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.     

Associations Between Poor Sleep Quality and Psychosocial Stress with Obesity in Reproductive-age Women of Lower Socioeconomic Status

BackgroundPrior studies have not examined the role of psychosocial stress in the relationship between poor sleep quality and obesity among women of lower socioeconomic status (SES). We tested the following hypotheses in a sample of reproductive-age women of lower SES: 1) Poor sleep quality is related to increased risk of obesity, and 2) psychosocial stress confounds this association between poor sleep quality and obesity.MethodsA total of 927 women age 16 to 40 years attending public health clinics in Southeastern Texas provided information on the Pittsburgh Sleep Quality Index and sociodemographic and health characteristics, including the Perceived Stress Scale. Height, weight, and waist circumference (WC) were measured in clinic. A series of models examined the associations between sleep disturbance, perceived stress, and weight outcomes, accounting for potential confounding factors.ResultsNearly 30% of women were overweight, and 35% were obese. Half of women had a WC of greater than 35 inches. Most women had poor sleep quality and high levels of stress. Sleep quality and perceived stress were not related to body mass index category or WC in models that adjusted for age and race/ethnicity. Adjusting for potential confounding factors did not alter results. Perceived stress did not modify the association between sleep quality and weight outcomes.ConclusionsPoor sleep quality and psychosocial stress were not related to weight in reproductive-aged women of lower SES. However, poor sleep quality, high stress, overweight, and obesity were common in this group.     

Alternate Day Fasting Combined with a Low Carbohydrate Diet: Effect on Sleep Quality,Duration, Insomnia Severity and Risk of Obstructive Sleep Apnea in Adults with Obesity

Background: Alternate day fasting combined with a low carbohydrate diet (ADF-LC) is an effective weight loss regimen. Whether the weight loss induced by ADF-LC can improve sleep, remains unknown. Objective: This study examined the effect an ADF-LC diet on sleep quality, duration, insomnia severity and the risk of obstructive sleep apnea. Methods: Adults with obesity (n = 31) participated in ADF (600 kcal “fast day”; ad libitum intake “feast day”) with a low-carbohydrate diet (30% carbohydrates, 35% protein, and 35% fat). The 6-month trial consisted of a 3-month weight loss period followed by a 3-month weight maintenance period. Results: Reductions in body weight (−5 ± 1 kg, p < 0.001) and fat mass (−4 ± 1 kg, p < 0.01) were noted during the weight loss period, and these reductions were sustained during the weight maintenance period. Lean mass and visceral fat remained unchanged. The Pittsburgh Sleep Quality Index (PSQI) score indicated poor sleep quality at baseline (6.4 ± 0.7) with no change by month 3 or 6, versus baseline. ISI score indicated subthreshold insomnia at baseline (8.5 ± 1.0), with no change by month 3 or 6, versus baseline. The percent of subjects with high risk of obstructive sleep apnea at baseline was 45%, with no change by month 3 or 6. Wake time, bedtime, and sleep duration remained unchanged. Conclusion: The ADF-LC diet does not impact sleep quality, duration, insomnia severity or the risk of obstructive sleep apnea in adults with obesity.     

Eating Earlier and More Frequently Is Associated With Better Diet Quality in Female Brazilian Breast Cancer Survivors Using Tamoxifen

