The association between sleep duration, sleep quality, and food consumption in adolescents: A cross-sectional study using the Korea Youth Risk Behavior Web-based Survey

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.

Food Intake and Sleep Disorders in Children and Adolescents with Obesity

Over the last few decades, numerous scientific studies have investigated the possible association between sleep duration and adiposity during childhood, since it has been reported that sleep deprivation causes a related increase in caloric intake. Even though the underlying pathogenetic mechanisms are still under study and not completely known, the effect of dietetic habits and nutrient intake on sleep quality and patterns has been reported. The aim of this study is to explore the intricate interplay between food intake/diet patterns and pediatric sleep disturbances in children and adolescents with obesity, emphasizing the importance of not underestimating this aspect in the prevention and treatment of this complex disease. Recent evidence supports a high correlation between specific diet patterns and foods with sleep disturbances in children at all ages. Diets rich in fiber, fruit, vegetables, and anti-inflammatory nutrients and low in saturated fats seem to promote better sleep quality. Sleep disturbances are, in turn, risk factors for the development of obesity. Therefore, food strategies should be applied to counteract this harmful process. Unraveling the complex links between dietary habits, sleep patterns, and obesity is essential for developing effective strategies to combat this critical public health issue.

Sleep deprivation in development of obesity, effects on appetite regulation, energy metabolism, and dietary choices

Sleep deprivation, which is a decrease in duration and quality of sleep, is a common problem in today's life. Epidemiological and interventional investigations have suggested a link between sleep deprivation and overweight/obesity. Sleep deprivation affects homeostatic and non-homoeostatic regulation of appetite, with the food reward system playing a dominant role. Factors such as sex and weight status affect this regulation; men and individuals with excess weight seem to be more sensitive to reward-driven and hedonistic regulation of food intake. Sleep deprivation may also affect weight through affecting physical activity and energy expenditure. In addition, sleep deprivation influences food selection and eating behaviours, which are mainly managed by the food reward system. Sleep-deprived individuals mostly crave for palatable energy-dense foods and have low desire for fruit and vegetables. Consumption of meals may not change but energy intake from snacks increases. The individuals have more desire for snacks with high sugar and saturated fat content. The relationship between sleep and the diet is mutual, implying that diet and eating behaviours also affect sleep duration and quality. Consuming healthy diets containing fruit and vegetables and food sources of protein and unsaturated fats and low quantities of saturated fat and sugar may be used as a diet strategy to improve sleep. Since the effects of sleep deficiency differ between animals and humans, only evidence from human subject studies has been included, controversies are discussed and the need for future investigations is highlighted.

Associations between Milk Intake and Sleep Disorders in Chinese Adults: A Cross-Sectional Study

We aimed to examine the association of milk intake with sleep disorders and their specific indicators. The current study included 768 adults aged 28-95 from Wenling, China. Milk intake was assessed using a food frequency questionnaire with ten food items, while sleep disorders were measured using the Pittsburgh Sleep Quality Index (PSQI), with higher scores indicating poorer sleep. The participants were divided into two groups according to the average intake of milk per week: rare intake (≤62.5 mL/week) and regular intake (>62.5 mL/week). Primary measurements were multivariate-adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for the prevalence of sleep disorders concerning regular milk intake compared with rare intake. In secondary analyses, linear regression analyses were performed to assess the effects of milk intake on sleep disorders and their specific dimensions. Regular intake of milk did not have a significant association with sleep disorders compared with rare intake (adjusted OR: 0.72, 95%; CI: 0.51, 1.03), but this association was found to be pronounced with sleep disturbances (OR: 0.49, 95%; CI: 0.28, 0.87). Increased intake of milk was significantly associated with the lower scores of PSQI for sleep quality (β: -0.045, 95%; CI: -0.083, -0.007) and sleep disturbances (β: -0.059, 95%; CI: -0.090, -0.029), respectively. When stratified by age and gender, the benefits of milk intake for sleep disorders and sleep disturbances were more significant in older adults (≥65) and men than in younger persons and women. In summary, regular milk intake benefits sleep quality, which may contribute to nutritional psychiatric support for prevention against sleep disorders.

Dietary sodium intake and its relation to sleep duration, sleep quality and nocturnal urination in working-aged Korean adults

Both sodium intake and sleep have an important effect on cardiovascular health. However, few studies have looked at the association between sodium intake and sleep. Therefore, we analysed the association of sodium intake with sleep quality, sleep duration and nocturnal urination. The data for the present study were obtained from the Kangbuk Samsung Health Study. Study participants were 156 696 working-aged Korean adults (average age 38.0 years ±8.0 in men and 36.0 years ±8.1 in women). They were categorised into five groups by quintile of sodium intake, measured by food frequency questionnaire. Poor sleep quality and short sleep duration were determined by Pittsburgh Sleep Quality Index >5, and sleep duration <7 h, respectively. Nocturnal urination was defined as awakening to urinate more than three times a week. Multivariable adjusted logistic regression analysis was used in calculating the odds ratio (OR) and 95% confidence interval (CI) for poor sleep quality, short sleep duration and nocturnal urination (adjusted OR [95% CI]) across five study groups. In all study participants, increased sodium intake was significantly associated with poor sleep quality (quintile 1: reference, quintile 2: 1.07 [1.04-1.11], quintile 3: 1.12 [1.08-1.16], quintile 4: 1.15 [1.11-1.19] and quintile 5: 1.13 [1.09-1.18]). This pattern of relationship was similarly observed in association of sodium intake with short sleep duration (p for trend <0.001) and nocturnal urination (p for trend <0.001). In gender subgroup analysis, increased sodium intake had a significant association with poor sleep quality and short sleep duration in men and with poor sleep quality and nocturnal urination in women. In conclusion, high sodium intake is associated with an increased likelihood of poor sleep quality, short sleep duration and nocturnal urination.

