Eating habits are associated with subjective sleep quality outcomes among university students: findings of a cross-sectional study

Irregular breakfast eating in type 2 diabetes mellitus is associated with greater social jetlag and poorer metabolic health

Circadian disruption, arising from conflict between internal circadian time and behavioural sleep-wake and fasting-feeding rhythms, may contribute to the prevalence of type 2 diabetes mellitus and disease severity. Previous studies have demonstrated a link between irregular breakfast eating and poorer metabolic health. We aimed to further explore the relationships between breakfast habits, circadian misalignment (social jetlag), and metabolic parameters in a cohort of adult participants with type 2 diabetes mellitus. A total of 330 adult participants with type 2 diabetes mellitus attending for routine clinical review completed structured questionnaires to assess habitual sleep timing, chronotype, and social jetlag. Statistical analysis was via inferential groupwise approaches and path analysis to establish interdependencies of effects of social jetlag, chronotype, and breakfast eating regularity on HbA1c. 22.7% of the participants reported eating breakfast five times or fewer a week, and were categorised as irregular breakfast eaters. Compared with those who ate breakfast six or seven times a week, irregular breakfast eaters had significantly higher HbA1c and diastolic blood pressure, were younger and had greater social jetlag. In the path analysis, irregular breakfast eating exerted a direct effect on HbA1c, whilst social jetlag exerted only an indirect effect on HbA1c through breakfast eating regularity. Chronotype did not exert any effect on HbA1c, but did exert an indirect effect on breakfast eating regularity via social jetlag. Our results showed that adult participants with type 2 diabetes mellitus, who ate breakfast irregularly had poorer metabolic health and greater social jetlag. The relationship between social jetlag and glycaemic control appears to be mediated through breakfast eating habits.

Food neophobia and its relationship with dietary quality and diversity in Turkish young adults: a cross-sectional study

Food neophobia, the fear of trying new foods, may reduce dietary variety, posing risks for nutritional deficiencies. This study examined the links between food neophobia, dietary quality, and diversity among Turkish young adults. A cross-sectional study with 949 participants (470 males, 479 females) aged 18-35 years used the Food Neophobia Scale (FNS) and a 24-h dietary recall to assess food intake. Dietary diversity score (DDS), food variety score (FVS), mean adequacy ratio (MAR), and healthy eating index (HEI-2015) were calculated. The mean neophobia score was 37.07 ± 12.17, with 13.4% high, 67.9% average, and 18.8% low neophobia. The average neophobia group had higher diet quality scores (MAR, DDS, FVS) than the low and high neophobia groups (p < 0.01). Positive relationships with food neophobia were found for niacin, calcium, zinc, plant protein, and cholesterol (p < 0.05). These findings suggest that food neophobia may affect dietary quality variably, with certain micronutrients positively linked to it.

Sleep Quality and its Predictors in Brazilian Marines

Objectives  The objective of this study was to evaluate the quality of sleep and its associated factors in marines ( Fuzileiros Navais - FN ) of the Brazilian Navy. Material and Methods  The participants included 1,248 military personnel who responded remotely to the following instruments: anamnesis, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, International Physical Activity Questionnaire, Eating Habits Scale, and the K10 Questionnaire. Anthropometric information was obtained from a database. Subgroup analysis (good x poor sleep) and regression analysis were performed to verify the factors associated with poor sleep quality. Results  A total of 74.12% of the military were characterized by poor sleep quality. There were differences between sleep quality and sociodemographic, behavioral, and professional factors. Age, being an Officer, and physical activity were protective factors, while living with young children, having more energy in the evening, daytime sleepiness, having problems at work, distress, and regular eating habits were predisposing to poor sleep. Discussion  Marines of the Brazilian Navy have a high prevalence of poor sleep quality associated with personal, family, and occupational factors as contributors to the problem, indicating the need to develop health actions that favor good sleep hygiene in these professionals.

Impact of sleep hygiene education on sleep and nutrition in children aged 10-18 years

INTRODUCTION

Sleep quality has positive effects on children's sleep and eating habits. In turn, improvement in sleep quality is associated with sleep hygiene training. The aim of our study was to determine the impact of sleep hygiene education on sleep and nutrition management in children aged 10-18 years. In addition, we explored the association between sleep problems and eating behaviours in participants before and after the training programme.