BackgroundEmerging literature demonstrates that eating time and frequency are associated with quality and quantity of food consumption and anthropometric measurements. Considering that unhealthy dietary choices and obesity are important modifiable risk factors for breast cancer incidence and recurrence, this subject is relevant and has not been studied sufficiently in breast cancer survivors.ObjectiveThis study’s aim was to examine the association of eating time and frequency with diet quality, quantity of food consumption, anthropometric measurements, and body composition parameters in female breast cancer survivors using tamoxifen.DesignThis was a cross-sectional study.Participants/settingThis study was conducted from March 2015 to March 2016 at a Brazilian university hospital (Clinic’s Hospital, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil) and included an assessment of 84 female breast cancer survivors using tamoxifen (mean [SD] age was 53.1 [8.7] years).Main outcome measuresQuantitative dietary assessment consisted of three 24-hour dietary recalls. The Brazilian Healthy Eating Index Revised was used for the qualitative diet analysis. Participants were classified by median eating time (early or late eaters of breakfast, lunch, and dinner), as well as by considering the middle time point between the first and last meal of the day (early or late midpoint eaters). Participants were also classified by median eating frequency (<5 or ≥5 eating episodes per day). Anthropometric measurements and body fat percentage by bioelectrical impedance were obtained.Statistical analysisGeneralized linear models and generalized mixed models were used to assess the associations between variables.ResultsEarly breakfast and dinner eating and early midpoint eating were associated with better scores for specific Brazilian Healthy Eating Index Revised components (P < .05). Early breakfast and dinner eating were also associated with better scores for the total index (P = .035 and P = .017, respectively). Early dinner eaters and early midpoint eaters had significantly lower daily energy consumption (P = .007 and P = .002, respectively). Eating ≥5 episodes per day was also associated with better scores of specific Brazilian Healthy Eating Index Revised components and the total index (P < .05). No significant associations between eating time and frequency with anthropometric measurements and body composition parameters were found (P > .05). However, women in the healthy body mass index category vs women in the overweight/obesity category had higher energy consumption at breakfast (P = .046).ConclusionsEarlier food intake time was associated with better diet quality and lower daily energy consumption. Higher frequency of eating was also associated with better diet quality. Future studies, such as randomized controlled trials, are needed to evaluate interventions addressing the timing and frequency of meals and their effect on diet quality and quantity in breast cancer survivors.     

Association between nocturnal sleep duration, body fatness, and dietary intake in Greek women

OBJECTIVE: We investigated the association of nocturnal sleep duration with body fatness, energy, and macronutrient intake in female adults. METHODS: Thirty healthy Greek women 30-60 y of age and under no medication were recruited for an observational, cross-sectional study in Athens, Greece, in 2005. Participants' height, weight, skinfold thickness, and waist and hip circumferences were measured. All subjects completed a Sleep Habits Questionnaire and a 7-d sleep diary to estimate nocturnal sleep duration. Two 24-h dietary recall interviews were conducted to assess dietary intake. RESULTS: Nocturnal sleep duration was negatively associated with body fatness (r = -0.614, P < 0.001) and body mass index (r = -0.401, P < 0.05). Each 1-h decrease in nocturnal sleep duration was associated with a significant increase in body fat of 2.8% (95% confidence interval -4.6 to -1.0) when the effects of age and energy intake were held constant. A weak positive association between sleep duration and saturated fat was observed (r = 0.392, P < 0.05). However, no significant association of sleep duration with certain central obesity indices, energy intake, or a preference for fat or carbohydrate consumption was found. CONCLUSION: The present study identifies an independent negative association of nocturnal sleep duration with body fatness. Therefore, the shorter the sleep duration, the greater is the body fatness. The hypothesis that sleep duration is associated with energy intake and a preference for fat or carbohydrate consumption was not supported.     

Eating behaviors and indexes of body composition in men and women from the Québec family study

OBJECTIVE: To put into relationship the dietary and anthropometric profile of men and women with their eating behaviors (cognitive dietary restraint, disinhibition, and susceptibility to hunger) and to assess whether gender and obesity status influence these associations. RESEARCH METHODS AND PROCEDURES: Anthropometric measurements (including visceral adipose tissue accumulation), dietary profile (3-day food record), and eating behaviors (Three-Factor Eating Questionnaire) were determined in a sample of 244 men and 352 women. RESULTS: Women had significantly higher cognitive dietary restraint and disinhibition scores than men (p < 0.0001). In both genders, scores for disinhibition and susceptibility to hunger, but not for cognitive dietary restraint, were higher in obese subjects than in overweight and nonobese subjects (p < 0.05). Positive correlations were observed between rigid restraint and most of the anthropometric variables studied (0.12 相似文献   

Assessment of adipose tissue distribution by computed axial tomography in obese women: association with body density and anthropometric measurements