Three-Year School-Based Multicomponent Intervention May Change Fruit and Vegetable Preferences in Primary School Children-A Quasi-Randomized Trial

Preference could be the trigger for fruit and vegetable (FV) consumption in children and could be modified by appropriate intervention to increase the acceptance of FVs. The primary objective of this study was to investigate the effects of the three-year school-based multicomponent intervention "Nutri-školica" on the FV preferences of primary school children. It also aimed to explore whether a positive change in FV preferences could lead to an increase in actual FV consumption. The study was conducted in 14 primary schools from the city of Zagreb on 193 children (52.3% boys; age, 7.7 ± 0.4 years; n = 85 in the control group and n = 108 in the intervention group) who completed a preference questionnaire before and after the intervention with a 5-point hedonic smiley-face scale, where 5 means "I like it a lot." The per-protocol approach was used for data analysis (28.3% of children from the study sample). After the intervention, children in the intervention group (before: 3.1 ± 0.8; after: 3.5 ± 0.8) increased their FV preferences significantly more than children in the control group (before: 3.2 ± 0.8; after: 3.3 ± 0.7). Children's FV preferences changed most toward the varieties for which they had the least preferences at the beginning of the study. Participation in the intervention had a stronger effect on changing FV intake than change in FV preferences among primary school children. In summary, the present study highlighted that a targeted intervention can increase children's FV preferences, but that participation in the intervention is substantial for increasing FV intake.

Dietary profile of pediatric obstructive sleep apnea patients, effects of routine educational counseling, and predictors for outcomes

Background

Dietary behavior is a main contributing yet modifiable factor to the body weight status of children and may be involved in the pathophysiology of childhood obstructive sleep apnea (OSA). This study aimed to investigate the dietary profile of pediatric OSA patients, effects of educational counseling after adenotonsillectomy, and predictor for disease resolution.

Methods

This observational study included 50 pediatric OSA patients undergoing adenotonsillectomy with routine educational counseling (Group 1), 50 pediatric OSA patients undergoing adenotonsillectomy without formal educational counseling (Group 2), and 303 healthy children without OSA (Control). The three groups were matched by age. The consumption frequency of 25 food items/groups was assessed by the Short Food Frequency Questionnaire. Quality of life was evaluated by the OSA-18 questionnaire. Sleep architecture and OSA severity were measured by standard polysomnography. Between- and within-group comparisons were analyzed by non-parametric approaches and generalized estimating equations. Prediction of disease recovery was performed by multivariable logistic regression models.

Results

Group 1 children consumed fruit drinks with sugar, vegetables, sweets, chocolate, rice, and noodles more frequently than Control Group children. At baseline, the distributions of sex, weight status, OSA-18 scores, and polysomnographic variables were comparable between Group 1 and Group 2. After a 12-month follow-up, Group 1 had better improvements in physical suffering, caregiver concerns, sleep architecture, and mean peripheral oxygen saturation compared to Group 2. Furthermore, Group 1 no longer had excessive consumption of fruit drinks with sugar, chocolate, and noodles; however, food consumption frequencies did not change significantly. Notably, younger age and reduced intake of butter/margarine on bread and noodles were independent predictors of cured OSA in Group 1.

Conclusion

The present study preliminarily characterized an unhealthy dietary profile among pediatric OSA patients and suggested that routine educational counseling in addition to adenotonsillectomy yielded some clinical benefits. Certain items/groups of food frequencies may be associated with disease recovery and further investigations are warranted.

Eating habits matter for sleep difficulties in children and adolescents: A cross-sectional study

Background

Sleep difficulties are a common sleep-related problem among children and adolescents. However, the association between eating habits and sleep difficulties has not been extensively studied. Therefore, this study aimed to investigate the relationship between eating habits and sleep difficulties in children and adolescents.

Methods

This study utilized cross-sectional data from the 2013/2014 Health Behaviour in School-aged Children survey. A total of 213,879 young adolescents provided self-reported information on their weekday and weekend breakfast consumption, fruit and vegetable intake, sweet and soft drink consumption, and sleep difficulties. Covariates such as sex, age, family affluence, physical activity, and body mass index were also assessed. Multilevel generalized linear modelling was used to analyse the association between independent and dependent. Results were reported as odds ratios (OR) with 95% confidence intervals.

Results

Of all study participants, approximately 50% were girls. Regression models indicated that more frequent breakfast consumption was associated with fewer sleep difficulties (e.g., consuming breakfast on weekdays for 5 days: OR = 1.49, 95% CI: 1.45-1.54). Fruit and vegetable consumption once a week or more was also linked to fewer sleep difficulties (all OR > 1.08, ≥ 1.07). In addition, consuming fewer sweets and soft drinks was generally associated with fewer sleep difficulties.

Conclusion

This study provides evidence supporting the association between healthier eating habits and reduced sleep difficulties in children and adolescents. Future research using longitudinal or experimental designs is encouraged to confirm or negate these findings. Additionally, this study offers practical guidance for nutritional counselling professionals and sleep health promotion practitioners.

Food consumption based on processing level (according to Nova system) during the COVID-19 pandemic among adolescents with immunocompromised conditions: a case-control study

The COVID-19 pandemic impacts on eating habits among adolescents may be more relevant in pediatric patients with immunocompromised chronic diseases. This case-control study conducted between June and October 2020 aimed to: (i) describe dietary patterns of adolescents with chronic conditions compared to healthy controls and (ii) determine associations between food consumption, health-related quality of life (HRQL) and sleep quality during the COVID-19 pandemic. Participants (184 immunocompromised and 58 healthy adolescents, aged 14.3 [SD 2.5]) responded to HRQL and sleep validated instruments (PedsQL and PSQI) and three 24 h food recalls via online software. Adjusted linear and logistic regressions were used to assess differences in dietary patterns and associations between food consumption (according to Nova classification) and HRQL and sleep quality. Adolescents with gastrohepatic, rheumatic, and kidney diseases had an improved dietary pattern vs. their healthy peers, showing greater consumption of unprocessed and minimally processed foods (unstandardized coefficient (b) = 7.35%[95%CI 1.59; 13.1]; b = 15.10%[95%CI 7.00; 23.1]; and b = 11.2%[95%CI 5.68; 16.8]), and lower consumption of ultraprocessed foods (b = -7.53%[95%CI-12.90; -2.18]; b = -11.4%[95%CI-18.90; -3.94]; b = -10.8%[95%CI-16.00; -5.68]). Consumption of culinary ingredients was associated with reduced psychological HRQL in controls (standardized coefficient (β) = -0.26[95%CI-0.52; -0.004]), and processed food consumption was associated with improved sleep latency in immunocompromised participants (β = 0.16[95%CI 0.01; 0.31]). These findings suggest diet quality may play a role in HRQL and sleep quality in this population, and may be relevant for clinical practitioners and policy makers when considering the importance of dietary quality in immunocompromised youths.