METHODS

We conducted a quasi-experimental study between August 25 and December 27, 2023, in children aged 10-18 years who participated in the study on a voluntary basis with the consent of their parents. We collected data from a total of 80 children aged 12-18 years. The study investigated the relationship between sleep problems and eating behaviours. We randomly allocated participants to one of two groups, the training group or the waitlist group. We assessed the association between changes in sleep problems and changes in eating behaviours in the training group. The data were collected using a sociodemographic data form, the Children's Sleep Habits Questionnaire, and the Three-Factor Eating Questionnaire.

RESULTS

In the study sample, the proportions of male and female participants (training group) were 60.0% and 40.0%, respectively. There was a statistically significant difference between the pretest and post-test scores in the Children's Sleep Habits Questionnaire and the Three-Factor Eating Questionnaire (P < .01) and significant differences in the changes in sleep and eating habit scores between groups between the pre- and post-sleep hygiene training timepoints (P < .01). Thus, we concluded that sleep hygiene training is associated with and has an impact on sleep and nutrition.

CONCLUSION

We observed that in children aged 10-18 years, sleep problems were associated with their eating behaviours. Sleep hygiene education had a significant and favourable impact on sleep and nutrition outcomes. Thus, sleep hygiene training has an important effect on children's sleep and diet.

Short Sleep Duration and Skipping Main Meals among University Students

Introduction  Admission to university influences lifestyle behaviors and is marked by a daily routine of accumulation of activities that can interfere with sleep duration, affecting food choices and meal consumption habits throughout the day. Objective  To analyze the association between short sleep duration and skipping main meals among university students. Materials and Methods  We conducted a cross-sectional study with 1,608 university students aged between 16 and 25 years, who were enrolled in full-time undergraduate courses at a public university in the Midwestern region of Brazil. Information on skipping breakfast, lunch, and dinner was collected through the question "On average, how often do you eat the following meals?". Given the lack of a uniform criterion to define "skipping a meal", in the present study, any answer that did not correspond to the daily consumption of the meal was classified as meal skipping, based on the recommendation of the Dietary Guidelines for the Brazilian Population. Short sleep duration was determined according to sleep time during the night (≤ 6 hours for those aged ≥18 years and ≤ 7 hours for those under 18 years of age). Associations were estimated using adjusted Poisson regression models. Results  The prevalences of skipping breakfast, lunch, and dinner were of 51.0%, 13.9%, and 35.6% respectively. Short sleep duration was observed in 27.2% of the study population. After adjusting for confounding variables, short sleep duration was positively associated with skipping breakfast (adjusted prevalence ratio [PRadj] = 1.20; 95% confidence interval [95%CI] = 1.08-1.34) and skipping lunch (PRadj = 1.64; 95%CI = 1.27-2.12). Conclusion  University students presented a high prevalence of skipping main meals. Short sleep duration was directly associated with skipping two major meals of the day: breakfast and lunch.

Meal Timing and Sleep Health Among Midlife Mexican Women During the Early Stages of the COVID-19 Pandemic

BACKGROUND/OBJECTIVES

This study aimed to examine associations between meal timing habits and sleep health in midlife Mexican women.

METHODS

Data comprised 379 midlife Mexican women who participated in a phone survey conducted within the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) project during the early stages of the COVID-19 pandemic. Women answered questions related to meal habits and sleep duration, latency, and quality. We used linear regression to investigate the associations between meal timing, frequency of meals/snacks, eating window (duration between first and last eating occasion of the day), duration between last meal, bedtime, sleep duration, and logistic regression to examine the associations between meal timing, sleep latency, and sleep quality, adjusting for confounders.

RESULTS

Later timing of meals throughout the day, and a shorter interval between the last meal of the day and bedtime, were associated with prolonged sleep latency and worse sleep quality. Associations with sleep duration were mixed: a longer eating window and a later largest and last meal were each associated with shorter sleep duration, while a later first meal and a shorter interval between the last meal of the day and bedtime were associated with longer sleep duration.

CONCLUSIONS

Meal timing habits are associated with sleep duration, latency, and quality in midlife women.

Association Between Chrononutrition Patterns and Multidimensional Sleep Health

BACKGROUND/OBJECTIVES

Sleep health has been associated with diet quality, but the relationship between chrononutrition patterns and multidimensional sleep health is unclear. This study identifies chrononutrition patterns among U.S. adults and examines their associations with multidimensional sleep health.

