Carotenoids, vitamin A, vitamin C, vitamin E, and folate and risk of self-reported hearing loss in women.
BACKGROUND
Higher intake of certain vitamins may protect against cochlear damage from vascular compromise and oxidative stress, thereby reducing risk of acquired hearing loss, but data are limited.


OBJECTIVE
We prospectively examined the relation between carotenoids, vitamin A, vitamin C, vitamin E, and folate intake and risk of self-reported hearing loss in women.


METHODS
This prospective cohort study followed 65,521 women in the Nurses' Health Study II from 1991 to 2009. Baseline and updated information obtained from validated biennial questionnaires was used in Cox proportional hazards regression models to examine independent associations between nutrient intake and self-reported hearing loss.


RESULTS
After 1,084,598 person-years of follow-up, 12,789 cases of incident hearing loss were reported. After multivariable adjustment, we observed modest but statistically significant inverse associations between higher intake of β-carotene and β-cryptoxanthin and risk of hearing loss. In comparison with women in the lowest quintile of intake, the multivariable-adjusted RR of hearing loss among women in the highest quintile was 0.88 (95% CI: 0.81, 0.94; P-trend < 0.001) for β-carotene and 0.90 (95% CI: 0.84, 0.96; P-trend < 0.001) for β-cryptoxanthin. In comparison with women with folate intake 200-399 μg/d, very low folate intake (<200 μg/d) was associated with higher risk (RR: 1.19; 95% CI: 1.01, 1.41), and higher intake tended to be associated with lower risk (P-trend = 0.04). No significant associations were observed for intakes of other carotenoids or vitamin A. Higher vitamin C intake was associated with higher risk; in comparison with women with intake <75 mg/d, the RR among women with vitamin C intake ≥1000 mg/d (mainly supplemental) was 1.22 (95% CI: 1.06, 1.42; P-trend = 0.02). There was no significant trend between intake of vitamin E intake and risk.


CONCLUSIONS
Higher intakes of β-carotene, β-cryptoxanthin, and folate, whether total or from diet, are associated with lower risk of hearing loss, whereas higher vitamin C intake is associated with higher risk.
Channing Division of Network Medicine and Harvard Medical School, Boston MA scurhan@partners.org.
Sharon G
SG
Curhan
Eaton-Peabody Laboratories and Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA; Department of Otology and Laryngology, Harvard Medical School, Boston, MA; Program in Speech and Hearing Bioscience and Technology, Division of Health Science and Technology, Harvard and Massachusetts Institute of Technology, Boston, MA;
Konstantina M
KM
Stankovic
Vanderbilt Bill Wilkerson Center for Otolaryngology and Communication Sciences, Vanderbilt University School of Medicine, Nashville, TN; and.
Roland D
RD
Eavey
Channing Division of Network Medicine and Departments of Biostatistics and Epidemiology, Harvard School of Public Health, Boston, MA.
Molin
M
Wang
Channing Division of Network Medicine and Epidemiology, Harvard School of Public Health, Boston, MA.
Meir J
MJ
Stampfer
Channing Division of Network Medicine and Renal Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA; Epidemiology, Harvard School of Public Health, Boston, MA, Harvard Medical School, Boston MA.
Gary C
GC
Curhan
D000328:Adult; D001205:Ascorbic Acid / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D015331:Cohort Studies; D065366:Cryptoxanthins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004032:Diet / Q000009:adverse effects*; D019587:Dietary Supplements / Q000009:adverse effects; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005500:Follow-Up Studies; D005527:Food, Fortified / Q000009:adverse effects; D034381:Hearing Loss / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D009726:Nurses; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D057566:Self Report; D014481:United States / Q000453:epidemiology; D014801:Vitamin A / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D014810:Vitamin E / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D055815:Young Adult; D019207:beta Carotene / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
D065366:Cryptoxanthins; D019207:beta Carotene; D014801:Vitamin A; D014810:Vitamin E; D005492:Folic Acid; D001205:Ascorbic Acid
aging; carotenoids; epidemiology; hearing loss; vitamins