Sleep Quality in Obesity: Does Adherence to the Mediterranean Diet Matter?

Obesity and unhealthy eating habits have been associated with sleep disturbances (SD). The Mediterranean diet (MD) is a healthy nutritional pattern that has been reported to be associated with better health and sleep quality. Thus, the aim of the study was to investigate whether adherence to the MD is associated with sleep quality in a population of middle-aged Italian adults. This cross-sectional study included 172 middle-aged adults (71.5% females; 51.8 ± 15.7 years) that were consecutively enrolled in a campaign to prevent obesity called the OPERA (Obesity, Programs of Nutrition, Education, Research and Assessment of the best treatment) prevention project that was held in Naples on 11–13 October 2019. Anthropometric parameters, adherence to the MD and sleep quality were studied. Overall, 50.6% of the subjects were good sleepers (the Pittsburgh Sleep Quality Index (PSQI) < 5) while 49.4% were poor sleepers (PSQI ≥ 5). Our results demonstrated that good sleepers, when compared to poor sleepers (p < 0.001) had significantly higher adherence to the MD as assessed by PREDIMED (Prevención con Dieta Mediterránea) score, lower BMI (body mass index) and waist circumference (WC). The higher PSQI, the higher the BMI (p < 0.001) and WC values (p < 0.001), thus suggesting that poor sleep was more common in subjects with obesity. In addition, a negative correlation between PSQI and the PREDIMED score (p < 0.001) was found. to the intake of the cluster of foods enclosed in the MD, rather than the intake of the single food, predicted PSQI. By performing a receiver operator characteristic (ROC) curve analysis, we determined a cut-off value at a PREDIMED score < 9 as the threshold for screening poor sleepers. In conclusion, good sleepers had lower BMI and WC and higher adherence to the MD than poor sleepers. PSQI was positively associated to BMI and WC while it was negatively associated to adherence to the MD. The consumption of the MD dietary pattern rather than the intake of a single nutrient has a beneficial effect on sleep quality. Hence, the assessment of sleep should be taken into account in the management of obesity and promoting adherence to the MD could be a tool to improve SD.

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Chronotype and Adherence to the Mediterranean Diet in Obesity: Results from the Opera Prevention Project

Nutrients ◽

10.3390/nu12051354 ◽

2020 ◽

Vol 12 (5) ◽

pp. 1354

Author(s):

Giovanna Muscogiuri ◽

Luigi Barrea ◽

Sara Aprano ◽

Lydia Framondi ◽

Rossana Di Matteo ◽

...

Keyword(s):

Nutrition Education ◽

Mediterranean Diet ◽

Eating Habits ◽

Common Finding ◽

Middle Aged ◽

Unhealthy Lifestyle ◽

Anthropometric Parameters ◽

Cross Sectional ◽

Prevention Project ◽

The Mediterranean

Chronotype is the attitude of a subject in determining individual circadian preference in behavioral and biological rhythm relative to the external light–dark cycle. Obesity and unhealthy eating habits have been associated with evening chronotype. The Mediterranean diet (MD) is a healthy nutritional pattern that has been reported to be associated with better health and quality of sleep. Thus, the aim of the study was to investigate the association of chronotype categories with adherence to the MD in a population of middle-aged Italian adults. This cross-sectional study included 172 middle-aged adults (71.5% females; 51.8 ± 15.7 years) that were consecutively enrolled in a campaign to prevent obesity called the OPERA (obesity, programs of nutrition, education, research and assessment of the best treatment) Prevention Project that was held in Naples on 11–13 October 2019. Anthropometric parameters, adherence to the MD and chronotype were studied. Chronotype was classified as morning in 58.1% of subjects, evening in 12.8% and intermediate in 28.1%. Our results demonstrated that individuals with evening chronotype, when compared to intermediate (p < 0.001) and morning chronotype (p < 0.001), were more prone to follow unhealthy lifestyle, performing less regular activity and being more frequently smokers. In addition, they showed the lowest adherence to the MD compared to morning (p < 0.001) and intermediate chronotypes (p < 0.001). The lower the chronotype score, the higher body mass index (BMI) values in the whole population (r = −0.158; p = 0.038), thus suggesting that evening chronotype was a common finding in subjects with obesity. In addition, positive correlations of chronotype score with age (r = 0.159; p = 0.037) and PREDIMED score (r = 0.656; p < 0.001) were found. The adherence to the MD, more than the intake of the single food items, was found to predict morning and evening chronotypes. In conclusion, evening chronotype was associated with unhealthy lifestyle and low adherence to the MD. Chronotype score was inversely associated to BMI and positively associated to age and adherence to the MD. Thus, the assessment of chronotype should be taken into account in the management of obesity and in the development of nutritional strategies.

