Skip to main content Accessibility help

Diet quality and hearing loss among middle–older aged adults in the USA: findings from National Health and Nutrition Examination Survey

  • Qiushi Huang (a1) (a2), Yichen Jin (a2), Nicholas S Reed (a3) (a4), Yan Ma (a5), Melinda C Power (a1) and Sameera A Talegawkar (a1) (a2)...



To examine the associations between overall diet quality and hearing function among middle–older aged adults in the USA.


Cross-sectional analysis. Diet quality was examined using the Mediterranean Diet Score (MDS), using data from a single 24 h dietary recall. Hearing function was objectively measured by audiometry assessments and hearing loss, including high- and low-frequency hearing loss, was defined as pure-tone averages at specific ranges of hearing frequencies >25 dB. Weighted logistic regression analyses were performed to examine the associations of MDS (scored 0–9, categorized at the median as ≤3 or >3) with hearing loss and high- and low-frequency hearing loss.


National Health and Nutrition Examination Surveys 2000–2006 and 2009–2012.


Adults aged ≥50 years (n 1639) with valid dietary and audiometry assessments.


After adjusting for potential confounders, a non-significant trend for a protective association of higher MDS was observed for hearing loss (OR = 0·78; 95 % CI 0·49, 1·23). A significant inverse association was observed for high-frequency hearing loss (OR = 0·64; 95 % CI 0·43, 0·95). No association was found for low-frequency hearing loss among women; however, higher MDS was significantly associated with higher odds of low-frequency hearing loss among men (OR = 2·63; 95 % CI 1·39, 4·95).


Among middle–older aged adults, adherence to a Mediterranean-style diet was inversely associated with hearing loss, including those at high hearing frequencies, among older adults. However, a detrimental association was observed at low hearing frequencies among men. Future investigations with a longitudinal design are needed to clarify the associations between diet quality and hearing loss.


