To prospectively examine the relations between adherence scores for three healthful dietary patterns, the Alternate Mediterranean diet (AMED), the Dietary Approaches to Stop Hypertension (DASH), and the Alternative Healthy Eating Index (AHEI-2010), and risk of hearing loss in the Nurses' Health Study II.

Inclusion Criteria:

• The investigators limited the study to women who provided information on their hearing on the 2009 or 2013 questionnaire.

Exclusion Criteria:

• The investigators excluded those who did not provide responses to the hearing questions on either questionnaire, reported a hearing problem that began before baseline for the current analysis (1991) or did not report date of onset, or reported cancer other than non-melanoma skin cancer. The investigators also excluded women who did not complete the baseline diet questionnaire and who had missing diet information for each subsequent time period.

The Conservation of Hearing Study (CHEARS) examines risk factors for hearing loss among participants in the Nurses' Health Study II, an ongoing cohort study of 116,430 female registered nurses in the US, aged 25-42 at enrollment in 1989. Participants have been followed by biennial mailed questionnaires that elicit updated information on diet, lifestyle, and various health outcomes; the follow-up rate over 26 years exceeds 90% of the eligible person-time. After exclusions, a total of 70,966 women were included in the analyses.

For investigators who wish to use the investigators' data, the investigators have adopted a data enclave approach to data sharing within the Nurses' Health Study II cohort. Along with a general description of the cohorts and questionnaires that have been used since 1989 (NHS II), guidelines are available upon request for outside users to access the resources of our studies. Typically, an outside user prepares a brief proposal that is reviewed by the Channing investigator group to identify a local investigator to assist the outside investigator. If uncertainty arises as to the merit of a request, the External Advisory Committees makes a final decision. After approval, the investigators facilitate access to our data either through programming support or orientation to the data.