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 Table of Contents  
ORIGINAL RESEARCH
Year : 2021  |  Volume : 9  |  Issue : 1  |  Page : 17-21

Sleep quality and processed food consumption among female college students


Department of Nutrition and Dietetics, Mount Carmel College, Bengaluru, Karnataka, India

Date of Submission23-Dec-2020
Date of Acceptance02-Jun-2021
Date of Web Publication24-Nov-2021

Correspondence Address:
Mitravinda Aneesh
Department of Nutrition and Dietetics, Mount Carmel College, Palace Road, Vasanth Nagar, Bengaluru - 560 052, Karnataka.
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/dypj.DYPJ_13_20

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  Abstract 

Background: Shorter sleep duration and processed food intake have been associated with higher body mass index and increased risk to metabolic syndrome. We conducted a cross-sectional study to find the association between processed food intake and sleep quality. Materials and Methods: We recruited 100 female college students aged 18–24 years. Height, weight, and waist circumference were measured. We used Pittsburgh Sleep Quality Index to assess sleep quality. Processed food intake was estimated by using a semiquantitative food frequency questionnaire. Results: Half of the students had poor sleep quality. One-fourth of the students slept for more than 7 h/day. Fast food intake was associated poorer sleep quality and higher daytime dysfunction (P < 0.05). Consumption of high sugar foods was associated with the shorter duration of sleep (P < 0.05). Conclusion: This study suggests that the quality of food can potentially influence the quality of sleep.

Keywords: College students, high sugar foods, processed food, Pittsburgh Sleep Quality Index, sleep quality


How to cite this article:
Aneesh M, Chaganty A. Sleep quality and processed food consumption among female college students. D Y Patil J Health Sci 2021;9:17-21

How to cite this URL:
Aneesh M, Chaganty A. Sleep quality and processed food consumption among female college students. D Y Patil J Health Sci [serial online] 2021 [cited 2021 Nov 27];9:17-21. Available from: http://www.dypatiljhs.com/text.asp?2021/9/1/17/331107




  Introduction Top


Lack of optimum sleep quality is a growing concern among the youth. The National Sleep Foundation[1] and the American Academy of Sleep Medicine and Sleep Research Society[2] recommend more than 7 h of sleep per day for adults above 18 years of age. Urban lifestyle, stress, hectic work-life, and emotional issues can adversely influence the duration and quality of sleep. Sleep-related problems not only affect the concentration and productivity at work but also health. Studies have reported an association between shorter sleep duration and increased body mass index (BMI) in children and adults.[3],[4],[5],[6],[7],[8] Further, sleep duration was also seen to be negatively associated with waist circumference,[3],[7],[8] HbA1c and C-reactive protein levels, and positively with serum high-density lipoprotein concentration.[7]

Few studies have explored the relationship between dietary pattern and sleep. Shorter sleep duration was associated with higher energy intake in children[4],[9] and reduced intake of vegetable and fruits in adolescents.[10] High carbohydrate consumption and the timing of consumption have been associated with sleep.[11] Shorter sleep duration was seen to be associated with higher consumption of energy-dense and fast foods in adolescents.[9],[10]

The transition from late adolescence to early adulthood is a critical period of life. This period witnesses a rather complex interplay between academics, personal relationships, financial concerns, and ambitions. Students pursuing higher education tend to spend considerable amount of time outside their homes. This can potentially influence their lifestyle including eating habits, physical activity, and sleep. Eating out and consumption of processed foods are likely to increase during this period. There is little literature to support any relationship between processed food consumption and sleep. Much of the literature has focused on the relationship between sleep and body weight status. Observational studies have thrown some light on the influence of sleep on food intake.[4],[9-11] Considering this, the present study was conducted to study the relation between processed food consumption and sleep quality in particular, if processed food intake had any influence on sleep.


  Materials and Methods Top


The present study was a cross-sectional study. The study was conducted among 100 female college students of Mount Carmel College, Bengaluru, India. Female students aged between 18 and 24 years were eligible to participate in the study. The students were selected through convenience sampling method. The students were informed about the purpose of the study and nature of data required from them. A verbal informed consent was obtained from them before data collection.

