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Original Article

Association of quantity and quality of fat intake with sleep quality: a cross-sectional study in Iran

Melika Fallah1,2orcid, Azadeh Aminianfar1orcid, Awat Feizi3orcid, Maryam Fallah4orcid, Peyman Adibi5orcid, Hamidreza Roohafza6orcid, Alireza Ani7orcid, Leila Azadbakht2,8orcid, Ahmad Esmaillzadeh2,9,10orcid
Osong Public Health and Research Perspectives 2026;17(2):165-181.
Published online: March 11, 2026

1Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran

2Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran

3Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran

4Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran

5Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

6Mental Health Department, Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

7Department of Bioinformatics, Isfahan University of Medical Sciences, Isfahan, Iran

8Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

9Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

10Department of Community Nutrition, Isfahan University of Medical Sciences, Isfahan, Iran

Corresponding author: Ahmad Esmaillzadeh Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, P.O. Box 14155-6117, Iran E-mail: a.esmaillzadeh@gmail.com
Co-Corresponding author: Azadeh Aminianfar Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, P.O. Box 8715981151, Iran E-mail: aaminianfar@gmail.com
• Received: July 28, 2025   • Revised: December 16, 2025   • Accepted: January 8, 2026

© 2026 Korea Disease Control and Prevention Agency.

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • Objectives
    The association between dietary fat intake and sleep quality remains unclear. This study investigated the impact of both dietary fat quality and quantity on sleep quality.
  • Methods
    In this cross-sectional study, participants completed a food frequency questionnaire and Pittsburgh Sleep Quality Index to assess quantity and quality of fat intake and sleep quality.
  • Results
    A total of 1,904 participants (55% female) were included in the study. Participants in the highest tertile of polyunsaturated fatty acids (PUFA) intake, compared with those in the lowest tertile, had significantly higher total sleep quality scores (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.01–1.62) and longer sleep onset latency (OR, 1.40; 95% CI, 1.08–1.83). Participants with higher animal fat intake exhibited higher total sleep quality scores (OR, 1.44; 95% CI, 1.09–1.89) and increased sleep disturbances (OR, 1.37; 95% CI, 1.02–1.83). Among women, those in the highest tertile compared with the lowest tertile showed increased odds of higher total sleep quality scores with total fat (OR, 1.37; 95% CI, 1.04–1.82), PUFA (OR, 1.41; 95% CI, 1.07–1.87), monounsaturated fatty acids (OR, 1.44; 95% CI, 1.09–1.90), saturated fatty acid (OR, 1.33; 95% CI, 1.01–1.77), and animal fat (OR, 1.58; 95% CI, 1.18–2.11).
  • Conclusion
    These findings suggest that higher intakes of PUFA and animal fat are associated with higher total sleep quality scores. When stratified by sex, higher intake of total fat and unsaturated fats was associated with higher total sleep quality scores in women only.
  • Keywords: Cross-sectional studies; Dietary fats; Polyunsaturated fatty acids; Sleep quality
Background
Sleep is a fundamental physiological process that is critical for maintaining healthy brain function and overall well-being. Poor sleep quality disrupts normal circadian rhythms and adversely affects both psychological well-being and physical health [1]. It is associated with an increased risk of medical and psychiatric complications, reduced quality of life, and diminished work efficiency [2]. Sleep quality encompasses multiple dimensions, including sleep duration, sleep onset latency, sleep disturbances, daytime dysfunction, and sleep efficancy [3]. In Iran, the prevalence of insomnia reached 35% in 2022, representing a substantial public health concern [1]. Lifestyle modifications, particularly dietary interventions combined with regular physical activity, have been shown to improve sleep management and reduce associated health risks [3]. Regular consumption of macronutrients plays a crucial role in sleep physiology and related health outcomes [4].
Fats are essential macronutrients that serve multiple vital functions, including energy provision, formation of structural components of cell membranes, and facilitation of fat-soluble vitamin absorption [5]. The type of dietary fat consumed directly influences neuroendocrine systems involved in sleep regulation [6]. High intake of saturated or processed fats increases systemic inflammation, which can disrupt sleep architecture [7]. In contrast, polyunsaturated fatty acids (PUFA) and monounsaturated fatty acids (MUFA), particularly long-chain omega-3 fatty acids, help maintain neuronal membrane integrity and optimize signaling pathways for sleep-regulating neurotransmitters such as gamma-aminobutyric acid, thereby enhancing nocturnal melatonin production [8]. Appropriate dietary fat intake is therefore considered an important component of effective sleep hygiene [9]. Although the essential role of dietary fats in overall health is well recognized, the literature examining their association with sleep quality remains inconsistent. Previous studies assessing total fat intake and sleep outcomes have produced contradictory findings: some cross-sectional studies report that higher total fat intake is associated with poorer sleep quality [4], whereas cohort studies suggest that lower fat intake may paradoxically be associated with worse sleep quality [9]. Moreover, most existing research has emphasized fat quantity rather than fat quality [10].
Indices of fat quality, such as PUFA/saturated fatty acid (SFA) and (PUFA+MUFA)/SFA ratios, may more accurately predict sleep outcomes than total fat consumption alone. Furthermore, the dietary source of fat, whether vegetable- or animal-derived, may influence sleep outcomes through distinct biological mechanisms [11,12]. Despite these considerations, the independent and combined effects of dietary fat quantity and quality on sleep architecture remain insufficiently characterized in large population-based studies.
Study Objectives
This study addresses the existing evidence gap by examining the associations between both the quantity and quality of dietary fat intake and sleep quality in a large sample of Iranian adults [1]. Specifically, we aimed to assess dietary fat intake patterns, including total fat and the relative contributions of PUFA, MUFA, and SFA; calculate indices of fat quality using established ratios; and examine the associations of fat quantity and quality with overall sleep quality scores as well as individual sleep components, including subjective sleep quality, sleep onset latency, sleep duration, sleep disturbances, sleep efficiency, sleep medication use, and daytime dysfunction [13].
Study Design and Setting
This cross-sectional study was conducted among healthy adults to examine the association between the quantity and quality of dietary fat intake and sleep quality.

