Diabetes

How Nutrition Affects Our Hearing

By Meagan Rowley

Nutrition is fundamental to health, but seldom does one learn about the relationship between diet and the auditory system. Nutrition and hearing ability are, in fact, connected.

There is no specific food that will definitely cause or prevent hearing loss. Likewise, lost hearing cannot be restored through a diet change. However, new research suggests that certain nutrition patterns may actually decrease—or increase—your risk of developing hearing loss.

A 22-Year Diet Study

A Brigham and Women’s Hospital study monitored the hearing health of more than 70,000 women on various diets for 22 years. These diets included the Alternate Mediterranean Diet (AMED), Dietary Approaches to Shop Hypertension (DASH), and Alternative Healthy Eating Index-2010 (AHEI-2010). These diets favor fruits, vegetables, seeds, nuts, legumes, whole grains, seafood, poultry, and low-fat dairy. All three also advise limiting foods that are high in sodium (salt) and LDL (low-density lipoprotein) cholesterol, discouraging consumption of refined and red meats, processed foods, and sugary drinks.

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Women following diets similar to the AHEI-2010, DASH, and AMED decreased their likelihoods of hearing loss by at least 30 percent, with DASH and AMED showing the greatest benefits. The researchers found that diets that prioritize fruits and vegetables with minerals like folic acid, potassium, and zinc decreased the risk of hearing loss.

Beneficial Nutrients

Other findings indicate that certain nutrients are associated with positive hearing health outcomes. Potassium—a mineral found in bananas, potatoes, and black beans—plays a large role in the way that the inner ear functions and converts sounds into signals for the brain to interpret. Regular intake can help you maintain your current level of hearing, says Sherif F. Tadros, M.D., of the International Center for Hearing and Speech Research in a Europe PubMed Central published study.

George E. Shambaugh, Jr., M.D., of the Shambaugh Hearing and Allergy Institute reports that the zinc in almonds, cashews, and dark chocolate can be an effective treatment for tinnitus, hearing ringing or buzzing without an external sound source. Magnesium is believed to combat free radicals emitted during loud noises and act as a barrier protecting inner ear hair cells.

Folic acid has also been shown to possibly slow the onset of hearing loss. Blood flow is restricted by homocysteine (an amino acid), so folic acid works to metabolize it to keep blow flow regulated. According to Jane Durga, Ph.D., of the Nestlé Research Center in Lausanne, Switzerland, because the inner ear relies on a regular flow of blood, folate is extremely important. Foods high in folic acid include spinach, broccoli, and asparagus.

Adverse Effects of Malnutrition

Conversely, malnutrition negatively affects the human body. In an examination of 2,193 participants ages 16 to 23, Susan D. Emmett, M.D., and colleagues found that malnutrition not only stunts anatomical development in children, but slows inner ear development. Malnourished children were observed as being twice as a likely to develop hearing loss as young adults compared to their well-nourished peers.

Further, the study acknowledges that that stunting often begins before birth. A malnourished woman who is pregnant or nursing is likely to pass on any deficiency she may have to her child. Hindered inner ear development in utero caused by malnutrition contributes to a higher risk of hearing loss than does malnutrition in vivo.

Diabetes Connection

Individuals with type II diabetes also are more likely to develop hearing loss than their nondiabetic counterparts, according to an National Institutes of Health-funded project by researcher Chika Horikawa, Ph.D., of Japan’s Niigata University. Subjects with prediabetes—those who have elevated blood sugar levels but not elevated enough for a diagnosis of diabetes—also have a 30 percent increased risk The study authors attribute the higher risk to damaged nerves and blood vessels of the inner ear, a consequence of having type II diabetes for an extended period of time.

Though rarely acknowledged, diet has a lot to do with the auditory system. Adding just a few foods to your daily diet and paying attention to the nutrients that your diet is missing may significantly impact hearing over the long term.

As an aspiring doctor currently studying nutrition during my undergraduate years, I understand how important it is to look at an individual's state of health from different angles and perspectives. Nutrition is vital to every aspect of health.

An HHF summer intern, Meagan Rowley is a senior on the pre-medicine track studying human nutrition at Case Western Reserve University in Cleveland.

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Educators Must Address Diabetes-Related Hearing Loss

By Susan Weiner, MS, RDN, CDE, CDN and Joanne Rinker, MS, RD, CDE, LDN

Hearing loss may not be commonly thought of as a complication of diabetes. How did you become interested in the condition?

As a diabetes educator, when I think of diabetes complications, I think of kidney, eye, heart and nerve damage. What I don’t think about is hearing loss. In 2012, a colleague asked me what screenings I do for my patients to determine if they have hearing loss. I realized I did nothing because hearing loss really was never on my radar. Then she asked me to think about how a patient who has diabetes might feel if they also had trouble hearing. I started to think about how hearing loss can not only make life more difficult, but could also lead to depression. For a diabetes patient who is already dealing with the pressures of a complicated disease, adding hearing impairment to the list of stressors would be devastating. So, I decided that this was something worth discussing with other diabetes educators.

