Determining The Diet Quality, Sleep Quality and Obesity Status of Undergraduate Students: A Cross-Sectional Study

Main Article Content

Gülşen Özduran https://orcid.org/0000-0001-9406-3165
Sevinç Yücecan https://orcid.org/0000-0003-4751-0924

Keywords

Diet quality, body mass index, obesity, sleep index

Abstract

Summary. Objectives: Intake of an adequate and balanced diet and improved nutritional quality are factors that affect and increase sleep quality. Poor diet quality and sleep quality have been associated with chronic diseases such as obesity. This study aimed to evaluate relations among diet quality, sleep quality and obesity in undergraduate students. Materials and Methods: The study was conducted with 299 individuals studying at the Department of Nutrition and Dietetics of Near East University between September 2016 and January 2017. A questionnaire was administered to all participants and some anthropometric measurements were obtained to determine obesity status. Diet quality was assessed using the Diet Quality Index-International (DQI-I) tool and 3-day food record, and the Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality. Results: The body mass index (BMI) values showed that 13.7% of the students were underweight, 68.9% were of normal, 12.7% were overweight and 4.7% were obese. Diet quality was poor in 89.3% and sleep quality was poor in 44.1% of the students. 4.9% of the students with good diet quality and 4.5% of the students with poor diet quality were obese, and 4.8% of the students with good sleep quality and 4.5% of the students with poor sleep quality were obese. Total DQI-I scores were negatively correlated and significantly associated with total PSQI scores (p<0.05) but BMI was not significantly associated with total DQI-I and PSQI scores (p>0.05). Conclusion: It was observed that improved diet quality was associated with better sleep quality. The study findings supported the primary hypothesis that improved diet quality will result in better sleep quality. More comprehensive studies in larger samples are warranted to conclusively determine relations among diet quality, sleep quality and obesity status.