Setting

The study was conducted from 2017 to 2019. Healthy adults visited primary health care centers in Kerdabad, located in Isfahan province. Kerdabad was selected for this study because of its diverse population, which encompasses a wide range of income levels and social statuses. This diversity enhances the generalizability of the study’s findings to the broader population of Isfahan province [14,15]. Households were examined using a census-based sampling method. All households in districts 4 and 5 of Kerdabad approximately n=4,000 were enumerated. From each household, 1 adult member was randomly selected with equal probability for all household members. Non-eligible individuals were replaced through random selection of another household member from the same household.
Participants
In this study, “healthy adults” refers to individuals without known chronic diseases or acute medical conditions. In Iran, generally healthy individuals routinely visit primary health care centers for preventive services or routine health checks, which explains why healthy adults were recruited from these centers.
The inclusion criteria for participants were as follows: (1) adults who appeared to be healthy; (2) individuals aged between 18 and 65 years; and (3) those capable of visiting the local health center and completing the questionnaire for data collection. Exclusion criteria included: (1) non-Iranian nationals; (2) pregnant or breastfeeding women; (3) individuals experiencing menopause; (4) those who had followed a special diet within the previous 3 months; and (5) individuals with significant physical or mental disabilities that would prevent them from visiting a local health center or participating in the data collection process. The following expression was used to estimate the appropriate sample size for assessing the association between diet and sleep [16].
m'=ca/2r+1P¯Q¯-c1-βrP1Q1+P2Q22´rP2-P12
m=m'41+1+2(r+1)m'rP2-P12
P=(p1+p2)/(1+r)
Q1=1-P1, Q2= 1-P2, Q=1-P
n1=m
n2=mr
n=n1+n2
The significance level, α (type I error), was set at 0.05, and the probability of a type II error, β, was set at 0.20, resulting in a study power of 80%. The initial estimated sample size was calculated to be 1,246 individuals. After accounting for an anticipated dropout rate of 30%, the final target sample size required for the cross-sectional analysis was set at 1,904 participants. All participants received a detailed explanation of the study’s purpose and provided written informed consent prior to enrollment. All methods were conducted in accordance with relevant guidelines and regulations.
Variables
Participants completed a food frequency questionnaire (FFQ) to assess intake of total fat, PUFA, MUFA, SFA, animal fat, and vegetable oil. Sleep quality was evaluated using the Pittsburgh sleep quality index (PSQI).
Data Sources/Measurement

