TABLE 4.

Healthful dietary pattern scores (cumulative average) and risk of moderate or worse hearing loss in the Nurses’ Health Study II HSSQ subcohort (n = 33,102)¹

Diet score	Quintile 1	Quintile 2	Quintile 3	Quintile 4	Quintile 5	P-trend
AMED
Median score2	2.0	3.0	4.0	5.0	6.0
Person-years	109,395	102,913	94,273	103,529	104,680
Cases	198	169	157	163	131
Age-adj. RR (95% CI)	1.00 (ref)	0.85 (0.69, 1.04)	0.88 (0.71, 1.09)	0.78 (0.63, 0.96)	0.62 (0.50, 0.78)	<0.001
MVRR3 (95% CI)	1.00 (ref)	0.84 (0.68, 1.03)	0.87 (0.70, 1.08)	0.78 (0.62, 0.97)	0.63 (0.49, 0.81)	<0.001
DASH
Median score2	17.0	21.0	24.0	27.0	31.0
Person-years	104,357	102,641	105,258	100,165	102,369
Cases	192	194	142	162	128
Age-adj. RR (95% CI)	1.00 (ref)	1.00 (0.82, 1.22)	0.71 (0.58, 0.89)	0.82 (0.67, 1.01)	0.62 (0.50, 0.78)	<0.001
MVRR3 (95% CI)	1.00 (ref)	1.01 (0.82, 1.23)	0.73 (0.58, 0.91)	0.82 (0.65, 1.02)	0.64 (0.50, 0.83)	<0.001
AHEI-2010
Median score2	34.5	42.0	48.0	54.0	63.0
Person-years	103,329	104,808	100,870	102,255	103,529
Cases	195	165	150	159	149
Age-adj. RR (95% CI)	1.00 (ref)	0.79 (0.64, 0.98)	0.71 (0.57, 0.88)	0.73 (0.59, 0.90)	0.65 (0.53, 0.81)	<0.001
MVRR3 (95% CI)	1.00 (ref)	0.79 (0.64, 0.97)	0.72 (0.58, 0.90)	0.74 (0.59, 0.92)	0.71 (0.56, 0.89)	0.004

¹Age-adj.RR, age-adjusted relative risk; AHEI-2010, Alternative Healthy Eating Index-2010; AMED, Alternate Mediterranean diet; DASH, Dietary Approaches to Stop Hypertension; HSSQ, Hearing Study Supplemental Questionnaire; MVRR, multivariable-adjusted relative risk; ref, reference.

²Median dietary pattern adherence score at baseline.

³Multivariable models adjusted for: age, race, BMI, waist circumference, physical activity, history of smoking, hypertension, diabetes mellitus, tinnitus, nonsteroidal anti-inflammatory drug use, acetaminophen use, and total energy intake.