健康饮食与降低听力损失的风险有关 Hear this: Healthful diet tied to lower risk of hearing loss

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Hear this: Healthful diet tied to lower risk of hearing loss

Adherence to diets such as dietary approaches to stop hypertension (DASH) and alternate mediterranean (AMED) diet associated with lower risk of hearing loss

BRIGHAM AND WOMEN’S HOSPITAL

Boston, MA — Investigators from Brigham and Women’s Hospital have found that eating a healthy diet may reduce the risk of acquired hearing loss. Using longitudinal data collected in the Nurses’ Health Study II Conservation of Hearing Study (CHEARS), researchers examined three-year changes in hearing sensitivities and found that women whose eating patterns more closely adhered to commonly recommended healthful dietary patterns, such as the Dietary Approaches to Stop Hypertension (DASH) diet, the Alternate Mediterranean (AMED) diet, and the Alternate Healthy Index-2010 (AHEI-2010), had substantially lower risk of decline in hearing sensitivity. The team’s findings are published in the American Journal of Epidemiology

“A common perception is that hearing loss is an inevitable part of the aging process. However, our research focuses on identifying potentially modifiable risk factors — that is, things that we can change in our diet and lifestyle to prevent hearing loss or delay its progression,” said lead author Sharon Curhan, MD, a physician and epidemiologist in the Brigham’s Channing Division of Network Medicine. “The benefits of adherence to healthful dietary patterns have been associated with numerous positive health outcomes and eating a healthy diet may also help reduce the risk of hearing loss.”

Previous studies have suggested that higher intake of specific nutrients and certain foods, such as the carotenoids beta-carotene and beta-cryptoxanthin (found in squash, carrots, oranges and other fruits and vegetables), folate (found in legumes, leafy greens, and other foods), long-chain omega-3 fatty acids (found in seafood and fish), were associated with lower risk of self-reported hearing loss. These findings revealed that dietary intake could influence the risk of developing hearing loss, but investigators sought to further understand the connection between diet and hearing loss by capturing overall dietary patterns and objectively measuring longitudinal changes in hearing sensitivities.

To do so, the researchers established 19 geographically diverse testing sites across the U.S. and trained teams of licensed audiologists to follow standardized CHEARS methods. The audiologists measured changes in pure-tone hearing thresholds, the lowest volume that a pitch can be detected by the participant in a given ear, over the course of 3 years. An audiologist presented tones of different frequencies (0.5, 1 and 2 kHz as low-frequencies; at 3 kHz and 4 kHz as mid-frequencies; and at 6 kHz and 8 kHz as higher frequencies) at variable “loudness” levels and participants were asked to indicate when they could just barely hear the tone.

Using over 20 years of dietary intake information that was collected every four years beginning in 1991, the researchers investigated how closely participants’ long-term diets resembled some well-established and currently recommended dietary patterns, such as the DASH diet, the Mediterranean diet, and Alternate Healthy Index-2010 (AHEI-2010). Greater adherence to these dietary patterns has been associated with a number of important health outcomes, including lower risk of heart disease, hypertension, diabetes, stroke and death as well as healthy aging.

The team found that the odds of a decline in mid-frequency hearing sensitivities were almost 30 percent lower among those whose diets most closely resembled these healthful dietary patterns, compared with women whose diets least resembled the healthful dietary patterns. In the higher frequencies, the odds were up to 25 percent lower.

“The association between diet and hearing sensitivity decline encompassed frequencies that are critical for speech understanding,” said Curhan. “We were surprised that so many women demonstrated hearing decline over such a relatively short period of time. The mean age of the women in our study was 59 years; most of our participants were in their 50s and early 60s. This is a younger age than when many people think about having their hearing checked. After only three years, 19 percent had hearing loss in the low frequencies, 38 percent had hearing loss in the mid-frequencies, and almost half had hearing loss in the higher frequencies. Despite this considerable worsening in their hearing sensitivities, hearing loss among many of these participants would not typically be detected or addressed.”

The study included female health care professionals, which enhanced the validity of the health information collected and reduced the variability in educational achievement and socioeconomic status, but the study population was limited to predominantly middle-aged, non-Hispanic white women. The authors note that further research in additional populations is warranted. The team hopes to continue to longitudinally follow the participants in this study with repeated hearing tests over time and is investigating ways to collect research-quality information on tens of thousands of participants for future studies across diverse populations.

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This work was supported by the National Institutes of Health (DC 010811 and UM1 CA 176726). Curhan serves as a consultant to Decibel Therapeutics. A co-author serves as a consultant to Decibel Therapeutics, AstraZeneca, Shire, Allena Pharmaceuticals, RenalGuard, Orfan Biotech, OM1, and Merck and receives royalties from UpToDate for being an author and Section Editor.

