Low-fat diets and testosterone in men: Systematic review and meta-analysis of intervention studies

J Steroid Biochem Mol Biol. 2021 Jun:210:105878. doi: 10.1016/j.jsbmb.2021.105878. Epub 2021 Mar 16.


Background: Higher endogenous testosterone levels are associated with reduced chronic disease risk and mortality. Since the mid-20th century, there have been significant changes in dietary patterns, and men's testosterone levels have declined in western countries. Cross-sectional studies show inconsistent associations between fat intake and testosterone in men.

Methods: Studies eligible for inclusion were intervention studies, with minimal confounding variables, comparing the effect of low-fat vs high-fat diets on men's sex hormones. 9 databases were searched from their inception to October 2020, yielding 6 eligible studies, with a total of 206 participants. Random effects meta-analyses were performed using Cochrane's Review Manager software. Cochrane's risk of bias tool was used for quality assessment.

Results: There were significant decreases in sex hormones on low-fat vs high-fat diets. Standardised mean differences with 95 % confidence intervals (CI) for outcomes were: total testosterone [-0.38 (95 % CI -0.75 to -0.01) P = 0.04]; free testosterone [-0.37 (95 % CI -0.63 to -0.11) P = 0.005]; urinary testosterone [-0.38 (CI 95 % -0.66 to -0.09) P = 0.009]; and dihydrotestosterone [-0.3 (CI 95 % -0.56 to -0.03) P = 0.03]. There were no significant differences for luteinising hormone or sex hormone binding globulin. Subgroup analysis for total testosterone, European and North American men, showed a stronger effect [-0.52 (95 % CI -0.75 to -0.3) P < 0.001].

Conclusions: Low-fat diets appear to decrease testosterone levels in men, but further randomised controlled trials are needed to confirm this effect. Men with European ancestry may experience a greater decrease in testosterone, in response to a low-fat diet.

Keywords: Androgen; Dietary fat; Low-fat diet; Meta-analysis; Sex hormone; Testosterone.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Diet, Fat-Restricted / adverse effects*
  • Diet, High-Fat
  • Dihydrotestosterone / analysis
  • Humans
  • Male
  • Sex Hormone-Binding Globulin / analysis
  • Testosterone* / blood
  • Testosterone* / urine


  • SHBG protein, human
  • Sex Hormone-Binding Globulin
  • Dihydrotestosterone
  • Testosterone