Abstract P205: Poor Sleep Quality and Daytime Sleepiness Associated With Lower Quality Diet in an Israeli Cohort

Abstract

Introduction: Sleep health and diet quality are bidirectionally linked. Poor sleep can impair metabolic function and alter eating behavior, while a poor quality diet may negatively impact sleep and daytime function through multiple pathways (i.e. inflammation, obesity, daytime fatigue). Methods: In a 2017 Israeli Bureau of Statistics population-based survey of households, 7,230 Israeli individuals reported habitual sleep and diet quality. Sleep variables included sleep duration (≤5, 6, 7, 8, or ≥9 hours per night), sleep disturbances (0, ≤1, 2-3, or 4+ nights per week), and daytime sleepiness (categorized as either “None”, “Not Much”, “Somewhat”, or “Greatly”). Diet variables were categorized as 0, 1, 2, 3, or 4+ daily servings of vegetables, fruits, and whole grains, and 0, 1, 2, 3, or 4+ weekly servings of legumes, red meat, and fish. Covariates included age, sex, BMI, financial status, and ethnicity. Results: Individuals who slept ≤5 hours were less likely to eat daily vegetables (oOR=0.863, p<0.05). Individuals who slept ≤7 hours were less likely to eat daily fruits (oOR=0.858, p<0.02), and whole grains (oOR=0.0.772, p<0.0005). Individuals who slept ≥9 hours were less likely to eat daily vegetables (oOR=0.803, p=0.038), fruits (oOR=0.783, p=0.025), or wholegrains (oOR=0.783, p=0.027), as well as weekly legumes (oOR=0.788, p=0.025), and fish (oOR=0.779, p=0.028). Those with severe sleep disturbances (4+ per week) were less likely to eat daily vegetables (oOR=0.675, p<0.0005), fruits (oOR=0.765, p<0.0005), and whole grains (oOR=0.840, p=0.011), or weekly legumes (oOR=0.806), p=0.001). Mild daytime sleepiness was associated with fewer daily vegetables (oOR=0.834, p=0.007), while “great” daytime sleepiness was associated with fewer vegetables (oOR=0.558, p<0.0005), fruits (oOR=0.689, p<>0.0005), wholegrains (oOR=0.751, p<0.0005), and legumes (oOR=0.734, p<0.0005). In a stepwise model adjusting for all sleep variables, many measures of poor sleep were independently associated with fewer daily vegetables, fruits, and wholegrains, fewer weekly legumes, and more weekly red meat. Conclusions: While the relationship between sleep and diet is complex, these data suggest that multiple independent pathways link poor sleep with an objectively unhealthier diet. The interaction between diet and daytime function, in particular, warrants further attention. Interventions targeting healthier sleep and diet must consider all aspects of sleep quality, including nocturnal sleep itself and daytime sleepiness.