Associations of chrono-nutrition with sleep and quality of life: The Maastricht Study

BACKGROUND & AIMS: Late-night eating may impair sleep quality, with poor sleep negatively affecting quality of life (QoL). As both sleep and eating behaviors are connected to circadian rhythms, interest in "chrono-nutrition", i.e., the timing, frequency and regularity of food consumption, has grown. This study investigated associations between chrono-nutrition and both sleep and QoL in a population-based study enriched with participants with type 2 diabetes. METHODS: Cross-sectional data from 3463 participants (51 % women, mean age 63.6 years) of The Maastricht Study were analyzed. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (range 0-21, higher scores indicating worse quality), and QoL via the SF-36 mental and physical functioning subscales (range 0-100, higher scores indicating better functioning). Sleep duration and fragmentation were estimated using activPAL accelerometers. Meal frequency and irregularity, time-window of caloric intake, and interval between last meal and bedtime were assessed via a chrono-nutrition questionnaire. Associations with sleep quality and QoL were analyzed using multiple linear regression; associations with sleep duration (9 h) and fragmentation (0,1 breaks/night) were analyzed using multinomial logistic regression, adjusted for sociodemographic, clinical, and lifestyle factors. RESULTS: Higher meal frequency was associated with poorer sleep quality (B (95%CI), 0.90 (0.33, 1.47) for Q2, 1.02 (0.49, 1.54) for Q3, and 0.68 (0.17, 1.20) for Q4, all vs. Q1), and lower mental functioning (-1.24 (-2.22, -0.25) for Q4vs.Q1). Higher meal irregularity was linearly associated with poorer sleep quality (B: 0.33, 0.20, 0.46) and lower physical functioning (B:-0.43, -0.65, -0.21). A longer time-window of caloric intake was associated with poorer sleep quality (0.57 (0.09, 1.06) for Q3 and 0.49 (-0.02, 0.99) for Q4, vs. Q1) and lower physical functioning (-0.17/hour, -0.32, -0.02) Conversely, a longer time-window between last meal and bedtime was associated with better sleep quality (-0.72 (-1.25, -0.19) for Q2 and -0.85 (-1.31, -0.39) for Q4, vs Q1) and higher mental (0.20/hour longer, 0.00, 0.41) and physical functioning (0.29/hour, 0.11, 0.48). There was no effect modification by glucose metabolism status. CONCLUSION: Higher meal frequency and irregularity were associated with impaired sleep and lower QoL. A longer interval between the last meal and bedtime may benefit sleep and QoL.