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.     

Analysis of audiometric notch as a noise-induced hearing loss phenotype in US youth: data from the National Health And Nutrition Examination Survey, 2005–2010

Objective: Bilateral audiometric notch (BN) at 4000–6000?Hz was identified as a noise-induced hearing loss (NIHL) phenotype for genetic association analysis in college-aged musicians. This study analysed BN in a sample of US youth. Design: Prevalence of the BN within the study sample was determined and logistic-regression analyses were performed to identify audiologic and other demographic factors associated with BN. Computer-simulated “flat” audiograms were used to estimate potential influence of false-positive rates in estimating the prevalence of the BN. Study sample: 2348 participants (12–19 years) following the inclusion criteria were selected from the National Health and Nutrition Examination Survey data (2005–2010). Results: The prevalence of BN was 16.6%. Almost 55.6% of the participants showed notch in at least one ear. Noise exposure, gender, ethnicity and age showed significant relationship with the BN. Computer simulation revealed that 5.5% of simulated participants with “flat” audiograms showed BN. Conclusion: Association of noise exposure with BN suggests that it is a useful NIHL phenotype for genetic association analyses. However, further research is necessary to reduce false-positive rates in notch identification.     

Acoustic reflexes are common but not pervasive: evidence from the National Health and Nutrition Examination Survey, 1999–2012

Abstract

Objective: To determine whether acoustic reflexes are pervasive (i.e. sufficiently prevalent to provide 95% confidence of at least 95% prevalence) and might be invoked in damage-risk criteria (DRC) and health hazard assessments (HHA) for impulsive noise.

Design: Cross-sectional analyses of a nationally-representative study.

Study sample: National Health and Nutrition Examination Survey (NHANES) data collected between 1999 and 2012 were used. Over 60 thousand reflex traces obtained from 15,106 NHANES participants were used in the study, along with demographic, audiometric, health and exposure variables obtained in that study.

Results: Acoustic reflexes were not sufficiently prevalent to be deemed pervasive by any detection method or in any subgroup defined by age or audiometric characteristics. The odds of observing acoustic reflexes were greater for women, young adults, and people with better hearing sensitivity. Abnormally high tympanometric admittance and “Other” race/ethnicity (i.e. people who do not self-identify as exclusively Non-Hispanic White, Non-Hispanic Black, Mexican–American, or Hispanic) were associated with lower odds.

Conclusions: Acoustic reflexes are not sufficiently prevalent to be included in DRC and HHA for impulsive noise.     

Is Hypozincemia Related to Tinnitus?: A Population Study Using Data From the Korea National Health and Nutrition Examination Survey

Objectives

The aim of present study was to determine the relationship between serum zinc level and tinnitus using data from the Korea National Health and Nutrition Examination Survey (KNHANES).

Methods

The present study examined the relationship between serum zinc level and tinnitus using data from the KNHANES. A total of 2,225 KNHANES participants responded to the tinnitus questionnaire and provided blood samples to measure serum zinc concentration. Based on questionnaire responses, participants were categorized into control, mild tinnitus, moderate tinnitus, and severe tinnitus subgroups.

Results

There were no significant differences between groups in serum zinc level after adjustment for sex, age, and hearing loss.

Conclusion

It was concluded that hypozincemia is not related to tinnitus in a large population.     

Is Body Mass Index Associated With the Development of Age-Related Hearing Impairment in Koreans? The Korean National Health and Nutrition Examination Survey 2009–2012