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References

1. Palmer CA, Alfano CA. Sleep and emotion regulation: an organizing, integrative review. Sleep Med Rev 2017; 31: 6-16.
2. Üstün Y, Çınar-Yücel Ş. Hemşirelerin uyku kalitesinin incelenmesi. Maltepe Üniversitesi Bilim ve Sanatı Dergisi 2011; 4(1): 29-38.
3. Copinschi G, Leproult R, Spiegel K. The important role of sleep in metabolism. How Gut and Brain Control Metabolism 2014; 42: 59-72.
4. Peuhkuri K, Sihvola N, Korpela R. Diet promotes sleep duration and quality. Nutr Res 2012; 32(5): 309-319.
5. Yan Z, Vhang-Quan H, Zhen-Chan Z, Bi-Rong D. Association between sleep quality and body mass index among Chinese nonagenarians/centenarians. AGE 2012; 34: 527-537.
6. Chaput JP, McNeil J, Després JP, Bouchard C, Tremblay A. Short sleep duration is associated with greater alcohol consumption in adults. Appetite 2012; 59(3): 650-655.
7. Haghighatdoost F, Karimi G, Esmaillzadeh A, Azadbakht L. Sleep deprivation is associated with lower diet quality indices and higher rate of general and central obesity among young female students in Iran. Nutr 2012; 28(11-12): 1146-1150.
8. Halson SL. Nutrition, sleep and recovery. Eur J Sport Sci 2008; 8(2): 119-126.
9. St-Onge MP, Mikic A, Pietrolungo CE. Effects of diet on sleep quality. Adv Nutr 2016; 7(5): 938-949.
10. Diethelm K, Remer T, Jilani H, Kunz C, Buyken AE. Associations between the macronutrient composition of the evening meal and average daily sleep duration in early childhood. Clin Nutr 2011; 30(5): 640-646.
11. Zuraikat FM, Makarem N, Liao M, St‐Onge MP, Aggarwal B. Measures of poor sleep quality are associated with higher energy intake and poor diet quality in a diverse sample of women from the Go Red for Women Strategically Focused Research Network. J Am Heart Assoc 2020; 9(4): e014587.
12. Momeni F, Javadi M, Mohammadi-Zeidi I, Abiri B, Sarbakhsh P, Vafa M. The Association of Sleep Quality with Dietary Intake and Rate of General and Central Obesity among Young Female Students in Qazvin City, Iran. JNFS 2020; 5(3): 218-226.
13. Weir CB, Jan A. (2019). BMI classification percentile and cut off points. Erişim: (https://www.ncbi.nlm.nih.gov/books/NBK541070/) Date of Access: 24/06/2020.
14. Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. https://www.nal.usda.gov/sites/default/files/fnic_uploads/DRIEssentialGuideNutReq.pdf Date of Access: 05/11/2020.
15. Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989; 28: 193-213.
16. Ağargün MY, Kara H, Anlar O. Pittsburgh Uyku Kalitesi İndeksi’nin geçerliliği ve güvenilirliği. Turk Psikiyatri Derg 1996; 7: 107-115.
17. Patterson RE, Haines PS, Popkin BM. Diet Quality Index: capturing a multidimensional behavior. J Am Diet Assoc 1994; 94: 57-64.
18. Kim S, Haines PS, Siega-Riz AM, Popkin BM. The Diet Quality Index-International (DQI-I) provides an effective tool for cross-national comparison of diet quality as illustrated by China and the United States. J Nutr 2003; 133: 3476-3484.
19. Setayeshgar S, Maximova K, Ekwaru JP, et al. Diet quality as measured by the Diet Quality Index–International is associated with prospective changes in body fat among Canadian children. Public Health Nutr 2017; 20(3): 456-463.
20. Kim S, Popkin BM, Siega-Riz AM, Haines PS, Arab L. A cross-national comparison of lifestyle between China and the United States, using a comprehensive cross-national measurement tool of the healthfulness of lifestyles: the Lifestyle Index. Prev Med 2004; 38(2): 160-171.
21. Williams J, Townsend N, Rayner M, et al. Diet quality of adolescents in rural Sri Lanka based on the Diet Quality Index–International: findings from the ‘Integrating Nutrition Promotion and Rural Development’project. Public Health Nutr 2019; 22(10): 1735-1744.
22. De Miguel-Etayo P, Moreno LA, Santabárbara J, et al. Diet quality index as a predictor of treatment efficacy in overweight and obese adolescents: The EVASYON study. Clin Nutr 2019; 38(2): 782-790.
23. Mariscal-Arcas M, Romaguera D, Rivas A, et al. Diet quality of young people in southern Spain evaluated by a Mediterranean adaptation of the Diet Quality Index-International (DQI-I). Br J Nutr 2007; 98(6): 1267-1273.
24. Tur JA, Romaguera D, Pons A. The Diet Quality Index-International (DQI-I): Is ıt a useful tool to evaluate the quality of the mediterranean diet? Br J Nutr 2005; 93: 369-376.
25. Bel S, Michels N, De Vriendt T, et al. Association between self-reported sleep duration and dietary quality in European adolescents. Br J Nutr 2013; 110(5): 949-959.
