Relationship between nutrition and sleep quality, focusing on the melatonin biosynthesis

Association of macronutrient intake, physical activity, anxiety, and depression with sleep quality among Iranian male adolescents

BACKGROUND

Adolescence is a unique stage of life accompanied by physiological and psychological modifications, along with stress, confusion, and depression.

MATERIALS AND METHODS

The present descriptive-analytical cross-sectional research was done on 267 male adolescents who studied at high schools in Zanjan, Iran. Demographic characteristics questionnaires, a 48-item food frequency questionnaire, a short version of the International Physical Activity Questionnaire (IPAQ), the Depression Anxiety Stress Scale (DASS-21), and the Pittsburgh Sleep Quality Index (PSQI) were used to collect data.

RESULTS

The mean ± standard deviation (SD) of age, weight, height, and sitting time was 15.94 ± 0.91 years, 68.53 ± 15.28 kg, 1.75 ± 0.06 m, and 449.25 ± 322.06 min, respectively. The study results showed that students with poor sleep quality showed a higher rate of depression than those with good sleep quality in the high and low physical activity groups (p < 0.05). The stress, depression, and anxiety scores significantly correlated with sleep quality in the physical activity groups (p < 0.05). The structural equation model analysis results showed that mental health directly affected sleep quality; this association was significant in the low physical activity group.

CONCLUSION

We found that sleep quality was independently related to mental health in young Iranian men. However, dietary intake was not a significant predictor of mental health or sleep quality. More studies are required to evaluate the association between dietary intake and sleep quality in adults.

Alpha-lactalbumin and sleep: A systematic review

Insufficient sleep is a growing global problem, with poor sleep associated with many negative health and performance outcomes. Previous reviews investigating the effect of diet on sleep have highlighted the amino acid tryptophan as a promising sleep-promoting nutrient, with the richest food source of tryptophan, ⍺-lactalbumin, requiring further investigation. Therefore, this systematic review aimed to review the existing evidence of association between ⍺-lactalbumin and sleep. Four electronic databases (CINAHL Complete, Embase, MEDLINE Complete, and SPORTDiscus with Full Text) were searched from database inception to March 2023, with primary research articles included if they contained α-lactalbumin as an independent variable, an outcome measure of sleep or sleepiness, and participants were ≥ 18 years old. Eight studies were reviewed, with four studies recruiting athletic populations (50%) and four recruiting healthy participants (50%). Sleep or sleepiness was measured objectively in six studies (75%), with two studies employing polysomnography and four utilizing actigraphy to assess sleep. Across the studies, 20-60 g of ⍺-lactalbumin was supplemented, with five studies (63%) observing a positive association between α-lactalbumin and sleep. Sleep-onset latency was the primary sleep metric improved following evening supplementation of α-lactalbumin (≤ 3.5 hr pre-sleep), with no studies observing any negative associations with sleep. Data from this review suggest that individuals that have difficulty initiating sleep may benefit most from pre-sleep α-lactalbumin supplementation. Further research is required to establish the effect that α-lactalbumin has on sleep architecture, through the use of more comprehensive sleep analysis tools such as portable electroencephalography or polysomnography, in combination with stringent dietary controls.

The association of dietary inflammatory index with sleep outcomes: A systematic review

Background

Sleep is a vital physiological process that plays a crucial role in various aspects of human health and well-being. Regarding the important role of diet on the sleep quality, the present study aimed to assess the association of dietary inflammatory index (DII) with the sleep outcomes and also to provide the potential mechanisms of action.

Methods

PubMed, Web of Science and Scopus databases and Google Scholar search engine were systematically searched for relevant studies related to DII and sleep outcomes using appropriate search terms until February 2024.

Results

From the initial systematic search of databases, 197 studies were retrieved. However, only 14 of them met the criteria for evaluation. Out of these, eleven studies indicated a significant correlation between higher DII scores and poor overall sleep quality and/or short/long sleep duration or its subscales. On the contrary, four studies did not find any proof of this association.

Conclusion

This systematic review indicated that following an anti-inflammatory diet could potentially lead to an improvement in the sleep outcomes. Well-designed clinical trials in the future will be necessary to provide a better understanding and quantification of this association.

