The Mediating Role of Sleep Quality and Quantity in the Link Between Food Insecurity and Obesity Across Race and Ethnicity

Abstract

Objective: The objective of the study was to examine the mediating role of sleep quality and quantity in the relationship between food insecurity and obesity across races/ethnicities. Methods: Bivariate negative binomial regression and multinomial logistic regression were used to examine direct associations between food insecurity and sleep quality and quantity among non-Hispanic Native Hawaiian and other Pacific Islanders (NHPI) relative to non-Hispanic White, Black, Asian, and Hispanic individuals with obesity. The potential outcomes approach and adjusted Wald test were used to explore the mediating role of sleep quality and quantity and the moderating role of race/ethnicity, respectively. Results: Among adults with obesity, the study found a positive and direct relationship between food insecurity and trouble falling asleep in each racial/ethnic group. Trouble staying asleep was associated with food insecurity in each racial/ethnic group, except in the Asian group. Positive and direct associations were observed between food insecurity and short/very short sleep. A positive and direct relationship was found between food insecurity and having obesity in each racial/ethnic group, except in the Black group. Sleep quality and sleep quantity partially mediated the relationship between food insecurity and obesity in non-Hispanic NHPI, White, Asian, and Hispanic individuals. Race/ethnicity moderated the indirect effects of food insecurity on sleep quality and quantity. Conclusions: Food security and sleep hygiene should be an integral part of the fight against obesity.