1. Abdominal obesity is associated with numerous metabolic complications. Deep abdominal adipose tissue is critical in the association between the level of abdominal obesity and cardiovascular risk factors. 2. Adipose tissue localization was assessed by computed axial tomography (CAT), and its association with body density and anthropometric measurements was investigated in a sample of fifty-one obese women (percentage body fat 45.9 (SD 5.6)) aged 35.7 (SD 5.5) years. The CAT scans were performed at three levels: lower chest, abdomen and mid-thigh. 3. The total adipose tissue volume computed from these three scans was highly correlated with body fat mass (r 0.94, P less than 0.001). The proportion of deep abdominal fat as measured by the ratio of deep: total adipose tissue areas at the abdominal level was not significantly correlated with body fat mass, but it was moderately associated with the ratio of waist: hip circumferences (WHR) (r 0.49, P less than 0.001). The absolute amount of deep abdominal fat was, however, significantly correlated with body fat mass (r 0.72, P less than 0.001). 4. The subscapular (r 0.38) and the abdominal (r 0.38) skinfolds were the only two skinfolds that were significantly associated with the proportion of deep abdominal fat (P less than 0.01). These skinfolds were also those which showed the highest correlation with the absolute amount of deep abdominal fat (r 0.65, P less than 0.001, for both skinfolds). 5. A three-site CAT-scan procedure can be used for the estimation of body fat mass in premenopausal obese women. 6. In these obese women, there was no significant association between total adiposity and the proportion of deep adipose tissue at the abdominal level. 7. In premenopausal obese women, the absolute amount of deep abdominal fat can be predicted from anthropometric measurements with more accuracy than the relative amount of deep abdominal fat.     

Effects of intragastric balloon on obesity in obese Korean women for 6 months post removal

BACKGROUND/OBJECTIVESThe prevalence of morbid obesity in Korean women has consistently been increasing, while the overall prevalence rate of obesity in Korean women seems to be stable. In addition to bariatric surgery, intragastric balloons (IGBs), as a nonsurgical therapy, have been reported to be effective in weight loss. However, the beneficial effects of IGB in Korean women with obesity have not been fully investigated. The aim of this study was to evaluate the changes in fat mass in Korean women with obesity who had undergone IGB treatment for 6 mon.SUBJECTS/METHODSSeventy-four women with obesity (body mass index [BMI] ≥ 25.0 kg/m²) were recruited. Clinical data, including general information, comorbidities with obesity, anthropometric data, and changes in the body fat composition before and after IGB treatment, were obtained from the subjects.RESULTSMost subjects had one or more comorbidities, such as osteoarthropathy and woman''s disease, and had poor eating behaviors, including irregular mealtimes, eating quickly, and frequent overeating. Body composition measurements showed that weight, fat mass, and waist-hip circumference ratio decreased significantly at 6 mon after IGB treatment. In particular, women with morbid obesity (BMI ≥ 30 kg/m²) showed 33% excess weight loss. There was no significant difference in skeletal muscle mass and mineral contents after IGB treatment.CONCLUSIONSThis study suggested that 6 mon of IGB treatment can be a beneficial treatment for obesity without muscle mass and bone mineral loss.     

Insulin resistance is not strictly associated with energy intake or dietary macronutrient composition in women with polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a heterogeneous disorder characterized by hyperandrogenism and chronic anovulation. Around 60% of PCOS patients are obese. Weight loss has consistently been shown to improve the clinical status of women with PCOS. We hypothesized that dietary factors are associated with the hormonal and metabolic abnormalities of PCOS. This case-control study included 43 women with PCOS and 37 ovulatory, nonhirsute controls matched to the study group by body mass index. Age ranged from 14 to 38 years. Both groups underwent anthropometric, laboratory, and nutritional assessment. End points included diet composition, body fat, and hormonal and metabolic variables related to insulin resistance. The groups had similar intake of energy, carbohydrate (53.51% ± 8.36% vs 51.83% ± 10.06%), protein (15% [12-18] vs 16% [13-19]), and total fat (30.51% ± 7.90% vs 30.80% ± 7.97%). Total body fat, sum of trunk skinfold measurements, and waist circumference were higher in the PCOS group (P < .05). Sex hormone-binding globulin was lower in PCOS patients than in controls, whereas total testosterone, free androgen index, postprandial glucose, fasting and postprandial insulin, homeostatic model assessment index, triglycerides, and total and low-density lipoprotein cholesterol (P < .050) were higher. Homeostatic model assessment index was correlated with central obesity in PCOS patients and controls alike. No association was detected between androgen status and macronutrient intake. In conclusion, central obesity and insulin resistance were not strictly associated with energy intake or dietary macronutrient composition in women with PCOS.     

