The Risk of Being Obese According to Short Sleep Duration Is Modulated after Menopause in Korean Women

Association between Body Image Flexibility and Intermittent Fasting in Chinese Medical Students: A Cross-Sectional Study

Unhealthy dietary behaviors and body dissatisfaction are becoming increasingly common among college students. Understanding the association between body image flexibility and intermittent fasting is particularly meaningful, especially for medical college students. This study aimed to investigate the association between body image flexibility and intermittent fasting among medical students. We conducted a cross-sectional study with 5138 medical college students at Jitang College of North China University of Science and Technology. Univariate and multivariate logistic regression were used to evaluate the association between body image flexibility and intermittent fasting. Subgroup analysis and interaction tests were further used to examine the possible interaction between body image flexibility and intermittent fasting. In this study, 1329 (25.87%) students had intermittent fasting behavior. After adjustment for confounding factors, there was a negative association between body image flexibility and intermittent fasting (OR = 0.94, 95%CI = 0.93 to 0.95, p < 0.001). A significant interaction between body image flexibility and intermittent fasting was found in gender, academic year, major, and monthly living expenses (p for interaction < 0.05). E-value analysis suggested there was unlikely to be an unmeasured confounding. This association could contribute to the establishment of personalized health intervention strategies and provide recommendations for promoting the physical and mental health of medical students.

Higher intakes of nutrients and regular drinking are associated with habitual sleep duration in pre- and postmenopausal women with comorbidities

OBJECTIVES

We aimed to assess the association between nutrient intake, health-related behaviors, and habitual sleep duration in pre- and postmenopausal women.

DESIGN

A cross-sectional study.

PARTICIPANTS

2084 pre- and postmenopausal women aged 18-80 years old.

MEASUREMENTS

Nutrient intake and sleep duration were measured by a 24-hour recall approach and self-reports, respectively. We examined the association and interaction between comorbidities, nutrient intake, and sleep duration groups among 2084 women using data from KNHASES (2016-2018) and multinomial logistic regression.

RESULTS

In premenopausal women, we observed negative associations between very short (<5 hours)/short (5-6 hours)/long (≥9 hours) sleep duration and 12 nutrients (vitamin B1, B3, vitamin C, PUFA, n-6 fatty acid, iron, potassium, phosphorus, calcium, fiber, carbohydrate) and a positive association between retinol and short sleep duration (prevalence ratio (PR), 1.08; 95% CI, 1.01-1.15). In premenopausal women, interactions were found between comorbidities and PUFA (PR, 3.83; 95% CI, 1.56-9.41), n-3 fatty acid (PR, 2.43; 95% CI, 1.17-5.05), n-6 fatty acid (PR, 3.45; 95% CI, 1.46-8.13), fat (PR, 2.77; 95% CI, 1.15-6.64), and retinol (PR, 1.28; 95% CI, 1.06-1.53) for very short and short sleep duration, respectively. Interactions between comorbidities, vitamin C (PR, 0.41; 95% CI, 0.24-0.72), and carbohydrates (PR, 1.67; 95% CI, 1.05-2.70) for very short and short sleep duration in postmenopausal women, respectively. Regular drinking was positively associated with a risk of short sleep duration in postmenopausal women (PR, 2.74, 95% CI: 1.11-6.74).

CONCLUSIONS

Dietary intake and alcohol use were found to be involved in sleep duration, so healthcare staff should encourage women to maintain a healthy diet and reduce alcohol use to improve sleep duration.

Associations of Diet Quality and Sleep Quality with Obesity

Short sleep duration or poor sleep quality has been associated with an increased risk of obesity. Although the underlying mechanism remains unclear, one proposed pathway is poor diet quality. This cross-sectional study investigated whether diet quality modifies the association between sleep status and obesity in Korean adults. We used the baseline data and samples of 737 men and 428 women (n = 1165) aged 19–64, who participated in the prospective Ewha–Boramae cohort study. Sleep duration was dichotomized into ≥7 h (adequate) and <7 h (insufficient). Pittsburgh Sleep Quality Index (PSQI) values, reflecting sleep quality, were dichotomized into >5 (poor quality) and ≤5 (good quality). Diet quality was evaluated by the Recommended Food Score (RFS). Obesity was associated with higher rates of insufficient sleep and poor sleep quality in women, but not in men. After adjustment for covariates, women with poor sleep quality had a higher risk of obesity than women with good sleep quality (OR = 2.198; 95% CI = 1.027–4.704); this association occurred only in the group with RFS ≤ median score. Our findings support a significant association between sleep quality and obesity, and this association has been potentially modified by dietary quality in women.

Structural equation model analysis for the evaluation of factors associated with overweight and obesity in menopausal women in RaNCD cohort study

OBJECTIVE

Weight gain and increased body fat mass are among the common complications of menopause. In addition to hormonal changes, behavioral and environmental factors aggravate transition through this phase. This study uses a structural equation model (SEM) to evaluate factors associated with overweight and obesity in menopausal women.

METHODS

This is a cross-sectional study of 4,471 women (pre/perimenopausal 3,150, menopausal 1,321) from baseline data of the Ravansar Non-Communicable Disease (RaNCD) cohort study in the west region of Iran in 2018. Obesity and overweight were the outcome variables. SEM was used to examine the relationships, using IBM SPSS, AMOS version 23.

RESULTS

The mean body fat percentage and visceral fat area in menopausal women was significantly greater than among pre/perimenopause women. The direct association of higher socioeconomic status (SES) with a healthy dietary pattern was stronger among pre/perimenopausal women than among menopausal women (ß = 0.574 vs ß = 0.552). In both groups, less physical activity was associated with depression and musculoskeletal disorders, and this association was stronger in menopausal women (ß = -0.174 vs ß = -0.215; P > 0.05). Overweight and obesity were directly decreased (ß = -0.011, P > 0.05) and indirectly increased (ß = 0.013, P > 0.05) in pre/perimenopausal women by sleep duration, but they were directly and indirectly decreased in menopausal women.