Brigham Health, a global leader in creating a healthier world, consists of Brigham and Women’s Hospital, Brigham and Women’s Faulkner Hospital, the Brigham and Women’s Physicians Organization and many related facilities and programs. With more than 1,000 inpatient beds, approximately 60,000 inpatient stays and 1.7 million outpatient encounters annually, Brigham Health’s 1,200 physicians provide expert care in virtually every medical and surgical specialty to patients locally, regionally and around the world. An international leader in basic, clinical and translational research, Brigham Health has nearly 5,000 scientists, including physician-investigators, renowned biomedical researchers and faculty supported by over $700 million in funding. The Brigham’s medical preeminence dates back to 1832, and now, with 19,000 employees, that rich history is the foundation for its commitment to research, innovation, and community. Boston-based Brigham and Women’s Hospital is a teaching affiliate of Harvard Medical School and dedicated to educating and training the next generation of health care professionals. For more information, resources, and to follow us on social media, please visit brighamandwomens.org.

健康饮食与降低听力损失的风险有关

坚持饮食,例如饮食方法可以降低高血压(DASH)和替代地中海(AMED)饮食,从而降低听力损失的风险

布里格姆妇女医院

马萨诸塞州波士顿市-布里格姆妇女医院的研究人员发现,饮食健康可以降低获得性听力损失的风险。研究人员使用在《护士健康研究II听力保护》(CHEARS)中收集的纵向数据,研究了听力敏感度的三年变化,发现饮食方式更符合通常推荐的健康饮食方式(例如饮食方式)的女性停止高血压(DASH)饮食,替代地中海(AMED)饮食和替代健康指数(2010)(AHEI-2010)降低了听力敏感性下降的风险。研究小组的发现发表在《美国流行病学杂志》上。

“人们普遍认为听力损失是衰老过程中不可避免的一部分。但是,我们的研究重点是确定潜在的可改变的风险因素,即我们可以通过饮食和生活方式改变的东西来预防或减少听力损失疾病进展”,首席作者Sharon Curhan博士说,他是布里格姆Channing网络医学部的医师和流行病学家。坚持健康饮食习惯的好处与许多积极的健康结果有关,饮食健康饮食也可能有助于降低听力损失的风险。”

先前的研究表明,特定营养素和某些食物的摄入量较高,例如类胡萝卜素β-胡萝卜素和β-隐黄质(在南瓜,胡萝卜,橙子和其他水果和蔬菜中发现),叶酸(在豆类,绿叶蔬菜中发现)和其他食物),长链omega-3脂肪酸(在海鲜和鱼类中发现)与自我报告的听力损失风险较低有关。这些发现表明,饮食摄入可能会影响发生听力下降的风险,但研究人员试图通过捕获总体饮食模式并客观测量听力敏感性的纵向变化来进一步了解饮食与听力下降之间的联系。

为此,研究人员在美国各地建立了19个地理位置不同的测试站点,并培训了有执照的听力学家团队,以遵循标准化的CHEARS方法。听力学家测量了纯音听力阈值的变化,这是参与者在3年的时间内可以检测到的最低音量。一名听力师以可变的“响度”电平呈现了不同频率的音调(低频率为0.5、1和2 kHz;中频为3 kHz和4 kHz;高频率为6 kHz和8 kHz),并且参与者要求指出何时他们几乎听不到声音。

研究人员使用从1991年开始每四年收集的20多年的饮食摄入信息,调查了参与者的长期饮食与某些公认的且目前推荐的饮食模式(例如DASH饮食,地中海饮食,以及《 2010年替代健康指数》(AHEI-2010)。坚持这些饮食方式与许多重要的健康结果有关,包括降低患心脏病,高血压,糖尿病,中风和死亡以及健康衰老的风险

研究小组发现,与那些饮食最不像健康饮食方式的女性相比,那些饮食最接近这些健康饮食方式的人中频听力敏感性下降的几率要低近30%。在较高的频率下,机率降低了25%。

Curhan说:“饮食与听力敏感性下降之间的关联包括对理解语音至关重要的频率。” “令我们惊讶的是,这么多女性在相对较短的时间内表现出听力下降。我们研究中女性的平均年龄为59岁;我们的大多数参与者都在50多岁和60多岁。这是一个年轻的年龄三年后,只有19%的人出现低频听力下降,38%的人出现中频听力下降,几乎一半的人出现高频听力下降。他们的听力敏感性大大恶化,许多参与者的听力损失通常不会被发现或解决。”

该研究包括女性卫生保健专业人员,这提高了所收集健康信息的有效性,并减少了教育成就和社会经济地位的差异,但研究人群仅限于中年,非西班牙裔白人妇女。作者指出,有必要在其他人群中进行进一步的研究。该小组希望继续通过反复的听力测试来纵向追踪本研究的参与者,并正在研究收集成千上万参与者的研究质量信息的方法,以用于将来在不同人群中进行研究。

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这项工作得到了美国国立卫生研究院(DC 010811和UM1 CA 176726)的支持。 Curhan担任Decibel Therapeutics的顾问。合著者担任Decibel Therapeutics,AstraZeneca,Shire,Allena Pharmaceuticals,RenalGuard,Orfan Biotech,OM1和Merck的顾问,并因作者和专栏作者而获得UpToDate的版税。

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