Total, direct and indirect effects of Hp_s on iron status, 1-C metabolites and antioxidant status (N = 3,057): NHANES 1999–00.

<p>*p<0.05</p><p>**p<0.01</p><p>***p<0.001.</p><p>See <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0121390#pone.0121390.g001" target="_blank">Fig. 1</a> footnote for additional control of exogenous variables.</p><p>Total, direct and indirect effects of Hp_s on iron status, 1-C metabolites and antioxidant status (N = 3,057): NHANES 1999–00.</p

Study sample characteristics, NHANES 1999–2000 (N = 3,055).

<p>Study sample characteristics, NHANES 1999–2000 (N = 3,055).</p

Data reduction and structural equations model.

<p>Data reduction and structural equations model.</p

Serum Nutritional Biomarkers and Their Associations with Sleep among US Adults in Recent National Surveys

<div><p>Background</p><p>The associations between nutritional biomarkers and measures of sleep quantity and quality remain unclear.</p><p>Methods</p><p>Cross-sectional data from the National Health and Nutrition Examination Surveys (NHANES) 2005–2006 were used. We selected 2,459 adults aged 20–85, with complete data on key variables. Five sleep measures were constructed as primary outcomes: (<b>A</b>) Sleep duration; (<b>B</b>) Sleep disorder; (<b>C</b>) Three factors obtained from factor analysis of 15 items and labeled as “Poor sleep-related daytime dysfunction” (<b>Factor 1</b>), “Sleepiness” (<b>Factor 2</b>) and “Sleep disturbance” (<b>Factor 3</b>). Main exposures were serum concentrations of key nutrients, namely retinol, retinyl esters, carotenoids (<i>α</i>-carotene, <i>β</i>-carotene, <i>β</i>-cryptoxanthin, lutein+zeaxanthin, lycopene), folate, vitamin B-12, total homocysteine (tHcy), vitamin C, 25-hydroxyvitamin D (25(OH)D) and vitamin E. Main analyses consisted of multiple linear, logistic and multinomial logit models.</p><p>Results</p><p>Among key findings, independent inverse associations were found between serum vitamin B-12 and sleep duration, 25(OH)D and sleepiness (as well as insomnia), and between folate and sleep disturbance. Serum total carotenoids concentration was linked to higher odds of short sleep duration (i.e. 5–6 h per night) compared to normal sleep duration (7–8 h per night).</p><p>Conclusions</p><p>A few of the selected serum nutritional biomarkers were associated with sleep quantity and quality. Longitudinal studies are needed to ascertain temporality and assess putative causal relationships.</p></div

Socio-demographic, lifestyle and dietary predictors of nutritional biomarkers (retinol, retinyl esters, vitamin C, vitamin E and total carotenoids): OLS multiple regression analyses; NHANES 2005–06 (<i>n</i> = 2,459).

<p>Socio-demographic, lifestyle and dietary predictors of nutritional biomarkers (retinol, retinyl esters, vitamin C, vitamin E and total carotenoids): OLS multiple regression analyses; NHANES 2005–06 (<i>n</i> = 2,459).</p

Selected baseline characteristics of NHANES 2005–06 participants by sleep duration categories (<i>n</i> = 2,459)¹^,².

<p><i>Abbreviations:</i> 25(OH)D = 25-hydroxyvitamin D; <i>n</i>-3 HUFA = <i>n</i>-3 highly unsaturated fatty acids; NHANES = National Health and Nutrition Examination Survey; SE = Standard error; tHcy = Total homocysteine.</p>1<p>Values are mean±SE or percent±SE. Sampling design complexity is taken into account in all analyses. This analysis is done among participants with complete data for sleep quality variables and other key variables of interest (n = 2,459).</p>2<p>P-value was based on design-based <i>F</i>-test if row variable is categorical and <i>t</i>-test if row variable is continuous (comparing normal sleep to each of the other categories).</p>3<p>P<0.05.</p>4<p>P<0.01 for null hypothesis of no difference by sleep duration category.</p

Socio-demographic, lifestyle and dietary predictors of nutritional biomarkers (folate, vitamin B-12, tHcy and 25(OH)D): OLS multiple regression analyses; NHANES 2005–06 (<i>n</i> = 2,459).

<p><i>Abbreviations:</i> 25(OH)D = 25-hydroxyvitamin D; <i>n</i>-3 HUFA = <i>n</i>-3 highly unsaturated fatty acids; NHANES = National Health and Nutrition Examination Survey; SEE = Standard error of the estimate; tHcy = Total homocysteine.</p

Relative risk ratio (RRR with 95% CI) per 1 SD nutritional biomarker: (A) Very short sleep vs. Normal sleep duration^a,b, (B) Short sleep vs. Normal sleep duration^a,b, (C) Long sleep vs. Normal sleep duration^a,b.

