 In 2013, I can't believe it's already been so long, I posted a video based on this study that found that three weeks of pistachios resulted in a significant improvement in erectile function in men. So it's nice to see a whole food intervention have clinical effects, and I was curious to revisit the topic to see what's been published since. Even if you ignore all the lab animal studies on, you know, how much hazelnuts improve the function of retesticles, you still never know what you'll find searching the medical literature for nuts and sexual function, like this case of penile strangulation with a metal hex nut. I guess nuts can sometimes make things worse if you can't remove them. They used the Dundee technique, which involves creating 20 puncture holes to relieve the pressure, but that didn't work so well. Diamond disc cutter was used to saw through it, and they slipped a few times, all so well that ends well. Well, that got me curious. Evidently, penile entrapment is so common, there's an entire grating system that emergency room docs can use. If a drill is not available, these surgeons advise a hammer and chisel may be used. A drill? Oh, a dental drill. I like how they brag about the precisely cut edges. Looks pretty jagged to me. To preserve the penis from a fatal outcome, that's a strange way to put it, you all just should be aware of all the available armamentarium. And if you don't know how to operate the saw, you can always call in your local blacksmith. Yeah, but how are you going to remove a barbell or steel sledgehammer head? A heavy-duty air grinder provided by the fire department, requiring six hours of cutting with the patient protected from the sparks with firecoats, whatever it takes, hacksaw, cement eater, or the silk winding method. But anyway, back to the task at hand. Consumption of at least one serving of vegetables a day and more than two serving of nuts a week was associated with more than a 50% decrease in the probability of erectile dysfunction in a snapshot-in-time cross-sectional study, but such observational studies can't prove cause and effect. It's like finding that men who eat more healthfully have better swimmers, maybe men who eat nuts are just health nuts, and the improvement is due to some other factor like exercise. Oh, what we need is an interventional trial, and here we go. The effect of nut consumption on semen quality and functionality, a randomized controlled trial, a standard American diet with or without a handful of walnuts, and a half-handful of each almonds and hazelnuts. And the nut group experienced significant improvements in their total sperm count, vitality, motility, and shape, perhaps because those in the nut group showed a significant reduction in SDF, sperm-DNA fragmentation. The nuts appeared to protect their sperm DNA. Too bad while they're at it, they didn't measure the guy's erectile and sexual dysfunction. Oh, but they did! The effect of nut consumption on erectile and sexual function from the same study, the researchers report that those in the nut group saw a significant increase in orgasmic function and sexual desire, but what about erectile function? Anytime you see this kind of selective glass half-full reporting, you suspect some kind of industry funding, and indeed that was the case here. Yes, there was a marginal increase in orgasmic function and sexual desire of questionable clinical significance, but no improvement in erectile function. Intercourse satisfaction or overall satisfaction. And with so many comparisons, even the so-called significant findings may not even be statistically significant. But why did the pistachios I talked about back in 2013 work, well, these other nuts didn't? Well, if you remember, the original study was done on men in their 40s and 50s, who already had chronic erectile dysfunction, whereas the average age in the new study was 24 years old. So they may have started out with near-maximum circulation, not leaving much room for the nuts.