Journal of the Academy of Nutrition and Dietetics最新文献

Background: Late sleep timing and sleep irregularity are associated with an increased risk of diabetes, and high diet quality is associated with a lower risk of diabetes. However, the associations of sleep timing and regularity with diabetes, as well as the potential interactions of diet quality with these associations, are unclear.

Objective: The aims of the study were to examine the associations of sleep timing and sleep regularity with diabetes and to examine whether sleep timing and sleep regularity interact with diet quality in relation to diabetes.

Design: This was a cross-sectional analysis of data from the National Health and Nutrition Examination Survey 2017-March 2020.

Participants: US adults 20 years or older who responded to questions regarding sleep health and completed at least 1 valid 24-hour diet recall were included in the analysis (n = 7270).

Main outcome measures: Diabetes was defined as having received a diagnosis of diabetes from a physician or health care professional; glycated hemoglobin ≥6.5%; fasting blood glucose ≥126 mg/dL (to convert to mmol/L, multiply by 0.0555); and taking insulin or oral medication for diabetes.

Statistical analyses: Survey-multivariable logistic regression models were used to estimate the associations of sleep timing, sleep regularity, and their interactions with diet quality and diabetes.

Results: A total of 1494 participants (15.3%) were identified as having diabetes. Late chronotype (odds ratio [OR] 1.45; 95% CI, 1.12 to 1.87; Bonferroni corrected P = .02) and social jet lag of >0.5 hours (OR 1.44; 95% CI, 1.10 to 1.87; Bonferroni corrected P = .03) were associated with higher ORs of diabetes. Interactions were observed for diet quality with social jet lag (P for interaction = .02) on diabetes. Among participants with social jet lag of >0.5 hour, medium (OR 0.62; 95% CI, 0.41 to 0.92) and high diet quality (OR 0.63; 95% CI, 0.43 to 0.94) were associated with lower ORs of diabetes compared with low diet quality.

Conclusions: Later chronotype and more severe social jet lag were associated with higher ORs of diabetes. Higher diet quality may attenuate the adverse association of social jet lag with diabetes.

Background: Household food insecurity is a major public health concern that disproportionately burdens mothers. Infants may be especially vulnerable to its negative impacts, given the central role mothers play in their feeding. Mothers' insights on infant complementary feeding while experiencing household food insecurity are needed to expand on previous research focused on breastfeeding.

Objective: The aim of the study was to explore the experiences of New Zealand mothers introducing complementary foods to their infants in the context of household food insecurity.

Design: This qualitative study involved in-person, semi-structured interviews (conducted in 2022) with participants from the First Foods New Zealand study (conducted in 2020-2022), focusing on mothers' infant feeding experiences and particularly complementary feeding.

Participants/setting: Participants were mothers (n = 15) living in Dunedin (New Zealand) who had been identified as experiencing moderate or severe household food insecurity when their infant was aged 7 to 10 months.

Analysis: Thematic analysis of transcripts was performed using a reflexive thematic analysis approach.

Results: Three main themes and 1 subtheme were generated: (1) Food purchasing strategies were used to stretch money; (2) the infant's nutrition was prioritized (subtheme: breast milk was perceived to support the infant's nutrition); and (3) support was appreciated, but seeking money or food often brought a sense of shame and disempowerment.

Conclusions: Mothers prioritized feeding their infants by stretching limited resources, compromising their own diets, and seeking support despite considerable challenges. Their determination and skill in feeding their infants nutritiously highlight the extensive labor involved in infant feeding and food provision in the context of household food insecurity. However, these efforts also contributed to ongoing cognitive and emotional strain for the mothers themselves.