Associations between dietary quality, noise, and hearing: data from the National Health and Nutrition Examination Survey, 1999-2002

Abstract

Objective: A statistically significant relationship between dietary nutrient intake and threshold sensitivity at higher frequencies has been reported, but evidence conflicts across studies. Here, the potential interaction between noise and diet in their association to hearing was examined.

Design: This cross-sectional analysis was based on Healthy Eating Index data and audiological threshold pure-tone averages for low (0.5 to 2 kHz) and high (3 to 8 kHz) frequencies.

Study sample: Data were drawn from the National Health and Nutrition Examination Survey, 1999-2002.

Results: Controlling for age, sex, race/ethnicity, education, diabetes, hypertension, and smoking we found statistically significant relationships between dietary quality and high-frequency threshold sensitivity as well as noise exposure and high-frequency thresholds. In addition, there was a statistically significant interaction between dietary quality and reported noise exposure with respect to high-frequency threshold sensitivity in participants, where greater reported noise exposure and poorer diet were associated with poorer hearing (p's < 0.05).

Conclusions: The current findings support an association between healthier eating and better hearing at higher frequencies; the strength of this relationship varied as a function of participant noise history, with the most robust relationship in those that reported military service or firearm use.

Trial registration: ClinicalTrials.gov NCT00808470 NCT01444846.

Keywords: Demographics/epidemiology; hearing conservation; noise; pharmacology.

Figures

Figure 1

1A) High frequency (HFPTA) and 1B) low frequency (LFPTA) pure-tone-average thresholds and healthy eating index quintiles. There was an overall statistically significant relationship between diet and HFPTA after adjusting for sex, race, age, education, diabetes, and smoking; as well as in pairwise comparison to the lowest quintile. Participants in the top 3 quintiles were statistically different from participants in the bottom quintile. LFPTA was not statistically related to HEI. 1C) HFPTA thresholds with participants dichotomized into healthier diets (top 60% of HEI scores) and poorer diets (bottom 40% of HEI scores). There was a statistically significant relationship between diet and HFPTA after adjusting for sex, race, age, education, diabetes, and smoking. 1D) Puretone thresholds with participants dichotomized into healthier diets (top 60% of HEI scores) and poorer diets (bottom 40% of HEI scores). There was a statistically significant relationship between diet and threshold at 3, 4, and 6 kHz after adjusting for sex, race, age, education, diabetes, and smoking. Data are Mean +/- standard error (SE); asterisks indicate statistically significant differences in HFPTA for pair-wise group comparisons (p’s

Figure 2

2A) High frequency (HFPTA) and low frequency (LFPTA) pure-tone-average thresholds and the number of reported noise sources. There was a statistically significant relationship between number of noise sources and HFPTA after adjusting for sex, race, age, education, diabetes, and smoking; pairwise comparisons to lowest number (0) are shown in 2A. Participants reporting 3 sources of noise were statistically different from participants reporting 0 sources. LFPTA was not statistically related to noise sources. 2B) HFPTA thresholds with participants dichotomized into more noise (2-4 sources) and less noise (0-1 sources). There was a statistically significant relationship between noise and HFPTA after adjusting for sex, race, age, education, diabetes, and smoking. 2C) Pure-tone thresholds with participants dichotomized into less noise and more groups. There was a statistically significant relationship between noise and threshold at 3, 4, 6, and 8 kHz after adjusting for sex, race, age, education, diabetes, and smoking. Data are Mean +/- standard error (SE); asterisks indicate statistically significant differences in HFPTA for pair-wise group comparisons (p’s

Figure 3

3A) There was a statistically significant interaction between number of noise sources (0-1 vs 2-4) and dietary quality (top 60% vs bottom 40%) with HFPTA after adjusting for sex, race, age, education, diabetes, and smoking (p

Figure 4

High frequency pure-tone-average (HFPTA) thresholds is influenced by dietary quality and noise. There was a statistically significant interaction between the reported noise source (4A: firearms; 4B: military service; 4C: occupational noise > 3 months; 4D: non-occupational noise) and dietary quality (top 60% vs bottom 40%) with HFPTA after adjusting for sex, race, age, education, diabetes, smoking and the other sources of noise reported. Outcomes of the pair-wise comparisons are shown in Tables 3 and 4. Data are Mean +/-standard error (SE).