Sleep, activity, and diet in harmony: unveiling the relationships of chronotype, sleep quality, physical activity, and dietary intake

Association between higher morning preference and better health-related quality of life in asthma

Background

Circadian preference for eveningness has been linked to a higher risk of asthma and allergies, but its association with health-related quality of life (HRQL) in asthma has not been studied yet.

Objective

We aimed to investigate the associations between individual circadian preference and HRQL in asthma.

Methods

Among 691 adult asthma patients from Canada, India, New Zealand, and the United Kingdom, a digital questionnaire was administered to capture demographic information, social and psychologic attributes, comorbidities, and medication adherence. Circadian preference and HRQL were assessed by the reduced version of the morningness-eveningness questionnaire (rMEQ) and the short form of the chronic respiratory questionnaire, respectively. We analyzed the association between chronotype and HRQL using mixed-effect linear regression models.

Results

Of all participants, 59% were female with a mean (standard deviation) age of 49 (17) years. Median (interquartile range) rMEQ total score was 17 (14-19). Mean (standard deviation) dyspnea, fatigue, emotional function, and mastery scores were 5.94 (1.2), 4.38 (1.3), 5.05 (1.3), and 1.96 (1.1), respectively. In regression analysis, a higher rMEQ total score (higher morningness) was associated with less fatigue (β = 0.06; 95% confidence interval, 0.04 to 0.09) and better emotional function (β = 0.03; 95% confidence interval, 0.004 to 0.06), and these associations were mediated by less anxiety, depression, and alcohol abuse, and better sleep quality.

Conclusion

Morning orientation is associated with better HRQL in patients with asthma. The results suggest that working with patients to promote schedules and habits related to morningness may be beneficial.

Exploring the Correlation Between Sleep Chronotype and the Volumes of Subcortical Structures and Hippocampal Subfields in Young Healthy Population

BACKGROUND/OBJECTIVES

Chronotypes significantly influence sleep quality, daily performance, and overall activity levels. Although there is growing evidence indicating that individuals with a late chronotype are more likely to experience cognitive decline, the specific neural mechanisms that contribute to this risk remain unclear. This study aims to explore the relationship between morning and evening preferences and the volumes of subcortical structures in a young, healthy population.

METHODS

A total of 123 participants (80 females), aged between 18 and 35 years, were recruited. They underwent MRI scans and completed several self-reported assessments, including the morningness-eveningness scale of the Chronotype Questionnaire (ChQ-ME), the amplitude scale of the Chronotype Questionnaire (ChQ-AM), the Epworth Sleepiness Scale (ESS), and the Pittsburgh Sleep Quality Index (PSQI). Participants were classified into early chronotype (EC) and late chronotype (LC) groups based on their ChQ-ME scores. High-resolution T1-weighted imaging was utilized to analyze the volumes of subcortical structures and hippocampal subfields.

RESULTS

The volumetric analysis indicated that the LC group showed significant reductions in the right Caudate (p = 0.03) and the left SR-SL-SM (p = 0.03) compared to the EC group. Additionally, a notable leftward hemispheric laterality of the Subiculum (p = 0.048) was observed in the EC group relative to the LC group. Furthermore, the ChQ-AM revealed significant positive (r = 0.23) and negative (r = -0.19) correlations with the volumes of the left thalamus and right amygdala, respectively. The PSQI demonstrated a significant negative correlation (r = -0.21) with the right SR-SL-SM, while the ESS indicated a significant positive correlation (r = 0.24) with the left SR-SL-SM. Multiple regression analysis indicated that variations in daytime sleepiness are linked to the change of the left SR-SL-SM volume.

CONCLUSIONS

Overall, the findings suggest that chronotype preferences are associated with the changes in the volumes of subcortical structures and hippocampal subfields and highlight the role of chronotypes in the neural mechanisms of these brain structures.