Data on dietary intake, and quantity and quality of fat intake

Dietary information was collected using a validated FFQ comprising 106 food items and designed in the Willett format. The validity and reliability of this FFQ have been established in previous studies [17]. This questionnaire assesses the frequency of food consumption over the previous year, thereby providing an estimate of long-term dietary intake. To convert FFQ data into nutrient values, the gram amount of food intake for each participant was calculated based on the reported consumption frequency and portion sizes. Each food item was then coded and entered into Nutritionist IV software, which facilitated the conversion of food items into specific nutrient data. Using this software, the amounts and percentages of energy, fat, and other nutrients consumed by each participant were calculated [18]. Although the FFQ is semi-quantitative, frequency categories were converted into numerical intake estimates by multiplying reported consumption frequencies by standard portion sizes and nutrient composition values.
Regarding the evaluation of fat quality, animal fat, vegetable oil, PUFA/SFA, and (PUFA+MUFA)/SFA ratios were calculated [19–22].

Structure of the PSQI

The validity [23] and reliability [23] of the PSQI have been previously established. This questionnaire consists of 19 questions organized into 7 components [24]: (1) subjective sleep quality, which assesses the individual’s personal perception of overall sleep quality; (2) sleep onset latency, which measures the severity and frequency of difficulty falling asleep, particularly when sleep onset exceeds 30 minutes; (3) sleep duration, for which scores are determined based on whether total sleep time is less than 6 hours, indicating a disturbance; (4) sleep efficiency, calculated as the ratio of actual sleep time to total time spent in bed multiplied by 100, with values below 75% indicating impairment in this component; (5) sleep disturbances, evaluated through questions addressing factors that may disrupt sleep, including environmental discomfort (such as feeling too hot or too cold), breathing difficulties, frequent awakenings, early awakening, pain, coughing, and related issues; (6) sleep medication, for which use is considered problematic when sleep medications are taken more than once or twice per week; and (7) daytime dysfunction, assessed through questions evaluating daytime sleepiness and difficulties with concentration during daily activities, including working, driving, eating, and other routine tasks.
Each component is scored on a scale from 0 to 3, with higher scores indicating poorer sleep quality. Scores from the 7 components are summed to generate a total scale score. This cumulative score serves as an overall indicator of sleep quality, with higher values reflecting poorer sleep quality.

Anthropometric assessment

Body weight and height were measured by trained research staff using standardized protocols. Weight was measured to the nearest 0.1 kg using a calibrated scale (SECA 700; SECA), with participants wearing light clothing and no shoes. Height was measured to the nearest 0.1 cm using a wall-mounted stadiometer (SECA 220; SECA), with participants standing upright without shoes. Body mass index (BMI) was calculated as weight (kg) divided by height squared (m²). Participants were categorized into 4 groups according to the World Health Organization classification: underweight (BMI<18.5 kg/m²), normal weight (BMI 18.5–24.9 kg/m²), overweight (BMI 25.0–29.9 kg/m²), and obese (BMI≥30.0 kg/m²).