METHODS

This cross-sectional analysis used data from the 2017-2020 National Health and Nutrition Examination Survey. Chrononutrition behaviors were assessed using two 24 h dietary recalls. Latent profile analysis was used to identify chrononutrition profiles. Multivariable survey regression models determined the associations between chrononutrition patterns and sleep health dimensions.

RESULTS

The sample included 5228 subjects with a median age of 49 years. Of the sample, 52% of the participants were female, and 65% were White. In adjusted models, each additional hour between wake time and first instance of eating was associated with a 19% increase in the odds of poor timing (sleep midpoint < 2:00 a.m. or >4:00 a.m.; 95% CI: 1.07-1.33) and a 21% increase in poor duration (<7 or >9 h/night; 95% CI: 1.09-1.33). Each additional hour between last eating and bedtime was associated with 9% higher odds of poor duration (95% CI: 1.03-1.16). A one-hour longer eating window was associated with 10% lower odds of poor timing (95% CI: 0.84-0.98). We identified five chrononutrition profiles: Typical Eating (reference), Early Finished Eating, Later Heavy Eating, Extended Window Eating, and Restricted Window Eating. The Later Heavy Eating profile exhibited 96% higher odds of poor timing (95% CI: 1.09-3.51) and the Restricted Window Eating profile had 94% higher odds of poor duration (95% CI: 1.10-3.43).

CONCLUSIONS

These findings highlight the importance of unique chrononutrition patterns in relation to multidimensional sleep health. We provide a framework for future studies to identify personalized chrononutrition interventions and their role in improving sleep health.

Diet and sleep quality in chilean university students

OBJECTIVES

To evaluate an association between eating patterns and sleep quality in Chilean university students.

METHODS

A cross-sectional analytical study was conducted. Participants included students from 4 Chilean universities. Each student was administered survey Questionnaire on the frequency of healthy and unhealthy eating habits and Pittsburgh Sleep Quality Index and their weight and height were taken to obtain the Body Mass Index (BMI).

RESULTS

A total of 1,079 young university students, 80.26 % were women and the average age was 21.7 years. The 73.68 % have inadequate sleep quality. There is a significant differences in frequency between sleep quality and the intake of breakfast (p<0.001), fish (p<0.05) and dinner (p<0.05), that is, university students who reported optimal sleep consume breakfast and dinner on a daily basis and their fish intake is in line with nutritional recommendations. With respect to the association between sleep quality and healthy dietary patterns, it is observed a significant association (p<0.01) between optimal sleep and daily breakfast consumption in model 3 (Odds Ratio (OR): 0.61 (0.46-0.82)). Regarding unhealthy dietary patterns, a significant association (p<0.05) is observed in model 3 between sleep quality and alcohol consumption (OR: 1.42 (1.02-1.96)). Furthermore, a significant association between optimal sleep and salt consumption is observed in both model 2 (OR: 0.73 (0.54-0.99)) and model 3 (OR: 0.72 (0.53-0.97)). Finally, a significant relationship between not tobacco use and optimal sleep is observed (OR: 0.68 (0.48-0.96)).

CONCLUSION

A positive relationship between healthy diet and sleep quality was observed in university students, which certain dietary patterns, such as the consumption of breakfast and low salt consumption and alcohol, are crucial to talk about a good sleep quality in this population group.

From Garden to Pillow: Understanding the Relationship between Plant-Based Nutrition and Quality of Sleep

The effect of diet on sleep quality has been addressed in many studies; however, whether/how plant-based diets (PBDs) impact sleep-related parameters has not been explored in detail. This review aims to give an overview of the components of PBDs and the possible mechanisms through which PBDs may improve sleep quality. Studies have indicated that diets such as PBDs, which are typically high in fruits, vegetables, nuts, seeds, whole grains, and fiber, are associated with better sleep outcomes, including less fragmented sleep and improved sleep duration. Several mechanisms may explain how PBDs impact and/or improve sleep outcomes. Firstly, PBDs are characteristically rich in certain nutrients, such as magnesium and vitamin B6, which have been associated with improved sleep patterns. Secondly, PBDs are often lower in saturated fats and higher in fiber, which may contribute to better overall health, including sleep quality. Additionally, plant bioactive compounds like phytochemicals and antioxidants in fruits, vegetables, and herbs may have sleep-promoting effects. According to available data, PBD and Mediterranean diet elements promise to enhance sleep quality; however, it is crucial to note that diets should be customized based on each person's needs.

