Habitual Short Sleep Duration, Diet, and Development of Type 2 Diabetes in Adults

Key Points Question Is there an association between adherence to healthy diet, sleep duration, and risk of developing type 2 diabetes (T2D) in adults? Findings This cohort study analyzing data from 247 867 adults in the UK Biobank found that individuals sleeping less than 6 hours daily had a notably higher risk of developing T2D compared with those with 7 to 8 hours of sleep. Despite the association between healthier diets and reduced T2D risk, the increased risk associated with short sleep duration persisted even among adults with healthy eating habits. Meaning These findings suggest that adopting a healthy diet may not reduce the risk of developing T2D among those with habitual short sleep duration.

1.53 [1.20-1.94] 1 during a median follow-up of 12.53 years 2 hazard ratios (HR) [95%-CI] derived from a COX regression analysis including the following categorical and continuous independent variables: daily sleep duration (four levels), age, sex, ethnicity, smoking status, frequency of weekly alcohol intake, antidepressant use, assessment center region, BMI, systolic blood pressure, socioeconomic status, educational level, Insomnia symptoms frequency, and physical activity level.

eTable 1 .
Cohort Characteristics Split by Sleep Duration Category eTable 2. Cohort Characteristics Split by Healthy Diet Score eTable 3. Association of Short Sleep Duration and Adherence to Consumption of Individual Food Groups With Incident Type 2 Diabetes Mellitus eTable 4. Association Between Short Sleep Duration and Incident Type 2 Diabetes Mellitus Stratified by Adherence to Consumption of Individual Food Groups eFigure 1. Final Sample Estimation eFigure 2. Association of Short Sleep Duration (Using 7-9 h of Daily Sleep as the Sleep Duration Reference Category) and Adherence to Healthy Diet With Incident Type 2 Diabetes Mellitus eFigure 3. Association Between Short Sleep Duration (Using 7-9 h of Daily Sleep as the Sleep Duration Reference Category) and Incident Type 2 Diabetes Mellitus Stratified by Diet Status eFigure 4. Association of Short Sleep Duration and Adherence to Healthy Diet With Incident Type 2 Diabetes Mellitus (Without First 5 Years T2DM Incidence) eFigure 5. Association Between Short Sleep Duration and Incident Type 2 Diabetes Mellitus Stratified by Diet Status (Without First 5 Years T2DM Incidence) eFigure 6. Association of Short Sleep Duration and Adherence to Healthy Diet With Incident Type 2 Diabetes Mellitus (Without Prediabetic Individuals) eFigure 7. Association Between Short Sleep Duration and Incident Type 2 Diabetes Mellitus Stratified by Diet Status (Without Prediabetic Individuals)

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2024 Nôga DA et al.JAMA Network Open.eFigure 1. Final Sample Estimation eFigure 2. Association of Short Sleep Duration (Using 7-9 h of Daily Sleep as the Sleep Duration Reference Category) and Adherence to Healthy Diet With Incident Type 2 Diabetes Mellitus (A) Unadjusted hazard ratios (HR) [95% CI] illustrating the link between sleep duration and incident type 2 diabetes mellitus (T2DM).(B) Unadjusted HR [95% CI] showcasing the relationship between healthy diet scores (HDS) and incident T2DM.(C) Adjusted HR [95% CI] presenting the association between sleep duration and incident T2DM.(D) Adjusted HR [95% CI] demonstrating the connection between HDS and incident T2DM.eFigure 3. Association Between Short Sleep Duration (Using 7-9 h of Daily Sleep as the Sleep Duration Reference Category) and Incident Type 2 Diabetes Mellitus Stratified by Diet Status.(A) Unadjusted Hazard Ratios HR [95% CI] illustrating the relationship between sleep duration and incident type 2 diabetes mellitus (T2DM) among participants with a T2DM-Non-Protective diet (B) Unadjusted HR [95% CI] illustrating the relationship between sleep duration and incident T2DM among participants with a T2DM-Protective diet.(C) Adjusted HR [95% CI] illustrating the relationship between sleep duration and incident T2DM among participants with a T2DM-Non-Protective diet.(D) Adjusted HR [95% CI] illustrating the relationship between sleep duration and incident T2DM among participants with a T2DM-Protective diet.

eFigure 4 .
Association of Short Sleep Duration and Adherence to Healthy Diet With Incident Type 2 Diabetes Mellitus (Without First 5 Years T2DM Incidence) (A) Unadjusted hazard ratios (HR) [95% CI] illustrating the link between sleep duration and incident type 2 diabetes mellitus (T2DM).(B) Unadjusted HR [95% CI] showcasing the relationship between healthy diet scores (HDS) and incident T2DM.(C) Adjusted HR [95% CI] presenting the association between sleep duration and incident T2DM.(D) Adjusted HR [95% CI] demonstrating the connection between HDS and incident T2DM.eFigure 5. Association Between Short Sleep Duration and Incident Type 2 Diabetes Mellitus Stratified by Diet Status (Without First 5 Years T2DM Incidence).(A) Unadjusted Hazard Ratios (HR) [95% CI] illustrating the relationship between sleep duration and incident type 2 diabetes mellitus (T2DM) among participants with a T2DM-Non-Protective diet (B) Unadjusted HR [95% CI] illustrating the relationship between sleep duration and incident T2DM among participants with a T2DM-Protective diet.(C) Adjusted HR [95% CI] illustrating the relationship between sleep duration and incident T2DM among participants with a T2DM-Non-Protective diet.(D) Adjusted HR [95% CI] illustrating the relationship between sleep duration and incident T2DM among participants with a T2DM-Protective diet.

eFigure 6 .
Association of Short Sleep Duration and Adherence to Healthy Diet With Incident Type 2 Diabetes Mellitus (Without Prediabetic Individuals).(A) Unadjusted hazard ratios (HR) [95% CI] illustrating the link between sleep duration and incident type 2 diabetes mellitus (T2DM).(B) Unadjusted HR [95% CI] showcasing the relationship between healthy diet scores (HDS) and incident T2DM.(C) Adjusted HR [95% CI] presenting the association between sleep duration and incident T2DM.(D) Adjusted HR [95% CI] demonstrating the connection between HDS and incident T2DM.

eFigure 7 .
Association Between Short Sleep Duration and Incident Type 2 Diabetes Mellitus Stratified by Diet Status (Without Prediabetic Individuals).(A) Unadjusted Hazard Ratios (HR) [95% CI] illustrating the relationship between sleep duration and incident type 2 diabetes mellitus (T2DM) among participants with a T2DM-Non-Protective diet (B) Unadjusted HR [95% CI] illustrating the relationship between sleep duration and incident T2DM among participants with a T2DM-Protective diet.(C) Adjusted HR [95% CI] illustrating the relationship between sleep duration and incident T2DM among participants with a T2DM-Non-Protective diet.(D) Adjusted HR [95% CI] illustrating the relationship between sleep duration and incident T2DM among participants with a T2DM-Protective diet.

Association of Short Sleep Duration and Adherence to Consumption of Individual Food Groups With Incident Type 2 Diabetes Mellitus
© 2024 Nôga DA et al.JAMA Network Open.eTable 4.

Association Between Short Sleep Duration and Incident Type 2 Diabetes Mellitus Stratified by Adherence to Consumption of Individual Food Groups
Sleep duration (hours/day) + Daily consumption of vegetables ≥ population median © 2024 Nôga DA et al.JAMA Network Open.