Assessment of other variables

In this study, sociodemographic variables were assessed using a general questionnaire designed to capture key participant characteristics, including age, sex, education level, marital status, number of family members, and home ownership status. Physical activity was assessed using the General Physical Activity Questionnaire (GPAQ), developed by the World Health Organization. The GPAQ includes 16 items that capture physical activity across 3 domains: (1) activity at work, (2) travel to and from places, and (3) recreational activities. The questionnaire also assesses sedentary behavior. Based on the total weekly minutes of moderate and vigorous physical activity, participants were categorized into 4 activity levels: never, less than 1 hour, 1–3 hours, and more than 3 hours per week. The GPAQ has demonstrated acceptable reliability and validity in previous studies, particularly in test–retest reliability assessments.
Bias
The present study minimized bias through several approaches. First, the large sample size enhanced the reliability and generalizability of the findings. Second, validated and reliable questionnaires were used, including the PSQI, a well-established instrument with demonstrated accuracy in measuring sleep quality. Third, sleep quality was assessed comprehensively by examining multiple indices, allowing for a more nuanced evaluation of factors influencing sleep patterns.
Quantitative Variables
The Kolmogorov-Smirnov test was used to assess data normality. Quantitative variables were described using means and standard deviations (SDs), whereas qualitative variables were reported as numbers and percentages. Sleep quality scores derived from the PSQI were categorized into tertiles: 0–3 (good), 4–5 (moderate), and >5 (poor).
Statistical Methods
Participant characteristics were compared across sleep quality tertiles using the independent t-test for quantitative variables and the chi-square test for qualitative variables. Analysis of covariance (ANCOVA) was used to evaluate differences in food intake, adjusted for age, sex, and energy intake, except for energy intake itself, which was adjusted for age and sex only. Dietary fat quantity and quality were compared with sleep quality using ANCOVA, with further adjustment for marital status, physical activity, education level, BMI, and socioeconomic status. Binary logistic regression analysis was performed to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for sleep quality components across tertiles of fat quantity and quality indices. Although the FFQ initially generated continuous intake values, these were categorized into tertiles (low, medium, high) for analytical purposes. Because the dependent variables were categorical rather than continuous, logistic regression was considered the appropriate analytical approach.
Ordinal regression analysis was conducted to explore the association between fat intake, including both quantity and quality, and overall sleep quality.
Analyses were conducted using 3 sequential adjustment models. Model 1 was adjusted for age, sex, and energy intake. Age and sex were included as fundamental demographic confounders influencing both sleep physiology and dietary patterns, while energy intake was included to account for total caloric consumption that could confound associations between macronutrient compositions and sleep outcomes. Model 2 (socioeconomic and lifestyle adjustment) additionally included socioeconomic status, education level, marital status, and physical activity, as these factors influence dietary behaviors and health-related outcomes. Model 3 (full adjustment model) further included BMI, which may partially mediate the association between dietary fat intake and sleep quality, given the established links between obesity, dietary fat consumption, inflammation, and sleep disturbances. Confounders were selected based on prior literature and their potential influence on both exposure and outcome to minimize bias.
All statistical analyses were performed using IBM SPSS ver. 25.0 (IBM Corp.), and a p-value <0.05 was considered statistically significant.
Ethics Statements
The study protocol was approved by the Ethics Committee of Tehran University of Medical Sciences and registered with the Iranian Registry of Clinical Trials (IR.TUMS.MEDICINE.REC.1401.624).
Participants
A total of 1,904 participants were included in this analysis.
Descriptive Data
Fifty-five percent of the participants were female. The mean±SD age and BMI of the study population were 39.63±10.24 years and 27.08±4.91 kg/m², respectively.
Outcome Data
The study identified an association between dietary fat intake and sleep quality. Higher consumption of animal fat and PUFAs was associated with higher total sleep quality scores and increased odds of longer sleep onset latency. Conversely, higher intake of animal fat and SFAs was associated with a greater likelihood of sleep disturbances. In addition, increased intake of PUFAs, MUFAs, and total fat was associated with higher odds of using sleep medication. When stratified by sex, higher intake of total fat and unsaturated fats was also associated with higher total sleep quality scores among women.
