Ryoko KATAGIRI, et al.: Association between Sleep Quality and Diets sleep quality was significantly associated with high carbohydrate intake (p for trend 0.03). Conclusions: A low intake of vegetables and fish, high intake of confectionary and noodles and unhealthy eating habits were independently associated with poor sleep quality. Poor sleep quality was also associated with high carbohydrate intake in free-living Japanese middle-aged female workers. (J Occup Health 2014; 56: 359-368) Key words: Eating habits, Food intake, Japanese female workers, Sleep quality Inadequate sleep is prevalent in modern societies 1) . Mean sleep duration has decreased in many countries, including Japan 2) , and attention has focused on the associations of inadequate sleep and health outcomes. Associations with inadequate, particularly short, sleep duration have been reported for obesity 3) and total mortality 4) . In the workplace too, shift work 5) and high work demands 6) have been associated with sleep disturbances, and people with poor sleep quality take more sick leave or have problems in occupational activities 7) . Thus, a reduction in sleep disturbance will positively impact both general and working populations.Sleep can be evaluated from two aspects, quantity (sleep duration) and quality. Although adequate methods of evaluating sleep quality have not been rigorously established 8) , Buysse and his group developed the "Pittsburgh Sleep Quality Index (PSQI)" to evaluate total sleep quality 9) . This questionnaire assesses seven aspects of sleep (subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, use of sleeping medications and daytime dysfunction), and their sum yields a global score for Here, we examined this association using information acquired from validated questionnaires. Methods: A total of 3,129 female workers aged 34 to 65 years were analyzed. Dietary intake was assessed using a self-administered diet history questionnaire (DHQ), and subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). The relationship between the intake of several food groups and nutrients and sleep quality was examined using multivariable logistic regression models. The effect of eating habits on sleep quality was also examined. Results: Poor sleep quality was associated with low intake of vegetables (p for trend 0.002) and fish (p for trend 0.04) and high intake of confectionary (p for trend 0.004) and noodles (p for trend 0.03) after adjustment for potential confounding factors (age, body mass index, physical activity, depression score, employment status, alcohol intake and smoking status). Poor sleep quality was also significantly and positively associated with consumption of energy drinks and sugar-sweetened beverages, skipping breakfast, and eating irregularly. In addition, poor

BackgroundProtein intake has been inversely associated with frailty. However, no study has examined the effect of the difference of protein sources (animal or plant) or the amino acid composing the protein on frailty. Therefore, we examined the association of protein and amino acid intakes with frailty among elderly Japanese women.MethodsA total of 2108 grandmothers or acquaintances of dietetic students aged 65 years and older participated in this cross-sectional multicenter study, which was conducted in 85 dietetic schools in 35 prefectures of Japan. Intakes of total, animal, and plant protein and eight selected amino acids were estimated from a validated brief-type self-administered diet history questionnaire and amino acid composition database. Frailty was defined as the presence of three or more of the following four components: slowness and weakness (two points), exhaustion, low physical activity, and unintentional weight loss.ResultsThe number of subjects with frailty was 481 (23%). Adjusted ORs (95% CI) for frailty in the first, second, third, fourth, and fifth quintiles of total protein intake were 1.00 (reference), 1.02 (0.72, 1.45), 0.64 (0.45, 0.93), 0.62 (0.43, 0.90), and 0.66 (0.46, 0.96), respectively (P for trend = 0.001). Subjects categorized to the third, fourth, and fifth quintiles of total protein intake (>69.8 g/d) showed significantly lower ORs than those to the first quintile (all P <0.03). The intakes of animal and plant protein and all selected amino acids were also inversely associated with frailty (P for trend <0.04), with the multivariate adjusted OR in the highest compared to the lowest quintile of 0.73 for animal protein and 0.66 for plant protein, and 0.67-0.74 for amino acids, albeit that the ORs for these dietary variables were less marked than those for total protein.ConclusionsTotal protein intake was significantly inversely associated with frailty in elderly Japanese women. The association of total protein with frailty may be observed regardless of the source of protein and the amino acid composing the protein.

BackgroundThe intake of protein and antioxidants has been inversely associated with frailty, individually. However, to our knowledge, no study has evaluated these associations in considering antioxidants or protein intakes as respective confounders. Further, the cooperative effect of dietary protein and antioxidants on frailty has not been investigated. Therefore, we examined the association of high protein and high dietary total antioxidant capacity (TAC) with frailty under the adjustment for dietary TAC or protein intake, respectively. The association between the combination of high dietary protein and high dietary TAC and frailty was also investigated.MethodsA total of 2108 grandmothers or acquaintances of dietetic students aged 65 years and older participated in this cross-sectional multicenter study conducted in 85 dietetic schools in Japan. Dietary variables, including protein intake, and dietary TAC were estimated from a validated brief-type self-administered diet history questionnaire. Frailty was defined as a score of three or more points obtained from the following four components: slowness and weakness (two points), exhaustion, low physical activity, and unintentional weight loss.ResultsMedian (interquartile range) age of the present subjects was 74 (71–78) years. Multivariate adjusted ORs (95% CIs) for frailty in the highest compared to the lowest tertile were 0.66 (0.49, 0.87) for total protein intake (P for trend = 0.003) and 0.51 (0.37, 0.69) for dietary TAC (P for trend <0.0001) after adjustment for dietary TAC or total protein intake, respectively. The OR of frailty for the group with both the highest tertiles of total protein intake and dietary TAC was markedly lower (multivariate adjusted OR [95% CIs]: 0.27 [0.16, 0.44]; P <0.0001) compared to the group with the lowest tertile of protein intake and the lowest tertile of dietary TAC.ConclusionsBoth protein intake and dietary TAC were independently inversely associated with frailty among old Japanese women. Further, a diet with the combination of high dietary protein and high dietary TAC was strongly inversely associated with the prevalence of frailty in this population. To select food combinations that allow for an increase of both protein and antioxidants in diet according to the local food culture and dietary habits may be an effective strategy for frailty prevention.

Dietary habits with high TAC showed a stronger inverse association with frailty in elderly Japanese women than the individual foods examined.

Only a few studies have focused on the association between overall diet, rather than intakes of individual nutrients or foods, and depressive symptoms in Japanese. This cross-sectional study examined associations between a diet quality score and depressive symptoms in 3963 young (age 18 years) and 3833 middle-aged (mean age 47·9 (sd 4·2) years) Japanese women. Dietary information was collected using a diet history questionnaire. A previously developed diet quality score was computed mainly based on the Japanese Food Guide Spinning Top. The prevalence of depressive symptoms was 22·0 % for young women and 16·8 % for middle-aged women, assessed as a Center for Epidemiologic Studies Depression (CES-D) score ≥23 and ≥19, respectively. As expected, the diet quality score was associated positively with intakes of 'grain dishes', 'vegetable dishes', 'fish and meat dishes', 'milk' and 'fruits' and inversely with intakes of energy from 'snacks, confection and beverages' and Na from seasonings. After adjustment for potential confounders, OR for depressive symptoms in the highest v. lowest quintiles of the diet quality score was 0·65 (95 % CI 0·50, 0·84) in young women (P for trend=0·0005). In middle-aged women, the corresponding value was 0·59 (95 % CI 0·45, 0·78) (P for trend<0·0001). Analyses where the diet quality and CES-D scores were treated as continuous variables also showed inverse associations. In conclusion, this cross-sectional study showed that a higher diet quality score was associated with a lower prevalence of depressive symptoms in young and middle-aged Japanese women. Prospective studies are needed to confirm a public health relevance of this finding.