YOUR HEALTH
Changes to Diet and Exercise Can Improve Tinnitus Although the evidence linking healthy eating, exercise, and tinnitus is limited at this juncture, the ATA consulted a nutrition researcher to get his viewpoint on why we should make an effort. Martin Hofmeister (MH): So far, there’s limited evidence that dietary quality affects tinnitus symptoms, so we need more high-quality analytical studies.1 But it’s well documented that a healthy, fiber-rich diet plays a positive role in overall well-being and helps prevent many diseases, including obesity, gout, diabetes, and cardiovascular diseases. Diabetes mellitus, for instance, is an independent significant risk factor for acquired hearing loss and tinnitus.2 Considering that, being more deliberate in food choices is important. Carrots, tomatoes, and apples not only provide important nutrients but also are low in calories. By adding nuts, whole grains (barley, brown rice, cracked wheat, oatmeal), legumes (chickpeas, lentils, peas, soybeans, and other beans), and fermented dairy products (yogurt, buttermilk, kefir), your diet becomes part of what keeps you well, mentally and physically. These foods provide ample fiber, vitamins, minerals, and polyphenols, which have a beneficial effect on the intestinal microbiome, which improves the immune system, mental health, and cognitive function (keyword: microbiotagut-brain axis).3,4 Eating healthy fats, such as vegetable oils derived 22
TINNITUS TODAY SUMMER 2020
from rapeseed or olives, and limiting consumption of sugar and alcohol also helps. We also know that cutting out or limiting consumption of processed foods makes a difference. Unfortunately, it isn’t always clear to patients and physicians that lifestyle changes take an average of eight weeks to become an integrated habit.5 Most people don’t make it to that eight-week mark because they change too much too fast (true for exercise as well), so start with small, incremental changes. For example, a simple and effective tip for creating a long-term behavioral change would be drinking two cups of water (500 ml) before each meal (beneficial effects include increased fullness, lower calorie intake, increased concentration and performance). The mantra should be “I want and can implement a small change in everyday life for eight weeks. And I know why I‘m doing it.”5 Also, primary care physicians and other front-line healthcare professionals need to support patients in their efforts to implement longterm lifestyle behavioral principles and goals for nutritional management. And it’s something that applies to physicians themselves in their own lives, considering that almost half of physicians are overweight or obese.6 Joy Onozuka: Is there a strong argument for exercise improving or maintaining hearing health, even with limited research in this area?
MH: Some research has documented that higher levels of physical activity are associated with better hearing acuity and lower levels of tinnitus distress.7–13 Unfortunately, specific exercise intervention studies in this area are indeed rare.14,15 Nonetheless, exercise remains the cornerstone of good health because it significantly reduces the incidence of a wide range of diseases, maintains motor skills, and strengthens our mental health and sense of well-being. Movement is part of living, so exercise should be viewed positively. It’s an evidence-based preventive and therapeutic tool for reducing the incidence of more than 30 different chronic diseases, including many well-known risk factors for developing tinnitus and conditions associated with tinnitus symptoms such as diabetes mellitus, hyperinsulinemia, hypertension, rheumatoid arthritis, anxiety, depression, and stress. So — please stand up! Right now? You don't have to sit while reading Tinnitus Today. Unfortunately, in everyday life, the numerous cardiovascular, hemodynamic, metabolic, endocrinological, immunological, brainfunctional, gerontological, and positive psychological adaptations of regular muscle activity lose the fight against the powerful physical law of inertia. Like changes in diet, changes in activity can also be made in small steps done daily. Tinnitus patients, for instance, www.ATA.org
