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A Systematic Review of the Bidirectional Association Between Consumption of Ultra-processed Food and Sleep Parameters Among Adults

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Abstract

Purpose of Review

We summarized research on the bidirectional association between intake of ultra-processed food (UPF) and sleep.

Recent Findings

Sleep contributes to cardiometabolic health in part via food intake patterns. Restricting sleep increases intakes of high-carbohydrate/high-fat foods, a profile representative of UPF.

Summary

This systematic review covers the association of UPF intake, as an exposure or an outcome, and sleep. UPF was defined as NOVA Group 4. MEDLINE and EMBASE were searched through April 2023 for epidemiological studies with general-population adult samples. Fifteen studies met the inclusion criteria; all were cross-sectional, published between 2016 and 2023, with samples from Brazil (n = 8), Spain (n = 2), Italy (n = 1), the UK (n = 1), Paraguay (n = 1), Iran (n = 1) and China (n = 1). Thirteen studies examined UPF intake as the exposure whereas two tested UPF intake as the outcome. UPF intakes were determined using food frequency questionnaires (73%) or 24-h recalls (27%). Two studies assessed sleep via accelerometry; the remaining studies relied on self-reports of sleep quality, duration, anxiety-induced insomnia, and napping, with 60% using a single question. The average methodological quality across the studies was deemed “fair”. Six of the 13 studies that examined UPF consumption as the exposure revealed inverse associations with sleep outcomes in adjusted (n = 5) or bivariate (n = 1) analyses. Both studies addressing UPF consumption as the outcome and sleep as the exposure showed significant inverse associations. Evidence for UPF-sleep associations is accumulating, although sleep assessment limitations are apparent. This review can provide impetus for research using comprehensive and validated sleep measures and nudge policymakers towards refining dietary guidelines worldwide.

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Abbreviations

BMI:

Body mass index

CI:

Confidence interval

CVD:

Cardiovascular diseases

FFQ:

Food Frequency Questionnaire

NIH:

National Institutes of Health

OR:

Odds ratio

PR:

Prevalence ratio

PSQI:

Pittsburgh Sleep Quality Index

T2D:

Type 2 diabetes

UPF:

Ultra-processed food (and beverages)

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Acknowledgments

This research was funded in part by the National Heart, Lung, and Blood Institute Award # R35HL155670. J.P.-J. was funded by the Spanish Ministry of Universities (mobility program for senior researchers) and by the Fulbright Commission.

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Authors and Affiliations

  1. Nutritional Epidemiology Research Group, INSERM U1153/INRAE U1125/CNAM, Epidemiology and Statistics Research Center (CRESS), Sorbonne Paris Nord University, 93017, Bobigny, France

    Valentina A. Andreeva

  2. Institute of Food Science, Technology and Nutrition, Spanish Research Council (ICTAN-CSIC), 28040, Madrid, Spain

    Jara Perez-Jimenez

  3. Division of General Medicine and Center of Excellence for Sleep & Circadian Research, Department of Medicine, Columbia University, New York, NY, 10032, USA

    Valentina A. Andreeva, Jara Perez-Jimenez & Marie-Pierre St-Onge

  4. CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), ISCIII, 28029, Madrid, Spain

    Jara Perez-Jimenez

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M-P S-O conceived the idea for the review article and provided theoretical and methodological guidance; VAA and J P-J evaluated the methodological quality of the reviewed studies; VAA performed the literature search and led the writing; all authors critically revised the work.

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Correspondence to Marie-Pierre St-Onge.

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Andreeva, V.A., Perez-Jimenez, J. & St-Onge, MP. A Systematic Review of the Bidirectional Association Between Consumption of Ultra-processed Food and Sleep Parameters Among Adults. Curr Obes Rep 12, 439–452 (2023). https://doi.org/10.1007/s13679-023-00512-5

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