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Association between Depression, Lifestyles, Sleep Quality, and Sense of Coherence in a Population with Cardiovascular Risk

Nutrients ◽

10.3390/nu13020585 ◽

2021 ◽

Vol 13 (2) ◽

pp. 585

Author(s):

Aina Riera-Sampol ◽

Miquel Bennasar-Veny ◽

Pedro Tauler ◽

Mar Nafría ◽

Miquel Colom ◽

...

Keyword(s):

Cardiovascular Risk ◽

Sleep Quality ◽

Mediterranean Diet ◽

Sense Of Coherence ◽

Cross Sectional Study ◽

Poor Sleep ◽

Protective Effects ◽

Cross Sectional ◽

Health Related ◽

The Mediterranean

People with cardiovascular risk have more depression than the general population. Depression and cardiovascular risk have been commonly linked to lower sense of coherence (SOC) values, unhealthy lifestyles, and poor sleep quality. The aim of this study was to analyze the association between depression, health-related lifestyles, sleep quality, and SOC in a population with cardiovascular risk. A cross-sectional study was conducted in 310 participants (aged 35–75 years) with cardiovascular risk. Sociodemographic and anthropometric characteristics, cardiovascular risk, SOC score, depression levels, sleep quality, and lifestyles (physical activity, diet quality (measured as the adherence to the Mediterranean diet), and tobacco and alcohol consumption) were determined. The regression analysis showed significant associations between depression levels and sex (odds ratio (OR): 2.29; 95% CI: 1.29, 4.07), diet (OR: 0.85; 95% CI: 0.73, 0.99), body mass index (BMI) (OR: 1.06; 95% CI: 1.01, 1.12), cardiovascular disease (CVD) (OR: 2.55; 95% CI: 1.18, 5.48), sleep quality (OR: 0.26; 95% CI: 0.15, 0.46), and SOC (OR: 0.96; 95% CI: 0.94, 0.98). Protective effects of male sex, a lower BMI, no CVD, a higher adherence to the Mediterranean diet, a high sleep quality, and a higher SOC were found. In conclusion, among lifestyles determined, only diet was associated with depression levels. SOC and sleep quality were also found as significant predictors for depression levels.

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Relationship Among Adherence to The Mediterranean Diet and Anthropometric and Metabolic Parameters in Subjects with Obesity

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530320999201111161220 ◽

2020 ◽

Vol 20 ◽

Author(s):

Luisa Lampignano ◽

Roberta Zupo ◽

Rossella Donghia ◽

Vito Guerra ◽

Fabio Castellana ◽

...