How common is hearing loss among people with diabetes?

I did some research, and it turns out that nearly 26 million people in the United States have diabetes, and an estimated 36 million people have some type of hearing loss (17%). NIH has found that hearing loss is twice as common among people with diabetes as among those who don’t have the disease. Also, of the 79 million adults thought to have prediabetes, the rate of hearing loss is 30% higher than in those with normal blood sugar levels.

Research suggests that diabetes may lead to hearing loss by damaging the nerves and blood vessels of the inner ear. Autopsy studies of patients with diabetes have shown evidence of such damage.


A recent study from Handzo and colleagues found that women between the ages of 60 and 75 years with well-controlled diabetes had better hearing than women with poorly controlled diabetes, with hearing levels similar to those of women of the same age without diabetes. The study also showed significantly worse hearing in all women younger than 60 years with diabetes, even when the disease is well controlled.

Additionally, a study by Bainbridge and colleagues showed that 54% of people with diabetes had at least mild hearing loss in their ability to hear high-frequency tones, compared with 32% of those with no history of diabetes. And 21% of participants with diabetes had at least mild hearing loss in their ability to hear low- to mid-frequency tones, compared with 9% of those without diabetes.

People with diabetes are 2.3 times more likely to have mild hearing loss, defined as having trouble hearing words spoken in a normal voice from more than 3 feet away. But the effects of hearing loss go beyond the ability to detect sound. Hearing loss is shown to lead to sadness and depression increasing with severity of hearing loss; worry and anxiety, including periods of a month or longer when the patient reports feeling worried, tense or anxious; paranoia (“people get angry at me for no reason”); less social activity; and emotional turmoil and insecurity.


What can diabetes educators do to help patients with hearing loss?

Encourage diabetes patients to be screened routinely for hearing loss, just as they are for eye and kidney problems. Those with mild to severe impairment should be referred to an audiologist for more intense screening and treatment.

Treatment for hearing loss will typically start with a hearing aid. Often this will alleviate the problem. In about 10% of the population, medication may also be necessary, but most hearing loss is corrected with the introduction of a hearing aid. With improved hearing, patients will also likely experience increased alertness; improved job performance, memory and mood; less loneliness, fatigue, tension, stress, negativism and anger; better relationships and feelings about themselves; and greater independence and security — improved overall quality of life.

The bottom line is that diabetes educators must remember to add this to their diabetes education curriculum. They should know the resources in their area and have a process for referring patients to an audiologist who can do more extensive screenings as well as order and fit patients for hearing aids. Lastly, they should follow up with patients with hearing loss about overall quality of life. I am sure they will surprised how much adding this one aspect of care can benefit the lives of their patients.

References:

  • Bainbridge KE, et al. Ann Intern Med. 2008;149(1):1-10.

  • Handzo D, et al. Effect of diabetes on hearing loss. Presented at: Triological Society 2012 Combined Sections Meeting. Miami Beach, Fla.; Jan. 26-28, 2012.

  • National Academy on an Aging Society. Hearing loss: a growing problem that affects quality of life. 1999. Available at: http://ihcrp.georgetown.edu/agingsociety/pdfs/hearing.pdf

This blog post orginally appeared on Healio.com on March 1, 2016. 

Joanne Rinker, MS, RD, CDE, LDN, is Senior Director for Community Health Improvement at Population Health Improvement Partners and the 2013 American Association of Diabetes Educators (AADE) Diabetes Educator of the Year. She has been elected to the AADE Board of Directors 2015-2018. She can be reached at jorinker@gmail.com.

Susan Weiner, MS, RDN, CDE, CDN, is the 2015 AADE Diabetes Educator of the Year and author of The Complete Diabetes Organizer and Diabetes 365 Tips For Living Well. She is the owner of Susan Weiner Nutrition PLLC and is the Endocrine Today Diabetes in Real Life column editor. She can be reached at susan@susanweinernutrition.com.

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Men's Health and Hearing Health are Linked

By Laura Friedman

Hearing health affects so many aspects of a man’s life that routine hearing tests should be part of a healthy lifestyle. Hearing Health Foundation and Better Hearing Institute (BHI) which are encouraging hearing tests during Men’s Health Month in June and Men’s Health Week (June 15-21). Addressing hearing loss can help men safeguard their wellbeing and quality of life. And new research shows that people with hearing loss who use hearing aids enjoy a better overall quality of life and are more likely to be optimistic, have a strong social network, tackle problems actively, and feel engaged in life. At the same time, an increasing number of studies are showing a link between hearing loss and other health conditions.

Men are more likely to suffer from hearing loss than women. But luckily, the vast majority of people with hearing loss can benefit from hearing aids. In fact, most people who currently wear hearing aids say it not only helps their overall ability to communicate effectively in most situations, but it also has a positive effect on their relationships. Most hearing aid users in the workforce even say it has helped their performance on the job.

Other research shows that addressing hearing loss can help protect your earnings. One study showed that the use of hearing aids reduced the risk of income loss dramatically—by 90-100% for those with milder hearing loss, and from 65 -77% for those whose hearing loss was severe to moderate.

