Madonna's preferences might be surprising, but they are clear: "Shoes are better than sex because they last longer."
But, according to the latest research, surprisingly large numbers of men and women see no reason to separate the two.
Results from the largest global study of sexual kinks ever undertaken show that feet and shoes are by far the biggest turn-ons.
Researchers from the University of Bologna found that, among sexual preferences for body parts, feet and toes were the most popular, with 47 per cent of those sampled preferring them. They also found that, when it came to objects associated with the body, shoes, boots and other footwear scored 64 per cent.
"Feet and objects associated with feet were the most common target of preferences," say researchers.
The survey, based on the views of men and women, also revealed some of the more obscure objects of affection. These included 150 people with a penchant for hearing aids, and two whose hearts go into overdrive thinking about pacemakers.
Some 12 per cent were turned on by underwear, 9 per cent by coats, body fluids and body size, 7 per cent by hair, 5 per cent by muscles, and 4 per cent by genitals and body modifications such as tattooing.
Three per cent cent went for navels, ethnicity and breasts, and 2 per cent for legs, buttocks, mouths, lips and teeth.
The lowest scores went to stethoscopes, wristwatches, bracelets, nappies and catheters. Body hair, nails, noses, ears, neck and body odour all scored less than 1 per cent.
The researchers, whose work will appear in The International Journal of Impotence Research, say little is known about fetishes, and that most existing information has been based on clinical cases with psychiatric patients, sex offenders and people in therapy. The aim of their study, they say, was to survey sexual preferences in a more general population.
"In everyday usage, fetish refers to sexually arousing stimuli that would not meet psychiatric criteria for a diagnosis of fetishism. In many cases, they may simply enhance sexual interest or satisfaction rather than being necessary for it," say the researchers.
The scientists monitored activity in discussion groups on the internet that have up to 150,000 members dedicated to fetishes, although the number of people surveyed was probably no more than 5,000.
How and why people develop sexual kinks is not known, and the researchers said that despite many theories having been put forward none is convincing.
Early life events may or may not be involved, and they noted that Freud ascribed an interest in feet "to the notion that feet are a penis symbol".
Other researchers have suggested that the feet and the genitals occupy the same region of the brain and that there might therefore be some overlap.
Whatever the reason, few doubt the sexual power of a well-turned heel in a shapely shoe. Designer Christian Louboutin expressed it in simple terms: "A good shoe is one that doesn't dress you but undresses you. So if a woman is naked, and wearing shoes, she should still look nude."
Shoes, boots and other footwear, and also some items that are worn up the leg
Costumes and coats - this includes other whole-body wear
Jackets and waistcoats, including other garments worn on the trunk
Hats and necklaces, plus other things worn on the head and neck
Wristwatches, bracelets, and other ornaments