The Impact of Dietary Factors, BMI, and Physical Activity on Tinnitus: A Scoping Review

Background: Emerging evidence suggests that metabolic and lifestyle factors may contribute to the onset and progression of tinnitus. Nutritional deficiencies, obesity, and sedentary behavior have been hypothesized to modulate auditory function and neural excitability. This scoping review aimed to map and summarize the available evidence on the associations between dietary factors, nutrient intake, body mass index (BMI), obesity, and physical activity with the risk, severity, and management of tinnitus. Methods: A scoping review was conducted following the PRISMA-ScR reporting guidelines. A comprehensive search of PubMed, Web of Science, and Cochrane Library databases was performed. Eligible designs included randomized controlled trials, cohort, case control, and cross-sectional studies. Data were extracted and synthesized narratively due to methodological heterogeneity. Results: Twenty-four studies met the inclusion criteria. Higher protein intake and favorable lipid profiles were associated with reduced tinnitus risk and severity. Micronutrient deficiencies, particularly vitamins B2, B3, D3, B12, zinc, and iron, were consistently associated with greater symptom burden. Evidence on antioxidant supplementation was inconclusive, with some trials reporting symptomatic improvement and others showing no effect. Elevated BMI and obesity were associated with both tinnitus onset and greater symptom severity. Importantly, randomized trials reported that structured weightloss and physical activity programs were associated with reduced tinnitus severity and improved quality of life. Conclusions: The available literature suggests potential associations between dietary patterns, micronutrient status, obesity, and physical activity with tinnitus risk and symptom severity. Although the current evidence is largely observational, some interventional studies indicate that lifestyle based approaches, including weight management and increased physical activity, may contribute to improvements in tinnitus related symptoms and quality of life.