Association between sleep-related factors, chronotype, and multidimensional food practices in Brazilian adults during COVID-19 home confinement: a cross-sectional study

The Brazilian Dietary Guidelines are internationally recognized for their comprehensive approach to healthy eating, incorporating biological, sociocultural, and environmental dimensions of food and nutrition. The Food Practices Brazil Scale is an instrument designed to assess adherence to these guidelines, providing an overall score as well as evaluating four domains: planning, household organization, eating patterns, and food choices. The COVID-19 pandemic led to substantial changes in lifestyle, posing challenges to maintaining both sleep habits and food practices. Although previous studies have examined the relationship between sleep-related factors and the consumption of specific foods or nutrients, there remains a gap in the literature regarding the association between sleep and overall food practices, particularly within the framework of the Brazilian Dietary Guidelines. This study aimed to investigate the association between sleep-related factors and chronotype with food practices among adults and older adults during COVID-19–related home confinement in Brazil. This cross-sectional study was conducted between April 2020 and March 2021, during the COVID-19 pandemic. Data collection was performed online and disseminated via social media platforms (Instagram®, Facebook®, X®) and email, using a snowball sampling strategy. Eligible participants included adults and older adults (≥ 18 years), of both sexes, residing in Brazil and able to complete online questionnaires. The outcome variable was the Food Practices Brazil Scale score, while the independent variables included sleep quality and sleep efficiency, assessed using the Pittsburgh Sleep Quality Index (PSQI), and chronotype, evaluated using the Morningness–Eveningness Questionnaire (MEQ). Covariates included eating behavior, assessed by the Three-Factor Eating Questionnaire (TFEQ-21), self-reported physical exercise, age, sex, body mass index (BMI), as well as socioeconomic status and educational level. The present study included 1,747 participants (77% women), with a mean age of 37.9 years (SD: 15.3; range: 18–93). Mean BMI was 25.6 kg/m² (SD: 4.85), Food Practices Brazil Scale score was 41.0 (SD: 10.2), PSQI score was 7.45 (SD: 3.41), sleep efficiency was 82.3% (SD: 11.8), and MEQ score was 53 (SD: 10.9). Poor sleep quality (OR: 0.64; 95% CI: 0.42–0.98; p = 0.044), lower sleep efficiency (OR: 0.42; 95% CI: 0.21–0.83; p = 0.014), and vespertine chronotype (OR: 0.39; 95% CI: 0.22–0.67; p < 0.001) were associated with lower odds of belonging to the highest quartile of the Food Practices Brazil Scale (Q4 vs. Q1). Conversely, morning chronotype (OR: 1.77; 95% CI: 1.16–2.70; p = 0.007) and definitely morning chronotype (OR: 4.24; 95% CI: 1.63–11.00; p = 0.003) were associated with higher odds of belonging to Q4. We observed that poor sleep quality, lower sleep efficiency, and a vespertine chronotype were associated with less favorable food practices during the COVID-19 pandemic in Brazil.