Keyword(s):

Mediterranean Diet ◽

Hdl Cholesterol ◽

Fat Distribution ◽

Serum Levels ◽

Overweight And Obesity ◽

Height Ratio ◽

Anthropometric Parameters ◽

Cross Sectional ◽

Waist To Height Ratio ◽

The Mediterranean

Background: There is moderate-to-high evidence that the Mediterranean diet prevents increases in body weight and waist circumference in non-obese individuals but less is known about its effects in subjects with overweight and obesity. The present study was focused on exploring the cross-sectional association among the adherence to Mediterranean diet and the most commonly used variables of metabolic and cardiovascular risk factors in a cohort of overweight subjects from a typical Mediterranean region, Apulia, in Southern Italy. Methods:: The study was performed in a cohort of 1214 individuals, all with overweight or obesity but no other clinical condition. We investigated the association among adherence to Mediterranean diet, assessed with the PREDIMED score, and anthropometric parameters [namely body mass index (BMI), WC, waist to height ratio (WHtR) and neck circumference (NC)], fasting serum levels of glucose, insulin, uric acid and lipids (triglycerides, total cholesterol, HDL cholesterol and LDL cholesterol), and blood pressure and insulin resistance, measured by HOMA-IR. Results:: The waist to height ratio was negatively associated to a PREDIMED score ≥7 (p<0.04), whereas HDL cholesterol was positively associated to a PREDIMED score ≥7 (p<0.04) Conclusion: This study suggests that body fat distribution and HDL-cholesterol are the parameters most strongly influenced by MedDiet in Apulian subjects.

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Social Jet Lag Associates Negatively with the Adherence to the Mediterranean Diet and Body Mass Index among Young Adults

Nutrients ◽

10.3390/nu11081756 ◽

2019 ◽

Vol 11 (8) ◽

pp. 1756 ◽

Cited By ~ 11

Author(s):

Zerón-Rugerio ◽

Cambras ◽

Izquierdo-Pulido

Keyword(s):

Body Mass Index ◽

Young Adults ◽

Mediterranean Diet ◽

Body Mass ◽

Jet Lag ◽

Sleep Habits ◽

Anthropometric Parameters ◽

Cross Sectional ◽

The Mediterranean ◽

Lower Adherence

Obesity and unhealthy eating habits have been associated with irregular sleep–wake patterns during the week, also known as social jet lag. The Mediterranean diet is a healthy pattern related with a better health and sleep quality. However, potential associations with social jet lag remain unexplored. The aim of this study was to examine whether higher social jet lag is linked to lower adherence to the Mediterranean diet and whether it is associated with BMI (Body Mass Index). This cross-sectional study included 534 young adults (18–25 years). Anthropometric parameters, adherence to the Mediterranean diet, chronotype and social jet lag were studied. Our results revealed that individuals with greater social jet lag showed lower adherence to the Mediterranean diet and had a higher BMI. Among the habits that characterized the Mediterranean dietary pattern, we observed that higher social jet lag was significantly associated with a lower intake of fruits and vegetables, as well as skipping breakfast. Hence, the promotion of regular sleep habits together with healthy dietary patterns should be considered for obesity prevention, especially among young adults.

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Sleep Among Long-Term Care Residents in China: A Narrative Review of Literature

Clinical Nursing Research ◽

10.1177/1054773816673175 ◽

2016 ◽

Vol 27 (1) ◽

pp. 35-60 ◽

Cited By ~ 5

Author(s):

Junxin Li ◽

Binbin Yang ◽

Miranda Varrasse ◽

Kun Li

Keyword(s):

Sleep Quality ◽

Sleep Disturbances ◽

Long Term Care ◽

Light Therapy ◽

Future Research ◽

Poor Sleep ◽

Sleep Research ◽

Cross Sectional ◽

Term Care

The objective of this study is to synthesize and evaluate the current body of sleep research among long-term care (LTC) residents in China and provide insights for future research. Systematic searches identified 15 studies that examined sleep in LTC residents in China. Sleep disturbances and poor sleep quality were prevalent in Chinese LTC residents. Eight cross-sectional studies reported that demographics, comorbidities, lifestyle, and environment were associated with sleep quality in Chinese LTC residents. Seven intervention studies, including exercise, traditional Chinese medicine, light therapy, and behavioral interventions resulted in improved sleep quality. Only subjective sleep measures were used in all 15 studies. Some methodological issues were identified in studies, especially those conducted in Mainland China. Sleep research in LTC residents in China is still at the beginning stages. Future studies should consider more rigorous designs and objective sleep measures, and develop target interventions based on factors associated with sleep disturbances.