General information including the age, stream of study, and place of stay was gathered. Anthropometry-anthropometric measurements such as height and weight were measured using standard methods.[12] Height was measured using a stadiometer (Model: Seca 213). Weight was measured using SC-240 TANITA Total Body Composition Analyzer. We measured the body composition of the participants as well. However, body composition variables are not being discussed in this study. Waist circumference was measured using a flexible and nonstretchable measuring tape.[13]


  Processed Food Consumption Top


We used a semiquantitative food frequency questionnaire (FFQ) to study the consumption of processed foods along with sugar and fats/oils. A total of 70 processed foods were included in the FFQ. The foods were categorized in the following groups – ready-to-eat (RTE), ready-to-cook (RTC), fast foods/street foods, sweets, spreads, aerated beverages, and nonaerated beverages (juices, buttermilk, milkshakes, tea, coffee, etc.,). In addition to this, consumption of sugars (honey, sugar, jaggery) and fats/oil (plant-based oils, butter, clarified butter, hydrogenated fat) was also recorded. The frequency of consumption was recorded as daily, weekly, fortnightly, rarely (once or twice in a month), and never. The participants were asked about the portion size of each food consumed. Standard measures (cups and spoons) were shown so that uniform responses regarding the portion sizes could be recorded. The frequency of consumption along with the portion sizes was converted into servings consumed per week. From the above-mentioned food categories, we grouped 15 foods rich in simple sugars in a separate group called high sugar foods. Likewise, 22 foods rich in salt or sodium were grouped into high sodium foods category.


  Sleep Quality Top


The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality and sleep disturbances of the participants.[14] The tool consisted of 19 self-related and 5 questions rated by the roommate/bed partner (if they have one) which collect information regarding sleeping habits of individuals in the past month. The tool assessed seven components, namely subjective sleep quality, sleep latency (time taken to fall asleep in the past month), duration of sleep, efficiency of sleep, disturbances, use of sleep medication, and daytime dysfunction. A global score of more than five indicated that the individual had moderate problems in at least three areas of sleep or had severe problems in at least two areas of sleep. A global score of more than 21 indicated that the individual is having severe sleep difficulties. A global PSQI score >5 yielded a diagnostic sensitivity of 89.6% and specificity of 86.5% (κ =0.75, P < 0.001) in distinguishing good and poor sleepers.[14]

Statistics

Data were analyzed using IBM SPSS version 20(IBM SPSS version 20.0 (Armonk, NY: IBM Corp). Shapiro–Wilk test was used to measure the normality of the variables. Processed food intake (servings/week) and PSQI were not normally distributed. Mean ± standard deviation and median were computed for the quantitative variables. Mann–Whitney U-test was carried out to see the difference in the consumption of processed foods between participants with PSQI score above and below five. We conducted bivariate logistic regression to find the factors that predict poor sleep quality. The predictor variables considered were servings per week of RTE, RTC, fast foods, aerated beverages, nonaerated beverages, sweets, sugar, and fat. The model was controlled for BMI and waist circumference.


  Results Top


Overall, 100 female students aged between 18 and 24 years participated in this study. The mean age of the participants was 21.33 ± 1.39 years. Nearly half of the participants (49%) were students of nutrition, whereas almost one-fourth (23%) of them were studying biological sciences. The remaining 28% belonged to humanities, languages, and commerce stream. Majority of the participants (48%) had moved to the city for higher studies and were residing away from their families in rented accommodation.

The mean BMI of the participants was 23.66 ± 4.90 kg/m2. Forty percent of the students had normal BMI while 35% were obese and 11% were overweight. The remaining 14% were classified as underweight. The mean waist circumference of the participants was 77.07 ± 10.81 cm. Sixty-four percent students had normal waist circumference while 36% of them had a waist circumference >80 cm.

The percent consumption along with mean consumption of the processed foods is been presented in [Table 1]. Among the processed foods, the most popular food among the participants was RTE followed by nonaerated beverages, fast foods, RTC, spreads, and aerated beverages. In addition to this, we grouped foods high in simple sugar and sodium. We found that nearly all the participants reported consumption of high sugar and high sodium foods. The median consumption of RTE and nonaerated beverages were higher than the other food categories. The median values suggested that the participants consumed at least two servings of RTE and a serving of nonaerated beverage daily. Likewise, it can be seen that the participants consumed at least two servings each of high sugar foods and high sodium foods daily.
Table 1: Percent and mean±standard deviation consumption of processed foods by the college students

