Associations of Dietary Factors, Body Mass Index, and Physical Activity with Tinnitus: A Scoping Review

Background: Emerging evidence suggests that metabolic, nutritional, and lifestyle-related factors may be associated with tinnitus occurrence and symptom burden. Nutritional status, obesity, and sedentary behavior have been hypothesized to be linked with auditory function, neural excitability, and tinnitus-related outcomes. This scoping review aimed to map and summarize the available evidence on associations between dietary factors, nutrient intake, body mass index (BMI), obesity, physical activity, and tinnitus occurrence, severity, and related clinical outcomes. Methods: A scoping review was conducted in accordance with 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 studies, case–control studies, and cross-sectional studies. Data were extracted and synthesized narratively due to methodological heterogeneity. Results: Twenty-four studies met the inclusion criteria. Several observational studies reported associations between protein intake, lipid profile, micronutrient status, BMI, obesity, physical activity, and tinnitus-related outcomes. Evidence on antioxidant supplementation was heterogeneous, with some trials reporting favorable changes in tinnitus-related measures and others showing no significant benefit compared with placebo. Elevated BMI, obesity, and altered body composition were generally associated with tinnitus occurrence or greater symptom severity. Randomized trials suggested that structured lifestyle programs involving dietary modification, weight reduction, and physical activity may be associated with improvements in tinnitus severity and quality of life in selected patient groups. Conclusions: The available literature suggests potential associations between nutritional, metabolic, and lifestyle-related factors and tinnitus occurrence or symptom severity. However, the evidence is heterogeneous and largely observational, with inconsistent adjustment for hearing loss, psychological distress, and general health status. Further well-designed prospective studies and randomized controlled trials are needed before causal or clinical recommendations can be formulated.