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Adherence to Mediterranean diet and risk of depression later in life. A cross sectional study in East Attica, Greece

Global Psychiatry ◽

10.2478/gp-2019-0012 ◽

2019 ◽

Vol 2 (2) ◽

pp. 201-210 ◽

Cited By ~ 1

Author(s):

Konstantinos Argyropoulos ◽

Evangelia Machini

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Older People ◽

Mediterranean Diet ◽

Sleep Disturbances ◽

Depression Scale ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

The Mediterranean

AbstractObjectivesThe purpose of the present study was to estimate the prevalence of depression later in life in an urban area and to investigate the associations between possible risk and protective factors including adherence to a Mediterranean diet.MethodsA cross-sectional study was conducted among the active members of the open day-care centres for older people, in East-Attica, Greece. An anonymous questionnaire was developed to collect basic demographic and medical data, the Geriatric Depression Scale (GDS-15) was applied to screen the elderly for depressive symptoms, the Athens Insomnia Scale (AIS) was used to quantify sleep disturbances and adherence to the Mediterranean diet was evaluated using the Mediterranean Diet Score (MDS). Statistics was processed with SPSS 24.0.Results154 older adults took part in the study. According to GDS-15, 24.7% (21.4% moderate and 3.2% severe type) screened positive for depressive symptoms. 29.9% of the participants reported inadequate sleep, based on AIS. Depression and insomnia in older participants were more frequent in women than in men, in lower educated, in participants with lower monthly income and in older people with comorbidity (p < 0.05).MDS revealed that adherence to a Mediterranean diet was moderate for 64.3% of the participants, and it was high for 34.4%. Depression diagnosed by a physician, was strongly associated with MDS (p = 0.035) and AIS (p = 0.001). Logistic regression analysis results revealed a diet higher in vegetables and lower in poultry and alcohol was associated with decreased likelihood of developing symptoms of depression later in life.ConclusionsOur results support that depression in older adults is common and strongly associated with several risk factors. Adherence to a Mediterranean diet may protect against the development of depressive symptoms in older age. Moreover, not only diet but also sleep-deficiency might contribute to the depression later in life.

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Sleep Quality and Mental Health of Medical Students in Greece During the COVID-19 Pandemic

Frontiers in Public Health ◽

10.3389/fpubh.2021.775374 ◽

2021 ◽

Vol 9 ◽

Author(s):

Anna Eleftheriou ◽

Aikaterini Rokou ◽

Aikaterini Arvaniti ◽

Evangelia Nena ◽

Paschalis Steiropoulos

Keyword(s):

