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

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

Mailed patient retrospective questionnaire and chart review.

Tertiary referral neurotologic private practice.

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.

Reduced sodium and caffeine-free diet.

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.

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).

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