Examination of sleep in relation to dietary and lifestyle behaviors during Ramadan: A multi-national study using structural equation modeling among 24,500 adults amid COVID-19

Background

Of around 2 billion Muslims worldwide, approximately 1.5 billion observe Ramadan fasting (RF) month. Those that observe RF have diverse cultural, ethnic, social, and economic backgrounds and are distributed over a wide geographical area. Sleep is known to be significantly altered during the month of Ramadan, which has a profound impact on human health. Moreover, sleep is closely connected to dietary and lifestyle behaviors.

Methods

This cross-sectional study collected data using a structured, self-administered electronic questionnaire that was translated into 13 languages and disseminated to Muslim populations across 27 countries. The questionnaire assessed dietary and lifestyle factors as independent variables, and three sleep parameters (quality, duration, and disturbance) as dependent variables. We performed structural equation modeling (SEM) to examine how dietary and lifestyle factors affected these sleep parameters.

Results

In total, 24,541 adults were enrolled in this study. SEM analysis revealed that during RF, optimum sleep duration (7-9 h) was significantly associated with sufficient physical activity (PA) and consuming plant-based proteins. In addition, smoking was significantly associated with greater sleep disturbance and lower sleep quality. Participants that consumed vegetables, fruits, dates, and plant-based proteins reported better sleep quality. Infrequent consumption of delivered food and infrequent screen time were also associated with better sleep quality. Conflicting results were found regarding the impact of dining at home versus dining out on the three sleep parameters.

Conclusion

Increasing the intake of fruits, vegetables, and plant-based proteins are important factors that could help improve healthy sleep for those observing RF. In addition, regular PA and avoiding smoking may contribute to improving sleep during RF.

From good sleep to health and to quality of life – a path analysis of determinants of sleep quality of working adults in Abu Dhabi

Background

Sleep quality has significant impacts on many aspects of quality of life. Therefore, identifying the association of sleep quality with that quality of life domains could lead to deeper insights for social policymakers and professionals to enhance their understanding of the lives of Abu Dhabi working adults. This research focuses on sleep quality among working people in Abu Dhabi. The direct and indirect associations of sleep quality with various quality-of-life domains such as income and housing, physical and mental health, sport and activities, eating habits and obesity, work-life balance, online hours, and social connections are investigated and discussed.

Methods

Data were drawn from 36,515 full-time employees in both public, and private sectors, obtained from the third Abu Dhabi Quality of Life (QoL) survey aimed to cover all community members using online platforms. Informed by international research on sleep quality, preliminary investigation using correlation analysis and simple regression identified many well-being variables deemed necessary for inclusion in the path model. Path analysis was then performed.

Results

The final path model produced excellent fit measures. The significant variables directly associated with sleep quality included sleeping hours, social connection, satisfaction with income, satisfaction with residence, subjective physical and mental health, income satisfaction, satisfaction with the surrounding environment, frequency of eating healthy food, work-life balance, and online time. In addition, most variables recorded an indirect association to sleep quality through subjective health.

Conclusions

The importance of multidimensional linkages between many well-being factors influencing sleep quality and subjective health is underscored.

Intake of ultra-processed foods and sleep-related outcomes: A systematic review and meta-analysis

The aim of this review article was to evaluate the association between the intake of ultra-processed foods and sleep-related outcomes through a systematic review and meta-analysis. Pubmed, LILACS, Scielo, Scopus, Embase, and Web of Science were searched on December 31, 2021, for studies that evaluated the association between ultra-processed foods and sleep-related outcomes (self-reported sleep duration and quality). Pooled odds ratios were assessed through a random-effects model; heterogeneity was evaluated using the I² statistic. Fifteen cross-sectional studies were included; 14 showed that the high intake of ultra-processed foods was statistically significantly associated with sleep-related outcomes (sleep duration and quality). In the crude analysis, compared with low intake, high intake of ultra-processed foods increased the odds of sleep-related outcomes, with increased odds among children and/or adolescents, and null results among adults. When adjusted for cofounders, we found statistically significant results for all ages. The high intake of ultra-processed foods was associated with sleep-related outcomes, with moderate credibility of the evidence. Longitudinal studies and clinical trials confirming these findings are necessary.

The association between daytime sleep and general obesity risk differs by sleep duration in Iranian adults

BACKGROUND

Sleep duration and daytime napping and obesity are related to adiposity; however, it is not clear whether the association between daytime napping and adiposity measures can differ by sleep duration.

AIM

To clarify the association between daytime napping and general and abdominal obesity based on sleep duration of participants.

SUBJECTS AND METHODS

This cross-sectional study was conducted on 1,683 individuals (837 men and 846 women) aged ≥ 35 years. Height, weight and waist circumference (WC) were measured according to the standard protocols. Body mass index (BMI) was calculated. Self-reported sleep duration (in a 24-hour cycle) was recorded. The odds of general and abdominal obesity were compared between nappers and non-nappers, stratified by their sleep duration (≤ 6 h, 6-8 h, ≥ 8 h).

