Association of dietary phytochemical index with sleep quality, and inflammatory markers in adults with type 2 diabetes: a cross-sectional study
Abstract
Background Type 2 diabetes mellitus (T2DM) is associated with sleep disturbances, inflammation, and gut dysbiosis, potentially modifiable by diet. This study examined associations between the dietary phytochemical index (DPI), sleep quality, systemic inflammation, and oxidative stress markers in adults with T2DM. Methods In this cross-sectional study, 675 adults with T2DM (aged 35–75 years) were recruited. DPI was calculated from a validated Food Frequency Questionnaire. Objective sleep was assessed via BodyMedia SenseWear armband (duration, efficiency, latency, WASO); subjective sleep via Pittsburgh Sleep Quality Index (PSQI). Inflammatory markers (CRP, IL-6, TNF-α), oxidative stress (MDA, TAC, SOD), and hormones (melatonin, cortisol) were measured. Linear regression and mediation analyses were performed. Results Participants in the highest DPI quartile (Q4) had longer sleep duration (422.69 ± 20.01 vs. 367.47 ± 43.36 min, p < 0.001), shorter sleep latency (11.9 ± 2.47 vs. 19.1 ± 7.8 min, p < 0.001), lower wake-after-sleep-onset (39.44 ± 4.09 vs. 52.3 ± 9.64 min, p < 0.001), higher sleep efficiency (90.21 ± 3.14 vs. 84.83 ± 6.68%, p < 0.001), and lower PSQI scores (4.49 ± 1.1 vs. 6.81 ± 1.5, p < 0.001) compared with Q1. Inflammatory markers were lower in Q4: CRP (1.90 ± 0.40 vs. 3.60 ± 0.90 mg/L), IL-6 (3.28 ± 0.58 vs. 5.07 ± 1.02 pg./mL), and TNF-α (4.71 ± 0.55 vs. 6.59 ± 1.13 pg./mL, all p < 0.001). Higher DPI was also associated with more favorable oxidative stress…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 675 participants or records.
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