Heart Health and Hearing Loss

At the age of eight, I became severely hearing-impaired as a result of a near-fatal attack of meningitis. It spurred me, however, to spend much of my life studying and treating people with hearing loss and tinnitus. Recently, my research led me to discover a disturbing relationship between diet and heart disease, hearing loss and tinnitus.

Tinnitus is a most annoying companion to the frustration that often happens with hearing loss. Many of my patients suffering from tinnitus complain of this apparently unstoppable noise in their heads, especially when they want to sleep. Silence is actually the worst enemy of tinnitus. It is most noticeable when there are no background sounds around to mask it. 

Typically, however, I find that more than 90 per cent of my patients who have both hearing loss and tinnitus report that their tinnitus seems to be much less noticeable when they are wearing their hearing aids. The extra stimulation of the hearing aids seems to keep most people’s auditory cortex in the brain busy enough that they can largely ignore the tinnitus, though some people don’t experience this relief.

In spite of significant research studies focusing on tinnitus, no-one has come up with a lasting cure as yet, although there are a few treatments around that attempt to mask the tinnitus with some other sound. 

The evidence

For a long time, I have privately suspected a relationship between lifestyle diseases on the one hand and certain types of hearing loss and tinnitus on the other—and for a simple reason: lifestyle diseases are typically characterised by higher blood pressure from increasingly narrowing arteries (arteriosclerosis). This restricts the supply of nutrients and oxygen throughout the body, especially the microscopically small and complex peripheral systems such as the ears, eyes, brain, fingers and toes. 

As these systems are starved of nutrients and oxygen, they begin to malfunction and may actually begin to shut down in much the same way that a car’s engine will malfunction and eventually stop running when it’s starved of fuel or air. Clearing the blockages results in the engine running smoothly again. While the idea may appear overly simplistic, recent research into the relationship between heart disease and diet appears to reinforce this theory.

One of the earliest indicators that diet could affect hearing loss appeared in a Finnish study in 1970. Over a period of five years, researchers investigated the relationship between coronary heart disease, high cholesterol levels, intake of saturated fats and hearing loss. Patients between the ages of 40 and 59 in two psychiatric hospitals were evaluated. In one hospital, the usual high-fat diet was continued, while the other instituted a low-fat diet. 

After five years, the diets in the two hospitals were reversed for four years. In the hospital with the high-fat diet, hearing loss and coronary heart disease increased. When the diets were swapped, the low-fat diet reversed the hearing loss and the incidence of coronary heart disease. The Finnish investigators concluded that an important factor in the prevention of coronary heart disease may well be a diet low in saturated fats, and that such a diet may well arrest, if not reverse, hearing loss. 

Another very large study in 2003 discovered that sensorineural hearing loss (a type of hearing loss in which the root cause lies in the inner ear or central processing centres of the brain) was more common in diabetic patients than in age-matched nondiabetic patients from the same institution. This study of more than 65,000 patient records also reported that poor control of diabetes correlated with worsening of hearing in diabetic patients who also had sensorineural hearing loss. In other words, the diabetes made the hearing loss worse.

Dr Dean Ornish’s study

One of the classic studies of the relationship between diet and coronary heart disease occurred in 1993, when Dr Dean Ornish published a report in the Lancet medical journal. 

Ornish spent a year studying 48 men with advanced heart disease who were candidates for bypass surgery. He divided them into two groups. Both were asked to quit smoking and walk daily. In addition, the first group practised stress management and followed a strict vegetarian diet with less than 10 per cent of kilojoules as fats and with virtually no cholesterol. The second group was given the American Heart Association’s “Prudent Diet” for heart disease, which allowed 30 per cent of kilojoules as fats and up to 300 milligrams of cholesterol a day. 

At the end of the year, Ornish reported that those on the very low-fat vegetarian diet not only dropped their dangerous LDL-cholesterol levels by 37 per cent, but also 82 per cent of their narrowed, plaque-filled arteries had widened, allowing more blood and oxygen to get to the heart muscle. The heart disease had begun to reverse itself! On the other hand, the group on the so-called “Prudent Diet” had virtually no lowering of their cholesterol and most of their coronary arteries showed increased narrowing. In general, their heart disease had gotten worse. 

Ornish concluded that “it appears that the ‘Prudent Diet’ developed by the American Heart Association for the prevention and treatment of heart disease does not do its job. The moderate diet recommendations . . . do not go far enough to effectively influence the progression of coronary heart disease. People with clinically demonstrated disease need to go beyond the present dietary recommendations.” 

Dr Caldwell Esselstyn’s study

In 2007, Dr Caldwell Esselstyn, a cardiac surgeon at the Cleveland Clinic in Ohio, published his many articles on preventive cardiology in the book Prevent and Reverse Heart Disease. A few years later, in 2011,Forks Over Knives was released—a full-length movie that featured some of his research. Both the book and the movie triggered a diet revolution and won rave reviews across North America.

In his 20-year nutritional study—one of the most comprehensive of its kind—Esselstyn convincingly argues that plant-based, oil-free nutrition not only prevents and stops the progression of heart disease, it also reverses its effects. He cited as proof the incredible results experienced by the patients who came to him with advanced coronary disease. Within months of following a plant-based, oil-free diet, their angina symptoms eased, their cholesterol levels dropped significantly and they had a marked improvement in blood flow to the heart. Esselstyn reported that 20 years later, these patients still remained free of symptoms. 

Dr Hans Diehl’s study 

Epidemiologist and founder of the Complete Health Improvement Program (CHIP) and president of the Lifestyle Medicine Institute in Loma Linda, California, Dr Hans Diehl says that arteriosclerosis is the primary cause of the epidemic of heart disease and associated conditions.

In this disease, fatty deposits from an unhealthy diet begin to clog the arteries, thereby causing elevated blood pressure and reduced blood and oxygen supply throughout the body. Eventually, these patients have a heart attack or stroke caused by overpressured arteries that trigger ruptures in the plaque, which creates blood clots. Dr Diehl says that these narrowed arteries and consequent diminished blood and oxygen supply to peripheral systems are also directly responsible for hearing loss, vision loss and kidney problems.  

Like Ornish and Esselstyn, who recommend the same plant-based diet regimens, CHIP participants who stay on that diet experience complete, ongoing freedom from the symptoms of progressive heart disease. 

The oil-free specification in addition to the plant-based requirement in Esselstyn’s and Diehl’s programs is intriguing. Apparently what is of concern to these researchers is not the natural oil found within foods such as avocados, legumes or nuts but rather the extraction and refining of these oils for inclusion in processed foods, which they believe convert them into harmful free radicals that lack nutritional value and contribute to heart disease. 

Looking ahead

Like heart disease, hearing loss from noise and ageing is usually progressive. However, recent research suggests that a strictly plant-based (vegetarian), oil-free diet can at least prevent and may reverse the lifestyle-related diseases that damage the hair cell function of the cochlear (the auditory part of the inner ear) due to arteriosclerotic plaque build-up in arteries. 

At this stage there seem to be no studies suggesting that hearing loss can be reversed to a normal condition once the hair cells in the cochlear have been completely destroyed, but at least we can be confident that the progression of age-related hearing loss and tinnitus can be slowed, if not completely arrested, by following a plant-based, oil-free diet as described in recent preventive health research studies. And as research progresses, the best may be yet to come.