Chronobiological perspectives: Association between meal timing and sleep quality

BACKGROUND

Meal timing has been associated with metabolism and cardiovascular diseases; however, the relationship between meal timing and sleep quality remains inconclusive.

OBJECTIVE

This study aims to investigate the relationship between meal timing and sleep quality from a chronobiological perspective.

METHODS

This study utilized data from the NHANES for the years 2005-2008, including a cohort of 7,023 participants after applying exclusion criteria. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Meal timing was analyzed based on two 24-hour dietary recalls from each individual, considering the timing of the initial and final meals, meal duration, and frequency of meal occasions. Multiple linear regression models and hierarchical analyses were employed to examine the relationship between meal timing and PSQI scores, adjusting for various demographic and habitat covariates.

RESULTS

Statistical analysis revealed a positive correlation between delayed meal timings, increased meal occasions, and elevated PSQI scores, indicating that later meal timing are intricately linked with diminished sleep quality. Both later meal timings and more frequent meal occasions were significantly associated with poorer sleep quality. Compared to the first tertile, the β (95%CI) values of the third tertile were 0.545 (0.226, 0.864) for first meal timing, 0.586 (0.277, 0.896) for midpoint meal timing, 0.385 (0.090, 0.680) for last meal timing, and 0.332 (0.021, 0.642) for meal occasions in the adjusted models.

CONCLUSION

These findings suggest that late initial, midpoint, and final meal timing, as well as more frequent meal occasions, are chrono-nutrition patterns associated with poor sleep quality.

Adherence to the Mediterranean diet and sleep quality are inter-correlated with flash glucose monitoring (FGM)-measured glycemia among children with type 1 diabetes

BACKGROUND

We examined the inter-correlation between diet quality, objectively measured sleep duration, and subjectively measured sleep quality with flash glucose monitoring (FGM)-measured glycemia among young patients with type 1 diabetes (T1D).

MATERIALS AND METHODS

Following cross-sectional design, Fitbit® accelerometers were used to objectively assess sleep duration, while the validated questionnaires Pittsburgh sleep quality index and Mediterranean diet (MD) adherence were used to subjectively assess sleep quality and diet quality, respectively. Glycated hemoglobin (HbA1c) and FGM-reported glycemia components among children with T1D were assessed as well.

RESULTS

Of the 47 participants surveyed (25 boys, 22 girls, 9.31 ± 2.88 years), the majority reported high HbA1c, good sleep quality, and high adherence to the MD. However, only one-third of the participants reported a healthy sleep duration. Only the sleep latency was significantly (P < 0.05) associated with the time above range level 2 and time below range level 2 (P = 0.048) components of the FGM. A positive correlation (r = 0.309, P = 0.035) was reported between adherence to MD and time in range of the FGM.

CONCLUSIONS

Diet quality and sleep quality are variably inter-correlated with FGM-measured glycemia among young patients with T1D and are suggested to be considered influential factors in FGM-monitored diabetes research on this age group.

The effect of circadian timing program for evening-chronotype individuals with obesity on obesity management and sleep quality: A randomized controlled trial

OBJECTIVES

The study aimed to investigate the effect of the circadian timing program (SİZAP) developed for evening-chronotype individuals with obesity on obesity management and sleep quality.

METHODS

This single-site, randomized controlled trial with an experimental research design was registered in ClinicalTrials.gov. It was reported in accordance with the "Consolidated Standards of Reporting Trials" (CONSORT) randomized controlled trial guidelines. The study sample consisted of 38 evening-chronotype individuals with first-degree obesity, with 19 individuals in each study group. The intervention group's sleep hygiene training was conducted and their lifestyle changes were ensured through SİZAP. The control group followed their normal daily lifestyle. No intervention was made in terms of the dietary practices of both groups. Study data were collected using the personal information form, the anthropometric measurement form, the Horne and Ostberg Morning and Evening Questionnaire (MEQ), the Impact of weight on quality of life-lite (IWQOL-lite), the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), the sleep diary, and the data tracked via the website and smart bracelets.

