Discussion
MeTS.The exercise-induced decrease, overactivity of the sympathetic nervous system, psoriasis, MeTS, overweight, diabetic, hypertensive, penile erection, diabetes
DIABETES, OBESE, PATHOGENESIS, PSORIASIS
This is the first lifestyle modification study that reported an improvement in ED, MeTS components, and PASI after a 12-week randomized-controlled program of exercise and diet restriction in men with CPP, ED, and MeTS.The exercise-induced decrease in psoriatic severity may be in part due to a decrease in obesity-associated high mass of adipose tissue. Decreased mass of adipose tissue is associated with a decreased release of inflammatory cytokines involved in the pathogenesis of psoriasis. Decreased production of cytokines not only restricts the causative role in the induction of CPP [The suggested mechanisms that explain the improvement in MeTS components in this CPP study reduction may be reported as follows: reduction in overactivity of the sympathetic nervous system; improvement in elastic and endothelial properties/functions of vessels; enhancement functions of micro- and macrocirculation; increased production of vasodilating substances such as nitric oxide (NO), reduced production of plasma vasoconstrictors/catecholamines [Supporting us, treatment with a low-calorie diet (a reduced food intake reaching 800–1000 kcal/day for 2 months followed by a reduced food intake reaching 1200 kcal/day for 2 months) in overweight/obese patients with CPP showed a trend in favor of clinically important improvements in BMI, WC, SFBG, PASI [The 24-week low-calorie diet produced significant changes in BMI, WC, STG, and SHDL, but SFBG did not show significant changes despite the decrease in its level due to the small number (In obese patients with CPP, despite non-significant improvements in SHDL and STG, PASI improvement could be increased by adding diet restriction protocols, mainly the low-calorie diet, to the course of pharmacological therapies [Regarding ED improvement, adherence to weight-loss programs including diet restriction and/or increased physical activity augments a strong penile erection in ED sufferers, likely via improving mood and self-esteem, increasing serum testosterone levels [Esposito et al. [Esposito et al. [The response of IIEFQ-5 to an 8-week interval exercise in hypertensive men with ED was compatible with our results because IIEFQ-5 significantly increased after the interval exercise program [Except for WC and diastolic BP, comparing the post results of obese men with ED who followed a Mediterranean diet protocol with the post results of obese men with ED who did not follow any calorie restriction diet showed significant improvements in systolic BP, SHDL, STG, blood glucose, and IIEFQ-5 in favor of Mediterranean diet men [The results of the random assignment of overweight and obese diabetic men with ED to a group of an intensive lifestyle-modification program (diet restriction with exercise) or a group of diabetes education/support program were compatible with our results due to the trend of improvement in tested outcomes (weight, glycosylated hemoglobin, BP, IIEFQ-5, and SHDL) was in favor of the group of the intensive lifestyle modification program [Opposite to us, despite augmenting the high efficacy of ED pharmacotherapies in the treatment of ED in MeTS men with ED, adding exercise to ED pharmacotherapies did not augment significant improvements in BP, WC, SHDL, STG, and blood glucose due to including a small number (