Eight weeks of intermittent fasting versus calorie restriction does not alter eating behaviors,mood, sleep quality,quality of life and cognitive performance in women with overweight

Human trials that compare intermittent fasting (IF) to calorie restriction (CR) with psychological, behavioral and cognition outcomes are limited. We hypothesized that there would be no difference between CR and IF on perceived eating behaviors, mood, sleep quality, quality of life (QOL) and cognition in women with overweight and obesity. In this prespecified secondary analysis of an open-label, single center, parallel assignment, randomized controlled trial, healthy women with overweight or obesity (N = 46, mean [SD] age 50 [9] years, BMI 32.9 [4.4] kg/m²), without a diagnosed eating disorder and who were randomized into 2 weight loss groups (prescribed 70% of calculated energy requirements as IF or CR) were included. Measurements were assessed in both IF and CR groups following a 12-hour overnight fast during baseline and week 8 and additionally following a 24-hour fast in the IF group only at week 8. We observed that IF produced greater weight and body fat loss than CR (P < .001). We did not detect any statistical difference between groups for the change in dietary restraint, disinhibition, hunger, mood, sleep quality, and QOL. An increase in cognitive performance was found in both IF (P = .036) and CR (P = .006) groups in one of the cognitive tasks, but there was no statistical difference between groups. Perceived eating behaviors, mood, sleep quality and cognitive performance were not changed by an acute 24-hour fast within the IF group (all P > .05). IF may be a viable alternative to CR for weight loss, in the short-term, without adversely impacting eating behaviors, mood, sleep quality, QOL or cognition in healthy women with overweight or obesity. However, larger and long term trials are required.     

Obesity indices in relation to cardiovascular disease risk factors among young adult female students

The objective of the present study was to compare the percentage of body fat (%BF), BMI, and central fat distribution anthropometric measures as indices of obesity and to assess the respective associations with cardiovascular risk factors in young female students. Subjects were 220 healthy Greek female students. Dual-energy X-ray absorptiometry was used to estimate %BF, anthropometric measurements were obtained and blood samples were analysed for CVD risk factors. Results showed that 48.6 % of students had increased adiposity, while a considerable proportion was characterised by central fat distribution irrespective of the anthropometric index used. The proportion of subjects with at least one metabolic risk factor present was 60.4 %. Although %BF was not associated with any of the CVD risk factors, waist circumference, waist:hip ratio and waist:height ratio were all associated with CVD risk factors. Higher levels of these anthropometric variables demonstrated higher prevalence of CVD risk factors. The lack of association between %BF and CVD risk factors could be attributed to the fact that females with undesirable adiposity had a tendency for the gynaecoid type of obesity. In contrast, the present results suggest that central body fat distribution in young women may reflect increased risk due to high visceral and particularly intra-abdominal fat levels. Recent epidemiological data from Greece show a high prevalence of overweight and obesity in young adults. Therefore, assessing the risk for the presence of CVD risk factors is of particular importance. Central obesity anthropometric indices seem to be valuable screening tools for young women.     

Associations between Avocado Consumption and Diet Quality,Dietary Intake,Measures of Obesity and Body Composition in Adolescents: The Teen Food and Development Study

Avocado is a nutrient-rich food that has been shown to benefit the health and diet quality of adults. In this paper, we examined if habitual intake of avocado among adolescents is associated with their diet quality, food and nutrient intake, and measures of obesity and body composition. Participants aged 12–18 years old (n = 534) from selected public and Adventist middle-high schools reported their dietary intake in a web-based food frequency questionnaire (FFQ); anthropometrics were measured during school visits. Diet quality (DQI-I) and avocado intake were calculated from the FFQ; BMI z-scores (BMIz), waist-to-height ratio (WHtR), and fat mass (FM), fat-free mass (FFM), and %body fat (%BF) were determined from the anthropometric data. Compared to non-consumers, avocado consumers had significantly higher covariate-adjusted mean scores on total DQI-I (68.3 vs. 64.6) and energy-adjusted mean scores on variety (18.8 vs. 18.0) and adequacy (36.4 vs. 33.4). Avocado consumption was significantly associated with DQI-I components adequacy (β [SE] = 0.11 [0.03]) and moderation (β [SE] = 0.06 [0.03]) but not with BMIz, WHtR, FM, FFM, and %BF. Mean intakes of fruits, vegetables, and plant protein foods, total and vegetable proteins, dietary fiber, retinol, vitamin C, calcium, magnesium, iron, and potassium were significantly higher for avocado consumers; saturated and trans fats intakes were significantly higher for non-consumers. In our adolescent population, avocado consumption was associated with higher diet quality and intake of plant-based foods and shortfall nutrients, but not with measures of obesity and body composition. Studies are needed to determine the optimal amount of avocado that would confer health benefits during adolescence.     