CONCLUSIONS

The direct and indirect effects of well-known risk factors associated with overweight and obesity were found to be different in pre/perimenopausal and menopausal groups. Some risk factors showed stronger effects among menopausal women compared with the pre/perimenopausal women. Physical activity and healthy dietary pattern had a mediator impact in the two study groups.

Sleep duration and body mass index: moderating effect of self-perceived stress and age. Results of a cross-sectional population-based study

PURPOSE

The objective of this analysis was to assess whether the association between sleep duration and BMI and between sleep duration and waist circumference is moderated by age and self-perceived stress.

METHODS

We analyzed data from 2034 participants enrolled in 2014 in the cross-sectional study Obesity in Romania Study-study of the prevalence of obesity and related risk factors in Romanian general population (ORO study).

RESULTS

Interaction between sleep duration, self-perceived stress and age, with BMI as dependent variable, was statistically significant after adjustment for demographic and lifestyle factors (p value for interaction 0.003). In participants without self-perceived stress, a linear negative association between sleep duration and BMI was observed only in those 18-39 years old (p = 0.049), with BMI decreasing in parallel with increased sleep duration. In participants with self-perceived stress, a U-shaped relationship was observed between BMI and sleep duration in those 40-64 years old, with higher BMI in those sleeping ≤ 6 h and ≥ 9 h/night compared to those sleeping > 6 and < 9 h/night (p = 0.002 and 0.005). Those ≥ 65 years old with self-perceived stress sleeping ≥ 9 h/night had a significantly higher BMI compared to those in other sleep duration categories (p = 0.041 vs. those sleeping ≤ 6 h/night and p = 0.013 vs. to those sleeping > 6 and < 9 h/night). No interaction between age, self-perceived stress and sleep duration, with waist circumference as dependent variable was observed.

CONCLUSIONS

In our sample, the association between sleep duration and BMI was moderated by self-perceived stress and age.

Sleep, Diet, and Cardiometabolic Health Investigations: a Systematic Review of Analytic Strategies

PURPOSE OF REVIEW

Poor sleep is a risk factor for cardiometabolic morbidity. The relationship of sleep and cardiometabolic health could be confounded, mediated, or modified by diet, yet the incorporation of diet in sleep-cardiometabolic health studies is inconsistent. This rapid systematic literature review evaluates the conceptualization of diet as a confounder, mediator, or effect modifier within sleep-cardiometabolic health investigations, and the statistical approaches utilized.

RECENT FINDINGS

Of 4692 studies identified, 60 were retained (28 adult, 32 pediatric). Most studies included diet patterns, quality, or energy intake as confounders, while a few examined these dietary variables as mediators or effect modifiers. There was some evidence, mostly in pediatric studies, that inclusion of diet altered sleep-cardiometabolic health associations. Diet plays a diverse role within sleep-cardiometabolic health associations. Investigators should carefully consider the conceptualization of diet variables in these relationships and utilize contemporary statistical approaches when applicable.

Bridging the Reciprocal Gap between Sleep and Fruit and Vegetable Consumption: A Review of the Evidence, Potential Mechanisms, Implications, and Directions for Future Work

A substantial burden of disease and mortality globally is attributable to both sleep disruption and low intakes of fruit and vegetable (FV) and there is increasing mechanistic and epidemiological evidence to support a reciprocal relationship between the two. This review provides an overview of experimental and observational studies assessing the relations between sleep and FV consumption from 52 human adult studies. Experimental studies are currently limited and show inconsistent results. Observational studies support a non-linear association with adults sleeping the recommended 7–9 hours/day having the highest intakes of FV. The potential mechanisms linking sleep and FV consumption are highlighted. Disrupted sleep influences FV consumption through homeostatic and non-homeostatic mechanisms. Conversely, FV consumption may influence sleep through polyphenol content via several potential pathways. Few human experimental studies have examined the effects of FV items and their polyphenols on sleep and there is a need for more studies to address this. An appreciation of the relationship between sleep and FV consumption may help optimize sleep and FV consumption and may reduce the burden of chronic diseases. This review provides implications for public health and directions for future work.

Associations between Self-Reported Sleep Quality and Duration and Dietary Consumptions, Psychological Symptoms, and Obesity in Korean Adults

Sleep pattern disruptions have been reported to be associated with an increased risk of obesity. This study was performed to investigate the association between sleep quality and sleep duration with dietary consumption, psychological factors, and obesity in Korean adults. A total of 288 Korean men and women who visited a public health center were included in this study. Data on general characteristics, health-related habits, psychological symptoms, dietary intake, and sleep patterns (including quality and duration) were collected using self-report questionnaires. Approximately half of the included Korean adults experienced sleep of low quality and short duration. Subjects who reported short sleep durations had a significantly higher weight (P=0.015), body mass index (P<0.001), and prevalence of obesity (P=0.012) than those reporting proper sleep durations. After adjustment for covariates, subjects reporting short sleep durations consumed more dietary carbohydrates (P=0.043) and higher levels of perceived stress (P=0.001), depression (P=0.001), and anxiety (P<0.001) than subjects reporting proper sleep durations. However, obesity-related variables, dietary intake and psychosocial symptoms did not differ significantly by reported sleep quality. The results of this study demonstrated that sleep duration but not sleep quality was associated with dietary macronutrient intake and psychological symptoms, which might affect obesity.