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Am J Epidemiol. 2019 Oct 14. pii: kwz223. doi: 10.1093/aje/kwz223. [Epub ahead of print]

Prospective Study of Dietary Patterns and Hearing Threshold Decline.

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Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
Harvard Medical School, Boston, Massachusetts.
Massachusetts General Hospital, Boston, Massachusetts.
Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts.
Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts.
Vanderbilt Bill Wilkerson Center for Otolaryngology and Communication Sciences and the Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, Tennessee.
Renal Division, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.


Healthier dietary patterns were associated with lower risk of self-reported hearing loss, but associations with worsening audiometric hearing thresholds have not been prospectively studied. Therefore, we conducted a prospective study among 3135 women (mean age 59 years) in the Nurses' Health Study II (2012-2018). Diet adherence scores for the Dietary Approaches to Stop Hypertension (DASH) and Alternate Mediterranean (AMED) diets and the Alternate Healthy Eating Index (AHEI-2010) were calculated using validated food-frequency questionnaires. Baseline and 3-year follow-up hearing sensitivities were assessed by pure-tone audiometry at 19 sites across the United States. Multivariable-adjusted logistic regression models examined independent associations between diet adherence scores and risk of low-frequency pure-tone average (PTA0.5,1,2 kHz), mid-frequency pure-tone average (PTA3,4 kHz), and high-frequency pure-tone average (PTA6,8 kHz) hearing threshold decline. Higher adherence scores were associated with lower risk of hearing loss. Compared with the lowest quintile of DASH score, the multivariable-adjusted odds ratios (MVORs) for mid-frequency and high-frequency decline in the highest quintile were 0.71 (95% CI:0.55,0.92; P-trend=0.003) and 0.75 (95% CI:0.59,0.96; P-trend=0.02). For AMED or AHEI scores, the MVORs for mid-frequency decline were 0.77 (95% CI:0.60,0.99; P-trend=0.02) and 0.72 (95% CI:0.57,0.92;P-trend=0.002); non-significant inverse associations were observed for high-frequency decline. There were no significant associations between adherence scores and low-frequency decline. Our findings indicate that eating a healthy diet may reduce the risk of acquired hearing loss.


Aging; Audiometry; Dietary Approaches to Stop Hypertension; Healthy Diet; Hearing loss; Mediterranean diet; Women


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