RESULTS

It was determined that the participants in the SİZAP group had a statistically significant decrease in the anthropometric measurements and daytime sleepiness (p < 0.05). The sleep quality scores and the scores of the bodily functions sub-dimension of the quality of life scale were significantly better in the intervention group than in the control group (p < 0.05).

CONCLUSION

It was found that SİZAP is effective in obesity management in evening-chronotype individuals and increases weight loss success and sleep quality.

European expert guidance on management of sleep onset insomnia and melatonin use in typically developing children

Sleeping problems are prevalent among children and adolescents, often leading to frequent consultations with pediatricians. While cognitive-behavioral therapy has shown effectiveness, especially in the short term, there is a lack of globally endorsed guidelines for the use of pharmaceuticals or over-the-counter remedies in managing sleep onset insomnia. An expert panel of pediatric sleep specialists and chronobiologists met in October 2023 to develop practical recommendations for pediatricians on the management of sleep onset insomnia in typically developing children. When sleep onset insomnia is present in otherwise healthy children, the management should follow a stepwise approach. Practical sleep hygiene indications and adaptive bedtime routine, followed by behavioral therapies, must be the first step. When these measures are not effective, low-dose melatonin, administered 30-60 min before bedtime, might be helpful in children over 2 years old. Melatonin use should be monitored by pediatricians to evaluate the efficacy as well as the presence of adverse effects.    Conclusion: Low-dose melatonin is a useful strategy for managing sleep onset insomnia in healthy children who have not improved or have responded insufficiently to sleep hygiene and behavioral interventions.

Faris M, G. Albalushi A, Alsaedi F, Khan SA, Khan MA. Sleep disruptions and associated risk factors among Iranians during Ramadan amid COVID-19 pandemic: A nationwide cross-sectional study

The global COVID-19 pandemic has disrupted daily routines and heightened stress levels worldwide, impacting various aspects of health, including sleep. This cross-sectional study conducted in Iran aimed to investigate the impact of Ramadan Intermittent Fasting (RIF) during the pandemic on sleep disturbances and associated risk factors in adults aged ≥ 18 years. Data was collected from Iranian participants observing RIF. A structured electronic questionnaire, translated into Persian, gathered information on sociodemographics, dietary habits, sleep parameters, physical activity, and more. The study assessed sleep quality, duration, and disturbances and conducted a thorough analysis to identify risk factors associated with sleep disruptions. The study revealed that 48% of the participants experienced sleep disturbances during RIF, with 21% reporting poor sleep quality and 46% having unusual sleep duration. Various factors were associated with an elevated risk of sleep disruptions, including body mass index, place of residence, income levels, cohabitation status, family history of obesity, hypertension, diabetes, heart disease, personal history of obesity, weight fluctuations, Shisha smoking, and unemployment. The results highlight the critical importance of health promotion strategies tailored to cultural contexts. This study advocates for enhanced health education initiatives focusing on sleep hygiene and stress management, especially during periods of significant lifestyle alterations like Ramadan amid a global pandemic. Such initiatives are vital in mitigating sleep disturbances and promoting overall well-being in populations facing unique health challenges.

The Effect of Sleep on the Health and Dietary Behaviours of GAA Athletes

Decreased sleep quality and duration is associated with an array of negative health outcomes. Evidence suggests athletes are susceptible to sleep inadequacies that may in turn affect their health and dietary behaviours. This study aimed to explore the sleep profile of both male and female Gaelic games players, at an elite and sub-elite level and compare how poor sleep relates to subjective health complaints and food cravings. One hundred and seventy Gaelic games players completed the Pittsburgh Sleep Quality Index (PSQI), Subjective Health Complaints Inventory (SHC) and Food Cravings Questionnaire-Trait-Reduced (FCQ-T-r). Participants were categorised into two groups: poor sleepers (PSQI ≥ 5) and good sleepers (PSQI < 5). Outcome measures of health and food cravings were analysed across the groups, Mann-Whitney U tests were used to assess differences, and Spearman's rank-order correlations were used to determine relationships between variables. Sixty-seven % of athletes were categorised as poor sleepers. There were no significant differences in PSQI scores across genders (p = 0.088) or playing level (p = 0.072). Poor sleepers experienced significantly increased SHC (p < 0.001) and female athletes had significantly more SHC compared to males (p < 0.001). Female athletes experienced more food cravings than males (p = 0.013). However, there were no significant differences in food cravings between good and poor sleepers (p = 0.104). The findings suggest a high prevalence of poor sleepers amongst GAA athletes. Furthermore, a significant relationship exists between poor sleep and health complaints with females at a higher risk of worsened health complaints and higher food cravings. Sleep screening and education interventions to enhance sleep in GAA athletes are advocated.