Mental Health ◽

Medical Students ◽

Sleep Quality ◽

Sleep Disturbances ◽

Online Survey ◽

Female Students ◽

Poor Sleep ◽

Special Focus ◽

Cross Sectional ◽

Health Parameters

Background-Aim: Medical students have been greatly affected by the COVID-19 pandemic due to their educational program, which comprises theoretical knowledge and also clinical duties, making them vulnerable to viral exposures and possibly affecting their everyday life. The aim of this study was to explore changes in sleep and mental health parameters among medical students in Greece during the second year of the pandemic.Methods: This cross-sectional study comprised students of all medical schools in Greece (n = 7), using an anonymous online survey. Participants completed the following questionnaires: Pittsburgh Sleep Quality Index (PSQI), Athens Insomnia Scale (AIS), Fatigue Severity Scale (FSS), General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9). Statistical analysis was conducted with the use of SPSS v.26 (IBM SPSS, Armonk NY, USA).Results: Out of the 562 received responses, 559 met the inclusion criteria. The largest proportion of the respondents came from 4th-year (27.8%) and the majority of the sample were females (69.8%). Only 5.9% of the participants reported having been infected by SARS-COV-2. Most of the respondents experienced insomnia (65.9%, mean AIS score: 7.59 ± 4.24), poor sleep quality (52.4%, mean PSQI score: 6.6 ± 3.25) and increased fatigue (48.5%, mean 35.82 ± 11.74). Moderate to severe symptoms of anxiety (mean 9.04 ± 5.66) and depression (mean 9.36 ± 6.15) were noted. Suicidal ideation was found in 16.7% of the sample, while use of sleeping pills in the previous month was reported by 8.8% (n = 47). Further analysis revealed independent associations between sleep and mental health parameters. Higher AIS score was associated with greater FSS score; higher PSQI scores with higher GAD-7 and PHQ-9 scores. Additionally, female students were found to be significantly more affected than males by the COVID-19 pandemic, displaying higher levels of insomnia, sleep disturbances, anxiety and depression. In addition, those with a history of COVID-19 infection or in close proximity with a positive case reported significantly more significant post-traumatic symptoms in IES-COVID-19 questionnaire.Conclusions: In the aftermath of the COVID-19 pandemic, prevalence of sleep and mental health disorders among Greek medical students is significant, highlighting the need for better surveillance of students' wellbeing and subsequent counseling, with special focus on female students and other affected groups.

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Dampak Kecanduan Smartphone Terhadap Kualitas Tidur Siswa SMP

JKEP ◽

10.32668/jkep.v6i1.463 ◽

2021 ◽

Vol 6 (1) ◽

pp. 69-85

Author(s):

Yupi Supartini ◽

Puput Dwi Martiana ◽

Titi Sulastri

Keyword(s):

Sleep Quality ◽

Sleep Disturbances ◽

Statistical Test ◽

High Rate ◽

Smartphone Addiction ◽

Poor Sleep ◽

Cross Sectional ◽

Significance Level ◽

Significant Difference

Excessive smartphone use has a higher risk of sleep disturbances and affects a person’s sleep quality. The purpose of this research is to determine the relationship between respondent’s characteristics and smartphone addiction to the sleep quality of adolescents at Budi Cendikia Islamic School Depok. This type of research is quantitative with a descriptive analytic approach and a cross sectional research design. The population is all 359 students. Sampling in this study using stratified random sampling technique with 112 respondents. The SAS-SV questionnaire was used to measure the level of smartphone addiction, while the PSQI questionnaire was used to measure sleep quality in adolescents. The statistical test used Chi Square and Mann Whitney with a significance level of α = 0.05. The results of the univariate statistical test showed that most of the respondents were male (52.7%), 13 years old (35.7%), had a high rate of smartphone addiction (61.6%), and poor sleep quality (70.5%). Meanwhile, the results of the bivariate statistical test showed that there was a significant difference between gender (p = 0.020) and smartphone addiction (p = 0.007) with sleep quality, but there was no significant difference between age and sleep quality (p = 0.938). This study concludes that there is a relationship between gender and smartphone addiction on students' sleep quality, but there is no relationship between age and sleep quality of students. Hence, it is necessary to limit the use of smartphones so that smartphone addiction can be minimized and sleep quality is good.”

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Associations between sleep quality and its domains and insufficient physical activity in a large sample of Croatian young adults: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2018-021902 ◽

2018 ◽

Vol 8 (7) ◽

pp. e021902 ◽

Cited By ~ 10

Author(s):

Lovro Štefan ◽

Goran Sporiš ◽

Tomislav Krističević ◽

Damir Knjaz

Keyword(s):

Physical Activity ◽

Young Adults ◽

Sleep Quality ◽

Sleep Disturbances ◽

Smoking Status ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Subjective Sleep Quality ◽