<p><i>Abbreviations</i>: BMI = Body Mass Index; CI = confidence interval; Met = Metabolic Equivalent; n-3 HUFA = omega-3 highly unsaturated fatty acids; NHANES = National Health and Nutrition Examination Survey; RRR = relative risk ratio; SEE = Standard error of the estimate. ^a Values are Relative Risk Ratios (RRR) with 95% confidence intervals. Sampling design complexity is taken into account in all analyses. ^b Models included all serum nutritional biomarker exposures simultaneously, and adjusted for socio-demographic factors: age, sex, race/ethnicity, marital status, educational level and poverty income ratio, and other potential confounders: Lifestyle and health-related factors (smoking status, BMI, physical activity: Mets.hr.wk⁻¹, history of selected chronic conditions (i.e. type 2 diabetes, CVD and cancer)), anti-depressant use and dietary intakes (total energy intake, alcohol, caffeine, fiber, <i>n</i>-3 HUFA, each of the five carotenoids, vitamin C, vitamin E, folate, vitamin B-12), fruit and vegetable intake, supplement use, anti-depressant use, and the inverse mills ratio, 2-stage Heckman selection model as well as serum cholesterol (See <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0103490#pone-0103490-t004" target="_blank"><b>Table 4</b></a><b>, Model 4</b> for more details).</p

Monetary Value of Diet Is Associated with Dietary Quality and Nutrient Adequacy among Urban Adults, Differentially by Sex, Race and Poverty Status

<div><p>Objective</p><p>The association between monetary value of the diet (MVD, $/day) with dietary quality was examined using a large sample of urban US adults, differentially by socio-demographic factors.</p><p>Methods</p><p>This was a cross-sectional study of 2,111 participants, aged 30–64y, using data from the Healthy Aging in Neighborhoods of Diversity across the Life Span Study. Dietary quality indices included Healthy Eating Index–2010 (HEI–2010) and Mean Adequacy Ratio (MAR), (two 24-hr recalls). A national food price database was used to estimate MVD. Multiple linear/logistic regression analyses were conducted stratifying separately by sex, race and poverty status.</p><p>Results</p><p>Women had significantly higher HEI-2010 scores than men (43.35 vs 41.57 out of 100, respectively), whereas MAR scores were higher for men (76.8 vs 69.9, out of 100), reflecting energy intake gender differentials. Importantly, a$3/day higher MVD (IQR: $3.70/d (Q1) to$6.62/d (Q4)) was associated with a 4.98±0.35 higher total HEI-2010 and a 3.88±0.37 higher MAR score, after energy-adjustment and control for key confounders. For HEI-2010 and MAR, stronger associations were observed among participants above poverty and among women, whilethe MVD vs. HEI-2010 association was additionally stronger among Whites. Sex and poverty status differentials were observed for many MAR and some HEI-2010 components.</p><p>Conclusions</p><p>Despite positive associations between measures of dietary quality and MVD, particularly above poverty and among women, approaching compliance with the Dietary Guidelines (80 or more for HEI-2010) requires a substantially higher MVD. Thus, nutrition education may further improve people’s decision-making regarding food venues and dietary choices.</p></div

Associations between serum nutritional biomarkers (per 1 SD increase) and sleep quality measures: Multiple OLS and logistic regression models, controlling for dietary intakes or supplement use: 2-stage Heckman selection models (N = 2,346); NHANES 2005–06¹.

<p><i>Abbreviations</i>: BMI = Body Mass Index; CI = confidence interval; Met = Metabolic Equivalent; n-3 HUFA = omega-3 highly unsaturated fatty acids; NHANES = National Health and Nutrition Examination Survey; OR = odds ratio; SEE = Standard error of the estimate.</p>1<p>Values are odds ratios with 95% confidence intervals or β±SEE. Sampling design complexity is taken into account in all analyses.</p>2<p>Model 1 included each nutritional biomarker exposure separately and adjusted for socio-demographic factors: age, sex, race/ethnicity, marital status, educational level and poverty income ratio, and other potential confounders: Lifestyle and health-related factors (smoking status, BMI, physical activity: Mets.hr.wk⁻¹, history of selected chronic conditions (i.e. type 2 diabetes, CVD and cancer)), anti-depressant use and dietary intakes (total energy intake, alcohol, caffeine, fiber, <i>n</i>-3 HUFA, each of the five carotenoids, vitamin C, vitamin E, folate, vitamin B-12), fruit and vegetable intake, supplement use, anti-depressant use, and the inverse mills ratio, 2-stage Heckman selection model.</p>3<p>Model 2 included all serum nutritional biomarker exposures simultaneously, controlling for the same covariate as above.</p>4<p>Model 3 is model 1 (i.e. controlling for the same covariates as above) but with main exposures being total retinol+retinyl esters and total carotenoids. The other nutritional biomarkers are not shown because their results were already presented in model 1.</p>5<p>Model 4 is model 2 (i.e. controlling for the same covariates as above) but with main exposures being total retinol+retinyl esters, total carotenoids and the other serum nutritional biomarkers entered into the model simultaneously.</p