Dietary carbohydrate quality, not quantity, is associated with sleep quality in the middle-aged and older population: evidence from the Chinese Square Dancer Study

Sleep disturbances have become a pressing public health problem. The association between diet and sleep health has attracted increasing attention in recent years. This study aimed to elucidate the associations of dietary carbohydrate amount and carbohydrate quality with sleep quality. This study was conducted among 4772 participants with a mean age of (62.4 ± 6.3) years in the Lifestyle and Healthy Aging of Chinese Square Dancer Study. Dietary data were collected using a 64-item food frequency questionnaire. Carbohydrate quality was assessed by the carbohydrate quality index (CQI), which is based on four components: dietary fiber intake, glycemic index, whole grain/total grain ratio, and solid carbohydrate/total carbohydrate ratio. Sleep quality was evaluated by the Pittsburgh sleep quality index. Multivariable logistic regression analysis was performed to analyze the association of carbohydrate amount and quality with sleep quality. After controlling for sociodemographic, lifestyle, and multiple disease-related factors, the odds ratio for the highest vs. the lowest quintile of the CQI was 0.64 (95% confidence interval (CI) 0.53, 0.78; P-trend < 0.0001). In contrast, no significant associations were observed between carbohydrate amount and sleep quality. The findings suggest that higher dietary carbohydrate quality, rather than carbohydrate amount, was associated with better sleep quality. This study provided a diet-related sleep-improving strategy for the general population.