Lower Diet Quality Is Associated with Poorer Sleep Outcomes among Black Adults in the United States

Adequate sleep and a healthy diet are known to play beneficial roles in promoting cardiometabolic health among adults in the United States. However, there is limited epidemiological evidence supporting this relationship among United States Black adults.

This cross-sectional study examines the associations between: 1) diet quality and insomnia severity, and 2) diet quality and sleep-related impairment (SRI) among Black adults.

Data were obtained from 525 participants (females, 64%; age range, 18-75 y) who were enrolled in the National Institutes of Health-funded ESSENTIAL (Psychosocial and Environmental Determinants of Insufficient Sleep) study. The Insomnia Severity Index (ISI) and the Patient-Reported Outcomes Measurement Information System-SRI were used to capture self-reported sleep disturbances. Diet quality was assessed via the Rapid Eating Assessment for Participants-Short Form (REAP-S). On the basis of REAP-S, we created separate categories for "healthy" and "unhealthy" diet scores. Multivariate linear regression models were used to evaluate the associations of diet quality with ISI and SRI. Adjusted covariates included age, sex, education, body mass index, and marital status.

Mean (SD) scores for ISI and SRI were 11.02 (7.07) and 53.62 (8.75), respectively, with a mean (SD) REAP-S score of 26.17 (5.03). Lower total diet quality (β = -0.20, P = 0.001) and a lower "unhealthy" diet score (β = -0.42, P = 0.002) were associated with higher ISI scores. Similarly, lower total diet quality (β = -0.30, P = 0.0001), a lower "unhealthy" diet score (β = -0.58, P = 0.001), and a lower "healthy" diet score (β = -0.72, P = 0.002) were associated with higher SRI scores.

Poorer diet quality was associated with worse sleep outcomes (insomnia and SRI) in this sample of Black adults. Future research should examine dietary patterns, sleep, and metabolic outcomes in larger Black adult populations to understand this relationship further.