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

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.