Association between macronutrient intake and excessive daytime sleepiness: An Iso-caloric substitution analysis from the north west adelaide health study

Research output: Contribution to journalArticle

Abstract

Epidemiological evidence on the association between macronutrient intake and excessive daytime sleepiness (EDS) is scarce. Using data from the North West Adelaide Health Study, we aimed to determine the association between iso-caloric substitution of macronutrients and EDS. Data from 1997 adults aged ≥ 24 years were analyzed. Daytime sleepiness was measured using the Epworth Sleepiness Scale, a score ≥ 11 was considered EDS. Dietary intake data were collected using a food frequency questionnaire. We determined absolute and relative energy intake based on consumption of saturated and unsaturated fats, protein, and carbohydrate. Odds ratios (ORs) were used to determine the associations using log-binomial logistic regression with and without isocaloric substitution methods, and models were adjusted for confounders. The prevalence of EDS in the sample was 10.6%. After adjusting for potential confounders, substituting 5% energy intake from protein with an equal amount of saturated fat (OR = 1.57; 95% CI: 1.00–2.45) and carbohydrate (OR = 1.23; 95% CI: 0.92–1.65) increased the odds of EDS. When carbohydrate was substituted with saturated fat (OR = 1.27; 95% CI: 0.93–1.59), the odds of EDS were increased. The odds of EDS were lower when saturated fat was substituted with unsaturated fat (OR = 0.74; 95% CI: 0.51–1.06), protein (OR = 0.63; 95% CI: 0.41–0.99) or carbohydrate (OR = 0.79; 95% CI: 0.57–1.08). While these results were consistent over different iso-caloric substitution methods, inconsistent results were found with standard regression. While substitution of fat and carbohydrate with protein was inversely associated with EDS, substitution of protein with fat and carbohydrate was positively associated with EDS. Randomized trials are needed to confirm if dietary interventions can be used to improve daytime alertness in those with EDS.

LanguageEnglish
Article number2374
JournalNutrients
Volume11
Issue number10
DOIs
Publication statusPublished - 1 Oct 2019

Keywords

  • Carbohydrate
  • Excessive daytime sleepiness
  • Fat
  • Protein
  • Saturated fat
  • Sleepiness
  • Substitution analysis
  • Unsaturated fat

ASJC Scopus subject areas

  • Food Science
  • Nutrition and Dietetics

Cite this

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title = "Association between macronutrient intake and excessive daytime sleepiness: An Iso-caloric substitution analysis from the north west adelaide health study",
abstract = "Epidemiological evidence on the association between macronutrient intake and excessive daytime sleepiness (EDS) is scarce. Using data from the North West Adelaide Health Study, we aimed to determine the association between iso-caloric substitution of macronutrients and EDS. Data from 1997 adults aged ≥ 24 years were analyzed. Daytime sleepiness was measured using the Epworth Sleepiness Scale, a score ≥ 11 was considered EDS. Dietary intake data were collected using a food frequency questionnaire. We determined absolute and relative energy intake based on consumption of saturated and unsaturated fats, protein, and carbohydrate. Odds ratios (ORs) were used to determine the associations using log-binomial logistic regression with and without isocaloric substitution methods, and models were adjusted for confounders. The prevalence of EDS in the sample was 10.6{\%}. After adjusting for potential confounders, substituting 5{\%} energy intake from protein with an equal amount of saturated fat (OR = 1.57; 95{\%} CI: 1.00–2.45) and carbohydrate (OR = 1.23; 95{\%} CI: 0.92–1.65) increased the odds of EDS. When carbohydrate was substituted with saturated fat (OR = 1.27; 95{\%} CI: 0.93–1.59), the odds of EDS were increased. The odds of EDS were lower when saturated fat was substituted with unsaturated fat (OR = 0.74; 95{\%} CI: 0.51–1.06), protein (OR = 0.63; 95{\%} CI: 0.41–0.99) or carbohydrate (OR = 0.79; 95{\%} CI: 0.57–1.08). While these results were consistent over different iso-caloric substitution methods, inconsistent results were found with standard regression. While substitution of fat and carbohydrate with protein was inversely associated with EDS, substitution of protein with fat and carbohydrate was positively associated with EDS. Randomized trials are needed to confirm if dietary interventions can be used to improve daytime alertness in those with EDS.",
keywords = "Carbohydrate, Excessive daytime sleepiness, Fat, Protein, Saturated fat, Sleepiness, Substitution analysis, Unsaturated fat",
author = "Yohannes Melaku and Reynolds, {Amy C.} and Tiffany Gill and Sarah Appleton and Robert Adams",
year = "2019",
month = "10",
day = "1",
doi = "10.3390/nu11102374",
language = "English",
volume = "11",
journal = "Nutrients",
issn = "2072-6643",
publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",
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T1 - Association between macronutrient intake and excessive daytime sleepiness

T2 - Nutrients

AU - Melaku, Yohannes

AU - Reynolds, Amy C.