Genetically Supported Causality Between Micronutrients and Sleep Behaviors: A Two-Sample Mendelian Randomization Study

BACKGROUND

Sleep behaviors, defined by the total duration of sleep and chronotype, significantly influence overall health. Compromised sleep quality, which is often manifested through reduced sleep duration and the prevalence of insomnia, has been found to be associated with micronutrient deficiencies. Nonetheless, the existence of a causal relationship between micronutrient levels and sleep behaviors remains to be established.

METHODS

A two-sample Mendelian randomization (MR) analysis, utilizing data from genome-wide association studies (GWAS), was employed to examine the associations between 15 micronutrients (copper; calcium; carotene; folate; iron; magnesium; potassium; selenium; vitamins A, B12, B6, C, D, and E; and zinc) and various sleep behaviors, including short and long sleep durations, insomnia, and chronotype. Furthermore, multivariable MR (MVMR) analysis was performed to address potential confounding due to the interrelationships among micronutrients and to discern potential causal relationships.

RESULTS

The MR analysis identified a causal association between folate levels and chronotype (odds ratio [OR] = 1.09; 95% confidence interval [CI]: 1.01-1.17; p = 0.02), indicating a tendency toward morningness. Conversely, vitamin B6 (OR = 0.91; 95% CI: 0.86-0.96; p = 1.05 × 10-3) and vitamin D (OR = 0.94; 95% CI: 0.88-1.00; p = 0.03) showed inverse associations with chronotype, indicative of a preference for eveningness. MVMR analysis confirmed the positive association between folate (OR = 1.286, 95% CI = 1.124-1.472, p < 0.001) and chronotype and a negative association with vitamin B6 (OR = 0.750, 95% CI = 0.648-0.868, p < 0.001). No causal relationships were established between micronutrient levels and either sleep duration or insomnia.

CONCLUSIONS

Elevated folate levels correlate with morning-type preferences ("morning birds"), while higher concentrations of vitamin B6 are associated with evening-type preferences ("evening owls").

The Role of the Chronotype in Developing an Excessive Body Weight and Its Complications-A Narrative Review

The chronotype, the personal predisposition towards morning or evening activities, significantly influences health conditions, sleep, and eating regulations. Individuals with evening chronotypes are often at a higher risk for weight gain due to misalignment between their natural tendencies of functioning and social schedules, resulting in insufficient sleep, disruptions in eating habits, and decreased physical activity levels. Often, impaired glucose tolerance and changes in melatonin, adiponectin, and leptin secretion, along with alterations in the clock gene functions in subjects with evening preferences, may be predisposed to obesity. These disturbances contribute to metabolic dysregulation, which may lead to the subsequent onset of obesity complications, such as hypertension, type 2 diabetes, sleep apnea, and liver diseases. Targeting critical components of the circadian system and synchronizing people's chronotypes with lifestyle conditions could deliver potential strategies for preventing and treating metabolic disorders. Thus, it is recommended to take a personalized chronobiological approach to maintain a normal body weight and metabolic health. Nevertheless, future studies are needed to identify the clear mechanisms between the chronotype and human health. This article provides a narrative review and discussion of recent data to summarize studies on the circadian rhythm in the context of obesity. The manuscript represents a comprehensive overview conducted between August and November 2024 using the National Library of Medicine browser (Medline, Pub-Med, Web of Science).

The relationship between carbohydrate intake and sleep patterns

Background

A healthy dietary habit may contribute to good sleep quality. The present study investigates the correlation between the quality and quantity of daily carbohydrate consumption and poor sleep patterns.

Methods

The exposures of interest included low-and high-quality carbohydrate consumption and total daily carbohydrate consumption. Subjects were classified into four different carbohydrate consumption patterns: Pattern 1 was characterized by high-quality carbohydrates below the median and low-quality carbohydrates above the median; Pattern 2 included both high-and low-quality carbohydrates below the median; Pattern 3 was defined as high-and low-quality carbohydrates above the median; Pattern 4 referred to high-quality carbohydrates above the median and low-quality carbohydrates below the median. The comprehensive sleep patterns included three different sleep behaviors: sleep duration, daytime sleepiness, and snoring, which were used to score sleep patterns. A score ranging from 0 to 1 was classified as having a healthy sleep pattern, while a score between 2 and 3 showed poor sleep patterns. Survey-weighted multivariable logistic regression analyses were adopted.