Relationship between dietary diversity and sleep quality: a Chinese community-based study

OBJECTIVES

The objective of this study was to examine the association between dietary diversity and sleep quality among Chinese middle-aged and older adults.

METHODS

The Lifestyle and Healthy Aging of Chinese Square Dancer Study is a prospective, community-based cohort study that enrolled participants aged 45 years and above from 2020 to 2021. Using the semiquantitative food frequency questionnaire to investigate the diets of study participants, and using the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality. Dietary diversity was assessed using two scoring methods covering ten food groups and 66 food items, respectively: the dietary diversity score (DDS) and the food variety score (FVS). The higher scores of DDS and FVS indicated greater dietary diversity and higher dietary quality. Logistic regression analysis explored the associations between these scores and sleep quality.

RESULTS

A total of 2409 individuals with completed information on PSQI and FFQ were included in this study, of whom 767 (31.8%) had poor sleep quality. Participants with higher DDS were associated with an 18% lower odds of poor sleep quality compared to those with low DDS (OR = 0.82, 95% CI, 0.68-0.98). Participants in the highest quartile of the FVS had a 32% lower odds of poor sleep quality than those in the lowest quartile (OR = 0.68, 95% CI, 0.52-0.89).

CONCLUSIONS

There was a positive correlation between higher FVS and DDS with better sleep quality. Therefore, ensuring a diverse diet may be beneficial for maintaining good sleep quality among middle-aged and older adults.

Evaluation of the relationship between the Mediterranean diet adherence and sleep quality in adults

PURPOSE

To investigate the association between Mediterranean diet adherence (MDA) and sleep quality in adults.

METHODS

This cross-sectional research was conducted among adults aged 19-64 years in Ankara, Türkiye. Data on demographics, education, lifestyle, and physical activity habits were collected. Mediterranean diet adherence was assessed with the Mediterranean Diet Adherence Screener (MEDAS). Healthy eating attitudes were evaluated with the Attitude Scale for Healthy Nutrition (ASHN). Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI). Data were gathered using an online format.

RESULTS

Among 1031 participants enrolled (74% women), mean age was 28.6 ± 8.3 years. Median age increased with MDA (p = 0.001). As individuals' MDA increased, ASHN total and subgroup scores also increased significantly (p < 0.001). The total sleep duration of the participants with low MDA was significantly lower than the other groups (p = 0.003). Pittsburgh Sleep Quality Index score and MEDAS (β =  - 0.222, p < 0.001), ASHN (β =  - 0.043, p < 0.001) and ASHN subgroups (β = (- 0.086) - (- 0.031)) were found to have a weakly signficant negative relation.

CONCLUSIONS

The findings suggest that healthy eating attitudes and nutritional behavior in accordance with the Mediterranean diet are associated with sleep quality.

Association between self-reported food intake and subjective sleep quality among truck drivers in a city in Southern Brazil

Introduction

Sleep is an activity of great importance for maintaining the homeostasis of the human body and some components may interfere with the quality of sleep, including the pattern of food consumption. Truck drivers may constitute a population particularly sensitive to this association, since they are routinely exposed to situations that may interfere with food intake and sleep quality. Thus, this study investigated the association between self-reported food intake and sleep quality in truck drivers.

Methods

This was a cross-sectional study, with drivers who traveled in a city in southern Brazil. Food intake was evaluated through the average of food intake over the last 30 days. Food intake was evaluated in two forms: division in food groups and evaluation only tryptophan-rich foods. Sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI). In addition to the descriptive analysis, to identify possible associations between food intake and sleep quality, linear regression, crude and adjusted for confounding variables, were performed to obtain the Beta and Beta adjusted (Betaadj), respectively, and p-value.

Results

A total of 352 truck drivers, mostly males, mean age 48.4 (±11.6) years, with a frequent consumption of meat, fruits, vegetables, sweets, and energy drinks participated in this study. The frequent consumption of dairy products (Betaadj: --0.614. p-value 0.004) and fruits (Betaadj: --0.342. p-value 0.034) was associated with lower PSQI score, while the consumption of energy drinks was associated with a higher PSQI score (Betaadj: 0.923. p-value <0.001). The frequency of consumption of tryptophan-rich foods was not associated with sleep quality.