ObjectivesThe aim of this study was to evaluate whether body mass index (BMI) is associated with age-related hearing loss (ARHL) in the Asian elderly population.MethodsData from the Korean National Health and Nutrition Examination Survey 2009–2012 were used for the analyses. The pure tones at 0.5 and 1 kHz of both ears of each subject were averaged to obtain the low-frequency, those at 2 and 3 kHz were averaged to obtain the mid-frequency, and those at 4 and 6 kHz were averaged to obtain the high-frequency. The average hearing threshold (AHT) was calculated as pure tone average at 4 frequencies in the better ear. ARHL was defined as the AHT >25 dB.ResultsUnivariate analyses revealed an increase in the BMI tertile in men was associated with a decreased low-frequency threshold, while an increase in the BMI tertile in women was associated with decreased mid- and high-frequency thresholds. Multivariate analyses adjusted for confounders show no significant differences in low-, mid-, or high-frequency. There was no significant difference in the prevalence of ARHL by BMI tertiles. Linear regression analyses show no association between BMI and low-, mid-, and high-frequency or AHTs. The area under the receiver operating characteristic curve values for AHT was 0.515 in men and 0.522 in women. The logistic regression analyses showed no association between BMI and ARHL in either sex.ConclusionBMI is not advantageous for the prediction of ARHL. In future epidemiological studies, BMI as a covariate of obesity may be replaced by other active metabolic parameters that have better predictive ability of ARHL than BMI.     

Vestibular evoked myogenic potential testing for the diagnosis of conductive hearing loss: Survey of pediatric otolaryngologists’ knowledge and beliefs

ObjectivesTo assess physicians’ knowledge and beliefs regarding vestibular evoked myogenic potential (VEMP) testing in children.MethodsA survey was delivered via email in html format to 1069 members of the American Academy of Otolaryngology – Head and Neck Surgery who identified as pediatric otolaryngologists. Study data were collected and managed using the Research Electronic Data Capture (REDCap) tools.Results443 (41.4%) physicians opened the email. 190 (42.9% of opens) initiated the survey, of which 117 (61.9%) fully completed the survey of the physicians who responded to a question regarding knowledge of VEMP, 16% of respondents had never heard of the test. 16% of participants would use it in the setting of diagnosing pediatric conductive hearing loss. Responses regarding the youngest age at which VEMP is possible ranged from younger than 6 months through greater than 13 years of age. Beliefs regarding utility and reliability of VEMP varied, with ‘unsure’ as the most frequent response. Additionally, only 26% of pediatric otolaryngologists indicated some access to the test.ConclusionThe knowledge and availability of VEMP testing in the pediatric otolaryngology community varies widely.     

Neutrophil–lymphocyte ratio as a new predictive and prognostic factor at the hearing loss of diabetic patients

Diabetes mellitus (DM) is a systemic inflammatory disease. Sensorineural hearing loss (SNHL) is seen more frequently in diabetic patients and it is believed that vascular complications of DM may be the cause of SNHL via inflammation. Neutrophil-to-lymphocyte ratio (NLR) was defined as a novel-potential marker to determine inflammation. We aimed to investigate the relationship between NLR levels and SNHL in diabetic patients using high-frequency audiometry (8–16 kHz) for the first time. The study included 58 patients diagnosed with DM. The control group was composed of 45 age–sex–BMI–matched healthy subjects. An automated blood cell counter was used for NLR measurements. The hearing assessments of the patients were carried out by Interacoustics Clinical Audiometer AC 40 device. The mean NLR values of the patients were significantly higher than the control group (p = 0.015). Speech recognition threshold values were higher and the speech discrimination values were lower in patients (p = 0.002, p < 0.001), respectively. Pure tone average of the patients at 500, 1,000, 2,000 Hz frequencies was divided into two groups (group 1 >25 dB and group 2 <25 dB). NLR levels of the diabetic patients with >25 dB were higher than the other diabetics (p = 0.007). In conclusion, while diabetic patients are evaluating, audiologic assessments of these patients should be performed because they are at more risk of SNHL and NLR may be considered as a predictive and prognostic marker of hearing loss or its beginning in these patients as a useful and reliable marker without any cost.     

