Association Between Mid-life Macronutrient Intake and Late-life Hearing Loss: The Atherosclerosis Risk in Communities Study

BACKGROUND: The relationship between hearing loss (HL) and diet is unclear. This study examined the association of midlife macronutrient intake and low-carbohydrate and low-fat diet patterns in relation to hearing function measured later in life. METHODS: This cross-temporal analysis included 2773 adults aged 45-64 years at baseline from the Atherosclerosis Risk in Communities Study, with follow-up extending for up to 30 years. Midlife dietary macronutrient intake and adherence to low-carbohydrate and low-fat diet patterns were assessed twice using a validated food frequency questionnaire. Hearing function was evaluated at the later-life visit using pure-tone audiometry (0.25-8 kHz) in the better-hearing ear. Linear mixed models, multinomial logistic regression, logistic regression, and restricted cubic splines were conducted after adjusting for the main potential confounders. RESULTS: Participants with high total protein intake (quintile 5) exhibited better hearing, particularly at mid and high frequencies, compared to those with lower intake (quintile 1). High protein intake was inversely associated with the odds of experiencing any HL (odds ratio = 0.63, 95% confidence interval [CI] 0.47-0.84). The relative risk ratio (RRR) for mild HL was 0.63 (CI 0.46-0.85), and for moderate or greater HL, the RRR was 0.64 (CI 0.44-0.94). In contrast, high total fat intake was linked to worse hearing outcomes; additionally, high adherence to a low-fat diet pattern was inversely associated with HL. No association was found between total carbohydrate intake and hearing. CONCLUSION: Our findings suggest that high dietary protein intake and adherence to a low-fat diet pattern in midlife are associated with better hearing function later in life.