The Inverted-U Relationship Between Dietary Inflammatory Potential and Hearing Loss Among Adults Aged 20 Years and Over in the United States: A Cross-Sectional Study

PURPOSE: The purpose of this study was to examine the relationship between dietary inflammatory index and objective hearing loss (HL). MATERIALS AND METHODS: A cross‐sectional analysis of a nationally representative sample of participants was performed based on data in National Health and Nutrition Examination Survey (NHANES) (2009–2016). HL was defined as pure tone averages >25 dB at 500, 1000, and 2000 Hz (low frequency); 3000, 4000, 6000, and 8000 Hz (high frequency) in either ear. The energy‐adjusted dietary inflammatory index (E‐DII) score was calculated for each participant based on two 24‐h dietary recalls to assess diet‐associated inflammation. Multivariable logistic regression was used to examine the linear relationship between HL and E‐DII score or E-DII quartiles. Restricted cubic spline was applied to identify any non‐linear associations of the E‐DII score with hearing loss. Subgroup analyses were performed by age and gender to explore the moderating roles of these factors. Akaike’s Information Criterion (AIC) values were used to select the better-fitted model among linear and non-linear models. RESULTS: An inverted-U shaped relationship with low-frequency hearing loss (LFHL) was identified for the E‐DII score (P-nonlinear =0.023) after adjustment for potential confounders. But significant linear or nonlinear association between E-DII score and high-frequency hearing loss (HFHL) was not found. CONCLUSION: E-DII score had inverted-U relationship with LFHL. Both pro-inflammatory diet and anti-inflammatory diet seemed to be associated with a decreased risk of LFHL compared to diet that was neither pro-inflammatory diet nor anti-inflammatory diet.