Global diet quality score and quality of sleep in patients with breast cancer: a population-based cross-sectional study

Abstract

Background Poor sleep quality is a common risk factor for a reduced quality of life in patients with breast cancer (BC). The Global Diet Quality Score (GDQS) is a validated measure of dietary quality; however, its association with sleep quality in BC patients remains unclear. Objective This study aimed to evaluate the association between dietary quality, as measured by the GDQS, and sleep quality, as assessed using the Pittsburgh Sleep Quality Index (PSQI), among patients with BC. Methods This cross-sectional study included 600 patients with BC registered in the Isfahan Breast Cancer Registry (2021-2023). Dietary intake was assessed using a validated food frequency questionnaire, and the GDQS was computed for 25 food groups. Sleep quality was evaluated using the Persian version of PSQI. Multiple linear regression models adjusted for confounders were used to assess the association between the GDQS and sleep quality. Results Each unit increase in the total and positive GDQS was associated with a decrease in the PSQI score and better sleep quality (beta = -0.12, 95 confidence interval (CI): -0.19, -0.05; p = 0.001 and beta = -0.14, 95 CI: -0.22, -0.06; p = 0.001, respectively). Patients in the highest total and positive GDQS quartiles had significantly better sleep than those in the lowest quartile (beta = -1.20, 95CI: -2.09, -0.32; p = 0.008 and beta = -1.72, 95 CI: -2.88, -0.57; p = 0.004, respectively), with a clear inverse relationship for both total and positive GDQS (p < 0.05). Conclusion This study underscores the role of dietary quality in improving the sleep health of patients with BC. Nutritional counseling should be integrated into oncology care to enhance sleep and well-being. Further studies are required to confirm these results regarding temporality.