RT Journal Article SR Electronic T1 Association of 15 common dietary factors with tinnitus: a systematic review and meta-analysis of observational studies JF BMJ Open JO BMJ Open FD British Medical Journal Publishing Group SP e091507 DO 10.1136/bmjopen-2024-091507 VO 15 IS 3 A1 Zhang, Mengni A1 Wang, Xiaocui A1 Zhang, Shipeng A1 He, Xinyi A1 Chen, Xi A1 Wang, Lu A1 Fu, Li A1 Wang, Hanyu A1 Fu, Qinwei A1 Jiang, Yanjie A1 Li, Xinrong A1 Zhang, Qinxiu YR 2025 UL http://bmjopen.bmj.com/content/15/3/e091507.abstract AB Objective A systematic analysis was conducted to investigate the association between tinnitus incidence and daily dietary patterns.Design We conducted a systematic review and meta-analysis of observational studies.Data sources The PubMed, Embase, Web of Science and Cochrane Library databases were searched from their inception to 25 May 2024.Eligibility criteria for selecting studies We included observational studies from peer-reviewed English-language journals that examined tinnitus presence or severity in adults aged 18 years or older, including associated prevalence estimates.Data extraction and synthesis Data extraction was independently conducted by two evaluators, who assessed research bias using the Agency for Newcastle-Ottawa Scale and applied evidence classification criteria for aggregate grade strength assessment. This study adhered to the guidelines of the Preferred Reporting Project (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and Meta-Analysis of Epidemiological Observational Studies, as well as the PROSPERO Registry protocols. A mixed-effect model combined maximum adjusted estimates, with heterogeneity measured using the I2 statistic. Sensitivity analysis validated the robustness of the analysis, and publication bias was assessed qualitatively and quantitatively.Results A total of 10 retrospective studies were identified and included in this analysis, with the last eight studies incorporated into the meta-analysis. Fifteen dietary factors were examined. Fruit intake, dietary fibre, caffeine and dairy product consumption were negatively correlated with tinnitus incidence (OR=0.649 (95% CI 0.532, 0.793), p<0.0001), (OR=0.918 (95% CI 0.851, 0.990), p=0.03), (OR=0.898 (95% CI 0.862, 0.935), p<0.00001), (OR=0.827 (95% CI 0.766, 0.892), p<0.00001), respectively. A sensitivity analysis confirmed the robustness of the findings.Conclusions This systematic review and meta-analysis suggest a link between particular dietary elements and a lower incidence of tinnitus.PROSPERO registration number CRD42023493856.Data are available upon reasonable request. The data used to support the findings of this study are available from the corresponding author upon request.