Maternal and Child Health Journal

, Volume 20, Issue 9, pp 1869–1877 | Cite as

Sleep Duration and Diet Quality Among Women Within 5 Years of Childbirth in the United States: A Cross-Sectional Study

  • Rui S. Xiao
  • Tiffany A. Moore Simas
  • Sherry L. Pagoto
  • Sharina D. Person
  • Milagros C. Rosal
  • Molly E. Waring


Objective Only 9 % of women with young children consume a high quality diet. The association between sleep duration and health may be U-shaped. We examined diet quality in relation to sleep duration among US women within 5 years of childbirth. Methods Data were from non-pregnant women aged 20–44 years within 5 years of childbirth who completed two 24-h dietary recalls (N = 896) in the National Health and Nutrition Examination Survey 2005–2012. Self-reported weekday/workday sleep duration was categorized as short (≤6 h), adequate (7–8 h), or long (≥9 h). The Healthy Eating Index (HEI-2010, range 0–100) estimated overall and components of diet quality. Multivariable-adjusted linear regression models estimated the association between sleep duration and diet quality, adjusting for age, race/ethnicity, and education. Results Thirty-four percent of women reported short, 57.1 % adequate, and 8.6 % long sleep duration. The average diet quality total score was 47.4 out of 100. Short sleep duration was not associated with diet quality. Long sleep duration was associated with lower quality diet (β = −4.3; 95 % CI −8.1 to −0.4), lower consumption of total fruit (β = −0.7; 95 % CI −1.3 to −0.1), whole fruit (β = −0.9; 95 % CI −1.6 to −0.2), and total protein (β = −0.7; 95 % CI −1.3 to −0.03), and higher consumption of empty calories (β = 2.2; 95 % CI −4.3 to −0.1). Conclusions for practice Future studies should examine the longitudinal association between sleep duration and diet quality among women following childbirth and whether interventions to improve sleep can enhance diet quality.


Sleep duration Diet quality Women Childbearing 



Support provided by NIH Grants UL1TR000161 (RSX), K24HL124366 (SLP), CDC award 1U01DP006093-01 (TMS), KL2TR000160 (MEW), and 1U01HL105268 (MEW).


