Poor Sleep Habits Tied to Diabetes Risk, Even with Healthy Dietary Habits

A new study is underlining the importance of sleep health in preventing chronic disease, with results indicating optimal diet may not be enough to counteract the negative impact of suboptimal sleep habits on risk of type 2 diabetes.

Results of the study, which was an analysis of data from participants within the UK Biobank cohort dating back to 2006, suggest those getting 5 hours of sleep per night and those getting 3-4 hours of sleep per night experienced 16% and 41% increases in relative risk of type 2 diabetes, respectively, compared to their counterparts getting 7-8 hours of sleep per night in covariate-adjusted analyses.¹

“Previous research has shown that repeated short daily rest increases the risk of type 2 diabetes, while healthy dietary habits such as regularly eating fruit and vegetables can reduce the risk. However, it has remained unclear whether people who sleep too little can reduce their risk of developing type 2 diabetes by eating healthily,” said Diana Noga, PhD, a sleep researcher in the Department of Pharmaceutical Biosciences at Uppsala University.²

Since the turn of the century, and even in the years predating 2000, the role of sleep health in overall wellbeing, among populations with and without chronic disease, has grown in recognition. As cited by investigators of the current study, research has begun to emerge linking suboptimal sleep duration and sleep health to increased risk in incidence of multiple metabolic illnesses. As the prevalence of diabetes continues to rise across the globe, a more thorough understanding of mitigation and prevention strategies could have a substantial impact on public health systems.^1,2

With this in mind, Noga and colleagues designed the current study with the intent of estimating long-term associations between sleep as well as dietary habits and type 2 diabetes risk among adult patients from within the UK Biobank cohort. From the UK Biobank, investigators obtained information related to a cohort of 247,867 individuals for inclusion in the current analysis.¹

For the purpose of analysis, patients were categorized into 4 sleep duration groups defined as normal (7-8 hours per day), mild short (6 hours per day), moderate short (5 hours per day), and extreme short (3-4 hours per day). Additionally, dietary habits were categorized based on population-specific consumption of red meat, processed meat, fruits, vegetables, and fish, with healthy diet scores ranging from 0 (unhealthiest) to 5 (healthiest).¹

The study cohort had a mean age of 55.9 (Standard Deviation [SD], 8.1) years, 52.3% were female, and 3.2% went on to receive a diagnosis of type 2 diabetes during a median follow-up of 12.5 (Interquartile Range [IQR] 11.8-13.2) years. Investigators pointed out 75.5% reported normal sleep duration, 19.8% reported mild short sleep duration, 3.9% reported moderate short sleep duration, and 0.8% reported extreme short sleep duration. Investigators also noted 1.5% had a healthy diet score of 0, 7.4% scored 1, 17.6% scored 2, 27.5% scored 3, 29.0% scored 4, and 17.0% scored 5.¹

Upon analysis, results indicated those with 5 or fewer hours of daily sleep were at a significantly increased risk of developing type 2 diabetes, with sleeping 5 hours per day associated with a 16% increase in relative risk (adjusted Hazard Ratio [HR] 1.16; 95% Confidence Interval [CI], 1.05-1.28) and sleeping 3 to 4 hours per day was associated with a 41% increase (aHR, 1.41; 95% CI, 1.19-1.68) compared with individuals with normal sleep duration. When assessing associations with dietary score, results indicate those with a healthy diet score of 5 had a 25% relative reduction in risk of type 2 diabetes (HR, 0.75; 95% CI, 0.63-0.88; P <.001) compared to those with the least healthy dietary patterns.¹

Investigators highlighted a lack of multiplicative interaction between sleep duration and the healthy diet score observed in the study, with these observations made in both the unadjusted (HR [95% CI ] range, 0.83-3.02 [0.30-7.20]; P =.48) or adjusted (HR [95%CI] range, 0.93-3.49 [0.39-8.34]; P =.38) analyses.¹

“Our results are the first to question whether a healthy diet can compensate for lack of sleep in terms of the risk of type 2 diabetes. They should not cause concern, but instead be seen as a reminder that sleep plays an important role in health,” explained lead investigator Christian Benedict, associate professor and sleep researcher at the Department of Pharmaceutical Biosciences at Uppsala University.²

References:

1. _{^{Nôga DA, de Mello e Souza Meth E, Pacheco AP, et al. Habitual Short Sleep Duration, Diet, and Development of Type 2 Diabetes in Adults. JAMA Network Open. Published online March 05, 2024. doi:10.1001/jamanetworkopen.2024.1147.}}
2. _{^{Uppsala University. Too little sleep raises risk of type 2 diabetes. EurekAlert! Accessed March 05, 2024. Published March 05, 2024. https://www.eurekalert.org/news-releases/1036450}}