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Duquenne P, Capperella J, Fezeu LK, Srour B, Benasi G, Hercberg S, Touvier M, Andreeva VA, St-Onge MP. The Association Between Ultra-Processed Food Consumption and Chronic Insomnia in the NutriNet-Santé Study. J Acad Nutr Diet 2024; 124:1109-1117.e2. [PMID: 38423510 DOI: 10.1016/j.jand.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 01/02/2024] [Accepted: 02/26/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND The consumption of ultra-processed foods (UPF) is on the rise worldwide, and it has been linked to numerous health conditions, such as diabetes, obesity, and cancer. Few studies have focused on the effect of UPF consumption on sleep health and even fewer on chronic insomnia. OBJECTIVE This study investigated the association between UPF intake and chronic insomnia in a large population-based sample. DESIGN This was a cross-sectional analysis using the NutriNet-Santé study data, an ongoing Web cohort in France. PARTICIPANTS/SETTING Thirty-eight thousand five hundred seventy adult males and females who had completed a sleep questionnaire (2014) and at least two 24-hour dietary records were included in the analysis. MAIN OUTCOMES MEASURES Chronic insomnia was defined according to established criteria. Categorization of food and beverages as UPF was based on the NOVA-Group 4 classification. STATISTICAL ANALYSES PERFORMED The cross-sectional association between UPF intake and chronic insomnia was assessed using multivariable logistic regression. RESULTS Among the 38,570 participants (mean age, 50.0 ±14.8 years, 77.0% female) included in the analysis, 19.4% had symptoms of chronic insomnia. On average, UPF represented 16% of the total amount (g/day) of the overall dietary intake. In the fully adjusted model, UPF consumption was associated with higher odds of chronic insomnia (odds ratio [OR] for an absolute 10% greater UPF intake in the diet = 1.06; 95% confidence interval [CI]: 1.02-1.09). Sex-specific OR for chronic insomnia for an absolute 10% greater UPF intake in the diet were 1.09 (1.01-1.18) among males and 1.05 (1.01-1.09) among females. CONCLUSIONS This large epidemiological study revealed a statistically significant association between UPF intake and chronic insomnia, independent of sociodemographic, lifestyle, diet quality, and mental health status covariates. The findings provide insights for future longitudinal research as well as nutrition- and sleep-focused intervention and prevention programs.
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Affiliation(s)
- Pauline Duquenne
- Sorbonne Paris Nord University and Paris Cité University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center for Research in Epidemiology and Statistics (CRESS), Bobigny, France.
| | - Julia Capperella
- Sorbonne Paris Nord University and Paris Cité University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center for Research in Epidemiology and Statistics (CRESS), Bobigny, France
| | - Léopold K Fezeu
- Sorbonne Paris Nord University and Paris Cité University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center for Research in Epidemiology and Statistics (CRESS), Bobigny, France
| | - Bernard Srour
- Sorbonne Paris Nord University and Paris Cité University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center for Research in Epidemiology and Statistics (CRESS), Bobigny, France
| | - Giada Benasi
- Division of General Medicine and Center of Excellence for Sleep & Circadian Research, Department of Medicine, Columbia University, New York, NY
| | - Serge Hercberg
- Sorbonne Paris Nord University and Paris Cité University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center for Research in Epidemiology and Statistics (CRESS), Bobigny, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University and Paris Cité University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center for Research in Epidemiology and Statistics (CRESS), Bobigny, France
| | - Valentina A Andreeva
- Sorbonne Paris Nord University and Paris Cité University, INSERM, INRAE, CNAM, Nutritional Epidemiology Research Team (EREN), Center for Research in Epidemiology and Statistics (CRESS), Bobigny, France; Division of General Medicine and Center of Excellence for Sleep & Circadian Research, Department of Medicine, Columbia University, New York, NY
| | - Marie-Pierre St-Onge
- Division of General Medicine and Center of Excellence for Sleep & Circadian Research, Department of Medicine, Columbia University, New York, NY.