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The mean overall PSQI was 5.83 ± 5.50. In all, half the participants had poor sleep quality, i.e., PSQI >5. PSQI has seven components – subjective sleep quality, sleep latency (time taken to fall asleep in the past month), duration of sleep, efficiency of sleep, disturbances, use of sleep medication, and daytime dysfunction. The distribution of the participants in the categories of the above-mentioned components has been presented in [Table 2]. Majority of the participants rated their sleep quality as “fairly good” and had a sleep efficiency of over 85%. Ninety percent of the participants did not report usage of sleep medicines. However, only one-fourth of the students slept for more than 7 h a day.
Table 2: Responses of the college students to the various components of Pittsburgh Sleep Quality Index

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We compared the anthropometric parameters and processed food consumption of participants with “good” and “poor” sleep quality [Table 3]. There were no differences in the mean BMI and waist circumference of the good sleepers and poor sleepers. The median servings per week of RTE, RTC, fast foods, and nonaerated beverages consumed by the participants with poor quality sleep were higher than those with good quality sleep. However, the difference was significant only for fast foods. The participants with poor quality sleep reported higher consumption of high sugar and high sodium foods than those with good sleep. However, these differences were not significant.
Table 3: Mean ± SD of anthropometric parameters and median servings/week of the processed foods in Pittsburgh Sleep Quality Index categories

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We conducted bivariate logistic regression to find the independent variables which predict sleep quality [Table 4]. After controlling for BMI and waist circumference, we found that increased consumption of fast foods/street foods was significantly associated with poor sleep quality (PSQI >5) and increased daytime dysfunction (P < 0.05). Likewise, increased consumption of high sugar foods was significantly associated with a sleep duration of <7 h/day (P < 0.05).
Table 4: Bivariate logistic regression of processed foods with overall Pittsburgh Sleep Quality Index, duration of sleep, and daytime dysfunction

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  Discussion Top


In this study, half the college students experienced poor sleep quality. We found that higher intake of fast foods was associated with poorer sleep quality and increased daytime dysfunction. Furthermore, higher intake of sugar-containing foods was seen to be related to shorter duration of sleep. This suggests that processed foods can influence sleep quality and duration of sleep in young college students.

Half the participants reported poor sleep quality, i.e., they had moderate problems in at least three areas of sleep or had severe problems in at least two areas of sleep. Majority (76%) of the participants slept for <7 h at night. One-fourth of the study participants considered daytime dysfunction as a problem. These findings are comparable with those reported by Vergas et al.[5] in college students.

In our study, higher intake of fast foods/street foods was associated with poorer sleep quality and increased daytime dysfunction. The fast foods consumed by the participants were mostly deep fried and made of refined flour. Many vendors commonly use hydrogenated fat or other oils rich in saturated fatty acids (SFA). These fats/oils tend to be cheaper than the ones rich in monounsaturated fatty acids (MUFA) and/or polyunsaturated fatty acids (PUFA). Furthermore, higher content of SFA improves the shelf life of the food cooked in it. An experimental study conducted by St-Onge et al.[15] found that high saturated fats decreased the duration of slow-wave sleep (SWS) or nonrapid eye movement Stage 3 of sleep. Likewise, Katagiri et al.[16] found that in a cross-sectional study, Japanese female workers who reported higher consumption of confectionaries and noodles had poorer sleep quality after adjusting for age, BMI, employment, smoking, alcohol, and depression score. Poor sleep quality can negatively affect the functioning during daytime especially during activities that require concentration such as driving, studying, work, and several others.

We also found that high sugar foods were associated with shorter sleep duration. Experimental studies conducted in healthy men who were put on high carbohydrate low-fat and low carbohydrate high-fat diet support this.[17],[18] Both these trials reported that a high carbohydrate diet decreased the SWS. In both these trials, reduction in SWS was seen in the first stage of sleep. It was suggested that increased oxidation of carbohydrate suppressed the SWS.[18] The quality of carbohydrates also seems to play a role. Simple sugars and nonfiber carbohydrates were seen to be associated with higher wake bouts during sleep.[15]

A number of studies have reported association between BMI and sleep duration.[5],[6],[7],[8] In the present study, nearly half the students were overweight/obese. Over one-third of the students were centrally obese. Over three-fourth of the students slept for less than the recommended duration. Despite this, we did not find any difference in the BMI of the “good sleepers” and the “poor sleepers.” The mean BMI (>7 h – 22.3 ± 4.1 kg/m2 and <7 h – 24.1 ± 5.1 kg/m2) of the participants who slept <7 h was higher than those who slept for more than 7 h. However, this difference was not statistically significant (P = 0.141). On the other hand, mean waist circumference of the participants who slept <7 h was higher than those who slept for more than 7 h (>7 h – 73.7 ± 8.0, <7 h – 78.1 ± 11.4, P = 0.043). Similar findings regarding waist circumference were reported in children[3] and adults.[7] Nevertheless, when we included waist circumference in the model for logistic regression, no association was seen with duration of sleep. This may be due to the small sample size.