RESULTS

The mean (SD) age of participants was 47.48 ± 9.35 years. Nappers with a short sleep duration (≤ 6 h) had greater BMI and higher risk for overweight/obesity compared with counterpart non-nappers after adjustment for potential confounders (OR = 1.61, 95% CI = 1.07-2.41). In subjects with moderate sleep duration (6-8 h), nappers had a tendency towards higher BMI in comparison with non-nappers (28.04 ± 0.25 vs. 26.93 ± 0.51 kg/m²; p = 0.05), however, no significant difference was observed for the risk of obesity. Daytime napping was not related to the risk of obesity in long sleepers. No significant association was observed for abdominal obesity measures.

CONCLUSIONS

Daytime napping is associated with increased risk of overweight/obesity in short sleepers. However, in subjects with longer sleep duration, it is not related to the risk of overweight/obesity.

Association of food intake with sleep disorders in children and adolescents with obesity

Introduction

the great increase in childhood obesity rates is well documented in the scientific literature. However, the influence of diet on sleep quality in children and adolescents still needs further research in order to be better understood. The objective of this study was to evaluate the association between diet and sleep characteristics and in children and adolescents with obesity.

Methods

observational analytical cross-sectional study with prospective data collection. Forty-three children and adolescents aged between 6 and 13 years diagnosed with obesity and treated at a public tertiary care institution participated in the study. The 6-day Food Intake Registry was used to evaluate the intake of energy and macronutrients. To investigate the risk of sleep disturbances and to know the routine and characteristics of sleeping habits, the Sleep Disturbance Scale for Children (SDSC) questionnaire was used.

Results

and discussion: Food intake showed association with Sleep Breathing Disorders (SBD) and Sleep Wake Transition Disorders (SWTD). The sum of all SDSC factors demonstrated the presence of pathological sleep in most patients (n = 25).

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Positive association between food intake and SBD through the analysis of the SDSC.

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Positive association between food intake and SWTD through the analysis of the SDSC.

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Positive association between food intake and the risk for sleep disorders.

Incidence of Asthma, Atopic Dermatitis, and Allergic Rhinitis in Korean Adults before and during the COVID-19 Pandemic Using Data from the Korea National Health and Nutrition Examination Survey

The prevalence of allergic diseases has been increasing globally prior to COVID-19. The pandemic resulted in changes in lifestyle and personal habits such as universal mask-wearing and social distancing. However, there is insufficient information on the impact of the COVID-19 pandemic on the prevalence of allergic conditions such as asthma, atopic dermatitis, and allergic rhinitis. We analyzed the incidence rate for self-reported and doctor-diagnosed cases of allergic diseases of asthma, atopic dermatitis, and allergic rhinitis. A total of 15,469 subjects were registered from a national cohort dataset of the National Health and Nutrition Examination Survey. Using multiple logistic regression analysis, we calculated the adjusted odds ratio (OR) for each disease in 2020 compared to 2019. Subgroup analyses were performed according to age and sex. There were no statistically significant differences between the incidence of doctor-diagnosed and current allergic diseases in 2019 and 2020 (asthma, p = 0.667 and p = 0.268; atopic dermatitis, p = 0.268 and p = 0.973; allergic rhinitis, p = 0.691 and p = 0.942, respectively), and subgroup analysis showed consistent results. Among the Korean population from 2019 to 2020, the incidence of the allergic diseases asthma, atopic dermatitis, and allergic rhinitis did not decrease as expected.

Association between short sleep duration and intake of sugar and sugar-sweetened beverages: A systematic review and meta-analysis of observational studies

BACKGROUND

Findings of previous investigations that evaluated the relationship between sleep duration and sugar or sugar-sweetened beverages (SSBs) intake have been inconsistent. We aimed to summarize extant research that assessed the relation between short sleep duration and sugar and SSB intake.

METHODS

A comprehensive search of PubMed, ISI Web of Sciences, Scopus, Science Direct, Embase, and Google Scholar was conducted. All observational studies that reported sleep duration as the exposure and intake of sugar or sugary drinks as the outcome were included. The quality of included studies was evaluated using the Newcastle-Ottawa Scale. The body of evidence was assessed using the GRADE approach. Random and fixed effects models were used to estimate pooled OR and 95% confidence intervals.

RESULTS

Twenty-two studies in children and twelve in adults were included in the systematic review. Only 10 studies in children and 3 investigations in adults provided odds ratios (95% confidence intervals) for this association and could be included in the meta-analysis. All studies had a cross-sectional design and found a negative association between sleep duration and sugar in children, but not in adults. SSB intake was lower in those with sufficient sleep in all populations. Compared with those with sufficient sleep, children with short sleep duration had 16% (significant) higher odds of consuming sugar (OR: 1.16; 95% CI: 1.10, 1.21), 21% higher odds of soda intake (OR: 1.21; 95% CI: 1.16, 1.26), and 92% higher odds of consuming energy drink intake (OR: 1.92; 95% CI: 1.66, 2.22). However, sleep duration was not significantly associated with soft drink intake in children (OR: 1.17; 95% CI: 0.93, 1.48). In adults, the odds of drinking soda in those with short sleep duration was 1.2 times more than in those with sufficient sleep (OR: 1.20; 95% CI: 1.12, 1.28). Also, low vs. optimal sleep duration in adults was associated with a 58% increased intake of energy drinks (OR: 1.58; 95% CI: 1.31, 1.90). Of note, these findings in the adult population resulted from only 2 included investigations, due to the limited number of studies.

CONCLUSION

The evidence reviewed supports a significant association between shorter sleep duration and higher SSBs intake in both children and adults, while such association with higher total sugar intake was significant in children but not in adults. Further research with more accurate measurements, sex-specific, and prospective designs should be carried out to clarify the causality and underlying mechanisms.

Sleep duration and eating behaviours among adolescents: a scoping review

INTRODUCTION

In the past decade, investigations of the relationship between sleep duration and eating behaviours have been emerging; however, a formal synthesis of the literature focussed on adolescent populations has not yet been conducted. We conducted a scoping review of the literature examining the relationship between sleep duration and eating behaviours in adolescents. Gaps in the research and directions for future research were identified based on the findings.

