Sleep and diet quality in racial and ethnic minorities following job loss: an 18-month cohort analysis.

IMPORTANCE

This study provides insight into the relationship between sleep and diet among racial and ethnic minority populations experiencing involuntary job loss.

OBJECTIVE

The study examined whether individuals from racial and ethnic minority groups with worse multidimensional sleep health (MSH) and more fragmented sleep after job loss would demonstrate worse diet quality over an 18-month period when compared to individuals identifying as non-Hispanic and White (NHW).

METHODS

Data were derived from the Assessing Daily Activity Patterns through occupational Transitions study, an 18-month cohort study with participants (N = 188) in the US Southwest who experienced involuntary job loss. After an initial baseline assessment, participants completed 5 additional visits that included a 24-hour dietary recall interviews and multimodal sleep assessments (actigraphy, daily sleep diaries, and interview). Data from the dietary recalls were used to calculate the dependent variable, Healthy Eating Index (HEI); higher scores indicated greater adherence to the Dietary Guidelines for Americans. Sleep data were used to generate a composite MSH score (covering regularity, satisfaction, alertness, timing, efficiency, and duration of sleep), and sleep fragmentation was the average number of wake bouts per hour of sleep and wake time after sleep onset (actigraphy). Mixed-effects linear modeling tested whether minority status (dichotomized to racial and ethnic minority and NHW) separately moderated the association between sleep and diet quality over time while controlling for body mass index, sex, education, and reemployment.

RESULTS

The HEI did not change significantly over time. No effects were found for MSH. More fragmented sleep was associated with healthier diets in racial and ethnic minorities and less healthy diets in NHW individuals. This interaction was driven by lower consumption of refined grains and saturated fats and increased consumption of greens and beans over time in racial and ethnic minorities and less consumption of whole grains in NHW.

CONCLUSIONS

In a population of individuals who recently experienced involuntary job loss, sleep fragmentation was associated with diet quality, but MSH was not. The association between sleep fragmentation and diet was in the opposite direction than hypothesized in racial and ethnic minorities. Future research may benefit from testing the daily relationships between sleep fragmentation and cultural differences in dietary choices when under financial strain.