Sleep and Biological Rhythms

, Volume 17, Issue 1, pp 79–92 | Cite as

Evaluating the associations of consumption of non-red meat protein sources and flavor preferences on sleeping patterns among older adults in China

  • Yen-Han LeeEmail author
  • Yen-Chang ChangEmail author
  • Ching-Ti Liu
  • Mack Shelley
Original Article



Non-red meat protein provides essential nutrients to human beings with fewer health burdens. Nevertheless, little is known about the relationships of non-red meat protein sources and flavor preferences with sleeping patterns among the older adults and the oldest-old in China.


Using a nationally representative database, the Chinese Longitudinal Healthy Longevity Survey (n = 5241, with 2407 males and 2834 females), older adults’ quality of sleep, daily hours of sleep, and recommended range of sleeping duration (7 to 8 h daily) were studied. Food consumption behaviors included fish, eggs, milk and bean products, nuts, and flavor preferences. Sex-stratified multivariable logistic and ordinary least squares regression models were performed for statistical analyses.


Nearly 61% of older adults reported good quality of sleep, but only 39% slept within the recommended hours of sleep daily. In general, less frequent consumption of eggs was associated with lower odds of reporting good quality of sleep among both male and female older adults. Among male participants, monthly consumption of milk products was associated with lower odds of good quality of sleep (Adjusted odds ratio [AOR] = 0.60, 95% CI 0.41, 0.88; p < 0.01), compared with daily consumers. However, this relationship was not observed among female older adults. Fish consumption was not associated with any sleeping patterns for either sex.


Chinese public health practitioners and nutritionists should promote the best non-red meat protein options for improving better sleep. Further recommendations and research directions are discussed.


Non-red meat protein Older adults Quality of sleep Dietary behavior China 



We sincerely thank the valuable comments from anonymous reviewers and the editors to improve the quality of this manuscript. Data used for this research were provided by the Chinese Longitudinal Healthy Longevity Survey (CLHLS) managed by the Center for Healthy Aging and Development Studies, Peking University. CLHLS is supported by funds from the U.S. National Institutes on Aging (NIA), the China Natural Science Foundation, the China Social Science Foundation, and the United Nations Population Fund.

Compliance with ethical standards

Conflict of interest

The authors declare no competing interests for this research.