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.

Identification of three dietary groups in French university students and their associations with nutritional quality and environmental impact

Introduction

The student period is associated with changes in eating habits, usually leading to diets of lower nutritional quality. However, some variability may exist in students' dietary patterns. We aimed to describe French students' diets and identify dietary groups that may vary in nutritional quality and environmental impact.

Methods

A representative sample of French students (N = 582) for age, sex and scholarship status completed an online 125-item food frequency questionnaire. The nutritional quality of diets was assessed by a score of adherence to the French nutritional guidelines (sPNNS-GS2 score, ranging from-17 to 11.5) and its environmental impact by greenhouse gas emissions for an isocaloric diet (GHGE). An ascending hierarchical classification analysis on food and beverage intakes led to three dietary groups. Between-group differences in food consumption, dietary indicators and sociodemographic characteristics were investigated using ANOVA models.

Results

The average sPNNS-GS2 score of students' diets was -0.8 ± 2.8, representing a 57% coverage of French nutritional recommendations, and GHGE were 5.4 ± 1.7 kg eCO2/2000 kcal. The three dietary groups were: a healthy diet group (20% of the sample) with the highest nutritional quality and high GHGE, which included older students with a higher level of physical activity; a Western diet group (40%) with the worst nutritional quality and high GHGE, which included more students who lived with their parents; and a frugal diet group (40%) with the lowest energy intake, intermediate nutritional quality, and low GHGE, which included more students who lived alone.

Conclusion

None of the dietary groups optimized both nutritional quality and environmental impact simultaneously, which suggests an apparent incompatibility in the student population between these two sustainability dimensions. These findings emphasize the need for tailored public health policies that acknowledge the diversity of student eating patterns and address specific individual barriers to healthy and sustainable diets.

Dietary polyphenols and sleep modulation: Current evidence and perspectives

Polyphenols are plant compounds with several biological activities. This review aims to summarize current knowledge on the potential role of polyphenols in modulating sleep. A total of 28 preclinical studies, 12 intervention studies and four observational studies exploring the role of polyphenol intake on sleep were identified. From animal studies, 26 out of the 28 studies found beneficial effects of polyphenols on sleep architecture. Three out of four human observational studies found a beneficial association between polyphenol intake and sleep parameters. And, among clinical intervention studies, eight from a total of 12 studies found some beneficial effect of polyphenol intake on various sleep parameters, although some discrepancies between studies were found. Overall, emerging evidence suggests a benefit of polyphenol intake on sleep. Several mechanisms of action have been suggested, ranging from effects on neurotransmitters to an action through the gut-brain axis. However, more research in this field is needed, emphasizing the use of nutritional doses in mechanistic studies and interventions targeting participants with sleep problems. This would allow to elucidate whether an additional biological effect of polyphenols is modulation of sleep, a behavior associated with adverse health outcomes.

Ramadan Fasting and Short-Term Maximal Physical Performance: Searching for Optimal Timing of the Last Meal "Suhoor" in Female Pre-University Handball Players

Aiming to identify the ideal suhoor timing for maintaining optimal physical performance and health indicators during Ramadan intermittent fasting, the present study compares the effects of early vs. late Suhoor on short-term high-intensity physical exercise while controlling the body mass index (BMI) oral temperature (OT), dietary intake, and sleep patterns. In a randomized design, 19 female pre-university handball players (age: 16.8 ± 0.4 y; height: 1.70 ± 0.9 m; and body mass: 61.5 ± 6.9 kg) underwent two test sessions (at 08:00 a.m. and 05:00 p.m.) at four different conditions: ten days prior to Ramadan (R - 10), the final ten days of Ramadan (R) including both Early Suhoor R(ES) and Late Suhoor R(LS) conditions, and the ten days immediately following Ramadan (R + 10). A recovery period of at least 48 h has been set between successive test sessions at each period. Outcome measures included the Countermovement Jumps Test (CMJ), Modified Agility t-Test (MATT), Repeated Sprint Ability (RSA), and Rating of Perceived Exertion (RPE). The Pittsburgh Sleep Quality Index (PSQI), OT, BMI, and daily diary intake were assessed across the three periods. The total scores of PSQI decreased significantly during R and R + 10 compared to R - 10. When performed in the afternoon, CMJ, MATT, and RSA performance decreased significantly at R(ES) and R(LS) conditions compared to R - 10. However, these performances decreased only after R(ES) when performed in the morning. Furthermore, performances were lower during R(ES) compared to R(LS) in the afternoon for all tests and the morning for MATT and RSA tests. These findings support prior research showing a deterioration of physical performance during Ramadan fasting and indicate a more pronounced impact following early Suhoor condition. Therefore, consuming a late suhoor, closer to pre-dawn time, could be suggested as an effective strategy to minimize physical performance decline during short-term high-intensity exercise.