Results

In the multivariate analysis, individuals who consumed more high-quality carbohydrates were linked to a decreased likelihood of experiencing poor sleep patterns [odds ratio (OR) 0.71; 95% confidence interval (CI) 0.62-0.81], while increased consumption of low-quality carbohydrates (OR 1.39; 95%CI 1.20-1.61) and total daily carbohydrates (OR 1.31; 95%CI 1.10-1.57) was related to an elevated risk of poor sleep patterns. Participants who adhered to carbohydrate intake pattern 4 exhibited a 36% lower risk of poor sleep patterns than those who followed carbohydrate intake pattern 1 (OR 0.64; 95%CI 0.56-0.74). There was a positive correlation between elevated added sugar consumption and an increased probability of developing poor sleep patterns. In contrast, an elevated intake of whole grains, fruits, or non-starchy vegetables was related to a decreased likelihood of experiencing poor sleep patterns.

Conclusion

The increased consumption of low-quality carbohydrates may heighten the susceptibility to poor sleep patterns, whereas the increased consumption of high-quality carbohydrates may mitigate the risk of developing poor sleep patterns.

Associations of nutrition education with diet quality indexes and chronotype: a cross-sectional study

This study examined the impact of nutrition education on chronotype, sleep quality, and dietary quality among university students. Participants included 317 students with nutrition education and 280 without. Data were collected through questionnaires assessing demographic characteristics, chronotype (using the Morning-Evening Questionnaire), sleep quality (via the Pittsburgh Sleep Quality Index), and dietary habits. Anthropometric measurements and 24-hour food recalls were also recorded. Dietary quality was evaluated using the Healthy Eating Index (HEI)-2020, while dietary fat and carbohydrate quality were assessed with the Fat Quality Index (FQI) and Carbohydrate Quality Index (CQI), respectively. Results indicated that students who received nutrition education had significantly lower body weight, height, and waist circumference compared to those without. Of the students, 8.9% had a morning, 7% had an evening and the rest had an intermediate chronotype. HEI-2020, CQI, and FQI scores were significantly higher in the nutrition education group. Although no significant relationship was found between nutrition education and chronotype, improved dietary and sleep quality were observed in the group with education. This suggested that enhancing nutritional knowledge can positively impact health by improving dietary quality and sleep.

The effect of diets with different inflammatory scores on inflammation and sleep in obese subjects: a randomized controlled trial

OBJECTIVE

The aim of this study was to investigate the effect of different dietary inflammatory index diets on inflammatory markers, anthropometric measurements, and sleep quality in obese subjects.

METHODS

This study was conducted in a public hospital in Turkey between November 2021 and May 2022. Participants with pro-inflammatory dietary habits were included in the study. Randomly divided into two groups of 33 participants, they were subjected to an anti-inflammatory diet or a control diet for 8 weeks. The study evaluated the anthropometric parameters, inflammatory biomarkers, and sleep quality indices of the diet groups.

RESULTS

Significant reductions in body mass index were observed in both groups, more marked in the anti-inflammatory diet cohort. C-reactive protein levels, indicative of inflammation, also decreased substantially in both groups, with a more marked reduction in the anti-inflammatory diet cohort. Despite the improvement in sleep quality in both groups, the variation was not statistically significant.

CONCLUSION

This study demonstrates the importance of anti-inflammatory diets in nutritional strategies for obesity by reducing body mass index and inflammation.

The association between diet and sleep with internalising symptoms in young athletes: a serial multiple mediation models

Introduction

Athletes frequently experience anxiety and depression at rates similar to or higher than non-athletes. A balanced diet can alleviate athletes internalizing symptoms. Moreover, diet and sleep are all associated with internalising symptoms. Our study investigates how sleep quality mediates the impact of dietary habits on internalizing symptoms in athletes.

