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Abstract Introduction Diet, sleep, and rest-activity rhythms (RAR) influence cardiometabolic health but the relationship among these behaviors is less clear. Evidence of associations between sleep and diet have focused on self-reported sleep duration and quality, and have rarely investigated sleep timing, regularity, and RAR metrics. This study assessed cross-sectional associations between sleep and RAR regularity and timing with overall diet quality. Methods Multi-ethnic Study of Atherosclerosis (MESA) participants who completed validated sleep and food frequency questionnaires and 7-day actigraphy monitoring (Actiwatch Spectrum) between 2010-2013 were eligible for study inclusion. Overall diet quality was measured with the Alternate Healthy Eating Index (AHEI) 2010 (range: 0-110, higher indicates healthier diet). Actigraphy records were processed using Actiware-Sleep (v5.59) software and manually annotated using a sleep diary. Sleep timing was measured with average sleep midpoint, and sleep regularity measures included within-individual standard deviation (SD) of daily sleep duration and onset. Parametric (extended cosine) and nonparametric 24-hour RAR measures were derived from 1-minute epoch-level activity counts. Associations between sleep and RAR metrics with AHEI were tested with multivariable linear regression adjusting for total energy intake, sociodemographic and lifestyle factors including smoking, total activity, and depressive symptoms. Results This study included 1828 participants (mean SD: age: 68.5 9 years, AHEI: 59 10.9; 46% male). Later sleep midpoint and L5-time (start time of the 5 least active hours) were associated with lower AHEI (0.61% and 0.77% lower AHEI per SD later midpoint p=0.005 and L5-time p=0.001, respectively). Irregular sleep timing (sleep onset-SD 60 minutes vs. less) was associated with 1.1% lower AHEI (p=0.014). Rhythm robustness, measured by the pseudo-F (parametric RAR) and relative amplitude (RA, non-parametric RAR) was associated with higher AHEI (0.49% and 0.48% higher AHEI per SD increase in pseudo-F p=0.031 and RA p=0.036, respectively). The associations between later sleep midpoint and L5-time with lower AHEI were robust to false discovery rate (FDR)-corrected significance thresholds. Conclusion Actigraphy-based measures of later sleep timing, irregular sleep, and weakened rest-activity rhythms were associated with lower/worse diet quality in an older, multi-ethnic sample, suggesting their potential utility in multi-component lifestyle interventions. Support (if any) NIH NHLIB T32HL007901, NHLBI HL56984, and NIA R01AG070867
Potts et al. (Sat,) studied this question.