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. 2023 Dec 20;16(1):12.
doi: 10.3390/nu16010012.

Mediterranean Diet and Cardiovascular Disease: The Moderating Role of Adequate Sleep-Results from the ATTICA Cohort Study (2002-2022)

Evangelia Damigou  1 , Christina Chrysohoou  2 , Christina Vafia  1 , Fotios Barkas  3 , Evrydiki Kravvariti  4 , Elpiniki Vlachopoulou  1 , Konstantina Kyrili  4 , Costas Tsioufis  2 , Christos Pitsavos  2 , Evangelos Liberopoulos  4 , Petros P Sfikakis  4 , Demosthenes Panagiotakos  1
Affiliations

Mediterranean Diet and Cardiovascular Disease: The Moderating Role of Adequate Sleep-Results from the ATTICA Cohort Study (2002-2022)

Evangelia Damigou et al. Nutrients. .

Abstract

The relationship between diet, sleep duration and cardiovascular disease (CVD) has not been well understood. The aim of the present study was to test the potential modifying role of sleep duration in the association between adherence to the Mediterranean-type diet (MD) and CVD risk. The study consisted of n = 313 initially free-of-CVD adults, from the ATTICA cohort study (2002-2022), with available information on sleep habits. Sleep habits were categorized as inadequate and adequate sleep duration (< or ≥7 h/day, respectively). In multi-adjusted analysis, MD adherence was inversely associated with CVD risk [Hazard Ratio-HR per 1/55 in MedDietScore: 0.80, 95% Confidence Interval-CI: 0.65, 0.98]. A significant interaction between sleep duration and MedDietScore was observed (p < 0.001). In subgroup analysis, the protective association between MD adherence and CVD risk was found only in participants who slept adequately, i.e., >7 h/day [HR:0.80, 95%CI: 0.65, 0.98]. Those who had a high adherence to the MD along with adequate sleep habits, had a 70% reduced 20-year CVD risk [HR:0.30, 95%CI: 0.11, 0.80], compared to those who had a low MD adherence and inadequate sleep habits. Sleep duration should be a part of an individual's lifestyle, together with dietary and other habits, to effectively evaluate CVD risk for future events.

Keywords: Mediterranean diet; Mediterranean dietary pattern; adequate sleep; cardiovascular disease; diet; sleep.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow-chart of the study sample during 2002–2022 (n = 313). Abbreviations: CVD: cardiovascular disease.
Figure 2
Figure 2
Classification tree model studying CVD incidence in relation to MD adherence, sleep habits, and age and sex in the ATTICA study sample during 2002–2022 (n = 313). Adequate sleep is defined as ≥7 h/day, and inadequate sleep as <7 h/day. Low MD adherence was defined as MedDietScore during 2012 <27 (median), and high MD adherence as MedDietScore during 2012 ≥27 (median). Abbreviations: CVD: cardiovascular disease, MD: Mediterranean-type diet.
See this image and copyright information in PMC

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