Cross-Sectional Association of Time Spent Outdoors with Serum Testosterone: Results from NHANES

No AccessJournal of UrologyOriginal Clinical Article19 Sep 2025Cross-Sectional Association of Time Spent Outdoors with Serum Testosterone: Results from NHANES Hriday P. Bhambhvani, MD Manish Kuchakulla, MD Phillip Poppas, BS Daniel R. Greenberg, MD James A. Kashanian, andMD Michael L. EisenbergMD Hriday P. BhambhvaniHriday P. Bhambhvani Corresponding Author Hriday Bhambhvani, MD (email protected) 525 E 68th St, Starr 900 New York, NY 10065 Phone: (212) 746-5455 Fax: (212) 305-0116 https://orcid.org/0000-0003-2127-2382 , Manish KuchakullaManish Kuchakulla Department of Urology, NewYork-Presbyterian Hospital, New York, NY Department of Urology, Weill Cornell Medical Center, New York, NY , Phillip PoppasPhillip Poppas Department of Urology, NewYork-Presbyterian Hospital, New York, NY Department of Urology, Weill Cornell Medical Center, New York, NY , Daniel R. GreenbergDaniel R. Greenberg Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois , James A. KashanianJames A. Kashanian Department of Urology, NewYork-Presbyterian Hospital, New York, NY Department of Urology, Weill Cornell Medical Center, New York, NY , and Michael L. EisenbergMichael L. Eisenberg Department of Urology, Stanford University School of Medicine, Stanford, California, USA View All Author Informationhttps://doi.org/10.1097/JU.0000000000004789AboutPDF Cite Export CitationSelect Citation formatNLMAMAIEEEACMAPAChicagoMLAHarvardTips on citation downloadDownload citationCopy citation ToolsAdd to favoritesTrack Citations ShareFacebookLinked InTwitterEmail Abstract Purpose: Testosterone levels are influenced by behavioral and environmental factors. As modern lifestyles have become increasingly sedentary with less time spent outdoors, understanding how daily outdoor exposure relates to serum testosterone may offer insight into the hormonal effects of contemporary behavior patterns. We evaluated the correlation between daily time spent outdoors (TSO) and serum testosterone. Methods: We identified adult men from the National Health and Nutrition Examination Survey (NHANES) database from 2011-2014. TSO was measured in average minutes per day (MPD). Low testosterone was defined as serum morning total testosterone < 300 ng/dL. Survey-weighted multivariable logistic and linear regression models were used to identify factors correlated with low testosterone and serum testosterone, respectively, while correcting for age, education, household income, BMI, physical activity (both self-reported and accelerometer-determined), diabetes, vitamin D concentration, and dietary habits. Results: 2,205 men were included. Mean age, testosterone, and MPD TSO were 45.8 years, 448.34 ng/dL, and 144.3 minutes, respectively. 19.3% of men had low testosterone. TSO was significantly associated with both serum testosterone (β=9.25 per 1 hour outside daily, p=0.007) and decreased odds of low testosterone (OR=0.86 per 1 hour outside daily, 95% CI 0.76-0.97, p=0.01) in multivariate analysis. Increasing age, BMI, and diabetes were positively correlated with low testosterone, while increasing physical activity was inversely correlated with low testosterone (p≤0.01 for all). Conclusions: This is the first report to describe a correlation between increased outdoor time and lower prevalence of low testosterone, independent of age, education, household income, BMI, physical activity, diabetes, vitamin D concentration, and dietary habits. © 2025 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Supplementary Materials Advertisement Copyright & Permissions© 2025 by American Urological Association Education and Research, Inc.Keywordssunsunlightsex hormone Author Information Hriday P. Bhambhvani Corresponding Author Hriday Bhambhvani, MD (email protected) 525 E 68th St, Starr 900 New York, NY 10065 Phone: (212) 746-5455 Fax: (212) 305-0116 More articles by this author Manish Kuchakulla Department of Urology, NewYork-Presbyterian Hospital, New York, NY Department of Urology, Weill Cornell Medical Center, New York, NY More articles by this author Phillip Poppas Department of Urology, NewYork-Presbyterian Hospital, New York, NY Department of Urology, Weill Cornell Medical Center, New York, NY More articles by this author Daniel R. Greenberg Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois More articles by this author James A. Kashanian Department of Urology, NewYork-Presbyterian Hospital, New York, NY Department of Urology, Weill Cornell Medical Center, New York, NY More articles by this author Michael L. Eisenberg Department of Urology, Stanford University School of Medicine, Stanford, California, USA More articles by this author Expand All Advertisement PDF downloadLoading ...