26. Rad NH. Üniversite öğrencilerinde uyku süresi ile diyet kalitesi ve obezite arasındaki ilişki. Yüksek Lisans Tezi. Hacettepe Üniversitesi. Ankara. 2015.
27. Beebe D, Chang JJ, Kress K, Mattfeldt‐Beman M. Diet quality and sleep quality among day and night shift nurses. J Nurs Manag 2017; 25(7): 549-557.
28. Bağcılar S, Akyol AM, Kabaran S. Kuzey Kıbrıs'ta yaşayan yetişkin bireylerin uyku kalitesi ve süresi ile beslenme durumlarının belirlenmesi. Int Peer-Reviewed J Nutr Res 2019; 5(15): 25-47.
29. Lee SY, Kim J, Oh S, et al. A 24-week intervention based on nutrition care process improves diet quality, body mass index, and motivation in children and adolescents with obesity. Nutr Res 2020; 84: 53-62.
30. Jalloun R A, Maneerattanasuporn T. Comparison of diet quality among female students in different majors at Taibah University. Nutr Health 2020; 0260106020967846.
31. Spira AP, Beaudreau SA, Stone KL, et al. Reliability and validity of the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale in older men. J Gerontol A 2012; 67(4): 433-439.
32. Mah CD, Kezirian EJ, Marcello BM, Dement WC. Poor sleep quality and insufficient sleep of a collegiate student-athlete population. Sleep Health 2018; 4(3): 251-257.
33. El Hangouche AJ, Jniene A, Aboudrar S, et al. Relationship between poor quality sleep, excessive daytime sleepiness and low academic performance in medical students. Adv Med Educ Pract 2018; 9: 631.
34. Park E, Lee HY, Park CSY. Association between sleep quality and nurse productivity among Korean clinical nurses. J Nurs Manag 2018; 26(8): 1051-1058.
35. Aşılar RH, Yıldırım A, Kadir CEBI, Şahin H. Investigation of the Relationship Between Eating Attitudes and Sleep Quality in University Students. TJFMPC 2020; 14(1): 3-14.
36. Wang J, Chen Y, Jin Y, Zhu L, Yao Y. Sleep quality is inversely related to body mass index among university students. Rev Assoc Med Bras 2019; 65(6): 845-850.
37. Abro SU, Khalid G, Saleem Q, Khan M, Ahmed S. Association of body mass index and gender with sleep quality in medical students: A Survey. Prof Med J 2020; 27(11): 2511-2516.
38. Xu Z, Su H, Zou Y, Chen J, Wu J, Chang W. Sleep quality of Chinese adolescents: distribution and its associated factors. J Paediatr Child Health 2012; 48(2): 138-145.
39. Cleator J, Abbott J, Judd P, Wilding JP, Sutton CJ. Correlations between night eating, sleep quality, and excessive daytime sleepiness in a severely obese UK population. Sleep Med 2013; 14(11): 1151-1156.
40. Grandner MA, Jackson N, Gerstner JR, Knutson KL. Dietary nutrients associated with short and long sleep duration. Data from a nationally representative sample. Appetite 2013; 64: 71-80.
41. Magee CA, Caputi P, Iverson DC. Is sleep duration associated with obesity in older Australian adults?. J Aging Health 2010; 22(8): 1235-1255.
42. Rontoyanni VG, Baic S, Cooper AR. Association between nocturnal sleep duration, body fatness, and dietary intake in Greek women. Nutr 2007; 23(11): 773-777.
43. Tepe SO, Gunes G, Pehlivan E, Genc M. The relationship between body mass index and Pittsburgh sleep quality index Erkan Pehlivan. Eur J Public Health 2017; 27(suppl_3): 369.
44. Beccuti G, Pannain S. Sleep and obesity. Curr Opin Clin Nutr Metab Care 2011; 14(4): 402-419.
45. Larcher S, Benhamou PY, Pépin JL, Borel AL. Sleep habits and diabetes. Diabetes Metab 2015; 41(4): 263-271.
46. National Sleep Foundation Recommends New Sleep Times. https://www.sleepfoundation.org/press-release/national-sleep-foundation-recommends-new-sleep-times. Date of Access: 19/01/2020.
47. Arber S, Marcos B, Robert M. Gender and socio-economic patterning of self-reported sleep problems in Britain. Soc Sci Med 2009; 68(2): 281-289.
48. Saygılı S, Akıncı AÇ, Arıkan H, Dereli E. Üniversite öğrencilerinde uyku kalitesi ve yorgunluk. EJOVOC 2011; 1(1): 88-94.
49. Imaki M, Hatanaka Y, Ogawa Y, Yoshida Y, Tanada S. An epidemiological study on relationship between the hours of sleep and life style factors in Japanese factory workers. J Physiol Anthropol Appl Human Sci 2002; 21(2): 115-120.
50. Rondanelli M, Opizzi A, Monteferrario F, Antoniello N, Manni R, Klersy C. The effect of melatonin, magnesium, and zinc on primary insomnia in long-term care facility residents in Italy: a double-blind, placebo-controlled clinical trial. J Am Geriatr Soc 2011; 59: 82-90.
51. Huang R, Ho SY, Lo WS, Lai HK, Lam TH. Alcohol consumption and sleep problems in Hong Kong adolescents. Sleep Med 2013; 14(9): 877-882.
52. Yano S, Moseley K, Azen C. Large neutral amino acid supplementation increases melatonin synthesis in phenylketonuria: a new biomarker. J Pediatr 2013; 162(5): 999-1003.