Timing Matters: The Interplay between Early Mealtime, Circadian Rhythms, Gene Expression, Circadian Hormones, and Metabolism-A Narrative Review

Achieving synchronization between the central and peripheral body clocks is essential for ensuring optimal metabolic function. Meal timing is an emerging field of research that investigates the influence of eating patterns on our circadian rhythm, metabolism, and overall health. This narrative review examines the relationship between meal timing, circadian rhythm, clock genes, circadian hormones, and metabolic function. It analyzes the existing literature and experimental data to explore the connection between mealtime, circadian rhythms, and metabolic processes. The available evidence highlights the importance of aligning mealtime with the body's natural rhythms to promote metabolic health and prevent metabolic disorders. Specifically, studies show that consuming meals later in the day is associated with an elevated prevalence of metabolic disorders, while early time-restricted eating, such as having an early breakfast and an earlier dinner, improves levels of glucose in the blood and substrate oxidation. Circadian hormones, including cortisol and melatonin, interact with mealtimes and play vital roles in regulating metabolic processes. Cortisol, aligned with dawn in diurnal mammals, activates energy reserves, stimulates appetite, influences clock gene expression, and synchronizes peripheral clocks. Consuming meals during periods of elevated melatonin levels, specifically during the circadian night, has been correlated with potential implications for glucose tolerance. Understanding the mechanisms of central and peripheral clock synchronization, including genetics, interactions with chronotype, sleep duration, and hormonal changes, provides valuable insights for optimizing dietary strategies and timing. This knowledge contributes to improved overall health and well-being by aligning mealtime with the body's natural circadian rhythm.

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.

Breakfast Frequency and Sleep Quality in College Students: The Multiple Mediating Effects of Sleep Chronotypes and Depressive Symptoms

Sleep disorders, which are prominent problems among college students, may be associated with skipping breakfast. Therefore, we aimed to explore the role of sleep chronotypes and depressive symptoms as mediators in the relationship between breakfast frequency and sleep quality. A cross-sectional survey enrolling random samples of 712 college students was conducted by the Questionnaire Star online platform. Statistical description and correlation analysis were performed by SPSS 25.0, and a chain mediation test was performed by model 6 in PROCESS 3.5. The result of the article demonstrated that breakfast frequency can affect sleep quality through two mediating pathways: ① sleep chronotypes, with a mediating effect of 32%; and ② depressive symptoms, with a mediating effect of 52.4%. However, the chain mediating effects of sleep chronotypes and depressive symptoms was not significant, and neither was the direct effect of breakfast frequency on sleep quality. Breakfast frequency can indirectly affect sleep quality by adjusting sleep chronotypes and depressive symptoms. Regular breakfast can increase morning and intermediate sleep chronotypes, reduce depressive symptoms, and thus improve sleep quality.

Association of social jetlag and eating patterns with sleep quality and daytime sleepiness in Japanese high school students

A high prevalence of excessive daytime sleepiness and poor sleep quality has been reported in adolescents, but the effects of social jetlag on sleep quality and daytime sleepiness are unclear. Therefore, we assessed the association of sleep and eating patterns with daytime sleepiness and sleep quality among a total of 756 Japanese high school students. Participants completed the Pittsburgh Sleep Quality Index to evaluate sleep quality, the Pediatric Daytime Sleepiness Scale to evaluate daytime sleepiness, and an 8-day sleep diary. Data on average sleep duration, social jetlag, midsleep on free days sleep corrected, and the differences in the first and last meal timing between school days and non-school days were obtained from participants' sleep diaries. The results reveal that social jetlag is associated with differences in the first meal timing between school days and non-school days, and that social jetlag of more than 2 hr is associated with extremely poor sleep quality and excessive daytime sleepiness in Japanese high school students. Our findings suggest that reducing social jetlag to within a 2-hr window is important to prevent poor sleep quality and excessive daytime sleepiness for this population.