  1. 1.
    Wirt, A., & Collins, C. E. (2009). Diet quality–What is it and does it matter? Public Health Nutrition, 12(12), 2473–2492. doi:10.1017/S136898000900531X.CrossRefPubMedGoogle Scholar
  2. 2.
    McCullough, M. L., Feskanich, D., Stampfer, M. J., et al. (2002). Diet quality and major chronic disease risk in men and women: Moving toward improved dietary guidance. American Journal of Clinical Nutrition, 76(6), 1261–1271.PubMedGoogle Scholar
  3. 3.
    Wolongevicz, D. M., Zhu, L., Pencina, M. J., et al. (2013). Diet quality and obesity in women: The Framingham Nutrition Studies. British Journal of Nutrition, 103(8), 1223–1229. doi:10.1017/S0007114509992893.Diet.Google Scholar
  4. 4.
    Kant, A. K., Leitzmann, M. F., Park, Y., Hollenbeck, A., & Schatzkin, A. (2009). Patterns of recommended dietary behaviors predict subsequent risk of mortality in a large cohort of men and women in the United States. Journal of Nutrition, 139, 1374–1380. doi:10.3945/jn.109.104505.reported.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Ye, E. Q., Chacko, S. A., Chou, E. L., Kugizaki, M., & Liu, S. (2012). Greater whole-grain intake is associated with lower risk of type 2 diabetes, cardiovascular disease, and weight gain. Journal of Nutrition, 142(7), 1304–1313. doi:10.3945/jn.111.155325.both.CrossRefPubMedGoogle Scholar
  6. 6.
    Carter, P., Gray, L. J., Troughton, J., Khunti, K., & Davies, M. J. (2010). Fruit and vegetable intake and incidence of type 2 diabetes mellitus: Systematic review and meta-analysis. British Medical Journal, 341, c4229. doi:10.1136/bmj.c4229.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Hu, F. B., Stampfer, M. J., Rimm, E. B., et al. (1999). Dietary fat and coronary heart disease: A comparison of approaches for adjusting for total energy intake and modeling repeated dietary measurements. American Journal of Epidemiology, 149(6), 531–540.CrossRefPubMedGoogle Scholar
  8. 8.
    Aburto, N. J., Ziolkovska, A., Hooper, L., Elliott, P., Cappuccio, F. P., & Meerpohl, J. J. (2013). Effect of lower sodium intake on health: Systematic review and meta-analyses. British Medical Journal, 346(April), f1326. doi:10.1136/bmj.f1326.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Hu, F. B., & Malik, V. S. (2010). Sugar-sweetened beverages and risk of obesity and type 2 diabetes: Epidemiologic evidence. Physiology & Behavior, 100(1), 47–54. doi:10.1016/j.physbeh.2010.01.036.CrossRefGoogle Scholar
  10. 10.
    Patrick, H., & Nicklas, T. A. (2005). A review of family and social determinants of children’s eating patterns and diet quality. Journal of the American College of Nutrition, 24(2), 83–92. doi:10.1080/07315724.2005.10719448.CrossRefPubMedGoogle Scholar
  11. 11.
    Laster, L. E. R., Lovelady, C. A., West, D. G., et al. (2013). Diet quality of overweight and obese mothers and their preschool children. Journal of the Academy of Nutrition and Dietetics, 113(11), 1476–1483. doi:10.1016/j.jand.2013.05.018.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Kim, S., DeRoo, L. A., & Sandler, D. P. (2011). Eating patterns and nutritional characteristics associated with sleep duration. Public Health Nutrition, 14(5), 889–895. doi:10.1017/S136898001000296X.CrossRefPubMedGoogle Scholar
  13. 13.
    National Sleep Foundation. (2004). Sleep in America poll summary of findings. Washington, DC: National Sleep Foundation.Google Scholar
  14. 14.
    Haghighatdoost, F., Karimi, G., Esmaillzadeh, A., & Azadbakht, L. (2012). Sleep deprivation is associated with lower diet quality indices and higher rate of general and central obesity among young female students in Iran. Nutrition, 28(11–12), 1146–1150. doi:10.1016/j.nut.2012.04.015.CrossRefPubMedGoogle Scholar
  15. 15.
    Kant, A. K., & Graubard, B. I. (2014). Association of self-reported sleep duration with eating behaviors of American adults: NHANES 2005–2010. American Journal of Clinical Nutrition, 2014, 938–947. doi:10.3945/ajcn.114.085191.938.CrossRefGoogle Scholar
  16. 16.
    Curtin, L. R., Mohadjer, L. K., Dohrmann, S. M., et al. (2012). The National Health and Nutrition Examination Survey: Sample design, 1999–2006. Vital Health Statistics, 2(155), 1–39.Google Scholar
  17. 17.
    Johnson, C. L., Dohrmann, S. M., Burt, V. L., & Mohadjer, L. K. (2014). National health and nutrition examination survey: Sample design, 2011–2014. Vital Health Statistics, 2(162), 1–33.Google Scholar
  18. 18.
    Guenther, P. M., Kirkpatrick, S. I., Reedy, J., et al. (2014). The healthy eating index-2010 is a valid and reliable measure of diet quality according to the 2010 dietary guidelines for Americans. Journal of Nutrition. doi:10.3945/jn.113.183079.PubMedPubMedCentralGoogle Scholar
  19. 19.
    Yawn, B. P., Pace, W., Wollan, P. C., et al. (2009). Concordance of Edinburgh Postnatal Depression Scale (EPDS) and Patient Health Questionnaire (PHQ-9) to assess increased risk of depression among postpartum women. The Journal of the American Board of Family Medicine, 22(5), 483–491. doi:10.3122/jabfm.2009.05.080155.CrossRefPubMedGoogle Scholar
  20. 20.
    Office of Disease Prevention and Health Promotion. (2012). Sleep health|healthy people 2020. Scholar
  21. 21.
