • Masuda H. Significance of nitric oxide and its modulation mechanisms by endogenous nitric oxide synthase inhibitors and arginase in the micturition disorders and erectile dysfunction.
      Int J Urol. 2008 Feb;15(2):128-34.
    • Bivalacqua TJ, Hellstrom WJ, Kadowitz PJ, Champion HC. Increased expression of arginase II in human diabetic corpus cavernosum: in diabetic-associated erectile dysfunction. Biochem Biophys Res Commun. 2001 May 18;283(4):923-7.
    • Baylis C. Nitric oxide deficiency in chronic kidney disease. Am J Physiol Renal Physiol. 2008 Jan;294(1):F1-9.

    Read the TYP report for more erectile dysfunction and CAD.

    Or DR. Davis's article

    Sarah Brightman:
    What A Wonderful World

    Live in Vegas, Courtesy of

    Gams, lambs, dam... damsel/princess/fairy-goddess! Here she is again, Sarah Brightman. The video is not-extremely-nsfw, but... your w**dy... will be...

    1 comment:

    Anonymous said...

    good article LOL