Relationship between dietary quality,tinnitus and hearing level: data from the national health and nutrition examination survey, 1999–2002

Objective: To examine the relationship between the healthy eating index (HEI), a measure of dietary quality based on United States Department of Agriculture recommendations and report of tinnitus. Design: This cross-sectional analysis was based on HEI data and report of tinnitus. Study sample: Data for adults between 20 and 69 years of age were drawn from the National Health and Nutrition Examination Survey (NHANES), 1999–2002. The NHANES is a programme of studies, to assess the health and nutritional status of adults and children in the United States. Two thousand one hundred and seventy-six participants were included in the analytic sample. Results: Of the sample, 21.1% reported tinnitus within the past year and 11.7% reported persistent tinnitus, defined as tinnitus experienced at least monthly or greater. Controlling for age, sex, race/ethnicity, diabetes, noise exposure and smoking status, we found that with healthier diet (poorer vs. better HEI) there was decreased odds of reported persistent tinnitus [odds ratio (OR); 0.67; 95% confidence interval (CI) 0.45–0.98; p?=?0.03].Conclusions: The current findings support a possible relationship between healthier diet quality and reported persistent tinnitus.     

Tinnitus and hearing loss in 15–16-year-old students: Mental health symptoms,substance use,and exposure in school

The current study assessed the responses from a survey titled ‘Life and Health – Young People 2005’, completed by 2878 15–16-year-old adolescents in mainstream schools in the county of Örebro, Sweden. Thirty-nine percent of students with hearing loss (slight, mild, or moderate) and 6% of students with normal hearing reported tinnitus often or always during the past three months. Almost no gender difference was observed among students with normal-hearing reporting tinnitus (boys 6.3%, girls 5.6%); however, a gender difference was noticed among hard-of-hearing (HH) students (boys 50%, girls 28%). Adolescents with both hearing loss and tinnitus reported considerably higher scores for mental health symptoms, substance use, and school problems than other students. Anxiety in the past three months, male gender, and alcohol consumption in the past year were associated with tinnitus in HH students; irritation and anxiety in the past three months, disability, use of illicit drugs, and truancy predicted tinnitus in the normal-hearing group. Consequently, students with a hearing loss and tinnitus are at high risk and should be monitored for subsequent problems.     

Thirty-day readmissions following parathyroidectomy: Evidence from the National Readmissions Database, 2013–2014

Purpose

Parathyroidectomy is one of the most common procedures performed in the United States, and are increasingly being performed safely in the outpatient setting. However, complications from surgery can be life-threatening, and thus an understanding of who may be at risk is essential. We analyzed and compared the risk factors for patients readmitted within 30?days following inpatient parathyroidectomy for primary or secondary hyperparathyroidism.

Screened and unscreened hearing threshold levels for the adult population: results from the Nord-Trøndelag Hearing Loss Study

This paper presents normative data of hearing threshold levels of a population screened with various criteria, as compared to unscreened population data. Computer-controlled pure-tone audiometry was administered to the adult population in Nord-Tr?ndelag County, Norway, during 1995-1997. The 51975 participants also provided questionnaire information about occupational and leisure noise exposure, previous ear infections, and head injury. While screening had little effect on the median hearing threshold levels of young adults, there was a substantial effect when screening men above 40 years of age for a history of noise exposure. Screening for known ear-related disorders and diseases resulted in small effects on the mean hearing threshold levels The median hearing thresholds of both the screened and the unscreened sample exceeded the age and sex specific thresholds specified by the ISO 7029.     

Oral health status in Sichuan Province:findings from the oral health survey of Sichuan, 2015–2016