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Wang Z, Wang Y, Shang W, Liu W, Lu C, Huang J, Lei C, Chen Z, Wang Z, Yang K, Li X, Lu C. Reporting quality and risk of bias of systematic reviews of ultra-processed foods: a methodological study. Eur J Clin Nutr 2024; 78:171-179. [PMID: 38093096 DOI: 10.1038/s41430-023-01383-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/22/2023] [Accepted: 11/27/2023] [Indexed: 03/13/2024]
Abstract
A dramatic shift in the global food system is occurring with the rapid growth of ultra-processed foods (UPFs) consumption, which poses potentially serious health risks. Systematic review (SR) method has been used to summarise the association between UPF consumption and multiple health outcomes; however, a suboptimal-quality SR may mislead the decision-making in clinical practices and health policies. Therefore, a methodological review was conducted to identify the areas that can be improved regarding the risk of bias and reporting quality of relevant SRs. Systematic searches to collect SRs with meta-analyses of UPFs were performed using four databases from their inception to April 14, 2023. The risk of bias and reporting quality were evaluated using ROBIS and PRISMA 2020, respectively. The key characteristics of the included SRs were summarised descriptively. Excel 2019 and R 4.2.3 were used to analyse the data and draw graphs. Finally, 16 relevant SRs written in English and published between 2020 and 2023 in 12 academic journals were included. Only one SR was rated as low risk of bias, and the others were rated as higher risk of bias mainly because the risk of bias in the original studies was not explicitly addressed when synthesising the evidence. The reporting was required to be advanced significantly, involving amendments of registration and protocol, data and analytic code statement, and lists of excluded studies with justifications. The reviews' results could improve the quality, strengthen future relevant SRs' robustness, and further underpin the evidence base for supporting clinical decisions and health policies.
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Affiliation(s)
- Ziyi Wang
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China
- Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Yan Wang
- Shangluo Central Hospital of Shaanxi Provincial, Shangluo, 726000, China
| | - Wenru Shang
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China
- Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Wendi Liu
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China
- Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Cui Lu
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China
- Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Jiayi Huang
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China
- Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Chao Lei
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, 100700, Beijing, China
| | - Zijia Chen
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, 100700, Beijing, China
| | - Zhifei Wang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, 100700, Beijing, China
| | - Kehu Yang
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China
- Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
| | - Xiuxia Li
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China.
- Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China.
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China.
| | - Cuncun Lu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, 100700, Beijing, China.
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3
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Barbaresko J, Bröder J, Conrad J, Szczerba E, Lang A, Schlesinger S. Ultra-processed food consumption and human health: an umbrella review of systematic reviews with meta-analyses. Crit Rev Food Sci Nutr 2024:1-9. [PMID: 38363072 DOI: 10.1080/10408398.2024.2317877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
Recently, ultra-processed foods received a lot of attention, but also criticism. Our aim was to provide an overview of the existing evidence of ultra-processed food consumption on human health. We conducted a systematic search in four databases until January 5th, 2024. Systematic reviews with meta-analyses on ultra-processed food consumption as defined by the NOVA classification system were included. The certainty of evidence was evaluated by the GRADE approach. We identified 16 publications. Moderate certainty of evidence was found for all-cause mortality (Summary Risk Ratio per 50 g: 1.02; 95% confidence Interval (CI): 1.01, 1.03), cardiovascular disease incidence and mortality (per 50 g/d: 1.04; 95% CI: 1.02, 1.06, and 1.05; 95% CI: 1.01, 1.08), type 2 diabetes incidence (per 10%: 1.12; 95% CI: 1.10, 1.13) and colorectal cancer (per 10%: 1.04; 95% CI: 1.01, 1.07). For several outcomes such as inflammatory bowel diseases, obesity, metabolic syndrome, nonalcoholic fatty liver disease, mental health as well as nutrient quality, similar estimates were observed, but certainty of evidence was limited. Discussing the NOVA concept, it remains unclear whether the processing of foods leads to increased health risks or if ultra-processed food consumption is only a measure for poor diet quality.