A major limitation of this study is the small sample size. Another drawback is that we could not include male participants in our study. Finally, this is an observational study and we cannot draw causal relations between processed food intake and sleep. The existing clinical trials have their own limitations. This indicates the need for robust, well-designed randomized controlled trials to explore the causal relation between food and sleep.


  Conclusion Top


The present study suggests that fast foods can negatively influence sleep quality and daytime dysfunction. Furthermore, high sugar foods can negatively influence sleep duration. In the long term, high processed food intake and poor quality of sleep can be detrimental for the overall health and quality of life.

Acknowledgment

We thank Department of Biostatistics, NIMHANS for helping us with the statistical analysis.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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Hirshkowitz M, Whiton K, Albert SM, Alessi C, Bruni O, DonCarlos L, et al National Sleep Foundation‚s updated sleep duration recommendations: Final report. Sleep Health 2015;1:233-43.  Back to cited text no. 1
    
2.
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Firouzi S, Poh BK, Ismail MN, Sadeghilar A. Sleep habits, food intake, and physical activity levels in normal and overweight and obese Malaysian children. Obes Res Clin Pract 2014;8:e70-8.  Back to cited text no. 3
    
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Vargas PA, Flores M, Robles E. Sleep quality and body mass index in college students: The role of sleep disturbances. J Am Coll Health 2014;62:534-41.  Back to cited text no. 5
    
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Potter GD, Cade JE, Hardie LJ. Longer sleep is associated with lower BMI and favorable metabolic profiles in UK adults: Findings from the National Diet and Nutrition Survey. PLoS One 2017;12:e0182195.  Back to cited text no. 7
    
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Golley RK, Maher CA, Matricciani L, Olds TS. Sleep duration or bedtime? Exploring the association between sleep timing behaviour, diet and BMI in children and adolescents. Int J Obes (Lond) 2013;37:546-51.  Back to cited text no. 9
    
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Kruger AK, Reither EN, Peppard PE, Krueger PM, Hale L. Do sleep-deprived adolescents make less-healthy food choices? Br J Nutr 2014;111:1898-904.  Back to cited text no. 10
    
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Hunsberger M, Mehlig K, Börnhorst C, Hebestreit A, Moreno L, Veidebaum T, et al Dietary carbohydrate and nocturnal sleep duration in relation to children‚s BMI: Findings from the IDEFICS study in eight European countries. Nutrients 2015;7:10223-36.  Back to cited text no. 11
    
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Fidanza F, Keller W. Anthropometric methodology. In: Fidanza F, editor. Nutritional Status Assessment: A Manual for Population Studies. London: Chapman and Hall; 1991. p. 6-11.  Back to cited text no. 12
    
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World Health Organization. Waist circumference and waist-hip ratio: Report of a WHO Expert Consultation, Geneva, 8-11 December 2008. Geneva: World Health Organization; 2011.  Back to cited text no. 13
    
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Katagiri R, Asakura K, Kobayashi S, Suga H, Sasaki S. Low intake of vegetables, high intake of confectionary, and unhealthy eating habits are associated with poor sleep quality among middle-aged female Japanese workers. J Occup Health 2014;56:359-68.  Back to cited text no. 16
    
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Phillips F, Chen CN, Crisp AH, Koval J, McGuinness B, Kalucy RS, et al Isocaloric diet changes and electroencephalographic sleep. Lancet 1975;2:723-5.  Back to cited text no. 17
    
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Yajima K, Seya T, Iwayama K, Hibi M, Hari S, Nakashima Y, et al Effects of nutrient composition of dinner on sleep architecture and energy metabolism during sleep. J Nutr Sci Vitaminol (Tokyo) 2014;60:114-21.  Back to cited text no. 18
    



 
 
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  [Table 1], [Table 2], [Table 3], [Table 4]



 

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