Corresponding author

*Corresponding author: Email


Hide All
1. Goman, AM & Lin, FR (2016) Prevalence of hearing loss by severity in the United States. Am J Public Health 106, 18201822.
2. Goman, AM, Reed, NS & Lin, FR (2017) Addressing estimated hearing loss in adults in 2060. JAMA Otolaryngol Head Neck Surg 143, 733734.
3. Lin, FR, Niparko, JK & Ferrucci, L (2011) Hearing loss prevalence in the United States. Arch Intern Med 171, 18511852.
4. Callander, EJ, Schofield, DJ & Shrestha, RN (2013) Chronic health conditions and poverty: a cross-sectional study using a multidimensional poverty measure. BMJ Open 3, e003397.
5. Helvik, AS, Krokstad, S & Tambs, K (2013) Hearing loss and risk of early retirement. The HUNT study. Eur J Public Health 23, 617622.
6. Pierre, PV, Fridberger, A, Wikman, A et al . (2012) Self-reported hearing difficulties, main income sources, and socio-economic status; a cross-sectional population-based study in Sweden. BMC Public Health 12, 874.
7. Lin, FR, Metter, EJ, O’Brien, RJ et al . (2011) Hearing loss and incident dementia. Arch Neurol 68, 214220.
8. Chen, DS, Betz, J, Yaffe, K et al . (2015) Association of hearing impairment with declines in physical functioning and the risk of disability in older adults. J Gerontol A Biol Sci Med Sci 70, 654661.
9. Mick, P, Kawachi, I & Lin, FR (2014) The association between hearing loss and social isolation in older adults. Otolaryngol Head Neck Surg 150, 378384.
10. Gopinath, B, Schneider, J, McMahon, CM et al . (2012) Severity of age-related hearing loss is associated with impaired activities of daily living. Age Ageing 41, 195200.
11. Hoffman, HJ, Dobie, RA, Losonczy, KG et al . (2017) Declining prevalence of hearing loss in US adults aged 20 to 69 years. JAMA Otolaryngol Head Neck Surg 143, 274285.
12. Uchida, Y, Sugiura, S, Sone, M et al . (2014) Progress and prospects in human genetic research into age-related hearing impairment. Biomed Res Int 2014, 390601.
13. Bainbridge, KE, Hoffman, HJ & Cowie, CC (2008) Diabetes and hearing impairment in the United States: audiometric evidence from the National Health and Nutrition Examination Survey, 1999 to 2004. Ann Intern Med 149, 110.
14. Oron, Y, Elgart, K, Marom, T et al . (2014) Cardiovascular risk factors as causes for hearing impairment. Audiol Neurootol 19, 256260.
15. Emmett, SD & West, KP Jr (2015) Nutrition and hearing loss: a neglected cause and global health burden. Am J Clin Nutr 102, 987988.
16. Le Prell, CG, Gagnon, PM, Bennett, DC et al. (2011) Nutrient-enhanced diet reduces noise-induced damage to the inner ear and hearing loss. Transl Res 158, 3853.
17. Choi, YH, Miller, JM, Tucker, KL et al . (2014) Antioxidant vitamins and magnesium and the risk of hearing loss in the US general population. Am J Clin Nutr 99, 148155.
18. Curhan, SG, Eavey, RD, Wang, M et al . (2014) Fish and fatty acid consumption and the risk of hearing loss in women. Am J Clin Nutr 100, 13711377.
19. Durga, J, Verhoef, P, Anteunis, LJ et al . (2007) Effects of folic acid supplementation on hearing in older adults: a randomized, controlled trial. Ann Intern Med 146, 19.
20. Shargorodsky, J, Curhan, SG, Eavey, R et al . (2010) A prospective study of vitamin intake and the risk of hearing loss in men. Otolaryngol Head Neck Surg 142, 231236.
21. Spankovich, C & Le Prell, CG (2013) Healthy diets, healthy hearing: National Health and Nutrition Examination Survey, 1999–2002. Int J Audiol 52, 369376.
22. Curhan, SG, Wang, M, Eavey, RD et al . (2018) Adherence to healthful dietary patterns is associated with lower risk of hearing loss in women. J Nutr 148, 944951.
23. Choi, JS, Betz, J, Deal, J et al . (2016) A comparison of self-report and audiometric measures of hearing and their associations with functional outcomes in older adults. J Aging Health 28, 890910.
24. Hu, FB (2002) Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 13, 39.
25. Martinez-Lacoba, R, Pardo-Garcia, I, Amo-Saus, E et al . (2018) Mediterranean diet and health outcomes: a systematic meta-review. Eur J Public Health 28, 955961.
26. Kiely, KM, Gopinath, B, Mitchell, P et al . (2012) Evaluating a dichotomized measure of self-reported hearing loss against gold standard audiometry: prevalence estimates and age bias in a pooled national data set. J Aging Health 24, 439458.
27. Bainbridge, KE & Wallhagen, MI (2014) Hearing loss in an aging American population: extent, impact, and management. Annu Rev Public Health 35, 139152.
28. Henderson, D, Bielefeld, EC, Harris, KC et al . (2006) The role of oxidative stress in noise-induced hearing loss. Ear Hear 27, 119.
29. Curtin, LR, Mohadjer, LK, Dohrmann, SM et al. (2013) National Health and Nutrition Examination Survey: sample design, 2007–2010. Vital Health Stat 2 issue 160, 123.
30. Trichopoulou, A, Costacou, T, Bamia, C et al. (2003) Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 348, 25992608.
31. National Center for Health Statistics (2011) National Health and Nutrition Examination Survey Audiometry Procedures Manual. (accessed November 2018).
32. World Health Organization (2018) Grades of hearing impairment. (accessed November 2018).
33. Gopinath, B, Schneider, J, Flood, VM et al. (2014) Association between diet quality with concurrent vision and hearing impairment in older adults. J Nutr Health Aging 18, 251256.
34. Croll, PH, Voortman, T, Vernooij, MW et al. (2019) The association between obesity, diet quality and hearing loss in older adults. Aging (Albany NY) 11, 4862.
35. Le Prell, CG, Yamashita, D, Minami, SB et al. (2007) Mechanisms of noise-induced hearing loss indicate multiple methods of prevention. Hear Res 226, 2243.
36. Partearroyo, T, Vallecillo, N, Pajares, MA et al. (2017) Cochlear homocysteine metabolism at the crossroad of nutrition and sensorineural hearing loss. Front Mol Neurosci 10, 107.
37. Joshi, R, Adhikari, S, Patro, BS et al. (2001) Free radical scavenging behavior of folic acid: evidence for possible antioxidant activity. Free Radic Biol Med 30, 13901399.
38. Sies, H, Stahl, W & Sundquist, AR (1992) Antioxidant functions of vitamins. Vitamins E and C, β-carotene, and other carotenoids. Ann N Y Acad Sci 669, 720.
39. Fujita, T, Yamashita, D, Uehara, N et al. (2015) A high-fat diet delays age-related hearing loss progression in C57BL/6J mice. PLoS One 10, e0117547.
40. Gopinath, B, Flood, VM, McMahon, CM et al. (2011) Dietary antioxidant intake is associated with the prevalence but not incidence of age-related hearing loss. J Nutr Health Aging 15, 896900.
41. Curhan, SG, Stankovic, KM, Eavey, RD et al. (2015) Carotenoids, vitamin A, vitamin C, vitamin E, and folate and risk of self-reported hearing loss in women. Am J Clin Nutr 102, 11671175.
42. Berner, B, Odum, L & Parving, A (2000) Age-related hearing impairment and B vitamin status. Acta Otolaryngol 120, 633637.
43. Michikawa, T, Nishiwaki, Y, Kikuchi, Y et al. (2009) Serum levels of retinol and other antioxidants for hearing impairment among Japanese older adults. J Gerontol A Biol Sci Med Sci 64, 910915.
44. Attias, J, Weisz, G, Almog, S et al. (1994) Oral magnesium intake reduces permanent hearing loss induced by noise exposure. Am J Otolaryngol 15, 2632.
45. Gopinath, B, Flood, VM, McMahon, CM et al. (2010) Dietary glycemic load is a predictor of age-related hearing loss in older adults. J Nutr 140, 22072212.
46. US Department of Agriculture, Center for Nutrition Policy and Promotion (1995) The Healthy Eating Index. (accessed December 2018).
47. Fung, TT, McCullough, ML, Newby, PK et al. (2005) Diet-quality scores and plasma concentrations of markers of inflammation and endothelial dysfunction. Am J Clin Nutr 82, 163173.
48. Park, Y, Dodd, KW, Kipnis, V et al. (2018) Comparison of self-reported dietary intakes from the automated self-administered 24-h recall, 4-d food records, and food-frequency questionnaires against recovery biomarkers. Am J Clin Nutr 107, 8093.
49. Center for Nutrition Policy and Promotion, US Department of Agriculture (2016) Healthy Mediterranean-Style Pattern – Recommended Intake Amounts. (accessed January 2019).


Type Description Title
Supplementary materials

Huang et al. supplementary material
Tables S1-S5

 Word (48 KB)
48 KB

Diet quality and hearing loss among middle–older aged adults in the USA: findings from National Health and Nutrition Examination Survey

  • Qiushi Huang (a1) (a2), Yichen Jin (a2), Nicholas S Reed (a3) (a4), Yan Ma (a5), Melinda C Power (a1) and Sameera A Talegawkar (a1) (a2)...


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed