Lifestyle and dietary interventions for Ménière’s disease

Abstract

Background Ménière's disease is a condition that causes recurrent episodes of vertigo, associated with hearing loss and tinnitus. Lifestyle or dietary modifications (including reducing the amount of salt or caffeine in the diet) are sometimes suggested to be of benefit for this condition. The underlying cause of Ménière's disease is unknown, as is the way in which these interventions may work. The efficacy of these different interventions at preventing vertigo attacks, and their associated symptoms, is currently unclear. Objectives To evaluate the benefits and harms of lifestyle and dietary interventions versus placebo or no treatment in people with Ménière's disease. Search methods The Cochrane ENT Information Specialist searched the Cochrane ENT Register; Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE; Ovid Embase; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 14 September 2022. Selection criteria We included randomised controlled trials (RCTs) and quasi‐RCTs in adults with Ménière's disease comparing any lifestyle or dietary intervention with either placebo or no treatment. We excluded studies with follow‐up of less than three months, or with a cross‐over design (unless data from the first phase of the study could be identified). Data collection and analysis We used standard Cochrane methods. Our primary outcomes were: 1) improvement in vertigo (assessed as a dichotomous outcome ‐ improved or not improved), 2) change in vertigo (assessed as a continuous outcome, with a score on a numerical scale) and 3) serious adverse events. Our secondary outcomes were: 4) disease‐specific health‐related quality of life, 5) change in hearing, 6) change in tinnitus and 7) other adverse effects. We considered outcomes reported at three time points: 3 to < 6 months, 6 to ≤ 12 months and > 12 months. We used GRADE to assess the certainty of evidence for each outcome. Main results We included two RCTs, one related to diet, and the other related to fluid intake and sleep. In a Swedish study, 51 participants were randomised to receive 'specially processed cereals' or standard cereals. The specially processed cereals are thought to stimulate the production of anti‐secretory factor ‐ a protein that reduces inflammation and fluid secretion. Participants received the cereals for three months. The only outcome reported by this study was disease‐specific health‐related quality of life. The second study was conducted in Japan. The participants (223) were randomised to receive abundant water intake (35 mL/kg/day), or to sleep in darkness (in an unlit room for six to seven hours per night), or to receive no intervention. The duration of follow‐up was two years. The outcomes assessed were 'improvement in vertigo' and hearing. As these studie...

Exploring causal correlations between inflammatory cytokines and Ménière’s disease: a Mendelian randomization

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Examination of betahistine bioavailability in combination with the monoamine oxidase B inhibitor, selegiline, in humans—a non-randomized, single-sequence, two-period titration, open label single-center phase 1 study (PK-BeST)

“…c) There is insufficient evidence for the effectiveness of many other measures that have been recommended, such as life-style changes, e.g., low salt diet ( 19 ), diuretics ( 4 ), pulsed low-pressure delivery ( 20 ), surgical interventions ( 21 ), intratympanic steroids ( 22 ), and intratympanic gentamicin ( 23 ). All in all, there is very limited evidence for the efficacy of any prophylactic therapy in MD that does not impair vestibular function.…”

Causality between alcohol usually taken with meals and Meniere disease: A 2-sample Mendelian randomization study

“…[1] However, in previous reviews, insufficient randomized controlled trials were found to provide evidence to support or refute the idea that MD should limit alcohol intake. [9,10] In addition, contrary to conventional advice, some clinical studies have shown that alcohol consumption may be negatively associated with MD, [11][12][13][14] but causal inference has remained unclear. Several studies have shown that average alcohol intake cannot fully explain the causal relationship between alcohol consumption and disease incidence, and different drinking patterns may have different effects on the occurrence and development of disease.…”