2015年中国15省(自治区、直辖市)18~65岁居民体脂率人群分布及其与体质指数关系

目的描述2015年中国15省(自治区、直辖市)18~65岁居民体脂率(body fat percentage,BF%)和体脂肪量的地区和人群分布特征,探讨体脂率与体质指数(body mass index,BMI)的关系。方法本研究利用2015年"中国居民营养状况变迁的队列研究"项目中有完整体格测量及相关人口经济学调查资料的10561名18~65岁成年人数据进行分析。采用生物电阻抗法测量调查对象体脂率和体重,分析不同性别成年人体脂率和体脂肪量在年龄、教育水平、家庭人均收入、地区和城乡之间分布的差异,并根据世界卫生组织(World Health Organization,WHO)推荐的体脂率的肥胖判定标准判断人群肥胖率。结果2015年中国15省(自治区、直辖市)18~65岁成年女性体脂率、体脂肪量分别为33.6%、19.5 kg,成年男性分别为23.0%、15.7 kg。体脂率、体脂肪量均呈现北方地区高于南方,差异有统计学意义(P<0.0001)。男性不同年龄、教育水平、家庭年人均收入水平、地域及城乡人群的体脂率和体脂肪量差异均有统计学意义(P<0.0001)。女性不同年龄、教育水平、地域的体脂率和体脂肪量差异均有统计学意义(P<0.0001),城乡和家庭收入水平差异没有统计学意义。按照WHO推荐的体脂率的肥胖判定标准,女性肥胖率42.0%,随年龄增长不断上升,60~65岁女性肥胖率高达52.4%。男性肥胖率37.1%,随着年龄增长呈上升趋势,但在60~65岁组下降。北方地区男女性肥胖率分别41.9%、45.6%,明显高于南方地区的34.3%、39.9%。BMI与BF%密切相关,但在超重人群中,体脂率达到肥胖水平的人超过50%。结论2015年中国15省(自治区、直辖市)不同性别成年人体脂率和体脂肪量存在明显的地区和人群差异,北方人群的肥胖率明显高于南方。     

乌鲁木齐市中学生睡眠状况及其与超重肥胖的相关分析

目的 了解乌鲁木齐市中学生睡眠状况及其与超重肥胖的相关性,为有效控制中学生超重肥胖提供支持。方法 2016年3-4月在乌鲁木齐市20所中学以班级为单位随机抽取8 242名中学生进行睡眠状况等方面的调查,并分析与超重肥胖之间的关系。结果 乌鲁木齐市中学生睡眠质量得分为(4.97±2.48)分;睡眠质量问题检出率为28.44%,男生(26.36%)低于女生(30.43%),差异有统计学意义(χ²＝16.66,P＜0.01)。中学生平均睡眠时间为(8.18±1.16)h/d,睡眠不足的检出率为48.24%。中学生超重肥胖率为15.47%,其中男生高于女生,城市高于乡村,初中高于高中,差异均有统计学意义(χ²＝191.04、11.21、44.36,P＜0.01)。多元回归分析表明,中学生性别、年龄、睡眠时间与体重指数(BMI)之间存在相关性(P＜0.05),睡眠时间与BMI呈现负相关关系,年龄与BMI呈现正相关关系。Logistic回归分析表明,中学男生睡眠时间不足是导致超重肥胖的危险因素(OR=1.23, 95%CI:1.04~1.47,P=0.02),未发现睡眠质量问题与超重肥胖存在统计学关联,亦未发现女生睡眠时间和质量问题与超重肥胖存在关联。结论 中学生睡眠时间与BMI之间存在密切联系,男生睡眠不足可能是导致超重肥胖的危险因素。     