  1. 1.
    Cappuccio FP, D’Elia L, Strazzullo P, Miller MA. Quantity and quality of sleep and incidence of type 2 diabetes: a systematic review and meta-analysis. Diabetes Care. 2010;33(2):414–20.CrossRefGoogle Scholar
  2. 2.
    Cappuccio FP, Cooper D, Delia L, Strazzullo P, Miller MA. Sleep duration predicts cardiovascular outcomes: a systematic review and meta-analysis of prospective studies. Eur Heart J. 2011;32(12):1484–92.CrossRefGoogle Scholar
  3. 3.
    Wu Y, Zhai L, Zhang D. Sleep duration and obesity among adults: a meta-analysis of prospective studies. Sleep Med. 2014;15(12):1456–62.CrossRefGoogle Scholar
  4. 4.
    Dean DA, Wang R, Jacobs DR, Duprez D, Punjabi NM, Zee PC, Shea S, Watson L, Redline S, A systematic assessment of the association of polysomnographic indices with blood pressure: the multi-ethnic study of atherosclerosis (MESA). Sleep. 2015;38(4):587–96.CrossRefGoogle Scholar
  5. 5.
    Medic G, Wille M, Hemels ME. Short- and long-term health consequences of sleep disruption. Nat Sci Sleep. 2017;9:151–61.CrossRefGoogle Scholar
  6. 6.
    Tel H. Sleep quality and quality of life among the elderly people. Neurol Psychiatry Brain Res. 2013;19(1):48–52.CrossRefGoogle Scholar
  7. 7.
    National Sleep Foundation. Lack of sleep is affecting Americans, finds the National Sleep Foundation. Retrieved from (Accessed April 4, 2018).
  8. 8.
    Chaput JP. Sleep patterns, diet quality and energy balance. Physiol Behav. 2014;134:86–91.CrossRefGoogle Scholar
  9. 9.
    Hoefelmann LP, Lopes AS, da Silva KS, da Silva SG, Cabral LGA, Nahas MV. Lifestyle, self-reported morbidities, and poor sleep quality among Brazilian workers. Sleep Med. 2012;13(9):1198–201.CrossRefGoogle Scholar
  10. 10.
    Kruger AK, Reither EN, Peppard PE, Krueger PM, Hale L. Do sleep-deprived adolescents make less-healthy food choices? Br J Nutr. 2014;111(10):1898–904.CrossRefGoogle Scholar
  11. 11.
    Lin H, Tsai P, Fang S, Liu J. Effect of Kiwifruit consumption on sleep quality in adults with sleep problems. Asia Pac J Clin Nutr. 2011;20(2):169–74.Google Scholar
  12. 12.
    Howatson G, Bell PG, Tallent J, Middleton B, Mchugh MP, Ellis J. Effect of tart cherry juice (Prunus cerasus) on melatonin levels and enhanced sleep quality. Eur J Nutr. 2011;51(8):909–16.CrossRefGoogle Scholar
  13. 13.
    Yakoot M, Helmy S, Fawal K. Pilot study of the efficacy and safety of lettuce seed oil in patients with sleep disorders. Int J General Med. 2011;4:451–6.CrossRefGoogle Scholar
  14. 14.
    Zhou J, Kim JE, Campbell WW. Higher protein intake improves sleep and blood pressure, and influences the relation between changes in blood pressure and sleep during energy restriction in middle-aged overweight and obese adults. FASEB J. 2016; 30(1)415–6.Google Scholar
  15. 15.
    Zhang B, Zhai F, Du S, Popkin BM. The China Health and Nutrition Survey, 1989–2011. Obes Rev. 2014. Scholar
  16. 16.
    Zhai F, Du S, Wang Z, Zhang J, Du W, Popkin B. Dynamics of the Chinese Diet and the Role of Urbanicity, 1991–2011. Obes Rev. 2014. Scholar
  17. 17.
    Zheng X, Pang L, Chen G, Huang C, Liu L, Zhang L. Challenge of population aging on health. In: Islam MDN, (eds). Public health challenges in contemporary China. Berlin: Springer; 2016.Google Scholar
  18. 18.
    The Lancet. The best science for achieving Healthy China 2030. The Lancet. 2016;388(10054):1851.CrossRefGoogle Scholar
  19. 19.
    Haseli-Mashhadi N, Dadd T, Pan A, Yu Z, Lin X, Franco OH. Sleep quality in middle-aged and elderly Chinese: distribution, associated factors and associations with cardio-metabolic risk factors. BMC Public Health. 2009;9:130.CrossRefGoogle Scholar
  20. 20.