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Affiliation(s)
- Janett Barbaresko
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
| | | | | | - Edyta Szczerba
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, Munich-Neuherberg, Germany
| | - Alexander Lang
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
| | - Sabrina Schlesinger
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, Munich-Neuherberg, Germany
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Wang Z, Lu C, Cui L, Fenfen E, Shang W, Wang Z, Song G, Yang K, Li X. Consumption of ultra-processed foods and multiple health outcomes: An umbrella study of meta-analyses. Food Chem 2024; 434:137460. [PMID: 37722333 DOI: 10.1016/j.foodchem.2023.137460] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 09/05/2023] [Accepted: 09/10/2023] [Indexed: 09/20/2023]
Abstract
Consumption of ultra-processed foods (UPFs) is associated with various adverse health outcomes, which significantly influence the global disease burden. This umbrella review aimed to fill the knowledge gap and guide public health practices by summarizing the association between UPFs and multiple health outcomes. A total of four databases were systematically searched from inception to December 2022, and 14 eligible systematic reviews (SRs) with meta-analyses (MAs) were identified. The SRs were published in 10 journals from 2020 to 2023, with 54,147-5,750,133 participants and 5-61 studies. The overall corrected covered area (CCA) was corresponded to a slight overlap. The results showed that an increased UPFs consumption is associated with multiple health outcomes (e.g., obesity, diabetes, hypertension, mortality). Only two SRs were "Moderate" regarding the overall methodological quality, while the other twelve were "Low" or "Critically low". Therefore, well-conducted SRs with high-quality prospective cohorts with a particular focus on special populations are needed to verify these findings further.
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Affiliation(s)
- Ziyi Wang
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China
| | - Cuncun Lu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China.
| | - Lu Cui
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China
| | - E Fenfen
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China
| | - Wenru Shang
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China
| | - Zhifei Wang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Guihang Song
- Gansu Healthcare Security Administration, Lanzhou 730000, China
| | - Kehu Yang
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China.
| | - Xiuxia Li
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou 730000, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China.
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5
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Andreeva VA, Perez-Jimenez J, St-Onge MP. A Systematic Review of the Bidirectional Association Between Consumption of Ultra-processed Food and Sleep Parameters Among Adults. Curr Obes Rep 2023; 12:439-452. [PMID: 37477854 PMCID: PMC11165373 DOI: 10.1007/s13679-023-00512-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/25/2023] [Indexed: 07/22/2023]
Abstract
PURPOSE OF REVIEW We summarized research on the bidirectional association between intake of ultra-processed food (UPF) and sleep. RECENT FINDINGS Sleep contributes to cardiometabolic health in part via food intake patterns. Restricting sleep increases intakes of high-carbohydrate/high-fat foods, a profile representative of UPF. This systematic review covers the association of UPF intake, as an exposure or an outcome, and sleep. UPF was defined as NOVA Group 4. MEDLINE and EMBASE were searched through April 2023 for epidemiological studies with general-population adult samples. Fifteen studies met the inclusion criteria; all were cross-sectional, published between 2016 and 2023, with samples from Brazil (n = 8), Spain (n = 2), Italy (n = 1), the UK (n = 1), Paraguay (n = 1), Iran (n = 1) and China (n = 1). Thirteen studies examined UPF intake as the exposure whereas two tested UPF intake as the outcome. UPF intakes were determined using food frequency questionnaires (73%) or 24-h recalls (27%). Two studies assessed sleep via accelerometry; the remaining studies relied on self-reports of sleep quality, duration, anxiety-induced insomnia, and napping, with 60% using a single question. The average methodological quality across the studies was deemed "fair". Six of the 13 studies that examined UPF consumption as the exposure revealed inverse associations with sleep outcomes in adjusted (n = 5) or bivariate (n = 1) analyses. Both studies addressing UPF consumption as the outcome and sleep as the exposure showed significant inverse associations. Evidence for UPF-sleep associations is accumulating, although sleep assessment limitations are apparent. This review can provide impetus for research using comprehensive and validated sleep measures and nudge policymakers towards refining dietary guidelines worldwide.
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Affiliation(s)
- Valentina A Andreeva
- Nutritional Epidemiology Research Group, INSERM U1153/INRAE U1125/CNAM, Epidemiology and Statistics Research Center (CRESS), Sorbonne Paris Nord University, 93017, Bobigny, France
- Division of General Medicine and Center of Excellence for Sleep & Circadian Research, Department of Medicine, Columbia University, New York, NY, 10032, USA
| | - Jara Perez-Jimenez
- Institute of Food Science, Technology and Nutrition, Spanish Research Council (ICTAN-CSIC), 28040, Madrid, Spain
- Division of General Medicine and Center of Excellence for Sleep & Circadian Research, Department of Medicine, Columbia University, New York, NY, 10032, USA
- CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), ISCIII, 28029, Madrid, Spain
| | - Marie-Pierre St-Onge
- Division of General Medicine and Center of Excellence for Sleep & Circadian Research, Department of Medicine, Columbia University, New York, NY, 10032, USA.