METHODS

A systematic search was employed on four research databases: PubMed, PsycInfo, CINAHL and Scopus; relevant grey literature was also reviewed. Studies that reported on the relationship between sleep duration and eating behaviours among high school-aged adolescents were included in the review. Data were extracted, charted and synthesized into a narrative. Consistent with the purpose of a scoping review, the methodological quality of the studies was not appraised. Stakeholders were consulted to validate the findings and provide insight into the interpretation and identification of pressing gaps in the research that remain to be addressed.

RESULTS

In total, 61 studies published between 2006 and 2021 met the criteria for review. Existing research focussed heavily on examining sleep duration in relation to intake of food from certain food groups, beverages and processed foods, and relied on a population study design, cross-sectional analyses and self-report measures.

CONCLUSION

Future research is needed to understand the link between sleep duration and eating-related cognition, eating contexts and disordered eating behaviours in order to better understand how ensuring sufficient sleep among adolescents can be leveraged to support healthier eating practices and reduce diet-related risks.

Depression, Stress, and Suicide in Korean Adults before and during the COVID-19 Pandemic Using Data from the Korea National Health and Nutritional Examination Survey

This study investigated changes in the prevalence of depression, stress, and suicidal attempts during the COVID-19 pandemic. The ≥19-year-old population in the Korea National Health and Nutrition Examination Survey in 2019 and 2020 was included. The histories of depression, stress, and suicidal attempts were compared between the 2019 and 2020 cohorts using multiple logistic regression analysis with complex sampling. The prevalence of depression was not significantly different between the 2019 and 2020 groups (4.1% vs. 4.5%, p = 0.326). The prevalence of stress and suicide attempts was also not significantly different between groups (all p > 0.05). The rates of depression, stress, and suicide attempts were not associated with the 2020 group compared to the 2019 group (all p > 0.05). The 19- to 39-year-old group in the 2020 group indicated a higher rate of depression (diagnosed by physicians) than the 19- to 39-year-old group in the 2019 group (adjusted odds ratio = 1.58, 95% confidence intervals = 1.00−2.50, p = 0.049). The risks of depression, stress, and suicidal attempts were not related to the COVID-19 pandemic in Korean adults. A young adult population demonstrated an increased risk of depression associated with the COVID-19 pandemic.

Physical Activity and Sedentary Time in Korean Adults before and during the COVID-19 Pandemic Using Data from the Korea National Health and Nutritional Examination Survey

Several recent studies suggested reduced physical activity (PA) related to the COVID-19 pandemic without consensus. This study investigated the changes in PA and sedentary time during the COVID-19 pandemic compared to before the COVID-19 era. The Korea National Health and Nutrition Examination Survey 2019 and 2020 were used. The ≥19-year-old population was examined in 2019 and 2020 for time spent engaging in high- and moderate-intensity PA and sedentary time. Based on the recommended level of PA by the World Health Organization, ≥75 min/wk of high PA and ≥150 min/of moderate PA were classified. A sedentary time of ≥120 min/d was selected. Multiple logistic regression analysis with complex sampling was conducted for ≥75 min/wk of high PA, ≥150 min/wk of moderate PA, and ≥120 min/d of sedentary time in the 2020 group compared to the 2019 group. The ≥75 min/wk high PA was not lower in the 2020 group than in the 2019 group (adjusted odds ratio (aOR) = 0.96, 95% confidence intervals (95% CIs) = 0.79–1.18, P = 0.696). The ≥150 min/wk of moderate PA was also not lower in the 2020 group (aOR = 1.12, 95% CI = 0.94–1.32, p = 0.201). However, the ≥150 min/wk of moderate PA in the female group was higher in the 2020 group than in the 2019 group (aOR = 1.29, 95% CI = 1.01–1.65, p = 0.042). Sedentary time ≥ 120 min/d was lower in the 2020 group (aOR = 0.35, 95% CI = 0.17–0.72, p = 0.005). This association was consistent in the 19–39-year-old and female group. In conclusion, during the COVID-19 pandemic, high and moderate PA were not decreased in Korean adults, while sedentary time was reduced.

A greater modified Mediterranean diet score is associated with lower insomnia score among adolescent girls: a cross-sectional study

Background

Previous studies has shown that a low quality diet is related to sleep disorders. A Mediterranean diet is considered to be a high quality diet and has been shown to have beneficial effects on overall health. Thus, the aim of our study was to investigate the association between adherence to Mediterranean dietary pattern and insomnia score among adolescent girls.

Methods

The data for 733 adolescent girls between 12–18 years old was assessed in this cross-sectional study. A 147 item-food frequency questionnaire was used to assess dietary intake. A modified model of Mediterranean diet score was calculated that ranged from 0–9 points. A validated version of Insomnia Severity Index questionnaire was used to assess insomnia. To explore the association between modified Mediterranean (mMED) diet score and insomnia, linear regression was conducted in crude and adjusted models (energy intake adjustmet in Model I, further adjustments were performed for physical activity, father’s and mother’s education in Model II and full adjusted model adjusted for age, body mass index percentiles, and abdominal obesity).

Results

A significant inverse association between mMED diet score and insomnia score was observed using a crude model (β = -0.091, 95% confidence interval (CI): -0.392 to -0.046); P-value = 0.013) and also after adjustment for confounding factors in Model I (β = -0.098, CI: -0.423 to -0.045; P = 0.015), Model II (β = -0.092, CI: -0.410 to -0.029; P-value = 0.024), Model III (β = -0.082, CI: -0.385 to -0.006); P = 0.044).

Conclusion

There was an inverse relationship between adherence to the mMED diet score and insomnia level among Iranian adolescent girls. Prospective studies are needed to confirm these results and clarify whether a causal relationship exists.