Nocturnal Lifestyle Behaviours and Risk of Poor Sleep during Pregnancy

The extent to which lifestyle practices at night influence sleep quality in pregnant women remains unknown. This study aimed to examine whether nocturnal behaviours were associated with poor sleep during pregnancy. We performed a cross-sectional analysis of a prospective cohort of pregnant women at 18–24 gestation weeks recruited from KK Women’s and Children’s Hospital, Singapore, between 2019 and 2021. Nocturnal behaviours were assessed with questionnaires, and sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) with a global score ≥5 indicative of poor sleep quality. Modified Poisson regression and linear regression were used to examine the association between nocturnal behaviour and sleep quality. Of 299 women, 117 (39.1%) experienced poor sleep. In the covariate-adjusted analysis, poor sleep was observed in women with nocturnal eating (risk ratio 1.51; 95% confidence interval [CI] 1.12, 2.04) and nocturnal artificial light exposure (1.63; 1.24, 2.13). Similarly, nocturnal eating (β 0.68; 95% CI 0.03, 1.32) and light exposure (1.99; 1.04, 2.94) were associated with higher PSQI score. Nocturnal physical activity and screen viewing before bedtime were not associated with sleep quality. In conclusion, reducing nocturnal eating and light exposure at night could potentially improve sleep in pregnancy.     

The effect of work shift and sleep duration on various aspects of police officers' health

Police officers are prone to cardiovascular disease, overweight, and obesity. Because night-shift work affects sleep, a modifiable risk factor linked to chronic disease, the researchers explored the relationship among shift work, sleep, and wellness for police officers. Sleep, C-reactive protein (CRP) levels, stress, fatigue, and body mass index were used to compare officers who worked primarily day shifts to those who worked primarily evening or night shifts, and officers who slept less than 6 hours per day to those who slept at least 6 hours per day. A cross-sectional study of 85 male officers, 20 to 63 years old, was completed at three Midwestern police departments. The Pittsburgh Sleep Quality Index was used to assess sleep. A questionnaire was used to collect officer demographics and work hours. Other measurements included serum CRP, height, weight, perceived stress, and vital exhaustion. The relative risk of sleeping less than 6 hours per day for officers who primarily worked non-day shifts, compared to those who worked day shifts, was 14.27 (95% confidence interval [CI], 1.98-102.95, p < .001), and the relative risk of overall poor sleep quality for officers who slept less than 6 hours per day, compared to those who slept more hours, was 2.44 (95% CI, 1.15-5.20, p = .027). CRP was not associated with shift or sleep duration, even when adjusted for officers' ages.     

Assessment of obesity, lifestyle, and reproductive health needs of female citizens of Al Ain, United Arab Emirates

This study was conducted to determine the reproductive and lifestyle characteristics in a representative sample (n = 535) of women in Al Ain, United Arab Emirates, to guide the development of health programmes for this population with rising affluence. A cross-sectional survey was carried out using the stratified two-stage sampling technique. Although most women were young, were pre-menopausal, did not smoke, reported good health status, and 84% (95% confidence interval [CI] 81-87%) reported being sufficiently active to meet expert recommendations, the prevalence of obesity (defined by body mass index > or = 30) was very high (35%; 95% CI 31-39%) and many (28%; 95% CI 24-32%) reported having a chronic disease. The prevalence of obesity was associated positively with age and negatively with education (p < 0.001 for both). Postmenopausal women had significantly more chronic diseases, reported poor health more often, were less physically active (p < 0.001 for all), and had a higher percentage of body fat (p = 0.002) compared to premenopausal women. Health services should emphasize the prevention and treatment of obesity and improving the general health status of postmenopausal women.     