    Dørheim, S. K., Bondevik, G. T., Eberhard-Gran, M., & Bjorvatn, B. (2009). Sleep and depression in postpartum women: A population-based study. Sleep, 32(7), 847–855.PubMedPubMedCentralGoogle Scholar
  22. 22.
    Grandner, M. A., Jackson, N., Gerstner, J. R., & Knutson, K. L. (2013). Dietary nutrients associated with short and long sleep duration. Data from a nationally representative sample. Appetite, 64, 71–80. doi:10.1016/j.appet.2013.01.004.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Stern, J. H., Grant, A. S., Thomson, C. A., et al. (2014). Short sleep duration is associated with decreased serum leptin, increased energy intake and decreased diet quality in postmenopausal women. Obesity, 22(5), E55–E61. doi:10.1002/oby.20683.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Boothe, A. S., Brouwer, R. J. N., Carter-Edwards, L., Ostbye, T., & Østbye, T. (2011). Unmet social support for healthy behaviors among overweight and obese postpartum women: Results from the active mothers postpartum study. Journal of Women’s Health, 20(11), 1677–1685. doi:10.1089/jwh.2010.2509.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Lee, S.-Y., & Hsu, H.-C. (2012). Stress and health-related well-being among mothers with a low birth weight infant: The role of sleep. Social Science and Medicine, 74(7), 958–965. doi:10.1016/j.socscimed.2011.12.030.Stress.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    George, G. C., Milani, T. J., Hanss-Nuss, H., & Freeland-Graves, J. H. (2005). Compliance with dietary guidelines and relationship to psychosocial factors in low-income women in late postpartum. Journal of the American Dietetic Association, 105(6), 916–926. doi:10.1016/j.jada.2005.03.009.CrossRefPubMedGoogle Scholar
  27. 27.
    Cappuccio, F. P., D’Elia, L., Strazzullo, P., & Miller, M. A. (2010). Quantity and quality of sleep and incidence of type 2 diabetes: A systematic review and meta-analysis. Diabetes Care, 33(2), 414–420. doi:10.2337/dc09-1124.CrossRefPubMedGoogle Scholar
  28. 28.
    Cappuccio, F. P., D’Elia, L., Strazzullo, P., & Miller, M. A. (2010). Sleep duration and all-cause mortality: A systematic review and meta-analysis of prospective studies. Sleep, 33(5), 585–592.PubMedPubMedCentralGoogle Scholar
  29. 29.
    Hunter, L. P., Rychnovsky, J. D., & Yount, S. M. (2009). A selective review of maternal sleep characteristics in the postpartum period. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 38(1), 60–68. doi:10.1111/j.1552-6909.2008.00309.x.CrossRefGoogle Scholar
  30. 30.
    Xiao, R. S., Simas, T. A. M., Person, S. D., Goldberg, R. J., & Waring, M. E. (2015). Diet quality and history of gestational diabetes mellitus among childbearing women, United States, 2007–2010. Preventing Chronic Disease, 12(25), 1–9.Google Scholar
  31. 31.
    Mitchell, D. C., Lawrence, F. R., Hartman, T. J., & Curran, J. M. (2009). Consumption of dry beans, peas, and lentils could improve diet quality in the US population. Journal of the American Dietetic Association, 109(5), 909–913. doi:10.1016/j.jada.2009.02.029.CrossRefPubMedGoogle Scholar
  32. 32.
    Ma, Y., Olendzki, B. C., Wang, J., et al. (2015). Single-component versus multicomponent dietary goals for the metabolic syndrome. Annals of Internal Medicine, 162, 248. doi:10.7326/M14-0611.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    van Ansem, W. J. C., van Lenthe, F. J., Schrijvers, C. T. M., Rodenburg, G., & van de Mheen, D. (2014). Socio-economic inequalities in children’s snack consumption and sugar-sweetened beverage consumption: The contribution of home environmental factors. British Journal of Nutrition, 112(3), 467–476. doi:10.1017/S0007114514001007.CrossRefPubMedGoogle Scholar
  34. 34.
    Ma, Y., Olendzki, B. C., Pagoto, S. L., et al. (2009). Number of 24-hour diet recalls needed to estimate energy intake. Annals of Epidemiology, 19(8), 553–559. doi:10.1016/j.annepidem.2009.04.010.Number.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Lauderdale, D. S., Knutson, K. L., Yan, L. L., Liu, K., & Rathouz, P. J. (2008). Self-reported and measured sleep duration: How similar are they? Epidemiology., 19, 838–845. doi:10.1097/EDE.0b013e318187a7b0.CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    United States Department of Agriculture. (2016). Nutrition needs while breastfeeding.
  37. 37.
    United States Department of Agriculture. (2015). Health and nutrition information.
  38. 38.
    United States Department of Agriculture. (2015). Myplate kid’s place.

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Rui S. Xiao
    • 1
  • Tiffany A. Moore Simas
    • 2
    • 3
  • Sherry L. Pagoto
    • 4
  • Sharina D. Person
    • 1
  • Milagros C. Rosal
    • 4
  • Molly E. Waring
    • 1
    • 2
  1. 1.Department of Quantitative Health SciencesUniversity of Massachusetts Medical SchoolWorcesterUSA
  2. 2.Department of Obstetrics and Gynecology, UMass Memorial Health CareUniversity of Massachusetts Medical SchoolWorcesterUSA
  3. 3.Department of PediatricsUniversity of Massachusetts Medical SchoolWorcesterUSA
  4. 4.Division of Behavioral and Preventive Medicine, Department of MedicineUniversity of Massachusetts Medical SchoolWorcesterUSA

Personalised recommendations