The Association between Dietary Inflammatory Index and Sex Hormones among Men in the United States

J Urol. 2021 Jul;206(1):97-103. doi: 10.1097/JU.0000000000001703. Epub 2021 Apr 21.


Purpose: This study investigated the association between Dietary Inflammatory Index and sex hormones in a large, nationally representative adult male sample.

Materials and methods: We utilized data from the 2013-2014 and 2015-2016 National Health and Nutrition Examination Survey. Males aged ≥20 years who provided a 24-hour dietary intake history and underwent serum sex hormone testing were included in analysis. Weighted proportions and multivariable analysis controlling for age, race, energy, smoking status, education level, body mass index and time of venipuncture were used to evaluate the associations between Dietary Inflammatory Index and sex hormones.

Results: For 4,151 participants, Dietary Inflammatory Index ranged from -5.05 to 5.48. Mean±SD total testosterone was 419.30±176.27 ng/dl. Mean±SD total testosterone was lower among men in the highest tertile compared with men in the lowest tertile group (410.42±171.97 vs 422.71±175.69, p <0.001). A per unit increase in Dietary Inflammatory Index was related to 4.0% (95% CI 0.5-7.6) higher odds of testosterone deficiency. In the fully adjusted multivariable model, males in Dietary Inflammatory Index tertile 3 (the most pro-inflammatory) had 29.6% (3.1-63.0) higher odds of testosterone deficiency than those in tertile 1 (p trend=0.025). Interaction tests revealed no significant effect of body mass index on the association of Dietary Inflammatory Index with testosterone deficiency and all sex hormone parameters.

Conclusions: Men adhering to a more pro-inflammatory diet appear to have a higher risk of testosterone deficiency, indicating the important role of diet in male reproductive health.

Keywords: deficiency diseases; diet; gonadal steroid hormones; inflammation; testosterone.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Diet*
  • Gonadal Steroid Hormones / blood*
  • Humans
  • Inflammation / blood*
  • Male
  • Middle Aged
  • Nutrition Surveys
  • United States


  • Gonadal Steroid Hormones