Factors associated with poor sleep quality in patients with multiple sclerosis differ by disease duration

BackgroundSleep disturbance is a common symptom of multiple sclerosis (MS) and knowledge about factors that contribute to poor sleep quality is scarce.ObjectiveThe aim was to explore the differences in the prevalence and determinants of poor sleep quality in a sample of patients with MS with disease duration ≤5 years and >5 years.MethodsWe collected data from 152 consecutive patients with MS; 66 patients (78% women, averaged 37.35 ± 10.1 years) were in the group with disease duration ≤5 years and 86 patients (73.3% women, averaged 42.10 ± 9.4 years) in the group with disease duration >5 years. Patients filled out the Pittsburgh Sleep Quality Index, the Hospital Anxiety and Depression Scale, the Multidimensional Fatigue Inventory, one item of the Incapacity Status Scale regarding bladder problems and one item of the Short Form-36 regarding pain. Multiple linear regression was used to analyze the relationship between the study variables.ResultsThe prevalence of poor sleep is significantly higher in patients with longer disease duration (34.8 vs. 51.2%). Anxiety, reduced motivation and mental fatigue (all p < 0.05) were associated with poor sleep quality in patients with disease duration ≤5 years, whereas pain (p < 0.01), depression and mental fatigue (both p < 0.05) were in patients with disease duration >5 years.ConclusionSleep problems are present in patients with MS with both short and long disease duration, but these problems are associated with different factors. These should be recognized and managed in addition to the treatment of sleep disorders.     

Dietary sodium intake and its relation to sleep duration,sleep quality and nocturnal urination in working-aged Korean adults

Both sodium intake and sleep have an important effect on cardiovascular health. However, few studies have looked at the association between sodium intake and sleep. Therefore, we analysed the association of sodium intake with sleep quality, sleep duration and nocturnal urination. The data for the present study were obtained from the Kangbuk Samsung Health Study. Study participants were 156 696 working-aged Korean adults (average age 38.0 years ±8.0 in men and 36.0 years ±8.1 in women). They were categorised into five groups by quintile of sodium intake, measured by food frequency questionnaire. Poor sleep quality and short sleep duration were determined by Pittsburgh Sleep Quality Index >5, and sleep duration <7 h, respectively. Nocturnal urination was defined as awakening to urinate more than three times a week. Multivariable adjusted logistic regression analysis was used in calculating the odds ratio (OR) and 95% confidence interval (CI) for poor sleep quality, short sleep duration and nocturnal urination (adjusted OR [95% CI]) across five study groups. In all study participants, increased sodium intake was significantly associated with poor sleep quality (quintile 1: reference, quintile 2: 1.07 [1.04–1.11], quintile 3: 1.12 [1.08–1.16], quintile 4: 1.15 [1.11–1.19] and quintile 5: 1.13 [1.09–1.18]). This pattern of relationship was similarly observed in association of sodium intake with short sleep duration (p for trend <0.001) and nocturnal urination (p for trend <0.001). In gender subgroup analysis, increased sodium intake had a significant association with poor sleep quality and short sleep duration in men and with poor sleep quality and nocturnal urination in women. In conclusion, high sodium intake is associated with an increased likelihood of poor sleep quality, short sleep duration and nocturnal urination.     

Anthropometric measurements in the elderly: age and gender differences

In clinical practice and epidemiological surveys, anthropometric measurements represent an important component of nutritional assessment in the elderly. The anthropometric standards derived from adult populations may not be appropriate for the elderly because of body composition changes occurring during ageing. Specific anthropometric reference data for the elderly are necessary. In the present study we investigated anthropometric characteristics and their relationship to gender and age in a cross-sectional sample of 3,356 subjects, randomly selected from an elderly Italian population. In both sexes, weight and height significantly decreased with age while knee height did not. The BMI was significantly higher in women than in men (27.6 SD 5.7 v. 26.4 SD 3.7; P<0.001) and it was lower in the oldest than in the youngest subjects (P<0.05) of both genders. The 75th year of age was a turning point for BMI as for other anthropometric measurements. According to BMI values, the prevalence of malnutrition was lower than 5 % in both genders, whereas obesity was shown to have a higher prevalence in women than in men (28% v. 16%; P<0.001). Waist circumference and waist: hip ratio values were higher for the youngest men than for the oldest men (P<0.05), whereas in women the waist: hip ratio values were higher in the oldest women, suggesting that visceral redistribution in old age predominantly affects females. In conclusion, in the elderly the oldest subjects showed a thinner body frame than the youngest of both genders, and there was a more marked fat redistribution in women.