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Subjective tinnitus is the perception of sound without any external stimulus. There is no consensus on the aetiology of tinnitus. Obesity is one condition that has been associated with subjective tinnitus. The authors conducted a randomised controlled trial to assess the efficacy of diet and exercise on tinnitus. A total of 63 patients with tinnitus were randomised into four groups: diet + physical activity (P.A.) (n=15), diet (n=16), P.A. (n=15) and control (n=17). P.A. involved taking an average of 10,000 steps per day. Patients who had dietary intervention had an individualised dietary programme. The interventions were undertaken over a period of 12 weeks. Body weight decreased in the diet + P.A. group, diet, and P.A. groups. There was a significant increase in the step counts in the diet + P.A. and P.A. groups. There was a more significant decrease in tinnitus frequency, tinnitus severity, and VAS scores in individuals with a weight loss of ≥ 5.0% than in those with < 5.0% (p < 0.05). This study suggests that diet and exercise alleviate tinnitus symptoms and improve quality of life in individuals with tinnitus, although the exact reason is unclear. Some studies have attributed tinnitus to change of pH in in the cochlea due to free fatty acids in obesity. Treating obesity may improve the pH balance of the inner ear and reduce cochlear vascular injury. Moreover, neurofunctional models that have been used to explain tinnitus include an emotional stress response. Since both diet and exercise are known to have a positive impact on emotional state and psychiatric disorders, they may also improve tinnitus symptoms. Nonetheless, even if further research is needed to investigate the exact reason of tinnitus, clinicians can emphasise the importance of diet and exercise to tinnitus sufferers for improved quality of life.

The effects of dietary and physical activity interventions on tinnitus symptoms: An RCT.
Özbey-Yücel Ü, Uçar A, Aydogan Z, et al.
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Praneta Kulloo

Lewisham and Greenwich NHS Trust, UK.

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