    Luo J, Zhu G, Zhao Q, et al. Prevalence and risk factors of poor sleep quality among Chinese elderly in an urban community: results from the Shanghai Aging Study. PLoS One 2013;8(11):e81261.CrossRefGoogle Scholar
  21. 21.
    Chiu HF, Leung T, Lam LC, Wing YK, Chung DW, Li SW, Chi I, Law WT, Boey KW. Sleep problems in Chinese elderly in Hong Kong. Sleep. 1999;22(6):717–26.CrossRefGoogle Scholar
  22. 22.
    Liu X, Liu L. Sleep habits and insomnia in a sample of elderly persons in China. Sleep. 2005;28(12):1579–87.Google Scholar
  23. 23.
    Marsh KA, Munn EA, Baines SK. Protein and vegetarian diets. Med J Australia. 2013;199(4 Suppl):7–10.Google Scholar
  24. 24.
    Song M, Fung TT, Hu FB, Willett WC, Longo V, Chan AT, Giovannucci EL. Animal and plant protein intake and all-cause and cause-specific mortality: results from two prospective US cohort studies. JAMA Internal Med. 2016;176(10):1453–63.CrossRefGoogle Scholar
  25. 25.
    Wasserman D, Mangels R. Simply Vegan. 5th ed. Baltimore: The Vegetarian Resource Group; 2012.Google Scholar
  26. 26.
    Palmer S. Plant proteins. Today’s Dietitian. 2017;19(2):26.Google Scholar
  27. 27.
    Sulochana KN, Punitham R, Ramakrishnan S. Beneficial effect of lysine and amino acids on cataractogenesis in experimental diabetes through possible antiglycation of lens proteins. Exp Eye Res. 1998;67(5):597–601.CrossRefGoogle Scholar
  28. 28.
    Garlick PJ. The nature of human hazards associated with excessive intake of amino acids. J Nut. 2004;134(6):1633S–1639S.CrossRefGoogle Scholar
  29. 29.
    Zhou J, Kim JE, Armstrong CL, Chen N, Campbell WW. Higher-protein diets improve indexes of sleep in energy-restricted overweight and obese adults: results from 2 randomized controlled trials. Am J Clin Nut. 2016;103(3):766–74.CrossRefGoogle Scholar
  30. 30.
    Liu J, Cui Y, Li L, Wu L, Hanlon A, Pinto-Martin J, Raine A, Hibbeln JR. The mediating role of sleep in the fish consumption—cognitive functioning relationship: a cohort study. Sci Rep. 2017;7(1):17961.CrossRefGoogle Scholar
  31. 31.
    Zeng Y. Towards deeper research and better policy for healthy aging—using the unique data of Chinese Longitudinal Healthy Longevity Survey. China Econ J. 2012;5(2–3):131–49.CrossRefGoogle Scholar
  32. 32.
    Center for Disease Control and Prevention. How much sleep do I need? Retrieved from (Accessed April 3, 2018).
  33. 33.
    Gu D, Sautter J, Pipkin R, Zeng Y. Sociodemographic and health correlates of sleep quality and duration among very old Chinese. Sleep. 2010;33(5):601–10.CrossRefGoogle Scholar
  34. 34.
    Schmidt C, Peigneux P, Cajochen C. Age-related changes in sleep and circadian rhythms: impact on cognitive performance and underlying neuroanatomical networks. Front Neurol. 2012;3:118.CrossRefGoogle Scholar
  35. 35.
    Blomhoff R, Carlsen MH, Andersen LF, Jacobs DR. Health benefits of nuts: potential role of antioxidants. Br J Nut. 2006; 96(S2):S52–60.CrossRefGoogle Scholar
  36. 36.
    Ros E. Health benefits of nut consumption. Nutrients. 2010;2(7):652–82.CrossRefGoogle Scholar
  37. 37.
    Vadivel V, Kunyanga CN, Biesalski HK. Health benefits of nut consumption with special reference to body weight control. Nutrition. 2012;28(11–12):1089–97.CrossRefGoogle Scholar
  38. 38.
    Aune D, Keum N, Giovannucci E, Fadnes LT, Boffetta P, Greenwood DC, Tonstad S, Vatten LJ, Riboli E, Norat T. Nut consumption and risk of cardiovascular disease, total cancer, all-cause and cause-specific mortality: a systematic review and dose-response meta-analysis of prospective studies. BMC Med. 2016;14:207.CrossRefGoogle Scholar
  39. 39.
    Bakker-Zierikzee A, Smits MG. Sleep improving effects of milk. Retrieved from (Accessed Apr 2, 2018).
  40. 40.
