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Title: Mediterranean diet pattern and sleep duration and insomnia symptoms in the Multi-Ethnic Study of Atherosclerosis (MESA)

Author
item CASTRO-DIEHL, CECILIA - BOSTON UNIVERSITY
item WOOD, ALEXIS - CHILDREN'S NUTRITION RESEARCH CENTER (CNRC)
item REDLINE, SUSAN - BRIGHAM & WOMEN'S HOSPITAL
item REID, MICHELLE - BRIGHAM & WOMEN'S HOSPITAL
item JOHNSON, DAYNA - BRIGHAM & WOMEN'S HOSPITAL
item MARAS, JANICE - NORTHEASTERN UNIVERSITY
item JACOBS, DAVID - UNIVERSITY OF MINNESOTA
item SHEA, STEVEN - COLUMBIA UNIVERSITY - NEW YORK
item CRAWFORD, ALLISON - COLUMBIA UNIVERSITY - NEW YORK
item ST-ONGE, MARIE - COLUMBIA UNIVERSITY - NEW YORK

Submitted to: Sleep
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/14/2018
Publication Date: 8/22/2018
Citation: Castro-Diehl, C., Wood, A.C., Redline, S., Reid, M., Johnson, D.A., Maras, J.E., Jacobs, D.R., Shea, S., Crawford, A., St-Onge, M.P. 2018. Mediterranean diet pattern and sleep duration and insomnia symptoms in the Multi-Ethnic Study of Atherosclerosis (MESA). Sleep. https://doi.org/10.1093/sleep/zsy158.
DOI: https://doi.org/10.1093/sleep/zsy158

Interpretive Summary: Shorter amounts of sleep, and sleep of a lower quality, are risk factors for weight gain. However, we do not know whether sleep directly impacts weight, or whether there are other factors, such as diet, that explain relationship; for example people who do not sleep as much may also have a poorer diet quality, and it is the poor diet which is impacting the weight gain directly, not the lack of sleep. To address this, we assessed the associations of sleep duration and insomnia with how closely a person’s diet matches that of the Mediterranean diet in a large, multi-ethnic cohort of adults, assessed over 10 years. We found that adults who reported consuming a diet that closely mirrored that of the Mediterranean diet were more likely to sleep 6-7 hours a night instead of those who did not report consuming such a diet, who were more likely to sleep less than 6 hours a night. These results suggest that a Mediterranean-style diet is associated with a longer sleep duration, and if substantiated by future research, may help clinicians advise patients on the best diet to follow to improve sleep.

Technical Abstract: Sleep duration and sleep quality are important predictors of risk for cardiovascular disease (CVD). One potential link between sleep health and CVD is through lifestyle factors such as diet. To clarify the association between diet and sleep, we assessed the associations of sleep duration and insomnia symptoms with current Mediterranean-style diet (aMed), and with historical changes in aMed score. Actigraphy-measured sleep duration and self-reported insomnia symptoms categorized as insomnia with short sleep (<6 h/night), insomnia without short sleep, no insomnia with short sleep and no insomnia or short sleep, were obtained from 2068 individuals who also had dietary intake data. A 10-point aMed score, derived from a self-report food frequency questionnaire, was collected concurrently with the sleep assessment, and 10 y before. Compared to individuals who currently reported a low aMed score, those with a moderate-high aMed score were more likely to sleep 6-7 h/night vs. <6 h/night (p<0.01) and less likely to report insomnia symptoms occurring with short sleep (vs. no insomnia or short sleep alone) (p<0.05). An increase in aMed score over the preceding 10 y was not associated with sleep duration or insomnia symptoms. However, compared to those with decreasing aMed score, individuals with an unchanging score reported fewer insomnia symptoms (p=0.01). These results suggest that a Mediterranean-style diet is associated with adequate sleep duration, less insomnia symptoms, and less likely to have insomnia accompanied by short sleep. Further research should identify possible mediators through which diet may promote adequate sleep duration and reduce the risk of insomnia.