| Cardio (moderate + intervals) | Do this | ●●●Strong | RCT / trial | A 3-month program of 150 min/week moderate aerobic activity improved erectile function (IIEF 11.0→16.5 vs negligible in controls) by restoring endothelial integrity. | Physical activity & erectile function (Transl Androl Urol, PMC4837314) (opens in a new tab) |
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| Tobacco / vaping — quit | Do this | ●●●Strong | Established clinical | Smoking is a major modifiable cause of erectile dysfunction and impairs sperm count, motility and DNA integrity, with broad fertility harms in both sexes. | Lifestyle modification & erectile dysfunction (PMC4291878) (opens in a new tab) |
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| Tobacco / vaping — quit | Do this | ●●●Strong | Established clinical | Smoking is a major modifiable cause of erectile dysfunction and impairs sperm count, motility and DNA integrity, with broad fertility harms in both sexes. | US Surgeon General — The Health Consequences of Smoking (opens in a new tab) |
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| Zinc | Eat enough of | ●●●Strong | RCT / meta-analysis | Zinc is critical for sperm production and testosterone; in asthenospermic men, zinc supplementation increased sperm volume, motility and total count. | Impact of food & nutraceuticals on fertility (ScienceDirect 2025) (opens in a new tab) |
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| Added Sugars | Don't overdo | ●●Moderate | Review / narrative | High glycemic load and sugary intake raise insulin/androgens and are associated with ovulatory infertility, PCOS and lower fertility potential. | Female infertility & diet (Frontiers Nutr 2022) (opens in a new tab) |
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| Alcohol — cut back | Do this | ●●Moderate | Cohort / observational | Excessive alcohol contributes to erectile dysfunction, lowers testosterone and impairs sperm and female fertility. | Lifestyle modification & erectile dysfunction (PMC4291878) (opens in a new tab) |
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| Anchor foods | Watch this | ●●Moderate | Review / narrative | Greater Mediterranean-diet adherence is associated with lower ED prevalence and better fertility in both sexes, sperm quality and IVF outcomes, via endothelial and hormonal health. | Dietary factors, Mediterranean diet & ED (ScienceDirect) (opens in a new tab) |
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| BMI | Watch this | ●●Moderate | Cohort / observational | Obesity lowers testosterone and nitric-oxide availability (→ ED) and drives PCOS/anovulation and poor sperm; underweight causes amenorrhea — U-shaped, and losing 5-10% of weight can restore ovulation. | Lifestyle modification & erectile dysfunction review (PMC4291878) (opens in a new tab) |
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| Blood pressure | Watch this | ●●Moderate | Review / narrative | Erectile dysfunction is fundamentally vascular; hypertension/endothelial dysfunction (and some antihypertensives) impair erections, and BP control is part of ED care. | Dietary factors, Mediterranean diet & ED (ScienceDirect) (opens in a new tab) |
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| Cardio / VO2max | Watch this | ●●Moderate | RCT / trial | Higher aerobic fitness supports the endothelial function behind erections and healthy testosterone; very excessive endurance can lower testosterone (J-curve). | Physical activity & erectile function (PMC4837314) (opens in a new tab) |
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| Colours a day | Watch this | ●●Moderate | Review / narrative | Antioxidant-rich fruits and vegetables (vitamin C, lycopene, carotenoids) are associated with higher sperm count/motility by limiting oxidative damage. | Diet & male infertility (PMC7291266) (opens in a new tab) |
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| Daily movement baseline | Do this | ●●Moderate | RCT / trial | Regular activity and less sitting support erectile/endothelial function and fertility; sedentary living worsens both. | Physical activity & erectile function (PMC4837314) (opens in a new tab) |
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| EPA/DHA (omega-3) | Eat enough of | ●●Moderate | Review / narrative | Omega-3s from fish or nuts support sperm-membrane structure and spermatogenesis and relate to better embryo quality in women. | Diet & men’s fertility (Fertil Steril 2018) (opens in a new tab) |
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| Folate (B9) | Eat enough of | ●●Moderate | Cohort / observational | Folate supports ovulation, embryo quality and IVF success and (with zinc/B12 in one-carbon metabolism) spermatogenesis; preconception folate is standard for neural-tube prevention. | Female fertility nutrition review (PMC8634384) (opens in a new tab) |
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| Hot food in plastic — avoid | Do this | ●●Moderate | Cohort / observational | Heating food in plastic leaches endocrine-disrupting BPA and phthalates that lower sperm quality and disrupt the hypothalamic-pituitary-gonadal axis; glass/steel are safer. | Endocrine-disrupting chemicals & male fertility (Frontiers 2023) (opens in a new tab) |
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| Iron | Eat enough of | ●●Moderate | Cohort / observational | Higher iron intake from plants and supplements was part of the "fertility diet" linked to markedly lower ovulatory-disorder infertility. | Diet & ovulatory-disorder infertility (Chavarro, NHS-II) (opens in a new tab) |
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| Movement (breaking up sitting) | Do this | ●●Moderate | Review / narrative | Prolonged sitting raises scrotal temperature and, with inactivity, is linked to reduced sperm quality; breaking up sitting helps. | Diet & male infertility (PMC7291266) (opens in a new tab) |
