(P13-068-25) Exploring Mediterranean Diet Adherence and Sleep Health Across Racial/Ethnic Groups: Results From a Nationally Representative Sample of US Adults

Objectives: The relationship between Mediterranean diet adherence and multiple dimensions of sleep health remains underexplored, particularly among racial/ethnic minority populations. This study explored these associations among United States (US) adults.

Methods: Data from 4,936 NHANES 2017-2018 adult participants were analyzed. Dietary data from a single 24-hour recall was used to calculate the alternate Mediterranean Diet (aMED) score, including nine components: vegetables, fruits, whole grains, nuts, legumes, fish, red and processed meats, alcohol intake, and the monounsaturated-to-saturated fat ratio. Participants received 0 or 1 point per component based on intake relative to the sex-specific median. The total aMED score was calculated by summing the scores for each component. Scores were dichotomized into poor ( < 4) or good (≥4) adherence. Sleep health was assessed across five dimensions—regularity, timing, duration, satisfaction, and alertness—and summed into a composite score, with scores < 3 representing “poor” sleep health. Weighted logistic regression models examined associations between aMED adherence and sleep, adjusting for sex, age, race, and energy intake. Interaction models were used to assess racial/ethnic disparities by examining differences between non-Hispanic White participants and racial/ethnic minorities.

Results: Participants' mean age was 47.5 years (SE = 0.7); 51.4% were female, 49.2% had poor aMED adherence, and 29% reported poor sleep health. Poor aMED adherence was associated with a 19% increased odds of poor sleep health (95%CI: 1.05-1.36, p = 0.01). It was also linked to significantly increased odds of poor sleep satisfaction (OR=1.22, 95%CI: 1.02-1.46, p = 0.03) and shorter sleep duration (OR=1.50, 95%CI:1.21-1.85, p = 0.001) compared to participants with good adherence. Among racial/ethnic minorities, poor aMED adherence was associated with a 27% increased odds of poor sleep health (OR=1.27, 95%CI: 1.01-1.60, p = 0.04) compared to non-Hispanic White participants with poor aMED adherence.

Conclusions: Poor adherence to the aMED was associated with worse sleep health among US adults. However, disparities exist for racial/ethnic minorities, who experience even worse sleep health with poor adherence to the aMED.

Funding Sources: ANZ was supported by Stanford University's Propel Postdoctoral Program.