Methods

The current cross-sectional study involved 758 Chinese young athletes. The adapted Australian Athletes Diet Index was used to assess dietary patterns, and sleep was measured using the Athletes Sleep Screening Questionnaire. The Generalised Anxiety Disorder 7 scale and the Patient Health Questionnaire 9-item scale were used to assess symptoms of anxiety and depression. Structural Equation Modelling (SEM) analysis was used to examine the mediating role of sleep quality in young athletes. Raw scores of chronotypes, sleep quality, anxiety and depression were calculated for the statistical analysis.

Results

No significant indirect effects were found in adolescents. In adult athletes, diet mediated the relationship between chronotype and sleep quality (β = -0.028, p  <  0.001). Sleep quality mediated the association between diet and anxiety (β = -0.060, p = 0.001), and depression (β = -0.076, p = 0.001). Additionally, diet and sleep quality mediated the association between chronotypes and anxiety (β = -0.028, p = 0.001), and depression (β = -0.028, p = 0.001).

Conclusion

Sleep quality mediated the relationship between dietary patterns and internalising symptoms in young adult athletes. Additionally, diet and sleep quality mediated the association between chronotypes and internalising symptoms in young adult athletes.

The role of dietary intake of live microbes in the association between leisure-time physical activity and depressive symptoms: a population-based study

Current research has shown promising associations between factors such as diet, total physical activity, and mental health outcomes, acknowledging the intricate interplay between these variables. However, the role of dietary intake of live microbes, coupled with leisure-time physical activity (LTPA), in their relationship to depressive symptoms necessitates further exploration. The present study examined a cohort of 25 747 individuals who participated in the National Health and Nutrition Examination Survey between the years 2007 and 2018. Patient's Health Questionnaire (PHQ-9) was employed, whereby individuals scoring ≥ 10 were classified as exhibiting symptoms of depression. LTPA status was reported by the Global Physical Activity Questionnaire and calculated by metabolic equivalent-minutes/week. Foods consumed by participants were evaluated by live microbes per gram, which were categorized into three groups: low, medium, and high. After controlling for all covariates, findings indicated that LTPA was negatively associated with depressive symptoms (OR (95% confidence interval (CI): 0.983 (0.976, 0.990), p < 0.001). Participating in more LTPA was positively correlated with consuming all three levels of dietary live microbes (low, β (95% CI): 0.086 (0.063, 0.109); medium, β (95% CI): 0.009 (0.007, 0.012); high, β (95% CI): 0.002 (0.001, 0.002)). Moreover, taking more foods with medium live microbes was associated with lower depressive likelihood (OR (95% CI): 0.931(0.882, 0.982), p = 0.010). Intake of medium and high levels of live microbes mediated the association between LTPA and depressive symptoms by 4.15% and 0.83%, respectively. Dietary intake of foods containing medium and high levels of live microbes may be a mediator of LTPA's negative association with depressive symptoms.

Determination of the relationship between body composition and nutritional habits and chronotype in healthy Turkish adults

This cross-sectional study aims to determine the relationship between chronotype characteristics, dietary habits, and body composition in 110 adults, of which 75.5% are female, residing in Mersin, Türkiye. Data collection included a descriptive information form, the Morningness-Eveningness Scale for assessing chronotype, a detailed 24-hour dietary record for evaluating dietary intake, and Bioelectrical Impedance Analysis for accurate anthropometric measurements of body composition. The evening types had higher BMI, body weight, waist circumference, hip circumference, total fat mass, and lower body water ratio than the morning types. Positive correlations were found between sleep duration and body mass index, total fat mass, and fat percentage. The evening types tended to skip breakfast more frequently and had higher energy intake during dinners and snacks. Additionally, the evening types consumed more lipids, carbohydrates, sodium, and saturated and polyunsaturated fatty acids. These findings suggest that chronotype influences anthropometric measurements, nutritional habits, and meal energy distribution. These findings highlight the importance of considering chronotype characteristics to understand how body composition and dietary patterns interact, underscoring the need for customized interventions to promote healthier lifestyles.