Poor Sleep Linked to Low-quality Diet, CVD Risk in Women

February 28, 2020

Irregular sleep patterns in women may impact quality of diet and calories consumed, increasing risk for cardiometabolic disease, concludes a new study.

Poor sleep patterns in women are associated with increased calorie intake and lower-quality dietary composition, according to results of a study published online February 17 in the Journal of the American Heart Association.

According to the researchers from the Columbia University Irving Medical Center, the study of nearly 500 women represents one of the earliest investigations of the relationships between measures of sleep quality and habitual dietary patterns in a diverse cohort representing a broad range of life stages.

Previous studies have shown that people who get less sleep are more likely to develop obesity, type 2 diabetes, and heart disease-and that the relationship may be partially explained by diet. But these studies focused only on specific foods or nutrients (eg, fish, sweets, or saturated fat) or only measured sleep duration, not sleep quality.

___________________________________________________
"Women are particularly prone to sleep disturbances
across the life span, because they often shoulder the
responsibilities of caring for children and family and, later,
because of menopausal hormones."
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"Women are particularly prone to sleep disturbances across the life span, because they often shoulder the responsibilities of caring for children and family and, later, because of menopausal hormones," said senior author Brooke Aggarwal, EdD, assistant professor of medical sciences at Columbia University Vagelos College of Physicians and Surgeons, in a university press release.

The researchers analyzed the sleep and eating habits of an ethnically diverse group of 495 women, aged 20 to 76 years (61% racial/ethnic minority). Sleep quality and sleep‐onset latency were measured using the Pittsburgh Sleep Quality Index (PSQI) and insomnia using the Insomnia Severity Index. Dietary patterns were captured using the Block Brief Food Frequency Questionnaire which allowed researchers to assess types and amounts of food typically consumed over a year.

Findings support literature 

Mean body mass index was 25.9 ± 5.7 kg/m2 with a balanced proportion of women with overweight/obesity compared with normal weight (51% vs 49%, P=0.93). Average total sleep time was 6.76 ± 1.24 hours. More than one-third of the sample (≥38%) had poor sleep quality or some insomnia. In addition, 27.5% of the sample had short‐sleep duration (<7 h/night) with poor sleep quality, and 24.6% had short sleep duration with insomnia.

On average, authors wrote, women exceeded recommendations for total and saturated fat intakes as well as added sugars, but failed to meet recommendations for whole grains, fiber, and dairy intakes. Energy consumption reported was 1433±862 kcal/day.

Links noted between sleep quality, sleep‐onset latency, and insomnia and specific nutrient intake included:  

  • Women with worse sleep quality consumed more of the added sugars associated with obesity and diabetes.

  • Women who took longer to fall asleep ate more calories and food by weight.

  • Women with more severe insomnia consumed more calories and less unsaturated fats than those with milder insomnia.

Findings, the authors write in the study, contribute to the current understanding of the link between sleep duration and diet, demonstrating that quality of sleep is associated with overall energy intake as well as the amounts and types of food consumed.  

“Our interpretation is that women with poor-quality sleep could be overeating during subsequent meals and making more unhealthy food choices,” said Aggarwal. 

Lead study author Faris Zuraikat, PhD, postdoctoral fellow at Columbia University Vagelos College of Physicians and Surgeons speculates in the university press release that poor sleep quality may stimulate hunger signals or suppress signals of fullness, thus insomnia may trigger overeating to reach satiety. He also proposes that  “Eating more could also cause gastrointestinal discomfort, for instance, making it harder to fall asleep or remain asleep.”

Authors, writing in the study’s discussion, conclude: “By showing that poor sleep quality can be linked to overeating and poor diet quality in women, this study provides insight into a potential mechanism underlying the relationship between sleep quality and cardiometabolic health in a population at increased risk for sleep disturbances and prone to CVD.”

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