AU - Gill, Tiffany

AU - Appleton, Sarah

AU - Adams, Robert

PY - 2019/10/1

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N2 - Epidemiological evidence on the association between macronutrient intake and excessive daytime sleepiness (EDS) is scarce. Using data from the North West Adelaide Health Study, we aimed to determine the association between iso-caloric substitution of macronutrients and EDS. Data from 1997 adults aged ≥ 24 years were analyzed. Daytime sleepiness was measured using the Epworth Sleepiness Scale, a score ≥ 11 was considered EDS. Dietary intake data were collected using a food frequency questionnaire. We determined absolute and relative energy intake based on consumption of saturated and unsaturated fats, protein, and carbohydrate. Odds ratios (ORs) were used to determine the associations using log-binomial logistic regression with and without isocaloric substitution methods, and models were adjusted for confounders. The prevalence of EDS in the sample was 10.6%. After adjusting for potential confounders, substituting 5% energy intake from protein with an equal amount of saturated fat (OR = 1.57; 95% CI: 1.00–2.45) and carbohydrate (OR = 1.23; 95% CI: 0.92–1.65) increased the odds of EDS. When carbohydrate was substituted with saturated fat (OR = 1.27; 95% CI: 0.93–1.59), the odds of EDS were increased. The odds of EDS were lower when saturated fat was substituted with unsaturated fat (OR = 0.74; 95% CI: 0.51–1.06), protein (OR = 0.63; 95% CI: 0.41–0.99) or carbohydrate (OR = 0.79; 95% CI: 0.57–1.08). While these results were consistent over different iso-caloric substitution methods, inconsistent results were found with standard regression. While substitution of fat and carbohydrate with protein was inversely associated with EDS, substitution of protein with fat and carbohydrate was positively associated with EDS. Randomized trials are needed to confirm if dietary interventions can be used to improve daytime alertness in those with EDS.

AB - Epidemiological evidence on the association between macronutrient intake and excessive daytime sleepiness (EDS) is scarce. Using data from the North West Adelaide Health Study, we aimed to determine the association between iso-caloric substitution of macronutrients and EDS. Data from 1997 adults aged ≥ 24 years were analyzed. Daytime sleepiness was measured using the Epworth Sleepiness Scale, a score ≥ 11 was considered EDS. Dietary intake data were collected using a food frequency questionnaire. We determined absolute and relative energy intake based on consumption of saturated and unsaturated fats, protein, and carbohydrate. Odds ratios (ORs) were used to determine the associations using log-binomial logistic regression with and without isocaloric substitution methods, and models were adjusted for confounders. The prevalence of EDS in the sample was 10.6%. After adjusting for potential confounders, substituting 5% energy intake from protein with an equal amount of saturated fat (OR = 1.57; 95% CI: 1.00–2.45) and carbohydrate (OR = 1.23; 95% CI: 0.92–1.65) increased the odds of EDS. When carbohydrate was substituted with saturated fat (OR = 1.27; 95% CI: 0.93–1.59), the odds of EDS were increased. The odds of EDS were lower when saturated fat was substituted with unsaturated fat (OR = 0.74; 95% CI: 0.51–1.06), protein (OR = 0.63; 95% CI: 0.41–0.99) or carbohydrate (OR = 0.79; 95% CI: 0.57–1.08). While these results were consistent over different iso-caloric substitution methods, inconsistent results were found with standard regression. While substitution of fat and carbohydrate with protein was inversely associated with EDS, substitution of protein with fat and carbohydrate was positively associated with EDS. Randomized trials are needed to confirm if dietary interventions can be used to improve daytime alertness in those with EDS.

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KW - Fat

KW - Protein

KW - Saturated fat

KW - Sleepiness

KW - Substitution analysis

KW - Unsaturated fat

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