Tinnitus is defined as the perception of sounds, such as electric currents, cicadas, or buzzing, without any external source of stimulation. Approximately 14.4% of adults and 13.6% of adolescents and children suffer from tinnitus. This condition drastically impairs mental health and overall quality of life. Its causes remain unclear but may involve abnormal brain activity, circulatory problems, and neurological dysfunction. Tinnitus is managed by different treatments such as hearing aids, surgery, tinnitus retraining therapy, medications, cognitive-behavioral therapy (CBT), non-pharmacological approaches, and psychological counseling.
Previous studies showed that a high intake of fruits and vegetables reduces the incidence of tinnitus, whereas diets high in fat and low in fiber may increase the risk. However, conflicting results highlight the need for systematic literature reviews to elucidate the association between tinnitus and diet. The recent study published in BMJ Open systematically investigated this relationship.
This systematic review and meta-analysis followed the International Prospective Register of Systematic Reviews (PROSPERO) registry protocol (CRD42023493856) and adhered to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) as well as Meta-analysis of Observational Studies in Epidemiology (MOOSE). The relevant articles were retrieved from databases such as PubMed, Cochrane Library, Embase, and Web of Science. This search was carried out using Medical Subject Headings (MeSH) terms such as Tinnitus’ and ‘Diet.’
This study included research on adult populations (≥18 years), case-control, cohort, cross-sectional, peer-reviewed English articles published from the start of the study to May 25, 2024. Randomized controlled trials (RCTs), cell studies, case reports, animal studies, literature reviews, and studies containing incomplete data or treatment methods were excluded.
Two evaluations independently extracted the data from the included articles. Aggregate grade strength was assessed using the evidence categorization standards and study bias using the agency for Newcastle-Ottawa scale. Using standardized diet/nutrition questionnaires, food sources and 15 common dietary factors were evaluated. Statistical analysis was performed using RevMan (V.5.3) and Stata (V.15.0).
Initially, 3484 studies were identified from databases. After applying inclusion and exclusion criteria, a total of 10 retrospective studies were included in this systematic analysis. Of these, eight articles (n = 301,533) were used for quantitative analysis (meta-analysis).
Tinnitus incidence was negatively associated with four diets such as caffeine (odds ratio [OR] =0.898 [95% confidence interval {CI} 0.862, 0.935], p<0.00001), dietary fiber (OR=0.918 [95% CI 0.851, 0.990], p=0.03), consumption of fruit (OR=0.649 [95% CI 0.532, 0.793], p<0.0001) and dairy products (OR=0.827 [95% CI 0.766, 0.892], p<0.00001).
Moreover, a statistical association was observed between the tinnitus incidence and the remaining 11 dietary factors like carbohydrates, eggs, varied diets, fat, margarine, meat, sugar, vegetables, fish, protein, and water. The comprehensive sensitivity analysis confirmed the relative robustness of the meta-analysis findings. The results of the Egger test and funnel plot demonstrated evidence of publication bias for sugar, fat, fruit, caffeine, and vegetables.
In conclusion, this study highlights that consuming fruit, caffeine, dairy products, and dietary fiber correlated with a lower risk of developing tinnitus. These dietary strategies played a crucial role in the prevention of tinnitus. This protective effect may be attributed to their benefits for nerve and blood vessels’ health as well as their antioxidant and anti-inflammatory properties. However, these findings should be interpreted with caution as the overall quality of the evidence is low.
Future research is necessary to confirm this relationship through large-scale, cross-population, and well-designed clinical studies. Furthermore, examining the dosage and particular dietary intake categories may provide insightful information.
Reference: Zhang M, Wang X, Zhang S, et al. Association of 15 common dietary factors with tinnitus: a systematic review and meta-analysis of observational studies. BMJ Open. 2025;15:e091507. doi: 10.1136/bmjopen-2024-091507