Conclusion

Fruits and dairy products are associated with better subjective sleep quality, while energy drinks are associated with worse sleep quality in truck drivers, whereas dietary tryptophan-rich foods intake was not associated with sleep quality.

[Properties of milk in sleep induction]

Introduction

Sleep induction and its quality are issues of growing concern because its deterioration affects a large number of people and poses a risk to their well-being and quality of life and long-term health. There are several factors involved in the problem, but nutrition is one of them and in particular milk consumption has often been linked to sleep habits, sometimes as a promoter and sometimes as an inhibitor. The purpose of this review is to examine the matter further. On reaching the brain, tryptophan is the basis for the synthesis of serotonin and melatonin, which improve the induction and quality of sleep. But there is competition between tryptophan and other long-chain neutral amino acids (LNAA) (valine, leucine, isoleucine, tyrosine and phenylalanine) to cross the blood-brain barrier and reach the brain. In this sense, milk proteins with a high tryptophan content and the highest ratio between tryptophan and LNAA are very useful in promoting sleep. Moreover, milk also provides various micronutrients that help in the transformation of tryptophan into serotonin and melatonin, as well as antioxidant components, anti-inflammatory and bioactive peptides, and recent studies indicate that it favorably modulates the composition of the intestinal microbiota. Studies show that increasing milk consumption, up to the recommended intake and within a correct diet, favors the achievement and maintenance of quality sleep.

Dietary insulinemic potential, sleep quality and quantity in Iranian adults: Yazd health study and TAMYZ study

BACKGROUND & AIMS

To examine the link between dietary insulin index (DII) and load (DIL) and sleep duration/quality for the first time.

METHODS

This cross-sectional study conducted on data from the recruitment phase of Yazd Health Study (YaHS)-Yazd Nutrition Study (TAMYZ), prospective study in Yazd, central Iran. Data on demographic characteristics, dietary intakes, sleep quantity and quality, and potential confounders were gathered by interview. Sleep quality and its components (insufficient sleep, delay in falling asleep, medication use for sleep, and sleep disorder) were assessed by a modified version of Pittsburgh questionnaire. The link between DII/DIL and low sleep quality and short/long sleep duration was studied using multivariable logistic regression.

RESULTS

In total, 5925 individuals aged 20 to 70 were eligible to take part in the current study. After adjustment for all potential confounders, participants in the highest DIL score tertile had a lower chance for sleep disorder (OR = 0.38; 95%CI: 0.17-0.85, P_trend = 0.02) and delay in falling asleep (OR = 0.66; 95%CI: 0.42-1.03, P_trend = 0.05) compared to those in the lowest tertile. The DII was also linked to a lower chance for sleep disorder (OR = 0.61; 95% CI: 0.39-0.93, P trend = 0.02). The DIL was inversely associated with sleep medication use and delay in falling sleep in men and women, respectively (P < 0.05). Moreover, DII was linked to a decreased odds of sleep disorder in women (P < 0.05). The associations were observed in those with overweight or obesity but not in those without overweight (P < 0.05).

CONCLUSION

Higher DIL and DII might be associated with sleep quality and its components. Prospective investigations are needed in the future to confirm these findings.

The relationships between physical function, nutrition, cognitive function, depression, and sleep quality for facility-dwelling older adults with dynapenia

BACKGROUND

The growing population of older adults worldwide is associated with an extended life expectancy and an increasing proportion of older adults with dynapenia. Most research on dynapenia has involved only populations of older adults living in the community; little research has examined the effects of risk factors on sleep quality among older adults with dynapenia residing in assisted living facilities.

AIM

This study examined the relationships among physical function, nutrition, cognitive function, depression, and sleep quality among older adults with dynapenia residing in assisted living facilities.

METHODS

In this cross-sectional study, data on physical function, nutrition, cognitive function, depression, and sleep quality was collected from 178 older adults with dynapenia residing in assisted living facilities, who were selected using purposive sampling. Descriptive statistical analysis, independent-sample t tests, chi-squared tests, and logistic regression analysis were performed using SPSS 25.0.