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| Selenium | Eat enough of | ●●Moderate | Review / narrative | Selenium is built into sperm selenoproteins; adequate status supports sperm motility and guards against oxidative sperm damage. | Diet & male infertility (PMC7291266) (opens in a new tab) |
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| Sleep duration | Watch this | ●●Moderate | Cohort / observational | One week of 5-hour nights cut daytime testosterone ~10-15% in healthy young men; short sleep also reduces fecundability, with fertility U-shaped to sleep duration. | Sleep restriction & testosterone (PMC6917985) (opens in a new tab) |
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| Sleep quality (refreshed) | Watch this | ●●Moderate | Cohort / observational | Fragmented sleep and obstructive sleep apnea are independently associated with lower testosterone, impaired semen quality and erectile dysfunction that improves when OSA is treated. | OSA & male reproductive function (PMC12483905) (opens in a new tab) |
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| Strength (resistance) | Do this | ●●Moderate | Cohort / observational | Resistance training acutely raises testosterone and supports the muscle mass and metabolic health tied to reproductive hormones. | Sleep restriction & testosterone (PMC6917985) (opens in a new tab) |
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| Sugary drinks & snacks — cut back | Do this | ●●Moderate | Review / narrative | High glycemic load and sugary intake raise ovulatory-infertility and PCOS risk (insulin/androgen effects) and are linked to poorer sperm quality. | Female infertility & diet (Frontiers Nutr 2022) (opens in a new tab) |
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| Supplement discipline | Do this | ●●Moderate | Review / narrative | Correcting deficiencies (folate, zinc, vitamin D, omega-3) supports fertility, but antioxidant megadosing can backfire via reductive stress — sensible, food-first dosing matters. | Dietary antioxidants & male infertility – antioxidant paradox (PMC8003818) (opens in a new tab) |
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| Trans fat | Don't overdo | ●●Moderate | Cohort / observational | Increasing trans-fat intake by even 2% of energy significantly raised ovulatory-disorder infertility risk, and trans/saturated fats relate to poorer sperm quality. | Female fertility nutrition review (PMC8634384) (opens in a new tab) |
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| Ultra-processed food — cut back | Do this | ●●Moderate | Review / narrative | Western/ultra-processed diets high in trans/saturated fat, processed meat and refined sugar are linked to reduced sperm quality and hormonal imbalance. | Diet & male infertility (PMC7291266) (opens in a new tab) |
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| Vitamin A (RAE) | Eat enough of | ●●Moderate | Mechanistic | Retinoic acid from vitamin A is essential for spermatogenesis; deficiency halts sperm production and higher serum retinol tracks with normal sperm parameters. | Nutrition & male fertility (Transl Androl Urol 2020) (opens in a new tab) |
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| Vitamin A (RAE) | Don't overdo | ●●Moderate | Established clinical | High-dose vitamin A is teratogenic (>10,000 IU/day risk in pregnancy; isotretinoin is a potent teratogen), and chronic excess also impairs sperm production, morphology and motility. | Vitamin A-mediated birth defects review (PMC10788247) (opens in a new tab) |
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| Vitamin C | Eat enough of | ●●Moderate | Review / narrative | Vitamin C is the principal antioxidant in seminal plasma; adequate intake protects sperm from reactive-oxygen-species damage and recycles vitamin E. | Diet & men’s fertility (Fertil Steril 2018) (opens in a new tab) |
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| Vitamin D | Eat enough of | ●●Moderate | Systematic review | Vitamin D is positively associated with semen quality and androgen status in men and with IVF outcomes and PCOS management in women. | Vitamin D & fertility systematic review (PubMed 22275473) (opens in a new tab) |
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| Vitamin E | Eat enough of | ●●Moderate | Review / narrative | Vitamin E neutralises reactive oxygen species in sperm plasma membranes; with vitamin C it reduces sperm DNA damage. | Diet & men’s fertility (Fertil Steril 2018) (opens in a new tab) |
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| Waist-to-height ratio | Watch this | ●●Moderate | Cohort / observational | Waist-based central-adiposity measures track reduced fertility beyond BMI alone. | Nutritional status & female infertility case-control (PMC11496271) (opens in a new tab) |
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| Waist-to-hip ratio | Watch this | ●●Moderate | Cohort / observational | Central/abdominal adiposity predicts reduced fertility partly independent of BMI, via insulin resistance and hormonal disruption. | Nutritional status & female infertility case-control (PMC11496271) (opens in a new tab) |
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| Body Roundness Index | Watch this | ●Emerging | Cohort / observational | Central-adiposity indices flag the fat distribution linked to hormonal and ovulatory disruption. | Nutritional status & female infertility case-control (PMC11496271) (opens in a new tab) |
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| Calcium | Eat enough of | ●Emerging | Systematic review | Calcium signalling (supported by vitamin D) contributes to sperm motility and capacitation. | Vitamin D & fertility systematic review (PubMed 22275473) (opens in a new tab) |