    Muehlhoff E, Bennett A, McMahon D. Milk and dairy products in human nutrition. Retrieved from (Accessed Apr 3, 2018).
  41. 41.
    Thorning TK, Raben A, Tholstrup T, Soedamah-Muthu SS, Givens I, Astrup A. Milk and dairy products: good or bad for human health? An assessment of the totality of scientific evidence. Food Nut Res. 2016. Scholar
  42. 42.
    Lindseth G, Helland B, Caspers J. The effects of dietary tryptophan on affective disorders. Arch Psychiatr Nurs. 2015;29(2):102–7.CrossRefGoogle Scholar
  43. 43.
    Manso HEC, Filho HCM, de Carvalho LE, Kutschenko M, Nogueira ET, Watford M. Glutamine and glutamate supplementation raise milk glutamine concentrations in lactating gilts. J Anim Sci Biotechnol. 2012;3(1):2.CrossRefGoogle Scholar
  44. 44.
    Aminoacid-studies. Amino acids and their significance for sleep, mood and performance. Retrieved from (Accessed September 21, 2018).
  45. 45.
    Nimalaratne C, Wu J. Hen egg as an antioxidant food commodity: a review. Nutrients. 2015;7(10):8274–93.CrossRefGoogle Scholar
  46. 46.
    Lin H, Tsai P, Fang S, Liu J. Effect of kiwifruit consumption on sleep quality in adults with sleep problems. Asia Pac J Clin Nut. 2011;20(2):169–74.Google Scholar
  47. 47.
    Hu FB, Stampfer MJ, Rimm EB, Manson JE, Ascherio A, Colditz GA, Rosner BA, Spiegelman D, Speizer FE, Sacks FM, Hennekens CH, Willet WC. A prospective study of egg consumption and risk of cardiovascular disease in men and women. JAMA. 1999;281(15):1387–94.CrossRefGoogle Scholar
  48. 48.
    Shin JY, Xun P, Nakamura Y, He K. Egg consumption in relation to risk of cardiovascular disease and diabetes: a systematic review and meta-analysis. Am J Clin Nut. 2013;98(1):146–59.CrossRefGoogle Scholar
  49. 49.
    Djoussé L, Gaziano JM. Egg consumption and risk of heart failure in the physicians’ health study. Circulation. 2008;117(4):512–6.CrossRefGoogle Scholar
  50. 50.
    Lv W, Finlayson G, Dando R. Sleep, food cravings and taste. Appetite. 2018;125:210–6.CrossRefGoogle Scholar
  51. 51.
    Knüppel A, Shipley MJ, Llewellyn CH, Brunner EJ. Sugar intake from sweet food and beverages, common mental disorder and depression: prospective findings from the Whitehall II study. Sci Rep. 2017; 7(1):6287.CrossRefGoogle Scholar
  52. 52.
    Schlosser AE. The sweet taste of gratitude: feeling grateful increases choice and consumption of sweets. J Consum Psychol. 2015;25(4):561–76.CrossRefGoogle Scholar
  53. 53.
    Meier BP, Noll SW, Molokwu OJ. The sweet life: the effect of mindful chocolate consumption on mood. Appetite. 2017;108:21–7.CrossRefGoogle Scholar
  54. 54.
    Blades M. Food and happiness. Nut Food Sci. 2009;39(4):449–54.CrossRefGoogle Scholar
  55. 55.
    Fukunaga A, Uematsu H, Sugimoto K. Influences of aging on taste perception and oral somatic sensation. J Gerontol Ser A. 2005;60(1):109–13.CrossRefGoogle Scholar
  56. 56.
    Fiocco AJ, Shatenstein B, Ferland G, Payette H, Belleville S, Kergoat M-J, et al. Sodium intake and physical activity impact cognitive maintenance in older adults: the NuAge Study. Neurobiol Aging. 2012;33(4):829. E21-8.CrossRefGoogle Scholar
  57. 57.
    Lee YH, Chang YC, Lee YT, Shelley M, Liu CT. Dietary patterns with fresh fruits and vegetables consumption and quality of sleep among older adults in mainland China. Sleep Biol Rhythms. 2018;16(3):293–305.CrossRefGoogle Scholar

Copyright information

© Japanese Society of Sleep Research 2018

Authors and Affiliations

  1. 1.Indiana University School of Public HealthBloomingtonUSA
  2. 2.National Tsing Hua UniversityTaiwanRepublic of China
  3. 3.Boston University School of Public HealthBostonUSA
  4. 4.Iowa State UniversityAmesUSA

Personalised recommendations