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Sleep, diet, and cardiometabolic health investigations
A systematic review of analytic strategies
Jansen, E. C., Dunietz, G. L., Tsimpanouli, M-E., Guyer, H. M., Shannon, C., Hershner, S. D., O'Brien, L. M., & Baylin, A. (2018). Sleep, diet, and cardiometabolic health investigations: A systematic review of analytic strategies. Current Nutrition Reports, 7(4), 235-258. https://doi.org/10.1007/s13668-018-0240-3
PURPOSE OF REVIEW: Poor sleep is a risk factor for cardiometabolic morbidity. The relationship of sleep and cardiometabolic health could be confounded, mediated, or modified by diet, yet the incorporation of diet in sleep-cardiometabolic health studies is inconsistent. This rapid systematic literature review evaluates the conceptualization of diet as a confounder, mediator, or effect modifier within sleep-cardiometabolic health investigations, and the statistical approaches utilized.
RECENT FINDINGS: Of 4692 studies identified, 60 were retained (28 adult, 32 pediatric). Most studies included diet patterns, quality, or energy intake as confounders, while a few examined these dietary variables as mediators or effect modifiers. There was some evidence, mostly in pediatric studies, that inclusion of diet altered sleep-cardiometabolic health associations. Diet plays a diverse role within sleep-cardiometabolic health associations. Investigators should carefully consider the conceptualization of diet variables in these relationships and utilize contemporary statistical approaches when applicable.
