Department of Clinical Medicine and Surgery, Endocrinology Unit, Federico II University "Federico II", Via Sergio Pansini 5, 80131 Naples, Italy.
Centro Italiano per la cura e il Benessere del Paziente con Obesità (C.I.B.O), Federico II University, Via Sergio Pansini 5, 80131 Naples, Italy.
Nutrients. 2020 May 10;12(5):1364. doi: 10.3390/nu12051364.
Obesity and unhealthy eating habits have been associated with sleep disturbances (SD). The Mediterranean diet (MD) is a healthy nutritional pattern that has been reported to be associated with better health and sleep quality. Thus, the aim of the study was to investigate whether adherence to the MD is associated with sleep quality in a population of middle-aged Italian adults. This cross-sectional study included 172 middle-aged adults (71.5% females; 51.8 ± 15.7 years) that were consecutively enrolled in a campaign to prevent obesity called the OPERA (Obesity, Programs of Nutrition, Education, Research and Assessment of the best treatment) prevention project that was held in Naples on 11-13 October 2019. Anthropometric parameters, adherence to the MD and sleep quality were studied. Overall, 50.6% of the subjects were good sleepers (the Pittsburgh Sleep Quality Index (PSQI) < 5) while 49.4% were poor sleepers (PSQI ≥ 5). Our results demonstrated that good sleepers, when compared to poor sleepers ( < 0.001) had significantly higher adherence to the MD as assessed by PREDIMED (Prevención con Dieta Mediterránea) score, lower BMI (body mass index) and waist circumference (WC). The higher PSQI, the higher the BMI ( < 0.001) and WC values ( < 0.001), thus suggesting that poor sleep was more common in subjects with obesity. In addition, a negative correlation between PSQI and the PREDIMED score ( < 0.001) was found. to the intake of the cluster of foods enclosed in the MD, rather than the intake of the single food, predicted PSQI. By performing a receiver operator characteristic (ROC) curve analysis, we determined a cut-off value at a PREDIMED score < 9 as the threshold for screening poor sleepers. In conclusion, good sleepers had lower BMI and WC and higher adherence to the MD than poor sleepers. PSQI was positively associated to BMI and WC while it was negatively associated to adherence to the MD. The consumption of the MD dietary pattern rather than the intake of a single nutrient has a beneficial effect on sleep quality. Hence, the assessment of sleep should be taken into account in the management of obesity and promoting adherence to the MD could be a tool to improve SD.
肥胖和不健康的饮食习惯与睡眠障碍（SD）有关。地中海饮食（MD）是一种健康的营养模式，据报道与更好的健康和睡眠质量有关。因此，本研究旨在调查中年意大利成年人中，遵循 MD 是否与睡眠质量有关。这项横断面研究纳入了 172 名中年成年人（71.5%为女性；51.8±15.7 岁），他们连续参加了一项名为 OPERA（肥胖、营养、教育、研究和评估最佳治疗）的预防肥胖运动。该项目于 2019 年 10 月 11 日至 13 日在那不勒斯举行。研究了人体测量参数、MD 的遵守情况和睡眠质量。总体而言，50.6%的受试者为良好睡眠者（匹兹堡睡眠质量指数（PSQI）<5），而 49.4%为睡眠不佳者（PSQI≥5）。我们的结果表明，与睡眠不佳者（<0.001）相比，良好睡眠者的 MD 遵医嘱程度更高（PREDIMED 评分），BMI（体重指数）和腰围（WC）更低。PSQI 越高，BMI（<0.001）和 WC 值（<0.001）越高，这表明肥胖者中睡眠不佳更为常见。此外，还发现 PSQI 与 PREDIMED 评分呈负相关（<0.001）。与 MD 中包含的食物群的摄入量，而不是单一食物的摄入量相关，可预测 PSQI。通过进行接受者操作特征（ROC）曲线分析，我们确定 PREDIMED 评分<9 作为筛查睡眠不佳者的阈值。总之，与睡眠不佳者相比，良好睡眠者的 BMI 和 WC 较低，MD 遵医嘱程度较高。PSQI 与 BMI 和 WC 呈正相关，与 MD 遵医嘱程度呈负相关。MD 饮食模式的摄入而非单一营养素的摄入对睡眠质量有有益影响。因此，在肥胖的管理中应考虑到睡眠评估，并促进 MD 的遵守可能是改善 SD 的一种工具。