What’s more, people with hearing difficulty who use hearing aids get more pleasure in doing things and are even more likely to exercise and meet up with friends to socialize!

Men who want to maintain a healthy, fulfilling lifestyle should know that new technological advances have revolutionized hearing aids in recent years. Today’s hearing aids can automatically adjust to all kinds of sound environments and filter out noise. Many are virtually invisible, sitting discreetly and comfortably inside the ear canal. Some are even waterproof, and others are rechargeable. Best of all, many are wireless, so you can stream sound from smartphones, home entertainment systems and other electronics directly into your hearing aid(s) at volumes just right for you.

5 Men’s Health Motivators for Getting a Hearing Test:

  1. Your hearing may say something about your heart. Cardiovascular and hearing health are linked. Some experts say the inner ear is so sensitive to blood flow that it’s possible that abnormalities in the cardiovascular system could be noted here earlier than in other less sensitive parts of the body.

  2. Hearing loss is about twice as common in people with diabetes. Studies show that people with diabetes are about twice as likely to have hearing loss. When broken down by age, one study showed that those 60 and younger are at greater risk.

  3. Addressing hearing loss may benefit cognitive function. Research shows a link between hearing loss and dementia, leading experts to believe that interventions, like hearing aids, could potentially delay or prevent dementia. Research is ongoing.

  4. Hearing loss is tied to sleep apnea. Research shows that sleep apnea is significantly associated with hearing loss at both high and low frequencies. Findings suggest that sleep apnea is a systemic disease and is associated with an increased risk of hearing loss, along with a number of diseases like diabetes, high blood pressure, heart disease, and stroke.

  5. Hearing loss is tied to depression. Studies show that hearing loss is associated with an increased risk of depression in adults of all ages, but is most pronounced in 18 to 69 year olds. Research also shows that the use of hearing aids reduces depressive symptoms.

BHI and HHF are encouraging men of all ages to take a free, quick, and confidential online hearing check at BetterHearing.org to help determine if they need a comprehensive hearing test by a hearing healthcare professional.

The content for this blog post originated in a press release issued by The Better Hearing Institute on June 3, 2015. 

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6 Facts Every Woman Should Know About Hearing Health

By Laura Friedman

National Women’s Health Week may only last a week (May 10-16, 2015), but women’s health is a year-round issue. A growing body of research shows an association between hearing loss, quality of life, and a number of common chronic diseases and health conditions.

In the United States today, as many as one-third of women in their 50s have some degree of hearing loss, along with nearly two-thirds of women in their 60s. The findings of a 2008 study also suggest that the prevalence of hearing loss among younger adults, specifically among those in their 20s and 30s, is increasing. Fortunately, for the vast majority of people with hearing loss, hearing aids can help.

For many years, experts have known the positive impact that addressing hearing loss has on quality of life. Research shows that many people with hearing loss who use hearing aids see an improvement in their ability to hear in many settings; and many see an improvement in their relationships at home and at work, in their social lives, and in their ability to communicate effectively in most situations. Many even say they feel better about themselves.

In honor of National Women’s Health Week, we are sharing 6 Facts Every Woman Should Know About Hearing Health from The Better Hearing Institute:

  1. Women with hearing loss are more likely to be depressed. Research shows that hearing loss is associated with depression among U.S. adults, but particularly among women.

  2. The ear may be a window to the heart. Cardiovascular and hearing health are linked. Some experts say the inner ear is so sensitive to blood flow that it’s possible that abnormalities in the cardiovascular system could be noted here earlier than in other less sensitive parts of the body. Heart disease is the No. 1 killer of women, according to the American Heart Association.

  3. If you have diabetes, you’re about twice as likely to have hearing loss. What’s more, having diabetes may cause women to experience a greater degree of hearing loss as they age, especially if the diabetes is not well controlled with medication. About 11% of women in the United States are affected by diabetes.

  4. Many of the same lifestyle behaviors that affect the heart impact hearing. More evidence of the interconnectedness between cardiovascular and hearing health is found in three studies on modifiable behaviors: One found that a higher level of physical activity is associated with lower risk of hearing loss in women. Another revealed that smokers and passive smokers are more likely to suffer hearing loss. And a third found that regular fish consumption and higher intake of long-chain omega-3 polyunsaturated fatty acids are associated with lower risk of hearing loss in women.

  5. Hearing loss in women is tied to common pain relievers. Ibuprofen and acetaminophen are associated with an increased risk of hearing loss in women. The link is even stronger among those younger than 50.

  6. Addressing hearing loss may benefit cognitive function. Research shows a link between hearing loss and dementia, which leads experts to believe that interventions, like hearing aids, could potentially delay or prevent dementia. Research is ongoing.

HI and HHF are encouraging women of all ages to take a free, quick, and confidential online hearing check at BetterHearing.org to help determine if they need a comprehensive hearing test by a hearing healthcare professional.

The content for this blog post originated in a press release issued by The Better Hearing Institute on May 8, 2015. 

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