RESULTS

The statistical analyses revealed correlations between sleep quality and age (t = 2.37, p < 0.05), level of education (χ2 = 3.85, p < 0.05), grip strength (t = 3.40, p < 0.01), activities of daily living (t = 4.29, p < 0.001), instrumental activities of daily living (t = 2.23, p < 0.001), calf circumference (t = 2.89, p < 0.01), Mini Nutritional Assessment scores (t = 2.29, p < 0.05), Mini Mental State Exam (MMSE) scores (t = 4.50, p < 0.001), and Geriatric Depression Scale (GDS) scores (t = - 4.20, p < 0.001). Calf circumference (OR = 0.8, 95% CI = 0.650.97, p < 0.05), GDS score (OR = 1.42, 95% CI = 1.05-1.92, p < 0.05), and MMSE score (OR = 0.85, 95% CI = 0.73-0.97, p < 0.05) were related to sleep quality among the sample population.

CONCLUSION

Physical function, nutrition, cognitive function, and depression affect the sleep quality of older adults with dynapenia residing in assisted living facilities. Facility nurses must regularly assess these aspects of their patients to ensure that facility-dwelling older adults can maintain their physical function and improve their health to improve the quality of their sleep.

Health and Nutrition Analysis in Older Adults in San José de Minas Rural Parish in Quito, Ecuador

Knowing the health and nutritional status of older adults is crucial to helping them live healthier lives and limiting the need for pharmaceuticals and complicated medical procedures. The objective of this research was to analyze the eating habits (EH), physical activity (PA), and sleep quality (SQ) of older adults in the rural parish of San José de Minas in Quito, Ecuador. Three validated questionnaires were used: the Pittsburgh PSQI for SQ, IPAQ for PA, and frequency of consumption for EH. The results revealed high consumption of refined flours and sugar (70% at least once a day), low intake of whole grains, fish, and olive oil, and considerable consumption of fruits and water. Fifty percent of respondents engage in moderate physical activity and 24% in low physical activity, while 90% of older adults have poor sleep quality. These results indicate a problem in the integral health of the population that does not allow older adults to have a good old age. Health campaigns should be developed to increase physical activity, encourage a better diet, and thus, improve the quality of sleep.

Association of Breastfeeding Practices During the First 3 Months with Infant Sleep Trajectories: A Prospective Cohort Study

BACKGROUND

Breastfeeding has numerous effects on maternal and child health. The effect of breastfeeding on infant sleep remains inconclusive.

OBJECTIVES

We aimed to examine whether full breastfeeding (FBF) during the first 3 mo is associated with longitudinal infant sleep trajectories in their first 2 y of life.

METHODS

The study was embedded in the Tongji Maternal and Child Health Cohort study. Information on infant feeding practices was collected at 3 mo of age, and maternal/child pairs were assigned to the FBF or the non-FBF group (including partially breastfeeding and exclusive formula feeding) on the basis of feeding practices during the first 3 mo of life. Sleep data of infants were obtained at 3, 6, 12, and 24 mo. Total, night, and day sleep trajectories across 3 to 24 mo were estimated with group-based models. Each sleep trajectory was differentiated on the basis of sleep duration at 3 mo (long/moderate/short) and the interval from 6 to 24 mo (moderate/short). Multinomial logistic regression was used to investigate the association of breastfeeding practices with infant sleep trajectories.

RESULTS

Among the 4056 infants studied, 2558 (63.1%) received FBF for 3 mo. When compared with FBF infants, non-FBF infants had shorter sleep duration at 3, 6, and 12 mo (P < 0.01). Non-FBF infants were more likely to experience Moderate-Short (OR: 1.31; 95% CI: 1.06, 1.61) and Short-Short (OR: 1.56; 95% CI: 1.12, 2.16) total sleep trajectories and more likely to experience Moderate-Short (OR: 1.84; 95% CI: 1.22, 2.77), and Short-Moderate (OR: 1.40; 95% CI: 1.06, 1.85) night sleep trajectories than FBF infants.

CONCLUSIONS

Full breastfeeding for ≥3 mo were positively associated with longer infant sleep duration. Infants fully breastfed were more likely to experience better sleep trajectories characterized by longer duration in their first 2 y of life. Full breastfeeding may benefit infants through healthy sleep.