Diet quality indices are associated with sleep and mental health status among diabetic women: a cross-sectional study

OBJECTIVE

Diabetes is a common chronic disease with many complications. Controlling these complexities may enhance the quality of life. This study was conducted to investigate the association between diet quality indices and sleep, stress, anxiety, and depression among diabetic women.

DESIGN

Cross-sectional study.

SETTING

A validated and reliable food frequency questionnaire was filled to assess the dietary intake and adherence to the diet quality indices. Pittsburgh Sleep Quality Index and 21 items Depression, Anxiety, and Stress Scale were used to assess the sleep and mental disorders, respectively.

PARTICIPANTS

This study was conducted on 230 Tehrani women with type 2 diabetes.

RESULTS

Patients who were in the top tertile of diet quality index consumed less fat, saturated mono-and poly-unsaturated fatty acids, and sodium (P < 0.05). Participants who were in top tertile of diet quality indices consumed more fruits, and vegetables. Patients in the highest tertile of diet quality index-international had less risk of depression (OR: 0.17; 95% CI: 0.07; 0.41), anxiety (OR: 0.36; 95% CI: 0.16; 0.80), stress (OR: 0.09; 95% CI: 0.04; 0.21), and poor sleep (OR: 0.12; 95% CI: 0.04; 0.36). Patients in the highest tertile of healthy eating index-international had less risk of depression (OR: 0.06; 95% CI: 0.02; 0.21), anxiety (OR: 0.10; 95% CI: 0.04; 0.26), stress (OR: 0.11; 95% CI: 0.05; 0.26), and poor sleep (OR: 0.08; 95% CI: 0.03; 0.20).

CONCLUSION

Patients with higher adherence to diet quality indices were likely less to have mental disorders or poor sleep.

LEVEL OF EVIDENCE

Level V: based on descriptive studies (a Cross-sectional study).

Changes in Dietary Habits and Exercise Pattern of Korean Adolescents from Prior to during the COVID-19 Pandemic

This study aimed to investigate changes in the exercise pattern and dietary habits in adolescents during the COVID-19 pandemic. The 12–18-year-old population in the Korea Youth Risk Behavior Web-Based Survey data of 2019 and 2020 was enrolled. The exercise pattern and dietary habits of 105,600 participants (53,461 in the 2019 group and 52,139 in the 2020 group) were compared. The odds ratios (ORs) for the dietary habits and exercise pattern of the 2020 group compared to the 2019 group were analyzed using multiple logistic regression analysis with complex sampling. The odds of eating fruit, drinking soda, drinking sweet drinks, and consuming fast food were lower in the 2020 group than in the 2019 group (all p < 0.001). The odds of eating breakfast were higher in the 2020 group than in the 2019 group (all p < 0.001). The 2020 group showed lower odds of frequent vigorous and moderate aerobic exercise and higher odds of frequent anaerobic exercise than the 2019 group (all p < 0.001). During the COVID-19 pandemic, adolescents consumed less fruit, soda, and sweet drinks, while they had more breakfast. The frequency of aerobic exercise was lower, while the frequency of anaerobic exercise were higher during the COVID-19 pandemic period.

The relationship between health-promoting behaviors, menopause syndrome, and sleep quality in Chinese middle-aged nurses: A cross-sectional study

BACKGROUND

Nursing staff are on the front line of providing healthcare that addresses patients' needs. Sleep quality is highly related to work performance and quality of life among nurses.

AIMS

This study aimed to examine the influence of sociodemographic variables, menopause syndrome, and health-promoting behaviors on sleep quality in a sample of middle-aged nurses in China.

METHODS

A cross-sectional design was employed. A consecutive sample of 424 nurses was recruited from a university-affiliated hospital in Bengbu, China. Self-reported, structured questionnaires, including sociodemographic surveys, the Kupperman Menopausal Index, the Health Promoting Lifestyle Profile II, and the Pittsburgh Sleep Quality Index, were administered between October 2018 and July 2019. This study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines.

RESULTS

Study participants had a mean sleep quality level of 5.30 points (SD = 3.16), indicating potential sleep problems. The results of regression models showed that menopause syndrome and spiritual growth were important predictors of sleep quality for premenopause, perimenopause, and postmenopause groups.

CONCLUSION

Middle-aged nurses with more severe menopause syndrome and less spiritual growth might experience worse sleep quality.

RELEVANCE TO CLINICAL PRACTICE

This study highlights important factors influencing the level of sleep quality in Chinese middle-aged nurses. Identifying the factors that are associated with sleep quality may help with the development of proper interventions.

Is sleep associated with BMI, waist circumference, and diet among long-term colorectal cancer survivors? Results from the population-based PROFILES registry

PURPOSE

In the general population, poor sleep quality and short sleep duration are associated with a higher body mass index (BMI) and waist circumference (WC), and an unhealthy diet. The aim of this study was to assess if the association between sleep quality and duration and BMI, WC, and diet quality also exists among colorectal cancer (CRC) survivors, as many CRC survivors have an unhealthy weight and diet.

METHODS

Cross-sectional data from a longitudinal CRC cohort were used. In this study, survivors were 4-13 years post diagnosis. The Pittsburgh Sleep Quality Index (PSQI) was used to assess both sleep quality and sleep duration. Diet quality was assessed by scoring adherence (low, moderate, high) to the 2007 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) recommendations of five food groups and nutrients: fruit and vegetables, dietary fiber, red and processed meat, alcoholic beverages, and sugary drinks, using a brief diet screener. BMI and WC were self-measured. Associations were analyzed by multivariable linear and multinomial logistic regression analyses.

RESULTS

Among 1002 CRC survivors, 23% reported poor sleep quality (PSQI score ≥ 8) and 24% reported short sleep duration (≤ 6 h). No associations between sleep and BMI, WC, and diet quality were found.

CONCLUSION

Sleep problems are common in long-term CRC survivors; however, sleep quality and duration was not associated with BMI, WC, and diet quality in this population. It is unknown why the results differ from findings in the general population.

