Definition
Ménière's syndrome is a rare condition that affects the inner ear.
It can cause dizziness, tinnitus (perception of acute noises or "whistles"), hearing loss and a feeling of pressure in the ear. Less frequently, it causes hypersensitivity to sound (hyperacusis) and distortions in perception.
The severity and symptoms of Ménière's disease vary from person to person. Some frequently complain of vertigo attacks with total hearing loss; others declare severe tinnitus with less intense vertigo.
Development and Incidence
Ménière's syndrome develops in different phases.
It starts suddenly and, due to dizziness, can induce nausea and vomiting.
In the later stages, these symptoms become irregular and sometimes decrease progressively. On the contrary, tinnitus and hearing disorders tend to worsen.
The unpredictability of Ménière's syndrome and the resulting invalidity can promote the onset of anxiety and depression.
The incidence is 1: 1000 or 1.5: 1000. It is more common in females and occurs mainly between the ages of 20 and 60.
Causes
The causes of Ménière's syndrome are not known.
The most accredited hypothesis concerns a hypothetical chemical imbalance in the aqueous matrix of the inner ear. The result would be the dropsy, or excessive pressure of the liquid in question.
Familiarity is very relevant.
Treatment
The treatment of Ménière's syndrome is aimed at symptom control; however, it is not conclusive.
Possible interventions are: drugs, diet, vestibular re-education, relaxation techniques and, in the most serious cases, surgery (with controversial efficacy).
Diet and Ménière Syndrome
There is no real "diet for Ménière's syndrome".
The diet is aimed at trying to reduce hydrops. However, this condition is NOT a "constant" of Ménière's syndrome. In the same way, the analyzes on cadavers reveal that some subjects present a completely asymptomatic form of hydrops.
Hydrops, Salts and Water
The diet for Ménière's syndrome is aimed at restoring the volumetric and compositional normality of the liquid inside the ear, fighting the symptomatic hydrops.
In the introduction, we specify that the stability of the fluid is independent of the blood composition.
Normally, the liquid is kept at constant osmotic volume and pressure by some intrinsic mechanisms.
Concentrations of sodium, potassium, chlorine and other electrolytes are highly specific and should not undergo any change.
The fluid interacts with the sensory cells of the inner ear and allows them to function properly.
Independent fluid control can be compromised due to injury or degeneration in specific internal structures.
In this way, the pressure and concentration of the liquid in the inner ear tend to balance with the blood plasma, significantly changing.
This alteration should cause the symptoms of hydrops.
Dietary principles
The diet for Ménière's syndrome is based on the control and restriction of sodium food.
Perhaps due to the abundance of food in the patient, this ion tends to increase excessively in the internal fluid causing the imbalances we have already discussed.
The normal portion of sodium, or the recommended dose in Italy, is between 600 and 3500 milligrams per day (mg / day). Instead, American RDAs suggest a range of 500-2300mg / day.
Before continuing with the explanation, it is necessary to specify some fundamental concepts:
- Sodium is naturally contained in food, is added as an ingredient in those preserved and is a condiment in the form of table salt (Na + Cl-).
- Table salt contains about 40% sodium and 60% chlorine.
- The average daily intake of sodium in Italy is around 3500mg / day.
- In the Bel Paese, around 10g of salt is consumed per day.
- Salt added as a condiment (called "discretionary") represents almost 40% of the total.
- The minimum sodium intake recommended in the diet is 575mg / day, or about 1, 500g / day of salt (1.5g / day).
The diet for Ménière's syndrome should NOT contain more than 1, 500-2, 000mg of SODIUM per day (1.5-2.0g / day); this value can be corrected based on sweating.
The dietary pattern for hydrops is not very different from the one recommended for arterial hypertension, to which the hydrope DOES NOT show an evident statistical correlation.
Moreover, in addition to the quantity of the ion, it seems that the hydrops worsens further with fluctuations in the plasma (variable concentration). This means that, in addition to the daily portion of sodium, the diet for hydrops must limit the foods, recipes and meals rich in this mineral.
Some argue that sodium is not the only element capable of modifying the composition of the internal liquid. It seems that simple sugars and the relative glycemic fluctuations are also involved.
Dehydration exerts an effect similar to the intake of highly osmotic molecules, such as sodium and sugars, which is why it would be better to avoid its occurrence.
High doses of nerves such as alcohol, caffeine, theobromine and theophylline can make the symptoms worse. The same is true for certain drugs (ibuprofen, naproxen, acetylsalicylic acid, etc.).
Synthesis
In summary, the diet for Ménière's syndrome must have the following characteristics:
- Reduction in total sodium intake to no more than 1750mg / day (less than 2g).
- Since about 40% of sodium is discretionary and cooking salt contains 40% of sodium, it is recommended NOT to season foods with more than 1.5-2.0g of total salt per day (half a teaspoon of tea)
- Avoid packaged or processed foods that are high in salt and sodium. These increase the total intake of the ion and favor the manifestation of plasma peaks. In particular, we suggest excluding the following foods from the diet:
- Preserved meats: sausages (salami, sausage, frankfurters, etc.), savory salami (ham, bresaola, etc.), smoked (speck, lonzini, etc.), dried (horse frays), canned (meat in jelly, etc.).
- Fishery products, especially preserved: canned (tuna, mackerel, prawns, crabmeat, etc.), dried eggs (bottarga), canned eggs (caviar and lumpfish roe), pickled molluscs, surimi, also FRESH bivalve molluscs ( clams, mussels, oysters, etc.), dried or smoked fish (herring, cod, etc.).
- Seasoned cheeses: pecorino, taleggio, provolone etc.
- Various condiments: soy sauce, bouillon cube, ketchup, margarine, mustard, barbecue sauce, tartar sauce, mayonnaise, Russian salad, pickle etc.
- Fast food: hamburgers, hot dogs, fried potatoes, croquettes etc.
- Snacks: chips in bag, salty popcorn, nachos, salted peanuts, salted corn etc.
- Preserved fruits and vegetables: pickled olives, pickled or pickled vegetables, mushrooms in cans etc.
- Legumes and cereals in brine: beans, chickpeas, lentils, peas, corn etc.
- Avoid excess sugar and packaged or processed foods with a high content of simple sugars (including glucose syrup, maltose and fructose). In particular, we suggest excluding sugary sweets and drinks from the diet, or limiting them drastically.
- Avoid excess drinks or foods containing high doses of nervine, such as energy drinks, cola-type drinks, coffees, chocolate and cocoa, fermented teas and spirits.
- Always avoid too abundant meals, especially if they contain foods from the "black list".
- Prefer fresh, unprocessed foods; avoid especially those preserved in cans, salted and dried.
- DO NOT add salt or possibly do it sparingly to be within 2g / day.
- Avoid systemic dehydration. It is possible to do this by drinking regularly, especially in the case of accentuated sweating (hot or physical activity), vomiting and diarrhea.
- Avoid medications and take them ONLY when necessary.