Carbohydrate and sleep: An evaluation of putative mechanisms

Sleep problems are extremely common in industrialized countries and the possibility that diet might be used to improve sleep has been considered. The topic has been reviewed many times, resulting in the frequent suggestion that carbohydrate increases the uptake of tryptophan by the brain, where it is metabolized into serotonin and melatonin, with the suggestion that this improves sleep. An alternative mechanism was proposed based on animal literature that has been largely ignored by those considering diet and sleep. The hypothesis was that, as in the hypothalamus there are glucose-sensing neurons associated with the sleep-wake cycle, we should consider the impact of carbohydrate-induced changes in the level of blood glucose. A meta-analysis found that after consuming a lower amount of carbohydrate, more time was spent in slow-wave sleep (SWS) and less in rapid-eye-movement sleep. As the credibility of alternative mechanisms has tended not to have been critically evaluated, they were considered by examining their biochemical, nutritional, and pharmacological plausibility. Although high carbohydrate consumption can increase the uptake of tryptophan by the brain, it only occurs with such low levels of protein that the mechanism is not relevant to a normal diet. After entering the brain tryptophan is converted to serotonin, a neurotransmitter known to influence so many different aspects of sleep and wakefulness, that it is not reasonable to expect a uniform improvement in sleep. Some serotonin is converted to melatonin, although the exogenous dose of melatonin needed to influence sleep cannot be credibly provided by the diet. This review was registered in the International Prospective Register of Systematic Reviews (CRD42020223560).

Examining the role of systemic chronic inflammation in diet and sleep relationship

BACKGROUND

It is well known that systemic chronic inflammation (SCI), which can be modulated by diet, is associated with poor sleep outcomes. However, the role of SCI in diet health and sleep quality relationship has not been well established.

METHODS

Here, by using the UK Biobank data set, we assessed the association between markers of SCI (leukocyte, platelet, lymphocyte, neutrophil, and basophil counts; C-reactive protein levels and neutrophil to lymphocyte ratio (NLR)), habitual intake of food groups, diet health and sleep quality in 449,084 participants. We also formally tested the possibility that SCI might mediate the relationship between diet health and sleep quality.

RESULTS

Our results revealed (i) negative associations between SCI and food groups that are abundant in healthy diets (fruit, vegetable and oily and non-oily fish) and (ii) positive associations between SCI and food groups that are abundant in unhealthy diets (processed meat). Sleep quality was also negatively associated with platelet counts, CRP levels and NLR. Crucially, however, while platelet and neutrophil counts, CRP levels and NLR fully mediated the association between diet health and sleep quality, leukocyte, lymphocyte and basophil counts partially mediated the associations between diet health and sleep quality.

CONCLUSION

Reducing SCI via dietary interventions could be an effective primary and/or complementary strategy to increase sleep quality. Further interventional trials are warranted to (i) establish the strength of associations, preferably by using validated diet and sleep measures and (ii) examine longer term effects of anti-inflammatory diets on sleep-, diet- and inflammation-related health outcomes.

Association Between Dietary Protein Intake and Sleep Quality in Middle-Aged and Older Adults in Singapore

Poor sleep has been associated with the increased risk of developing detrimental health conditions. Diet and certain nutrients, such as dietary protein (PRO) may improve sleep. This cross-sectional study aimed to investigate the relationship between PRO intake, their amino acid components, and sources with sleep quality in middle-aged and older adults residing in Singapore. A dataset of 104 healthy subjects between the age of 50 and 75 years old were used. Collected data included 3-day food record and sleep quality [sleep duration, global sleep score (GSS), sleep latency (SL), and sleep efficiency (SE)]. The collected 3-day food records were extracted for PRO, tryptophan (Trp), and large neutral amino acid (LNAA) intake. PRO intake was further categorized into plant and animal PRO. A multivariate multiple linear regression (MLR) was performed to assess the association between PRO intake and sleep quality. Dietary Trp:LNAA ratio was positively associated with sleep duration (β_total: 108.234 h; p: 0.005) after multiple covariates adjustment. Similarly, plant Trp (β_plant: 2.653 h/g; p: 0.020) and plant Trp:LNAA (β_plant: 54.006 h; p: 0.008) was positively associated with sleep duration. No significant associations were observed for both SL and SE. Sleep duration in middle-aged and older Singaporean adults was positively associated with dietary Trp and Trp:LNAA, especially when obtained from plant sources.