To investigate oral health status in the residents of Sichuan Province, southwest China, a cross-sectional study was performed using the latest Oral Health Survey Basic Methods recommended by the World Health Organization. A multistage stratified random cluster-sampling method was used to enroll participants from the following three groups: children aged 3–5 years, adolescents aged 12 years, and people aged 65–74 years. In these three groups, the mean numbers of teeth that were affected by caries were 3.28, 0.86 and 5.13, respectively, resulting in a prevalence of 63.47%, 37.20%and 83.20%, respectively. Relative to the high rate of decayed teeth, the prevalence of fillings was very low in all age groups (0.97%, 7.24% and 5.43%, respectively). In the 12-year-old adolescent group, only 3.61%had good pit and fissure sealing. In addition, the rate of dental fluorosis was 24.80%, and the Community Fluorosis Index value was 0.39. In the elder group, the community periodontal index was 2.92. The prevalence in the elderly of having lost at least one tooth was 75.54%. Additionally, 4.44%of these participants were edentulous. The incidence of dental prosthesis was 51.75%, the proportion with a removable partial denture, a fixed denture, full dentures, dental implants and an informal fixed bridge was 21.59%, 11.45%, 4.64%, 0 and 16.67%, respectively. In this study, 8.2%of the elderly participants were affected by different types of oral mucosal lesions. Among such lesions, recurrent aphthous ulcers were most prevalent (2.69%) and oral lichen planuses were second (1.6%). The conclusion presented in this survey is that oral diseases, especially dental caries and periodontal disease, are frequent and common in Sichuan province, China. Moreover, the treatment rate is very low, and primary prevention and treatment options are therefore urgently needed in this population.     

Accuracy of auditory steady state and auditory brainstem responses to detect the preventive effect of polyphenols on age-related hearing loss in Sprague–Dawley rats

Aging causes histological, electrophysiological and molecular changes in the cochlea. The free radical theory of aging, has obtained consensus, and the mitochondrion is reported to play a key role in aging as a major source of reactive oxygen species. In the last years, there has been a significant increase in the interest in polyphenols because of the antioxidant properties and their role in the prevention of various diseases associated with oxidative stress, including aging. The aim of this study was to evaluate the preventive effect of different polyphenols on ARHL with auditory-evoked potentials. 100 Healthy female Sprague–Dawley (SD) rats were used for this study. Five groups were created based on the age of the rats, in months: 3, 6, 12, 18 and 24 months old. Two additional groups were created based on the treatment received. In the control group, 50 animals were assigned to no treatment. In the treated group, 50 animals were given a vehicle mixture of polyphenols for the half of the life before euthanization. Nine frequencies were tested (0.5–16 kHz) with ASSR and tone-burst ABR, performed on all of the rats prior to sacrifice. 100-μs auditory clicks ABRs were also recorded. A significant decrease in the audition was detected with ABR and ASSR in both treated and non-treated groups, as the different groups became older. This deterioration was more accurately measured at acute frequencies. Significantly lower thresholds were observed in the treated rats in the 6, 12 and 18-month-old group in the treated rats compared with the control group. All of the thresholds elicited using the ASSR technique were lower than the thresholds obtained using the ABR, regardless of the stimulus type. The present study demonstrated the benefits of the polyphenols, which generated a significant protection against ARHL, with significantly improved ASSR and tone-burst ABR auditory thresholds in rats receiving treatment with polyphenols.     

Tinnitus and hyperacusis therapy in a UK National Health Service audiology department: Patients’ evaluations of the effectiveness of treatments

Objective: To assess patients’ judgements of the effectiveness of the tinnitus and hyperacusis therapies offered in a specialist UK National Health Service audiology department. Design: Cross-sectional service evaluation questionnaire survey. Patients were asked to rank the effectiveness of the treatment they received on a scale from 1 to 5 (1?=?no effect, 5?=?very effective). Study sample: The questionnaire was sent to all patients who received treatment between January and March 2014 (n?=?200) and 92 questionnaires were returned. Results: The mean score was greatest for counselling (Mean?=?4.7, SD?=?0.6), followed by education (Mean?=?4.5, SD?=?0.8), cognitive behavioural therapy - CBT (Mean?=?4.4, SD?=?0.7), and hearing tests (Mean?=?4.4, SD?=?0.9). Only 6% of responders rated counselling as 3 or below. In contrast, bedside sound generators, hearing aids, and wideband noise generators were rated as 3 or below by 25%, 36%, and 47% of participants, respectively. Conclusion: The most effective components of the tinnitus and hyperacusis therapy interventions were judged by the patients to be counselling, education, and CBT.