Disentangling the Relationship between Food Insecurity and Poor Sleep Health

The COVID-19 pandemic has created disruptions in global and national food supply chains. Along with an increase in the unemployment rate, this resulted in a rise in food insecurity at the community-level, threatening individual and family well-being. Food insecurity is associated with inadequate nutrient intakes, weight gain, and psychological distress, including anxiety and depressive symptoms, all of which are known to affect sleep. Yet, little is known about whether and how food insecurity is associated with sleep health, a critical but underrecognized health outcome. This paper reviews literature describing associations between food insecurity and sleep, summarizes key findings based on proposed mechanisms, and discusses directions for future research.

The Effects of Sleep Quality and Resilience on Perceived Stress, Dietary Behaviors, and Alcohol Misuse: A Mediation-Moderation Analysis of Higher Education Students from Asia, Europe, and North America during the COVID-19 Pandemic

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has increased the already high levels of stress that higher education students experience. Stress influences health behaviors, including those related to dietary behaviors, alcohol, and sleep; yet the effects of stress can be mitigated by resilience. To date, past research studying the connections between dietary behaviors, alcohol misuse, sleep, and resilience commonly investigated singular relationships between two of the constructs. The aim of the current study was to explore the relationships between these constructs in a more holistic manner using mediation and moderation analyses.

METHODS

Higher education students from China, Ireland, Malaysia, South Korea, Taiwan, the Netherlands, and the United States were enrolled in a cross-sectional study from April to May 2020, which was during the beginning of the COVID-19 pandemic for most participants. An online survey, using validated tools, was distributed to assess perceived stress, dietary behaviors, alcohol misuse, sleep quality and duration, and resilience.

RESULTS

2254 students completed the study. Results indicated that sleep quality mediated the relationship between perceived stress and dietary behaviors as well as the relationship between perceived stress and alcohol misuse. Further, increased resilience reduced the strength of the relationship between perceived stress and dietary behaviors but not alcohol misuse.

CONCLUSION

Based on these results, higher education students are likely to benefit from sleep education and resilience training, especially during stressful events.

Association of carbonated soft drink and fast food intake with stress-related sleep disturbance among adolescents: A global perspective from 64 countries

BACKGROUND

Poor quality sleep adversely impacts on adolescent wellbeing. More multinational research is needed to understand modifiable risk factors, such as dietary behaviours. This study aimed to examine the association of carbonated soft drink and fast food intake with stress-related sleep disturbance among adolescents across 64 countries.

METHODS

We analysed the Global School-based Student Health Survey data from 175,261 adolescents (mean age 13.8 [0.98]; 48.5% females). Adolescents reported frequency of stress-related sleep disturbance and consumption of carbonated soft drinks and fast foods. Country-level estimates were obtained by using multivariable logistic regression and meta-analysis to obtain pooled estimates.

FINDINGS

Overall, 7.5% of adolescents reported sleep disturbance during the past 12 months (males: 6.6%; females: 8.4%). Meta-analysis showed that adolescents having carbonated soft drinks ≥3 times/day had over 50% higher odds of reporting sleep disturbance than <once/day (OR=1.55, 95% CI 1.42-1.70 for males; 1.51, 1.37-1.68 for females). Adolescent males who had fast foods ≥4 days/week had 55% higher odds of reporting sleep disturbance than ≤1 day/week (1.55, 1.39-1.73), while the odds was 50% higher in females (1.50, 1.32-1.70). Carbonated soft drinks ≥3 times/day and fast foods ≥ 4 days/week were significantly associated with sleep disturbance in all but low-income countries for both genders; while the associations were significant in males and mixed in females across WHO regions.

INTERPRETATION

Our findings suggest strong positive associations between carbonated soft drink and fast food intake with stress-related sleep disturbance. Prospective studies are needed to understand the directionality of the relationship.

Dietary patterns in relation to gestational depression and sleep disturbance in Chinese pregnant women

AIM

To investigate the association of dietary patterns with gestational depression and sleep disturbance.

METHODS

Women in early pregnancy were recruited from the Chinese Pregnant Women Cohort Study (CPWCS) through July 25th, 2017 to November 26th, 2018, and eventually 7615 participants were included in this study. The qualitative food frequency questionnaire (Q-FFQ), Edinburgh Postnatal Depression Scale (EPDS), and the Pittsburgh Sleep Quality Index (PSQI) were used to assess dietary, depression and sleep quality during pregnancy, respectively. Dietary patterns were derived by factor analysis. Logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (95% CI) of each outcome according to quartiles of each dietary pattern.

RESULTS

Five dietary patterns were identified. Participants with the highest quartile in plant-based pattern had a significantly lower likelihood of mental problems (OR: 95% CI for depression: 0.66, 0.55-0.79; sleep disturbance: 0.80, 0.68-0.93); Similar results were observed in vitamin-rich pattern (OR: 95% CI for depression: 0.46, 0.38-0.55; sleep disturbance: 0.76, 0.65-0.89); However, contrary results were found in high-fat pattern (OR: 95% CI for depression: 2.15, 1.25-1.85; sleep disturbance: 1.43, 1.22-1.67); In animal protein-rich pattern, participants with the highest quartile had a decreased likelihood of depression (OR: 0.80, 95% CI: 0.67-0.96). As for bean products pattern, participants with the highest quartile had an increased risk of depression (OR: 1.28, 95% CI:1.06-1.53). Interactions of dietary patterns and lifestyles on mental disorders were observed.

CONCLUSION

Dietary patterns were associated with gestational depression and sleep disturbance. Relevant departments and maternal and child health personnel should conduct health education for pregnant women and guide them to eat properly.

Measures of Poor Sleep Quality Are Associated With Higher Energy Intake and Poor Diet Quality in a Diverse Sample of Women From the Go Red for Women Strategically Focused Research Network

Background

Poor sleep increases cardiovascular disease risk, and diet likely contributes to this relationship. However, there are limited epidemiological data on the relationship between measures of sleep quality and habitual dietary patterns. This study examined these associations in a diverse sample of women.

