| Abstrakt: |
Background:Food insecurity (FI), defined as lack of consistent access to enough food for an active, healthy lifestyle, affects 40% of people across the Caribbean and is associated with adverse cardiovascular outcomes. Despite evidence that suggests an association between FI and sleep health and FI prevalence in the Caribbean, few studies have been conducted. We aimed to examine the relationship between FI and sleep health in the Eastern Caribbean.We hypothesized that FI would be negatively associated with sleep health.Methods:Baseline data from the Eastern Caribbean Health Outcomes Research Network Cohort Study (ECS) were analyzed (2013-2018). Participants (n= 2,961) are community-dwelling individuals 40 years or older residing in Barbados, Puerto Rico, Trinidad and Tobago, or U.S. Virgin Islands. Participants completed a questionnaire including the 9-item Latin American and Caribbean Food Security Scale. Responses were summed to create a score (0-9) and create four categories: 0 no FI, 1-3 mild FI, 4-6 moderate, and 7-9 severe FI. FI was also operationalized as a binary variable (yes/no). Sleep outcomes included adequate sleep and insomnia. Sleep variables were measured by the items, “how many hours of sleep do you usually get at night,” and “has a doctor or other health professional has ever told you that you have insomnia.” Adequate sleep was defined as 7+ hours (yes/no) and insomnia was also operationalized as binary variable (yes/no). Other variables included sex and age. Chi-square tests and multivariable logistic regression modeling were used for the analysis.Results:Analyses included 2,321 participants. Sixty-five percent were women, and the mean age was 57 years. Findings showed 28% (644 of 2,321) of participants experienced food insecurity: 17.1% (397 of 2,321) mild, 6.2% (144 of 2,321) moderate, and 4.4% (103 of 2,321) severe. Fifty-five percent (1279 of 2,321) of participants had inadequate sleep (<7 hours) and five percent reported insomnia. FI was not significantly associated with inadequate sleep in bivariate or multivariable analyses. Bivariate results for insomnia showed statistically significant associations with FI (p=0.0002). Multivariable results showed moderate and severe FI were associated with 2 (CI=1.01-4.16) and 4 (CI=1.95-7.05) times greater odds of insomnia compared to those who were food secure. Sex-stratified results showed men with severe FI had 9 times greater odds of insomnia (CI=3.2-23.7). Results were not statistically significant for women.Conclusions:Future research should examine mechanisms that explain sex differences in the relationship between FI and insomnia. |
