Do diet and sleep disorders combine to raise death risk?

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In 23,212 NHANES adults, low Mediterranean-diet scores plus sleep disorders raised all-cause (HR 2.16) and CVD (HR 2.68) mortality, with a significant CVD interaction.

Source

Sleep disorder, Mediterranean diet, and all-cause and cause-specific mortality: a prospective cohort study

Wang Y, Fan H, Ren Z, et al. · BMC public health · 2023

doi.org/10.1186/s12889-023-15870-x Read the full paper ↗24 citationscc by

Study at a glance

Design: Cohort — NHANES 2005–2014 prospective mortality follow-up; Cox models of aMED × sleep disorder interaction
N: N=23212 · 23,212 NHANES 2005–2014 participants
Population: US NHANES adults with diet scores, sleep questionnaires, and mortality linkage
Outcome: All-cause, cardiovascular, and cancer mortality; interaction between aMED adherence and sleep disorders

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What they did

Scored alternative Mediterranean diet (aMED, 9 points), assessed sleep disorder and sleep hours by questionnaire, and ran Cox models for all-cause, cardiovascular, and cancer death, including aMED × sleep-disorder interaction.

What they found

Lower aMED plus sleep disorders: all-cause HR 2.16 (1.49–3.13) and CVD HR 2.68 (1.58–4.54). Interaction was significant for CVD mortality (p=0.033) but not all-cause (p=0.184) or cancer (p=0.955).

The limits

What it doesn't show

Observational NHANES cannot prove changing diet or treating sleep disorders will cut deaths; sleep was self-reported, not polysomnography.

Key terms

aMED: Alternative Mediterranean diet 9-point adherence index.
NHANES: US National Health and Nutrition Examination Survey.
Sleep disorder: Self-reported sleep problem on structured questionnaires.
Cox regression: Time-to-event model for mortality hazard ratios.
Interaction: Joint departure from multiplying diet and sleep effects.

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Common questions

How large was the cohort?

23,212 NHANES 2005–2014 participants.

Combined low aMED + sleep disorder HRs?

All-cause 2.16; cardiovascular 2.68.

Where was interaction significant?

Cardiovascular mortality (p=0.033), not all-cause or cancer.

How was diet scored?

9-point alternative Mediterranean diet (aMED).