Cross Sectional ◽

Insufficient Physical Activity

ObjectivesThe main purpose of the present study was to explore the associations between sleep quality and insufficient physical activity.DesignCross-sectional.SettingFaculties in Croatia.Participants2100 university students (1049 men and 1051 women) aged 18–24 years were recruited.Primary outcomeTo assess the domains of sleep quality (independent variables) and ‘insufficient’ physical activity (dependent variable), we used previously validated Pittsburgh Sleep Quality Index and International Physical Activity questionnaires. Logistic regressions were used to calculate the associations between the sleep quality and ‘insufficient’ physical activity.ResultsWhen sleep quality domains were entered separately into the model, very bad subjective sleep quality (OR 3.09; 95% CI 1.50 to 6.56), >60 min of sleep latency (OR 2.17; 95% CI 1.39 to 3.39), <7 hours of sleep (OR 1.56; 95% CI 1.24 to 1.96), <65% of habitual sleep efficiency (OR 2.26; 95% CI 1.26 to 4.05), sleep disturbances >1/week (OR 1.61; 95% CI 1.03 to 2.52), use of sleep medication >1/week (OR 3.35; 95% CI 1.83 to 6.10), very big daytime dysfunction problem (OR 2.78; 95% CI 1.57 to 4.93) and poor sleep quality (1.53; 95% CI 1.23 to 1.91) were associated with ‘insufficient’ physical activity. When all sleep quality domains were entered simultaneously into the model, the same significant associations remained, except for sleep disturbances. Both models were adjusted for gender, body mass index, self-rated health, life satisfaction, socioeconomic status, presence or absence of chronic diseases, smoking status, binge drinking and psychological distress.ConclusionsOur results show that ‘poor’ sleep quality is associated with ‘insufficient’ physical activity in young adults. In order to improve, special strategies and policies that leverage ‘good sleep’ quality are warranted.

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0129 Association of Sleep Quality with Serum Lipids in Obese Adults

SLEEP ◽

10.1093/sleep/zsaa056.127 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A51-A51

Author(s):

B Mehta ◽

A Ankita ◽

P Raghav ◽

S Chambial ◽

N Dutt

Keyword(s):

Waist Circumference ◽

Sleep Quality ◽

Lipid Profile ◽

Blood Sugar ◽

Sleep Disturbances ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Fasting Blood Sugar ◽

Poor Sleep ◽

Anthropometric Parameters

Abstract Introduction Sleep disturbances have been associated with metabolic dysregulation and have known to contribute to weight gain, obesity, type II diabetes, and cardiovascular disease risk. Obesity due to sleep fragmentation is mediated by multiple pathways like upregulation of orexin neurons and changes in appetite-regulating hormones like Leptin, Ghrelin, which affect food intake and hedonic feeding. Conversely, body mass index (BMI) is associated with alterations in sleep and with high circulating lipids and incidence of coronary heart disease. We hypothesized that poor sleep quality is associated with an adverse serum lipid profile. Methods In this cross-sectional study, till date, 27 obese adult participants were recruited after informed consent. The obesity criterion was taken as BMI ≥ 25 kg/m2. Anthropometric parameters, waist circumference, neck circumference, hip circumference, and BP were measured. Sleep quality was assessed by the “Pittsburgh Sleep Quality Index” (PSQI) questionnaire. A score of 5 or more was considered to be adverse sleep. The fasting blood sugar and lipid profile of each participant was determined. Results The average age, BMI and waist circumference of the subjects were 48.96 ±13.9 years, 32.41± 6.18 kg/m2 and 107.4 ±12.18 cm respectively. The Spearman correlation test revealed a significant correlation between the PSQI scores and triglyceride levels of the participants (p=0.033, r = 0.420). The correlation with BMI (p=0.33, r=0.192), fasting blood sugar (p=0.26, r=0.241), HDL (p=0.27, r = -0.221) and waist circumference (p=0.69, r = -0.082) were not found to be statistically significant. Conclusion We conclude that high triglyceride levels are associated with poor quality of sleep in adults. Although other biochemical parameters did not show a significant correlation, a greater sample size may give us a clear insight into it. Support The study is an intramural project supported by AIIMS, Jodhpur.

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