Association between dietary carbohydrate-to-fiber ratio and sleep duration among American adults with constipation: A cross-sectional study

BACKGROUND: The carbohydrate-to-fiber ratio is a novel indicator for evaluating dietary carbohydrate quality that can more accurately reflect an individual's dietary quality, but its association with sleep duration in the constipated population has not been fully investigated. METHODS: Using information from the National Health and Nutrition Examination Survey (NHANES) conducted in the United States between 2005 and 2010, this study included a total of 947 participants. Constipation was defined according to the Bristol Stool Form Scale (BSFS). The carbohydrate-to-fiber ratio was obtained through the first 24-h dietary recall questionnaire. Sleep duration was assessed through the Sleep Disorder Questionnaire. Multivariable logistic regression, subgroup analyses, and restricted cubic splines (RCS) were employed to examine the association between carbohydrate-to-fiber ratio and sleep duration. Multicollinearity was quantified using the variance inflation factor. RESULTS: We used reference group with normal sleep duration, the logistic regression results showed that, compared to individuals with a carbohydrate-to-fiber ratio < 12.84, higher carbohydrate-to-fiber ratios of 17.66-26.18 (OR = 2.02, 95% CI: 1.25-3.28, P = 0.009) and > 26.18 (OR = 2.02, 95% CI: 1.13-3.62, P = 0.03) both increased the risk of short sleep duration in the constipated population. A nonlinear association was observed between carbohydrate-to-fiber ratios and short sleep duration in adults with constipation. No association was observed between the carbohydrate-to-fiber ratio and long sleep duration in constipated individuals. CONCLUSION: A higher carbohydrate-to-fiber ratio in the diet may lead to a greater risk of short sleep duration in individuals with constipation. The results did not confirm an association between the carbohydrate-to-fiber ratio and long sleep duration.