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.

Translation, adaptation and validation of the Chrononutrition Profile - Questionnaire (CP-Q) in Brazilian Portuguese

Chrononutrition is a science that studies the relationship between mealtimes and sleep/wake habits. However, these behaviors are not evaluated by a single questionnaire. Therefore, this study aimed to translate and culturally adapt the Chrononutrition Profile - Questionnaire (CP-Q) into Portuguese and validate the Brazilian version. The translation and cultural adaptation process consisted of: translation; synthesis of translations; backtranslation; expert committee and pre-test. The validation was performed with 635 participants (32.4 ± 11.2 years) who answered the CPQ-Brazil and Pittsburgh Sleep Quality Index (PSQI); Munich Chronotype Questionnaire (MCTQ); Night Eating questionnaire; Quality of life and health index (SF-36) and 24 h-recall. The participants were mostly female, single, from the northeastern region, a eutrophic profile, and average quality of life score of 55.8 ± 17.9. Moderate to strong correlations were observed in the sleep/wake schedules between CPQ-Brazil, PSQI and MCTQ, both for work/study days and free days. The correlations between largest meal, skipping breakfast, eating window, nocturnal latency, and last eating event with the same variables in the 24 h-recall showed moderate to strong positive correlations. The translation, adaptation, validation and reproducibility of the CP-Q generates a valid and reliable questionnaire to assess the sleep/wake and eating habits in the Brazilian population.

Food Involvement, Food Choices, and Bioactive Compounds Consumption Correlation during COVID-19 Pandemic: How Food Engagement Influences Consumers' Food Habits

The containment measures due to the COVID-19 pandemic affected food-related activities, influencing dietary behavior, food habits, and dietary choices. This study aimed to compare the relationship between food involvement and dietary choices before and during the pandemic, investigating the role played by food in dietary habits. Responses given by 2773 Italian consumers to an online survey were studied through the Food Involvement Scale (FIS) and correlated to eating habits. FIS scores were then used to explain the importance given to food in circumstances related to well-being, health, and protection against COVID-19 and used to study the relationship between FIS and bioactive compound knowledge, use, and efficacy against COVID-19. The consumers more involved in food issues recognized the importance of food in circumstances related to well-being, health, and protection against COVID-19 and improved their diet during the pandemic. Moreover, consumers who gave more importance to food also revealed higher attention to the use of healthy substances, such as bioactive compounds, considering them effective against COVID-19. These results showed that food experiencing and involvement could be important elements to promote healthy dietary habits that are essential to maintain physical and mental health during emergency periods such as the COVID-19 pandemic.

Skipping Breakfast Is Associated with Hypertension in Adults: A Meta-Analysis

Previous studies evaluating the association between skipping breakfast and hypertension in adult population showed inconsistent results. We performed a meta-analysis to systematically evaluate the association. Observational studies which evaluated the relationship between skipping breakfast and hypertension in adult population with multivariate analyses were identified by systematic search of PubMed, Embase, and Web of Science databases. A random-effect model which incorporated the potential intrastudy heterogeneity was used for the meta-analysis. A total of six observational studies with 14189 adults were included, and 3577 of them were breakfast skippers. Pooled results showed that skipping breakfast was independently associated with hypertension in these populations (adjusted odds ratio (OR): 1.20, 95% confidence interval: 1.08 to 1.33, $P<0.001$ ) with no significant heterogeneity (I2 = 0%). Sensitivity by excluding one study at a time showed consistent results (OR: 1.18 to 1.22, all $P$ <0.01). Subgroup analyses showed that the association between skipping breakfast and hypertension in adults was consistent in the general population and in patients with type 2 diabetes, in studies from different countries, in cohort and cross-sectional studies, in breakfast skippers defined as taking breakfast ≤3 days/week and as self-reported habitual breakfast skipping, and in studies with and without adjustment of body mass index ( $P$ for subgroup difference, all $P$ >0.10). In conclusion, skipping breakfast is associated with hypertension in the adult population.