Lack of association between serum vitamin B12 and nocturnal sleep parameters following cyanocobalamin supplementation in healthy adults

Background

This study examined the effect of vitamin B12 supplementation on sleep parameters of latency, total sleep time, wake-after-sleep onset, total time in bed and sleep efficiency in healthy adults.

Methods

This quasi-experimental pre-test, post-test design recruited adults 25–50 years old, with normal vitamin B12 levels. Sleep parameters were assessed using Phillips Respironics Actiwatch-2® on non-dominant wrist from Monday to Thursday for four weeks. Pre-supplementation data was collected for the first two weeks; then participants started 3mg pre-packaged cyanocobalamin supplements daily for 14 days. Post-supplementation data was collected for weeks three and four. Serum was collected by venipuncture at the beginning and end of the study for vitamin B12 assay. Descriptive statistics involved median and interquartile range [IQR]. A comparison of the sleep parameters before and after cyanocobalamin supplementation was done using non-parametric inferential analysis.

Results

Fourteen healthy adult participants completed the study; nine females and five males with median age of 37[17] years and a normal range of serum vitamin B12 level (169–695 pmol/L). Median serum vitamin B12 level was significantly elevated following supplementation (355[217] to 961[679]) pmol/L; p = 0.020); but there was no change in any of the sleep parameters measured. Spearman's rho correlation analysis showed no correlation between serum vitamin B12 levels and the sleep parameters for pre-supplementation and post-supplementation weeks.

Conclusion

Two weeks of cyanocobalamin supplementation (3mg/day) resulted in the expected increase in serum vitamin B12 levels in healthy adults but did not influence their sleep wake activity.

Dietary glycemic index and glycemic load in association with sleep duration: YaHS-TAMYZ and Shahedieh observational studies

BACKGROUND & AIMS

Current data on the association between dietary glycemic index (GI) and glycemic load (GL) and sleep duration are limited and controversial. The present cross-sectional study aimed to investigate the relationship between dietary GI and GL with sleep duration in a large number of adults living in central Iran.

METHODS

Baseline data from two Iranian cohorts were pooled for the current analysis: the YaHS-TAMYZ (n = 9962) and Shahedieh (n = 9977) studies. Demographic data as well as dietary intakes, sleep duration, and possible confounders, were collected by interview. Anthropometric measurements were also conducted by trained interviewers. Participants were categorized based on sleep duration [short (<6 h), normal (6-8 h), and long (>8 h)]. Multivariable logistic regression was used to determine the relationship between dietary GI/GL and the likelihood of short and long sleep duration.

RESULTS

In total, 10,451 participants aged 20-70 years were included in the analyses. After controlling for all possible confounders, no significant association was observed between dietary GI and short or long sleep duration (P > 0.05). Individuals in the highest quartile of dietary GL had a higher chance for long sleep duration compared to participants in the lowest quartile (OR = 1.41; 95% CI: 1.14, 1.74, P_trend = 0.001). No significant association was observed between dietary GL and short sleep duration.

CONCLUSION

Dietary GL is positively associated with the likelihood of long sleep duration. Future prospective studies are required to confirm the current findings.

Lifestyle Adjustments in Long-COVID Management: Potential Benefits of Plant-Based Diets

PURPOSE OF REVIEW

The SARS-CoV-2-pandemic has caused mortality and morbidity at an unprecedented global scale. Many patients infected with SARS-CoV-2 continue to experience symptoms after the acute phase of infection and report fatigue, sleep difficulties, anxiety, and depression as well as arthralgia and muscle weakness. Summarized under the umbrella term "long-COVID," these symptoms may last weeks to months and impose a substantial burden on affected individuals. Dietary approaches to tackle these complications have received comparably little attention. Although plant-based diets in particular were shown to exert benefits on underlying conditions linked to poor COVID-19 outcomes, their role with regard to COVID-19 sequelae is yet largely unknown. Thus, this review sought to investigate whether a plant-based diet could reduce the burden of long-COVID.

