Dietary modification as adjunct treatment in Ménière's disease: patient willingness and ability to comply

Abstract

Objective: To evaluate ease of use and compliance with dietary modification in the treatment of vertigo in patients with Ménière's disease.

Study design: Mailed patient retrospective questionnaire and chart review.

Setting: Tertiary referral neurotologic private practice.

Subjects: 136 patients with Ménière's who returned a mailed questionnaire. Mean age at first clinic visit was 53 years, and at questionnaire was 62 years, with 54.4% female subjects. Median initial hearing was AAO-HNS Stage 1. Most patients also received diuretics and/or other treatments.

Intervention: Reduced sodium and caffeine-free diet.

Main outcome measures: Ratings of diet difficulty, length of use, compliance level and nutritional understanding, and AAO-HNS vertigo class and functional rating before and with nutritional intervention.

Results: 46.3% of the respondents received written diet guidelines; only 3.2% were referred for nutritional counseling, and another 7.8% sought counseling independently. 77.8% and 84.7% rated a low sodium and a caffeine-free diet, respectively, as manageable or easy to follow; 77.9% followed the diet for 1 year or greater, but only 10.3% could list 5 "correct" foods to eat and 26% 5 foods to avoid. Those who followed the diet greater than 6 months had larger improvement in number of spells and functional rating and a higher rate of Class A/B vertigo outcome (p ≤ 0.01, p = 0.012, and p = 0.038, respectively). Knowledge of foods to eat and avoid correlated with vertigo class (rho = -0.21, p ≤ 0.029 and rho = -0.26, p ≤ 0.01, respectively); the more foods correctly listed, the better the AAO-HNS class).

Conclusion: Nutrition education by referral to a registered dietitian may improve outcomes in the medical treatment of Ménière's disease.