Main Results
The general characteristics of participants according to tertiles of total sleep quality score are presented in Table 1. Compared with participants in the lowest tertile, those in the highest tertile had a higher mean age and higher BMI (p<0.001). In addition, they were more likely to be overweight or obese and to have postgraduate education (p<0.001). A higher percentage of men were classified in the lowest tertile compared with the highest tertile, whereas a higher percentage of women were classified in the highest tertile compared with the lowest tertile (p<0.001). With respect to socioeconomic status, participants in the third tertile of total sleep quality score were more likely to be in the medium socioeconomic category (p=0.005). No other significant differences were observed in other general characteristics across tertiles of total sleep quality score.
Table 2 presents comparisons of dietary intake among participants across tertiles of total sleep quality score at baseline. The results showed that participants in the third tertile consumed less fiber (p=0.004) compared with those in the first tertile. No other significant differences were observed in other dietary intakes among participants (p>0.05).
The association between dietary fat quantity and quality and total sleep quality score is shown in Table 3. Individuals in the third tertile of PUFA intake, compared with those in the first tertile, had 27% higher odds of having a higher total sleep quality score (OR, 1.27; 95% CI, 1.006–1.62), which was statistically significant. Although modest, this increase may have some clinical relevance for adults with poor baseline sleep quality. Similarly, for animal fat intake, individuals in the third tertile compared with the first tertile had 44% higher odds of having a higher total sleep quality score (OR, 1.44; 95% CI, 1.09–1.89), which was also statistically significant and suggests a potentially meaningful association with sleep quality.
The associations between dietary fat quantity and quality and total sleep quality score stratified by sex are presented in Table 4. The findings indicate that among women, higher intake of total fat and specific types of fatty acids was associated with a higher likelihood of being classified in higher categories of total sleep quality score. In contrast, no statistically significant associations were observed among men.
Specifically, women in the third tertile of total fat intake, compared with those in the first tertile, had a higher likelihood of having a higher total sleep quality score (OR, 1.37; 95% CI, 1.04–1.82). In addition, being in the third tertile compared with the first tertile of PUFA intake (OR, 1.41; 95% CI, 1.07–1.87), MUFA intake (OR, 1.44; 95% CI, 1.09–1.90), SFA intake (OR, 1.33; 95% CI, 1.01–1.77), and animal fat intake (OR, 1.58; 95% CI, 1.18–2.11) was also associated with a higher likelihood of being in higher categories of total sleep quality score among women.
An examination of dietary fat profiles in relation to individual sleep components revealed several notable associations, as presented in Tables 5–11. A higher percentage of PUFAs was associated with increased sleep onset latency, which may adversely affect sleep efficiency in susceptible individuals (Table 6). Furthermore, higher intake of SFAs and total animal fat was associated with an increased probability of sleep disturbances, indicating a potentially important effect on sleep quality (Table 9). Elevated total fat intake, along with higher proportions of PUFAs and MUFAs, was positively associated with sleep medication use, highlighting a clinically relevant implication (Table 10). No other significant associations were observed for other dietary intakes. Detailed results are provided in Tables 4–10.
Key Results
In this cross-sectional study, several associations between dietary fat intake and sleep quality were observed. Higher PUFA intake and higher animal fat intake were associated with higher total sleep quality scores. Among women in particular, higher intakes of total fat, PUFA, MUFA, SFA, and animal fat were associated with a higher likelihood of being classified in higher categories of total sleep quality score.
Limitations
Several limitations should be acknowledged, including (1) the cross-sectional design, which does not allow causal relationships to be established and limits inference regarding directionality; (2) the potential for recall and response bias, as the use of self-reported questionnaires, such as the FFQ for dietary intake and the PSQI for sleep quality, may affect measurement accuracy; (3) limited generalizability, as the findings may not be applicable to broader populations or different settings; (4) the possibility of residual confounding, which cannot be excluded and may have influenced the observed associations; (5) the absence of objective sleep assessment methods, such as actigraphy or polysomnography, which could provide more precise measures of sleep quality; and (6) recruitment from primary health care centers, which may further restrict generalizability to the wider population.