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Affiliation(s)
- Rachael Hall
- Department of Cardiology, Bankstown Hospital, Bankstown, New South Wales, Australia
- Deparment of Cardiology, St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Hariharan Raju
- Faculty of Human Sciences, Macquarie University, Sydney, New South Wales, Australia
- Department of Cardiology, Concord Hospital, Concord, New South Wales, Australia
| | - Chrishan Nalliah
- Department of Cardiology, Bankstown Hospital, Bankstown, New South Wales, Australia
- Faculty of Human Sciences, Macquarie University, Sydney, New South Wales, Australia
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Grimaldi M, Bacaro V, Natale V, Tonetti L, Crocetti E. The Longitudinal Interplay between Sleep, Anthropometric Indices, Eating Behaviors, and Nutritional Aspects: A Systematic Review and Meta-Analysis. Nutrients 2023; 15:3179. [PMID: 37513597 PMCID: PMC10385596 DOI: 10.3390/nu15143179] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 07/11/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
Sleep is fundamental for adolescents' healthy development but undergoes dramatic changes in quantity and quality due to the conflict between biological and social rhythms. Insufficient sleep has been associated with worse physical health status and irregular eating behaviors in adolescents. This review aims to systematically synthesize the longitudinal associations between adolescents' sleep dimensions (i.e., duration, timing, quality, and insomnia symptoms) and physical health indicators (i.e., anthropometric indices, fat percentage, and risk of obesity), eating behaviors, and nutritional aspects (i.e., type of diet related to the intake of specific foods and nutrients, amount and timing of food consumption, energy expenditure). A total of 28 longitudinal studies were included. The meta-analytic results showed that longer sleep duration, better sleep quality, and lower insomnia symptoms were associated with lower BMI and fat percentage and that shorter sleep duration (<7 h) and lower sleep quality were associated with a higher risk of obesity. Conversely, anthropometric indices were not related to sleep over time. Limited literature examined the bidirectional association between adolescents' sleep and their eating behaviors and nutritional aspects. Such knowledge sheds new light on the role of sleep for adolescents' health, highlighting the need to examine further the interplay between these variables.
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Affiliation(s)
- Martina Grimaldi
- Department of Psychology "Renzo Canestrari", University of Bologna, 40126 Bologna, Italy
| | - Valeria Bacaro
- Department of Psychology "Renzo Canestrari", University of Bologna, 40126 Bologna, Italy
| | - Vincenzo Natale
- Department of Psychology "Renzo Canestrari", University of Bologna, 40126 Bologna, Italy
| | - Lorenzo Tonetti
- Department of Psychology "Renzo Canestrari", University of Bologna, 40126 Bologna, Italy
| | - Elisabetta Crocetti
- Department of Psychology "Renzo Canestrari", University of Bologna, 40126 Bologna, Italy
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Alves ÁE, Canaan MM, Baruqui Junior AM, Barros FC, Andrade EF, Castelo PM, Pereira LJ. Metabolic control of diabetic patients assisted by private and public health care systems during the COVID-19 pandemic: A retrospective cohort study. Prim Care Diabetes 2023; 17:242-249. [PMID: 37031080 PMCID: PMC10070783 DOI: 10.1016/j.pcd.2023.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 03/04/2023] [Accepted: 04/03/2023] [Indexed: 04/07/2023]
Abstract
AIMS We sought to analyze the impacts of social restriction measures imposed by the pandemic COVID-19 on the control of metabolic parameters in diabetic patients. METHODS We accessed the medical records of patients who underwent clinical follow-up in the public and private health systems between July 2019 and June 2021. The sample consisted of 288 patients (111 adults and 177 older individuals). A two-way ANOVA mixed model was used to test the effects of intra- (time: baseline and after 24 months) and inter-subject factors. Linear regression analysis was used to predict the difference in body weight considering age, sex, HbA1c, health care system and insulin use. RESULTS Among adults, we observed an increase in body weight and LDL-c levels, especially for insulin users (p ≤ 0.05). Adults assisted by the public health care system showed higher HbA1c levels (p = 0.001). Among older individuals using insulin, blood glucose levels decreased (p = 0.019). Body weight decreased in those assisted by the private system (p = 0.005), while glycemia decreased for patients assisted by both health care systems (p = 0.043). The linear regression model confirmed that the increase in body weight was more pronounced in adults than in older individuals. CONCLUSION The social restriction measures imposed by the pandemic affected the metabolic control of diabetic patients, especially adults assisted by the public health care system.
