Abstract
Evidence on the association between sleep, diet, and eating behaviors in pregnant women is lacking. We examine this in a cohort of apparently healthy pregnant women. At 26–28 weeks gestation, 497 participants completed the Pittsburgh Sleep Quality Index to assess sleep and a 24-h recall to assess dietary intake. Diet quality was assessed by the Healthy Eating Index for pregnant women in Singapore (HEI-SGP) score and previously derived dietary patterns (vegetables-fruit-rice, seafood-noodles, and pasta-cheese-meat pattern). Eating behaviors studied included the longest night-time fasting interval, frequency of consumption occasions, energy from discretionary foods, and nighttime eating. Adjusted means were estimated between poor/good quality and short/normal sleepers using linear regressions, including covariates. Good sleep quality versus poor sleep quality, was associated with better diet quality (mean HEI-SGP 54.6 vs. 52.0; p = 0.032), greater adherence to the vegetables-fruit-rice pattern (mean 0.03 vs. −0.15; p = 0.039), lesser adherence to the seafood-noodle pattern (mean −0.14 vs. 0.03; p = 0.024), and a trending lower calories from discretionary foods (mean 330.5 vs. 382.6 kcal; p = 0.073), after adjusting for covariates. After additional adjustment for anxiety, only sleep quality and the seafood-noodle pattern remained significantly associated (p = 0.018). Short sleep was not associated with any diet or eating behavior. In conclusion, good sleep quality is associated with a better diet quality and a greater adherence to the vegetable-fruit-rice pattern, but with lesser adherence to the seafood-noodle diets in pregnant women.
Highlights
Dietary intake and thereby the risk of chronic diseases and excessive weight gain can be altered by many lifestyle behaviors
We are the first to show that good sleep quality was accompanied by a significantly lesser adherence to the seafood-noodle pattern during pregnancy and borderline significantly better diet quality and greater adherence to the vegetable-fruit-rice pattern
No associations were observed for sleep duration with diet or eating behaviors
Summary
Dietary intake and thereby the risk of chronic diseases and excessive weight gain can be altered by many lifestyle behaviors. It has been suggested that short sleep alters the release of the appetite-related hormones. Studies have observed lower leptin and higher ghrelin concentrations, which are associated with increased dietary intake, in short sleepers [4]. The two most common methods to study overall diet are diet quality indices that are based on pre-existing knowledge of diet-disease associations (e.g., dietary recommendations) or data-reductions methods (e.g., principal components analyses) [6]. Evidence from trials in adults and children suggests that sleep restriction increases food and total energy intakes [1]. Short sleep duration (
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