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Adherence to the Mediterranean lifestyle is inversely associated with insomnia presence and severity: cross-sectional analysis in obstructive sleep apnea patients
- Ioanna Kechribari, Meropi Kontogianni, Michael Georgoulis, Kallirroi Lamprou, Antonia Kalogera, Emmanouil Vagiakis, Nikos Yiannakouris
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- Journal:
- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E555
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Insomnia is the most prevalent sleep disorder and frequently co-occurs with obstructive sleep apnea (OSA), a chronic disease characterized by repetitive pauses of breathing during sleep due to obstructions of the upper airways. The link between lifestyle and sleep quantity and quality is an area of intensive research, however data exploring associations between lifestyle habits and insomnia symptoms are still scarce. The aim of the present study was to investigate the potential association between the level of adherence to the Mediterranean lifestyle (ML), a healthy lifestyle pattern incorporating the prudent Mediterranean diet, adequate physical activity and healthy sleep habits, and insomnia presence and severity. The study sample consisted of 243 adult patients with polysomnography-diagnosed OSA. Participants’ insomnia-related disorders were evaluated through the Athens Insomnia Scale (AIS), an 8-item index ranging from 0 (absence of any sleep-related problem) to 24 (severe degree of insomnia); AIS values of > 6 were used to establish the diagnosis of insomnia. All patients were evaluated with regard to anthropometric indices and lifestyle habits, and adherence to the ML was estimated through the MEDLIFE index, a 28-item index ranging from 0 to 28, with higher values indicating greater proximity to the healthy lifestyle of the Mediterranean region. An inverse correlation was observed between the MEDLIFE index and total AIS (rho = -0.22, p = 0.001), as well as most individual components of AIS, including difficulty in sleep induction (rho = -0.14, p = 0.03), awakenings during the night (rho = -0.2, p = 0.008), short sleep duration (rho = -0.16, p = 0.01), low quality of sleep (rho = -0.13, p = 0.05), low well-being during the day (rho = -0.16, p = 0.02), and low functioning capacity during the day (rho = -0.15, p = 0.02). Patients with insomnia (AIS > 6), compared to those without (AIS ≤ 6), exhibited lower MEDLIFE index values [13 (11–15) vs. 14 (12–15), P = 0.002], had more severe OSA as assessed by the apnea-hypopnea index (AHI) [55 (24–87) vs. 35 (17–57) events/hour, P < 0.001] and tended to have higher body mass index (BMI) [35.0 (30.6–39.7) vs. 32.4 (29.5–38.6) kg/m2, P = 0.06]. According to logistic regression analysis, MEDLIFE index was inversely associated with the presence of insomnia (OR: 0.89, 95%CI: 0.80–0.99, P = 0.04) after adjustment for age, sex, smoking, BMI, daily energy intake and AHI. In conclusion, a higher adherence to the ML is inversely associated with insomnia presence and severity in patients with obstructive sleep apnea. Future research should assess whether this association applies in other samples, as well as whether the ML could be an efficient therapeutic tool alleviating or treating insomnia symptoms.
The association between preconception fruit and vegetable intake in relation to in-vitro fertilization treatment outcome among women attempting fertility
- Dimitrios Karayiannis, Meropi Kontogianni, Minas Mastrominas, Nikos Yiannakouris
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- Journal:
- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E584
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AbstractIntroduction
Adequate intake of fruits and vegetables (F&V) has been long promoted as a public health priority based on the evidence supporting various health benefits attributed to these food groups. Their effects on reproductive outcomes, however, remain poorly explored. F&V intake has been positively associated with embryo quality in women undergoing in-vitro fertilization (IVF) but there is lack of data regarding potential associations with IVF final outcomes (clinical pregnancy and live birth). Thus, the aim of this study was to evaluate habitual F&V intake in relation to clinical pregnancy and live birth among women undergoing infertility treatment.
Materials and MethodsNulliparous non-obese women [n = 244, 22–41 years old, body mass index (BMI) < 30 kg/m2] undergoing their first IVF cycle were recruited from an Assisted Conception Unit in Athens, Greece, between November 2013 and September 2016. Habitual F&V intake was estimated via a validated for the Greek population semi-quantitative food-frequency questionnaire and expressed in servings/day. Intermediate outcomes (i.e. oocyte yield and embryo quality measures) and clinical endpoints (implantation, clinical pregnancy and live birth) were prospectively recorded. Generalized linear models adjusting for age, ovarian stimulation protocol, BMI, physical activity, anxiety levels, infertility diagnosis, caloric intake and supplements use were used to test associations between F&V intake and IVF outcomes.
ResultsOverall, 229 women (93.9%) had an embryo transfer, 104 (42.6%) achieved a clinical pregnancy and 99 (40.5%) had a live birth. Women with a clinical pregnancy and live birth did not differ in age, BMI, smoking habits, physical activity or stress levels, compared to those who did not achieve pregnancy (all P > 0.05). Compared to women with IVF failure, those achieving clinical pregnancy and live birth reported consuming more fruits (median values: 1.77 vs. 1.49 servings/day and 1.77 vs. 1.41 servings/day, respectively) and more vegetables (1.79 vs. 1.37 servings/day and 1.89 vs. 1.36 servings/day, respectively), all P < 0.05. No significant association between F&V intake and IVF intermediate outcomes was recorded. The multivariable-adjusted relative risk (95% confidence interval) for clinical pregnancy for increasing intake of fruit and vegetable (servings/day, continuous) was 1.23 (1.06–1.44) and 1.25 (1.02–1.57), respectively, and for live birth it was 1.29 (1.10–1.51) and 1.36 (1.10–1.71), respectively.
DiscussionHigher pre-treatment F&V was related to higher probability of clinical pregnancy and live birth among women undergoing IVF. These results highlight the importance of dietary influences on fertility and suggest the need for additional research on the effects of F&V intake on reproductive endpoints in women conceiving through infertility treatments.