High glycemic index and glycemic load diets as risk factors for insomnia: analyses from the Women’s Health Initiative

Abstract

Background Previous studies have shown mixed results on the association between carbohydrate intake and insomnia. However, any influence that refined carbohydrates have on risk of insomnia is likely commensurate with their relative contribution to the overall diet, so studies are needed that measure overall dietary glycemic index (GI), glycemic load, and intakes of specific types of carbohydrates. Objective We hypothesized that higher GI and glycemic load would be associated with greater odds of insomnia prevalence and incidence. Methods This was a prospective cohort study with postmenopausal women who participated in the Women's Health Initiative Observational Study, investigating the relations of GI, glycemic load, other carbohydrate measures (added sugars, starch, total carbohydrate), dietary fiber, and specific carbohydrate-containing foods (whole grains, nonwhole/refined grains, nonjuice fruits, vegetables, dairy products) with odds of insomnia at baseline (between 1994 and 1998; n = 77,860) and after 3 y of follow-up (between 1997 and 2001; n = 53,069). Results In cross-sectional and longitudinal analyses, higher dietary GI was associated with increasing odds of prevalent (fifth compared with first quintile OR: 1.11; CI: 1.05, 1.16; P-trend = 0.0014) and incident (fifth compared with first quintile OR: 1.16; CI: 1.08, 1.25; P-trend < 0.0001) insomnia in fully adjusted models. Higher intakes of dietary added sugars, starch, and nonwhole/refined grains were each associated with higher odds of incident insomnia. By contrast, higher nonjuice fruit and vegetable intakes were significantly associated with lower odds of incident insomnia. Also, higher intakes of dietary fiber, whole grains, nonjuice fruit, and vegetables were significantly associated with lower odds of prevalent insomnia. Conclusions The results suggest that high-GI diets could be a risk factor for insomnia in postmenopausal women. Substitution of high-GI foods with minimally processed, whole, fiber-rich carbohydrates should be evaluated as potential treatments of, and primary preventive measures for, insomnia in postmenopausal women.

A Mediterranean Dietary Pattern Predicts Better Sleep Quality in US Women from the American Heart Association Go Red for Women Strategically Focused Research Network

“…This loosely corresponds with observation of an increase in time spent in deep sleep following higher fiber intake over the previous day [36]. Associations of fruits and vegetables and legumes with future sleep quality in this study may also help to explain previous findings linking lower dietary glycemic index with reduced risk of insomnia symptoms [10], since fiber-rich foods such as these can lower overall dietary glycemic index [37]. A potential sleep quality-promoting role of fruits and vegetables, indicated in our findings, adds to the various health benefits of this food group, including weight management [38] and reduced cardiovascular disease risk [39].…”

“…Results of small-scale trials demonstrate that supplementation with foods rich in melatonin, tryptophan, or other nutrients can impact parameters of sleep [9]. Recently, compelling data from the limited number of available epidemiological studies also demonstrate associations between dietary patterns and measures of sleep quantity and quality [1,10]. There is particular interest in the Mediterranean diet pattern for the promotion of sleep health [1].…”

The Effects of Dietary Nutrition on Sleep and Sleep Disorders

“…The result is supported by another study that low-carbohydrate intake was associated with difficulty maintaining sleep [ 27 ]. However, other studies, including a recently published by Gangwisch et al, suggested that high glycemic index and glycemic load diets is a risk factor for insomnia [ 28 ]. This prospective study of a much larger population of postmenopausal women population demonstrated that high-GI diet was associated with increased insomnia incidence over 3 years, and higher intakes of dietary added sugars, starch, and nonwhole/refined grains each were associated with higher incidence of insomnia.…”

“…However, this theory has been challenged by the recent publication by Gangwisch et al who suggested that this theory may not be realistic as it required the meal to contain only carbohydrate. If the meal contains as little as 5% protein, this can prevent the increase of tryptophan concentrations [ 28 ]. Moreover, the increase of serotonin is not necessarily associated with melatonin whose production is regulated by the presence of darkness [ 28 ].…”

“…If the meal contains as little as 5% protein, this can prevent the increase of tryptophan concentrations [ 28 ]. Moreover, the increase of serotonin is not necessarily associated with melatonin whose production is regulated by the presence of darkness [ 28 ]. Instead, they proposed that hyperglycemia induced after high-GI diet and resulting compensatory hyperinsulinemia could induce the release of autonomic counterregulatory hormones including adrenaline, cortisol, glucagon, and growth hormone which contributed to insomnia [ 28 , 34 ].…”