Interpretation
The findings suggest that different types of dietary fats may be differentially associated with sleep-related outcomes. The observed association between higher PUFA intake and poorer sleep quality is consistent with some previous studies [25,26], although the overall literature remains inconsistent. For example, some evidence indicates beneficial effects of ω-3 fatty acids, whereas other studies suggest more complex or potentially adverse associations with ω-6 fatty acids [25]. Given that PUFA intake in Iran predominantly derives from ω-6–rich oils such as sunflower, corn, and soybean oils [26], these dietary patterns may partly explain the observed associations. The biological pathways linking dietary fat intake to sleep outcomes remain uncertain. Several speculative mechanisms proposed in the literature include the following: higher intake of ω-6 PUFAs or SFAs may promote inflammatory responses that affect neural processes involved in sleep regulation [27,28]; certain ω-6–rich plant oils may interfere with melatonin production, although supporting evidence is limited [29,30]; and saturated and animal fats may influence sleep indirectly through effects on digestion, metabolic regulation, or alterations in the gut microbiome [6,31].
In this study, higher intake of total fat and specific fatty acids (PUFA, MUFA, SFA, and animal fat) was associated with poorer sleep outcomes among women, whereas no statistically significant associations were observed among men, suggesting a sex-specific relationship between dietary fat intake and sleep quality. Previous research on dietary fat and sleep has yielded mixed findings, and the present results are consistent with evidence indicating that women may be more sensitive to the effects of dietary fat on sleep quality [32]. Women in this study tended to have poorer baseline sleep quality than men, which may increase susceptibility to the adverse effects of both dietary factors and sleep disturbances. In addition, women are particularly sensitive to hormonal fluctuations, including changes in estrogen and progesterone, which can influence sleep quality, circadian rhythms, and fat metabolism [33]. Differences in fat storage and metabolism, such as subcutaneous versus visceral fat distribution, may further modify the effects of dietary fat on sleep among women [34]. Biologically, women may be more responsive to fat quality, including SFA, MUFA, and PUFA [32]. Higher intake of certain fats may disrupt sleep architecture in women by affecting sleep stages, increasing nighttime awakenings, and reducing overall sleep quality. In contrast, men may be less affected, as their dietary fat intake tends to vary less and their sleep regulatory mechanisms may be more resilient, rendering sleep less sensitive to dietary fat exposure [35,36].
Similarly, higher MUFA and total fat intakes were associated with greater use of sleep medication. While some studies support this association [37,38] and others report opposing findings [39,40], several speculative mechanisms may account for these inconsistencies. MUFAs may influence lipid-related signaling pathways involved in sleep regulation, and individual differences in fat sensitivity, as well as variation in dietary MUFA sources, may further contribute to heterogeneous findings [41,42]. These explanations remain hypothetical and warrant further investigation.
Generalizability
The use of the validated PSQI instrument and multiple sleep-quality indices supports the reliability of sleep assessment in this study. However, the findings primarily reflect characteristics of participants from a single province in Iran and therefore may not be generalizable to other populations or cultural contexts.
This study demonstrates that both the quantity and quality of dietary fat intake are significantly associated with sleep quality.
Higher intakes of PUFA and animal fat were associated with higher total sleep quality scores. When stratified by sex, higher intake of total fat and unsaturated fats was associated with higher total sleep quality scores among women.
These findings underscore the need for future studies employing more robust methodological designs, including longitudinal or interventional approaches, and incorporating objective measures such as dietary records, actigraphy, or polysomnography. Such approaches are expected to improve the precision and validity of assessments.
• Poor sleep quality and longer time to fall asleep were associated with higher intake of polyunsaturated fatty acids (PUFA).
• Consuming more animal fat was associated with worse sleep quality and increased sleep disturbances.
• Saturated fatty acids also contributed to an increase in sleep disturbances.
• Higher overall fat intake, particularly consumption of PUFA and monounsaturated fatty acids, was associated with a significantly higher likelihood of using sleep medication.
• The study suggests that the type and amount of dietary fat contribute to regulating sleep.

