Insufficient sleep duration is a recognized determinant of cardiometabolic disease, with poor diet quality as a likely intermediate. Yet, inconsistencies in findings on sleep duration and diet quality among adult populations remain, particularly regarding a potential non-linear relationship. Thus, within a nationally representative survey of US adults (2011-2016 National Health and Nutrition Survey), we evaluated cross-sectional associations between sleep duration and diet quality. Self-reported typical sleep duration was categorized into four groups (≤5 h per night, 6 h, 7-8 h, and ≥9 h per night). Diet was assessed with two 24-h recalls (averaged), and diet quality was measured with the Healthy Eating Index-2015 (score range 0-100), which is comprised of 13 dietary components. Regression analyses that accounted for complex survey weights were used to compute multivariable-adjusted models of sleep duration categories and HEI-2015 overall scores, and individual HEI components. Within this nationally-representative sample of adults ≥18 years, 10% reported 5 or fewer hours of sleep, and 20% reported 6 h, while 12% obtained ≥9 h (long sleep duration). Compared to adults with 7-8 h of sleep, those with ≤5 h had 1.7 lower multivariable-adjusted HEI-2015 score (95% CI 0.6, 2.7), and those with ≥9 h had 1.2 lower adjusted HEI-2015 score (95% CI 0.2, 2.2). Upon examination of individual HEI-2015 components, short sleepers had lower consumption of healthier components (total fruits, whole fruits, total vegetables, greens and bean, whole grains, dairy, total protein, and seafood), while long sleepers had higher consumption of some unhealthier components (refined grains and added sugar) as well as some healthier components (dairy and total protein). In conclusion, within a nationally-representative US survey, a reverse U-shaped association was observed between sleep duration and dietary quality.

中文翻译：

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睡眠时间和饮食质量之间的关联：来自美国成年人的全国代表性调查的结果

睡眠时间不足是公认的心脏代谢疾病的决定因素，饮食质量差可能是中间原因。然而，成年人群中睡眠时间和饮食质量的研究结果仍然不一致，特别是在潜在的非线性关系方面。因此，在美国成年人的全国代表性调查（2011-2016 年全国健康和营养调查）中，我们评估了睡眠时间和饮食质量之间的横断面关联。自我报告的典型睡眠时间分为四组（每晚≤5小时、每晚6小时、7-8小时和每晚≥9小时）。饮食通过两次 24 小时回忆（平均）进行评估，饮食质量通过健康饮食指数 - 2015（得分范围 0-100）进行衡量，该指数由 13 种饮食成分组成。考虑到复杂调查权重的回归分析用于计算睡眠持续时间类别和 HEI-2015 总分的多变量调整模型，以及单个 HEI 组件。在这个 18 岁以上成人的全国代表性样本中，10% 的人报告睡眠时间为 5 小时或更少，20% 的人报告睡眠时间为 6 小时，而 12% 的人睡眠时间≥9 小时（睡眠时间长）。与睡眠时间为 7-8 小时的成年人相比，睡眠时间≤5 小时的多变量调整后 HEI-2015 得分低 1.7（95% CI 0.6，2.7），睡眠时间≥9 小时的多变量调整后 HEI-2015 得分低 1.2（ 95% 置信区间 0.2, 2.2)。在检查单个 HEI-2015 成分后，短睡眠者对健康成分（总水果、全水果、总蔬菜、蔬菜和豆类、全谷物、乳制品、总蛋白质和海鲜）的消耗较低，而长睡眠者会更多地摄入一些不健康的成分（精制谷物和添加糖）以及一些更健康的成分（乳制品和总蛋白质）。总之，在一项具有全国代表性的美国调查中，观察到睡眠时间和饮食质量之间呈倒 U 形关联。