RECENT FINDINGS

The number of clinical trials investigating the role of plant-based nutrition in COVID-19 prevention and management is currently limited. Yet, there is evidence from pre-pandemic observational and clinical studies that a plant-based diet may be of general benefit with regard to several clinical conditions that can also be found in individuals with COVID-19. These include anxiety, depression, sleep disorders, and musculoskeletal pain. Adoption of a plant-based diet leads to a reduced intake in pro-inflammatory mediators and could be one accessible strategy to tackle long-COVID associated prolonged systemic inflammation. Plant-based diets may be of general benefit with regard to some of the most commonly found COVID-19 sequelae. Additional trials investigating which plant-based eating patterns confer the greatest benefit in the battle against long-COVID are urgently warranted.

Evaluation of nutritional status and health behaviors of patients infected with COVID-19

INTRODUCTION

Coronavirus disease 2019 (COVID-19) was a health emergency for the world in which started in 2019. Various factors are involved in the pathogenesis of this virus, including age, gender, body mass index (BMI), the type of diet, the degree of observance of health protocols, and the health status of people. The purpose of this study was to evaluate the nutritional status and health behaviors of patients infected with COVID-19.

METHODS

A descriptive-analytical research method was used in this study. One of the outpatient centers for the patients infected with COVID-19 in Kermanshah was selected as the research setting. The study population included all patients infected with COVID-19 and the sample size was 200 people. Data were analyzed by SPSS version 22.

RESULTS

Most patients (51%) were females and most of them suffered from body aches (81%) and headaches (94%). Most of the patients (76%) did not use a mask. Regarding the nutritional status, a large number of patients used all food groups such as carbohydrates, proteins, fruits, and vegetables less than the standard amount.

CONCLUSION

It can be concluded that people with underlying diseases are more prone to the disease than others and adherence to social distancing and mask use helps a lot to control the disease. In addition, the appropriate intake of food groups reduces the severity of the disease by strengthening the immune system in people.

Diet, Sleep, and Mental Health: Insights from the UK Biobank Study

Diet has long been the focus of attention as a leading risk factor for non-communicable diseases. As such, a better understanding of it is crucial to establish priorities for dietary guidelines and to inform, design, and implement strategies for preventing, helping manage, and stopping the progression of sleep and mental health-related symptoms/disorders. The aim of the current study is to conduct the largest investigation of diet, sleep, and mental health to date by utilizing the UK Biobank (UKB) dataset to identify the associations between diet and (i) sleep quality/health, and (ii) mental health symptomatology. This cross-sectional population-based study involved 502,494 middle-aged adults. UKB food frequency, sleep, and psychological factors and mental health questionnaires at baseline were used. Scores were also calculated for healthy diet, healthy sleep, mental health symptomatology, partial fibre intake, and milk intake. We observed positive associations with healthy diet and sleep and mental health, especially benefits of high intakes of vegetable, fruit, fish, water, and fibre. However, processed meat and milk intake were adversely associated with sleep and mental health. These findings make clear that there are health and wellbeing benefits and drawbacks of different diets, but do not, at this stage, demonstrate the clear causal relationships, which would support dietary interventions that might play a role in the treatment and also self-management of sleep and mental health disorders/symptoms. Further research is required to understand mechanisms of actions of which diet acts on to modulate sleep and mental health, while taking comorbidity of sleep and mental health disorders/symptoms into consideration.

The Effects of Milk and Dairy Products on Sleep: A Systematic Review

Several studies have assessed the effects of milk and dairy product intake on sleep quality and duration. Such investigations have varied in terms of their geographic locations, amounts of milk and dairy products, study participants (age, sex, race), and study designs. The present study aimed to summarize this literature and provide a unified view on whether the intake of milk and dairy products affects sleep quality. This systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The following keywords were chosen as electronic database search items from MeSH (medical subject headings) terms and descriptors in health sciences (DeHS) lists: milk, yogurt, dairy product, cheese, sleep, human, observational study, and interventional study. As a result, a total of 14 studies published between 1972 and 2019 were included in this review, including eight randomized controlled trials, two experimental studies with cross-over designs, one longitudinal study, and three cross-sectional studies. Four studies targeted older adults, three included toddlers, two targeted children, and six enrolled adults inclusive of university students. Overall, these studies indicated that a well-balanced diet that includes milk and dairy products is effective in improving sleep quality, despite mixed results across studies attributable to differences in study populations and methods.