Ethics Approval

This study was approved by the Institutional Review Board of Tehran University of Medical Science and performed in accordance with the principles of the Declaration of Helsinki.

Written informed consent was obtained for publication of this study and accompanying images.

Conflicts of Interest

The authors have no conflicts of interest to declare.

Funding

Financial support for conception, design, data collection, data analysis and manuscript drafting came from Tehran University of Medical Sciences, Tehran, Iran and Isfahan University of Medical Sciences, Isfahan, Iran.

Availability of Data

All data generated or analyzed during this study are included in this published article. For other data, these may be requested through the corresponding author.

Authors’ Contributions

Conceptualization: MF, AE, PA, HR, AA; Data curation: AA, AF; Formal analysis: MF; Investigation: MF, AA; Methodology: HR, PA, AA; Project administration: PA, HR; Resourc­es: AE; Supervision: LA, AE; Validation: MF, AA; Visualization: MF, LA; Writing–original draft: MF; Writing–review & editing: all authors. All authors read and approved the final manuscript.

Additional Contributions

Isfahan University of Medical Science provided support for data collection.

Acknowledgements

We are thankful to Tehran University of Medical Sciences and Isfahan University of Medical Sciences to support this process.

Association of quantity and quality of fat intake with sleep quality: a cross-sectional study in Iran
Table 1.
General characteristics of participants at the beginning of the study according to tertiles of total sleep quality scores
Table 1.
Characteristic Tertiles of total sleep quality p
First tertile (≤3, n=780) Second tertile (4–5, n=278) Third tertile (>5, n=767)
Quantitative variable
 Age (y) 38.26±9.78 39.23±10.25 40.97±10.47 ≤0.001
 Body mass index (kg/m2) 26.41±4.40 26.84±4.69 27.77±5.41 ≤0.001
Qualitative variables
 Classification of body mass index ≤0.001
  Low weight 15 (1.9) 9 (2.3) 13 (1.9)
  Normal weight 277 (37.8) 119 (30.3) 208 (29.8)
  Overweight 298 (40.7) 165 (42.0) 262 (37.5)
  Obese 143 (19.5) 100 (25.4) 215 (30.8)
 Sex ≤0.001
  Male 426 (54.6) 138 (49.6) 266 (34.7)
  Female 354 (45.4) 140 (50.4) 501 (65.3)
 Marital status 0.13
  Married 580 (83.1) 319 (81.4) 605 (82.5)
  Widow 17 (2.4) 7 (1.8) 7 (1)
  Divorced 14 (2) 3 (0.8) 12 (1.6)
  Single 87 (12.5) 63 (16.1) 109 (14.9)
 Education (y) ≤0.001
  ˂12 203 (27.9) 121 (30.8) 279 (40.4)
  ≥12 524 (72.6) 272 (69.2) 411 (59.6)
 Socioeconomic status 0.005
  Low 76 (12) 46 (13.3) 104 (16.5)
  Moderate 339 (53.6) 200 (58) 367 (58.1)
  High 218 (34.4) 99 (28.7) 161 (25.5)
 Physical activity (per week) 0.50
  None 182 (40.4) 90 (20) 179 (39.9)
  <1 h 163 (38.2) 97 (22.7) 167 (39.1)
  1–3 h 158 (36.9) 97 (22.7) 173 (40.4)
  >3 h 184 (43.3) 91 (21.4) 150 (35.3)

Data are presented as mean±standard deviation or n (%). Values were obtained from 1-way analysis of variance to compare quantitative variables among more than 2 groups. The independent t-test was used to compare quantitative variables between 2 groups. The chi-square test was used to compare qualitative variables.

Table 2.
Comparison of dietary food intake of the participants at the beginning of the study among tertiles of total sleep quality score
Table 2.
Variable Tertiles of total sleep quality p
First tertile (≤3, n=780) Second tertile (4–5, n=278) Third tertile (≤5, n=768)
Energy (kcal/d) 2,529.29±46.55 2,529.86±62.95 2,529.61±47.94 1.00
CHO (g/d) 321.16±2.64 316.22±3.58 317.09±2.72 0.43
Protein (g/d) 93.28±0.62 93.84±0.84 92.92±0.64 0.69
Fat (g/d) 102.04±0.99 103.92±1.35 103.76±1.02 0.388
PUFA (g/d) 36.68±0.43 37.08±0.58 37.33±0.44 0.569
MUFA (g/d) 27.11±0.30 27.68±0.42 27.45±0.31 0.51
SFA (g/d) 24.03±0.27 24.37±0.37 24.29±0.28 0.72
Animal fat (g/d) 10.16±0.33 11.04±0.44 10.79±0.34 0.21
Vegetable oil (g/d) 44.34±0.63 44.21±0.86 45.51±0.65 0.35
Fiber intake (mg/d) 16.21±0.16 16.13±0.22 15.50±0.16 0.008

Data are presented as mean±standard deviation. All values are adjusted for age, sex, and energy intake, except for energy intake, which is only adjusted for age and sex. p-values are obtained from analysis of covariance.

CHO, carbohydrate; PUFA, polyunsaturated fatty acid; MUFA, monounsaturated fatty acid; SFA, saturated fatty acid.

