Association of dietary acid load and plant-based diet index with sleep, stress, anxiety and depression in diabetic women

Diabetes is a common chronic disease with various complications. The present study was conducted to determine the association of plant-based diet index (PDI) and dietary acid load (DAL) with sleep status as well as mental health in type 2 diabetic women. In this cross-sectional study, a validated FFQ was used to assess dietary intakes of 230 diabetic patients. We created a whole PDI, healthful PDI (hPDI) and unhealthful PDI (uPDI). DAL was calculated based on potential renal acid load and net endogenous acid production method. The Pittsburgh Sleep Quality Index and twenty-one-item Depression, Anxiety and Stress Scale were used to assess sleep and mental health disorders, respectively. Participants in the top group of uPDI had greater risk of poor sleep (OR 6 center dot 47, 95 % CI 2 center dot 75, 15 center dot 24). However, patients who were in the top group of hPDI had a lower risk of sleep problems (OR 0 center dot 28, 95 % CI 0 center dot 13, 0 center dot 62). Participants in the top group of uPDI had greater risk of depression, anxiety and stress (OR 9 center dot 35, 95 % CI 3 center dot 96, 22 center dot 07; OR 4 center dot 74, 95 % CI 2 center dot 28, 9 center dot 85; OR 4 center dot 24, 95 % CI 2 center dot 14, 8 center dot 38, respectively). In conclusion, participants with higher DAL scores and patients who adhered to animal-based diets rather than plant-based diets were more likely to be poor sleepers and have mental health disorders.