Methods and Results

Baseline data from 495 participants in the AHA Go Red for Women prospective cohort study (age: 20–76 years; 61% racial/ethnic minority) were examined. Sleep quality and sleep‐onset latency were measured using the Pittsburgh Sleep Quality Index (PSQI) and insomnia using the Insomnia Severity Index. The validated Block Brief Food Frequency Questionnaire was used to assess diet quantity and quality. Linear regression models adjusted for confounding variables tested relationships between sleep and diet variables. Results showed that higher PSQI scores, indicative of poorer sleep quality, were associated with lower unsaturated fat intake (β=−0.14, P<0.05) and higher food weight (β=14.9, P=0.02) and added sugars consumed (β=0.44, P=0.04). Women with sleep‐onset latency >60 minutes had higher intakes of food by weight (β=235.2, P<0.01) and energy (β=426, P<0.01), and lower intakes of whole grains (β=−0.37, P=0.01) than women with sleep‐onset latency ≤15 minutes. Greater insomnia severity was associated with higher food weight (β=9.4, P=0.02) and energy (β=17, P=0.01) consumed and lower total (β=−0.15, P=0.01) and unsaturated fat intakes (β=−0.11, P<0.01).

Conclusions

Poor sleep quality was associated with greater food intake and lower‐quality diet, which can increase cardiovascular disease risk. Future studies should test whether promoting sleep quality could augment efforts to improve cardiometabolic health in women.

Dietary behaviors and poor sleep quality among young adult women: watch that sugary caffeine!

PURPOSE

Associations of dietary patterns with sleep quality have not been sufficiently studied, particularly among young adults. Studying factors associated with sleep quality among young adults are especially important given the significant life changes they are experiencing, which can influence not only sleep quality but also dietary behaviors.

METHODS

We examined the cross-sectional association of sleep quality among 462 women at age 23 years. We used the Pittsburg Sleep Quality Index (PSQI) to define sleep quality. Intake over the previous 7 days of fruits and vegetables, soda, sports drinks, other sweetened drinks, and coffee drinks was assessed by a self-report questionnaire. Linear regression analysis examined the association between PSQI scores and dietary intake.

RESULTS

About 47% of participants were White, 25% Black, 10% Hispanic, and 18% Other. Almost ½ (45%) reported poor sleep quality. Compared with participants reporting consuming no energy drinks, participants who reported consuming any energy drinks had PSQI scores that were 0.84 points higher (7.08 ± 0.51 vs 6.24 ± 0.39; p=0.04) (indicating poorer sleep quality). Participants who reported drinking one or more high-calorie coffee drinks had PSQI scores that were 1.00 points higher compared with those reporting drinking no high-calorie coffee drinks (7.14 ± 0.51 vs 6.14 ± 0.42; p=0.02). Fruit or vegetable intake was not associated with PSQI score.

CONCLUSIONS

Poor sleep quality is prevalent among young women. Young women with poor sleep quality should consider their sugary caffeine use to determine if it may be associated with their sleep.

Relationship of sleep quality, smartphone dependence, and health-related behaviors in female junior college students

INTRODUCTION

Smartphone usage has become commonplace and impact on sleep quality among adolescents. Adolescent girls have a greater tendency toward sleep quality problems. However, relationship of sleep quality, smartphone dependence, and health-related behaviors in female junior college students has not been studied.

OBJECTIVES

This study had the two goals: to investigate the relationship between female college students' sleep quality, smartphone dependence, and health-related behaviors, and to identify predictors of sleep quality.

METHODS

This study employed a cross-sectional research approach to gather 409 subjects at a junior college in southern Taiwan, and used a structured questionnaire to collect data. The questionnaire consisted of four parts: basic demographic data, the Pittsburgh Sleep Quality Index, assessment of smartphone dependence, and the Health Promoting Lifestyle Profile (HPLP). Logistic regression analysis was employed to check for any association between sleep quality and smartphone dependence or HPLP.

RESULTS

Sleep quality was significantly associated with degree of smartphone dependence, total HPLP score, and scores on the four HPLP subscales of nutritional behavior, self-actualization, interpersonal support, and stress management behavior. The lower the subjects' degree of smartphone dependence was, the better their sleep quality was. Furthermore, the degree of smartphone dependence and total HPLP score were significant predictors of sleep quality.

CONCLUSIONS

Smartphone dependence is associated with poor sleep quality among female college students. Improving health-related behaviors (nutritional behavior, self-actualization, interpersonal support, and stress management behavior) can also promote improvement in sleep quality.

Sleep Quality among Police Officers: Implications and Insights from a Systematic Review and Meta-Analysis of the Literature

Poor sleep is associated with bad health outcomes, worse wellbeing and decreases in performance, productivity and safety at work. Police officers are exposed to several risk factors including extended work schedules, shift work, occupational stress, dangerous and traumatic events and can, as such, develop sleep problems. The aim of the present study was to analyze the sleep quality among police officers. A systematic literature search, in PubMed/MEDLINE, PsycINFO, Scopus, ISI/Web of Science (WoS) and the Cochrane Library was conducted. Original articles, published in English, French, Italian, Spanish and Portuguese, the primary objective of which was the evaluation of the quality of sleep through the Pittsburgh Sleep Quality Index (PSQI) in Police Forces, were selected. From an initial sample of 1,149 studies, 13 articles were included in the meta-analysis (3,722 police officers). The pooled prevalence of bad sleep quality in police officers was 51% [95%CI 42–60%]. The pooled global score of the PSQI was 5.6 [95%CI 5.0–6.3], corresponding to a low average quality. At the meta-regressions, statistically significant associations could be found for work seniority (in terms of years of service) and being on shift. The poor quality of sleep in police officers could have negative consequences for workers’ health and for the safety of third parts. The implementation of health and sleep hygiene promotion programs in police forces is strongly recommended.