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Affiliation(s)
| | - Marcelo Martins Canaan
- Department of Medicine, Universidade Federal de Lavras (UFLA), Lavras, Brazil; Health Sciences Program, Universidade Federal de Lavras (UFLA), Lavras, Brazil
| | | | | | - Eric Francelino Andrade
- Department of Medicine, Universidade Federal de Lavras (UFLA), Lavras, Brazil; Health Sciences Program, Universidade Federal de Lavras (UFLA), Lavras, Brazil
| | - Paula Midori Castelo
- Department of Pharmaceutical Sciences, Universidade Federal de São Paulo (UNIFESP), Diadema, Brazil
| | - Luciano José Pereira
- Department of Medicine, Universidade Federal de Lavras (UFLA), Lavras, Brazil; Health Sciences Program, Universidade Federal de Lavras (UFLA), Lavras, Brazil.
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López-Gil JF, Smith L, Victoria-Montesinos D, Gutiérrez-Espinoza H, Tárraga-López PJ, Mesas AE. Mediterranean Dietary Patterns Related to Sleep Duration and Sleep-Related Problems among Adolescents: The EHDLA Study. Nutrients 2023; 15:665. [PMID: 36771375 PMCID: PMC9919059 DOI: 10.3390/nu15030665] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 01/20/2023] [Accepted: 01/24/2023] [Indexed: 01/31/2023] Open
Abstract
PURPOSE The aim of the present study was to examine the association of adherence to the Mediterranean Diet (MD) and its specific components with both sleep duration and sleep-related disorders in a sample of adolescents from the Valle de Ricote (Region of Murcia, Spain). METHODS This cross-sectional study included a sample of 847 Spanish adolescents (55.3% girls) aged 12-17 years. Adherence to the MD was assessed by the Mediterranean Diet Quality Index for Children and Teenagers. Sleep duration was reported by adolescents for weekdays and weekend days separately. The BEARS (Bedtime problems, Excessive daytime sleepiness, Awakenings during the night, Regularity and duration of sleep, and Sleep-disordered breathing) screening was used to evaluate issues related to sleep, which include difficulties at bedtime, excessive drowsiness during the day, waking up frequently during the night, irregularity, length of sleep, and breathing issues while sleeping. RESULTS Adolescents who presented a high adherence to the MD were more likely to meet the sleep recommendations (OR = 1.52, 95% CI 1.12-2.06, p = 0.008) and less likely to report at least one sleep-related problem (OR = 0.56, 95% CI 0.43-0.72, p < 0.001). These findings remained significant after adjusting for sex, age, socioeconomic status, waist circumference, energy intake, physical activity, and sedentary behavior, indicating a significant association of adherence to the MD with sleep outcomes (meeting sleep recommendations: OR = 1.40, 95% CI 1.00-1.96, p = 0.050; sleep-related problems: OR = 0.68, 95% CI 0.50-0.92, p = 0.012). CONCLUSIONS Adolescents with high adherence to the MD were more likely to report optimal sleep duration and fewer sleep-related problems. This association was more clearly observed for specific MD components, such as fruits, pulses, fish, having breakfast, dairies, sweets, and baked goods/pastries.
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Affiliation(s)
- José Francisco López-Gil
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02138, USA
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | | | | | - Pedro J. Tárraga-López
- Departamento de Ciencias Médicas, Facultad de Medicina, Universidad de Castilla-La Mancha, 02008 Albacete, Spain
| | - Arthur Eumann Mesas
- Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina 86057-970, Brazil
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