Abstract
Since first reporting the association of hyperlipoproteinemia with inner ear disease in a study of 300 patients in 1973, I have continued to focus attention on the presence of lipid abnormalities in patients with inner ear dysfunction. With over 1,400 patients now identified with both abnormal lipids and inner ear symptoms, it has become increasingly apparent that most patients seen by otolaryngologists because of Meniere's disease come from that same large population group who are prone to obesity, maturity-onset diabetes, coronary artery disease, and atherosclerosis. These patients share the common problem of being unable to handle refined carbohydrates well. Based on the reports and studies of many authorities, a hyperinsulinism exists in these conditions. These patients are helped by replacing refined carbohydrates with complex carbohydrates having increased fiber. When these conditions can be identified in patients with Meniere's disease, dietary management has been found to be the most effective therapy.

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