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| Calm rest space | Do this | ●Emerging | Cohort / observational | Chronic stress raises cortisol, which suppresses GnRH and reproductive-hormone output and dampens libido and sexual function. | Sleep restriction & testosterone (PMC6917985) (opens in a new tab) |
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| Carotenoids (provitamin A) | Eat enough of | ●Emerging | Review / narrative | Dietary beta-carotene has been associated with lower sperm chromosomal aneuploidy and provides antioxidant/provitamin-A support. | Diet & men’s fertility (Fertil Steril 2018) (opens in a new tab) |
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| Cook real food | Do this | ●Emerging | Review / narrative | Home-cooked whole-food meals underpin the Mediterranean/fertility pattern and reduce ultra-processed and packaging-related exposures. | Diet & male infertility (PMC7291266) (opens in a new tab) |
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| Falling & staying asleep | Watch this | ●Emerging | Cohort / observational | Sleep continuity underpins the nocturnal testosterone surge; fragmented sleep blunts it. | Sleep restriction & testosterone (PMC6917985) (opens in a new tab) |
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| Indoor air quality | Do this | ●Emerging | Cohort / observational | Air pollution and airborne pollutants are among the environmental exposures associated with reduced sperm quality and fertility. | Endocrine-disrupting chemicals & male fertility (Frontiers 2023) (opens in a new tab) |
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| Iron | Don't overdo | ●Emerging | Review / narrative | Excess iron generates oxidative stress in seminal plasma that can damage sperm; iron overload is unfavourable to reproductive cells. | Diet & male infertility (PMC7291266) (opens in a new tab) |
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| Loneliness — reduce | Watch this | ●Emerging | Review / narrative | Isolation, depression and low mood are associated with reduced sexual desire and function; connection and mood support sexual health. | Lifestyle modification & erectile dysfunction (PMC4291878) (opens in a new tab) |
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| Morning daylight | Do this | ●Emerging | Systematic review | Daylight supports vitamin D synthesis and circadian regulation of reproductive hormones. | Vitamin D & fertility systematic review (PubMed 22275473) (opens in a new tab) |
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| Protein | Eat enough of | ●Emerging | Cohort / observational | Adequate energy/protein maintains reproductive function; chronic under-fuelling suppresses ovulation (though excess animal protein links to more ovulatory infertility than plant protein). | Female fertility nutrition review (PMC8634384) (opens in a new tab) |
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| Saturated fat | Don't overdo | ●Emerging | Review / narrative | Diets high in saturated fat are associated with reduced sperm concentration and quality. | Diet & male infertility (PMC7291266) (opens in a new tab) |
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| Screens before bed — cut back | Do this | ●Emerging | Review / narrative | Late-night screens disrupt the sleep/circadian rhythm that governs testosterone, and laptops on the lap add scrotal heat that can impair sperm. | Sleep & men’s health (PMC7108988) (opens in a new tab) |
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| Selenium | Don't overdo | ●Emerging | Review / narrative | Selenium is essential for sperm but has a narrow window; excess (selenosis) can reduce sperm quality. | Dietary antioxidants & male infertility – antioxidant paradox (PMC8003818) (opens in a new tab) |
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| Sleep regularity | Watch this | ●Emerging | Review / narrative | Circadian regularity supports the hypothalamic-pituitary-gonadal rhythm; disrupted schedules relate to poorer reproductive-hormone profiles. | Sleep & men’s health (PMC7108988) (opens in a new tab) |
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| Vitamin B12 | Eat enough of | ●Emerging | Review / narrative | Vitamin B12, via one-carbon metabolism with folate, supports spermatogenesis and sperm DNA integrity. | Diet & men’s fertility (Fertil Steril 2018) (opens in a new tab) |
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| Vitamin C | Don't overdo | ●Emerging | Review / narrative | Megadosing antioxidants such as vitamin C can create reductive stress detrimental to sperm function — more is not better. | Dietary antioxidants & male infertility – antioxidant paradox (PMC8003818) (opens in a new tab) |
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| Vitamin E | Don't overdo | ●Emerging | Review / narrative | Excess antioxidant supplementation including vitamin E may disturb the redox balance sperm need, potentially harming function. | Dietary antioxidants & male infertility – antioxidant paradox (PMC8003818) (opens in a new tab) |
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| Warmth & quality of ties | Watch this | ●Emerging | Review / narrative | Relationship quality and psychological wellbeing strongly shape sexual desire and function alongside the physical drivers of ED. | Lifestyle modification & erectile dysfunction (PMC4291878) (opens in a new tab) |
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| Zinc | Don't overdo | ●Emerging | Review / narrative | Excess zinc can induce copper deficiency and, as antioxidant over-supplementation, may impair rather than help sperm function. | Dietary antioxidants & male infertility – antioxidant paradox (PMC8003818) (opens in a new tab) |
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