Diet, Eating Habits, and Lifestyle Factors Associated with Adequate Sleep Duration in Children and Adolescents Living in 5 Mediterranean Countries: The DELICIOUS Project

Background/Objectives: Sleep is a fundamental physiological function that plays a crucial role in maintaining health and well-being. The aim of this study was to assess dietary and lifestyle factors associated with adequate sleep duration in children and adolescents living in five Mediterranean countries. Methods: Parents of children and adolescents taking part in an initial survey for the DELICIOUS project were examined to assess their children's dietary and eating habits (i.e., meal routines), as well as other lifestyle behaviors (i.e., physical activity levels, screen time, etc.) potentially associated with adequate sleep duration (defined as 8-10 h according to the National Sleep Foundation). The youth healthy eating index (Y-HEI) was used to assess the diet quality of children and adolescents. Multivariate logistic regression analyses were performed to calculate the odds ratios (ORs) and 95% confidence intervals (CIs), indicating the level of association between variables. Results: A total of 2011 individuals participated in the survey. The adolescents and children of younger parents reported being more likely to have inadequate sleep duration. Among eating behaviors, having breakfast (OR = 2.23, 95% CI: 1.62, 3.08) and eating at school (OR = 1.33, 95% CI: 1.01, 1.74) were associated with adequate sleep duration. In contrast, children eating alone, screen time, and eating outside of the home were less likely to have adequate sleep duration, although these findings were only significant in the unadjusted model. After adjusting for covariates, a better diet quality (OR = 1.63, 95% CI: 1.24, 2.16), including higher intake of fruits, meat, fish, and whole grains, was associated with adequate sleep duration. Conclusions: Adequate sleep duration seems to be highly influenced by factors related to individual lifestyles, family and school eating behaviors, as well as diet quality.