Association between low carbohydrate diet (LCD) and sleep quality by mediating role of inflammatory factors in women with overweight and obesity: A cross-sectional study

Food Sci Nutr. 2021 Sep 28;9(11):6252-6261. doi: 10.1002/fsn3.2584. eCollection 2021 Nov.


Poor sleep quality can lead to increased obesity. Low carbohydrate diet (LCD) is considered as an approach for sleep quality and obesity improvement. The aim of this investigation is to evaluate the relationship between LCD and sleep quality with the mediatory effect of inflammatory markers including transforming growth factor-β (TGF-β), high-sensitivity C-reactive protein (hs-CRP), total antioxidant capacity: In our cross-sectional study, 304 obese women aged from 19 to 50 years were enrolled. Body mass index (BMI) in these women ranged from 25.2 to 48.3 kg/m2. LCD score was assessed by a 147- item semi-quantitative food frequency questionnaire (FFQ). The Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality. FFQ and PSQI questionnaires are completed simultaneously by the participants. Biochemical indicators (inflammatory markers) were measured and anthropometric components were evaluated. The relationship between sleep quality and LCD with quantitative variables was assessed by independent sample t-test and with qualitative variables by chi-square test. Binary logistic regression was used to estimate confounding variables including age, job, stress, weight to investigate the relationship between LCD and sleep. Following of LCD had a significant negative relationship with PSQI score. It can be said that with increasing LCD adherence, the possibility of poor sleep quality decrease (OR = 0.43, 95% CI = 0.19-0.94,p = .03). It was also showed, hs-CRP (OR = 0.61, 95% CI = 0.3-1.21, p = .16) and TAC (OR = 0.6, 95% CI = 0.25-1.4, p = 0.24), eliminated the significance of the association and it is possible that they play a mediating role in this relationship Following the LCD can have a positive effect on improving PSQI scores by reduction in inflammatory markers levels.

Keywords: inflammatory factors; low carbohydrate diet; obesity; overweight; sleep quality.