Table 3.
Association between quantity and quality of fat intake and total sleep quality score
Table 3.
Model First tertile (ref.) Second tertile (OR, 95% CI) Third tertile (OR, 95% CI)
Tertiles of fat intake ˂33.7 (n=631) 33.7–40.14 (n=631) ˃40.14 (n=630)
 Crude model 1.00 1.80 (0.76–1.16) 1.46 (0.89–1.35)
 Model 1 1.00 0.98 (0.95–1.46) 1.18 (0.95–1.46)
 Model 2 1.00 1.003 (0.79–1.26) 1.20 (0.94–1.52)
 Model 3 1.00 1.01 (0.79–1.27) 1.20 (0.94–1.52)
Tertiles of PUFA percentage from energy ˂11.96 (n=631) 11–14.74 (n=630) ˃14.74 (n=630)
 Crude model 1.00 1.10 (0.89–1.36) 1.20 (0.97–1.48)
 Model 1 1.00 1.08 (0.87–1.34) 1.18 (0.95–1.47)
 Model 2 1.00 1.16 (0.92–1.47) 1.27 (1.008–1.62)
 Model 3 1.00 1.16 (0.92–1.47) 1.27 (1.006–1.62)
Tertiles of MUFA percentage from energy ˂8.65 (n=631) 8.65–10.70 (n=630) ˃10.7 (n=630)
 Crude model 1.00 1.009 (0.81–1.24) 1.33 (0.83–1.26)
 Model 1 1.00 1.05 (0.85–1.30) 1.15 (0.92–1.43)
 Model 2 1.00 1.14 (0.90–1.44) 1.21 (0.96–1.54)
 Model 3 1.00 1.13 (0.89–1.43) 1.20 (0.94–1.52)
Tertiles of SFA percentage from energy ˂7.61 (n=631) 7.61–9.46 (n=631) ˃9.46 (n=630)
 Crude model 1.00 1.03 (0.84–1.27) 1.06 (0.86–1.31)
 Model 1 1.00 1.02 (0.83–1.27) 1.15 (0.93–1.43)
 Model 2 1.00 1.06 (0.84–1.34) 1.17 (0.92–1.49)
 Model 3 1.00 1.05 (0.83–1.33) 1.16 (0.91–1.47)
Tertiles of animal fat (g/d) ˂6.33 (n=631) 6.33–9.57 (n=631) ˃9.57 (n=630)
 Crude model 1.00 1.20 (0.97–1.48) 1.09 (0.88–1.35)
 Model 1 1.00 1.30 (1.05–1.61) 1.40 (1.10–1.78)
 Model 2 1.00 1.37 (1.08–1.74) 1.50 (1.15–1.96)
 Model 3 1.00 1.32 (1.04–1.69) 1.44 (1.09–1.89)
Tertiles of vegetable oil (g/d) ˂31.43 (n=628) 31.43–47.63 (n=665) ˃47.63 (n=628)
 Crude model 1.00 0.80 (0.65–0.99) 0.79 (0.64–0.97)
 Model 1 1.00 0.90 (0.72–1.12) 0.90 (0.69–1.19)
 Model 2 1.00 0.92 (0.72–1.18) 0.99 (0.73–1.33)
 Model 3 1.00 0.92 (0.72–1.17) 0.98 (0.72–1.33)
Tertiles of PUFA/SFA ˂1.40 (n=631) 1.40-1.73 (n=631) ˃1.73 (n=630)
 Crude model 1.00 1.02 (0.83–1.26) 1.15 (0.93,1.42)
 Model 1 1.00 0.95 (0.77–1.18) 1.03 (0.83–1.28)
 Model 2 1.00 0.98 (0.77–1.24) 1.07 (0.84–1.35)
 Model 3 1.00 0.99 (0.78–1.25) 1.08 (0.85–1.38)
Tertiles of PUFA+MUFA/SFA ˂27.67 (n=631) 27.67–40.93 (n=631) ˃40.93 (n=630)
 Crude model 1.00 0.80 (0.65–0.99) 0.75 (0.61–0.93)
 Model 1 1.00 0.85 (0.67–1.06) 0.81 (0.60–1.09)
 Model 2 1.00 0.86 (0.67–1.10) 0.88 (0.64–1.22)
 Model 3 1.00 0.84 (0.66–1.08) 0.88 (0.64–1.22)

Obtained from the ordinal regression test.

Ref., reference; OR, odds ratio; CI, confidence interval; model 1, adjusted for age, sex, and energy intake; model 2, in addition to previous items, adjusted for physical activity, marital status, socioeconomic status and education; model 3, in addition to the previous models, adjusted for body mass index; PUFA, polyunsaturated fatty acid; MUFA, monounsaturated fatty acid; SFA, saturated fatty acid.

Table 4.
Association between quantity and quality of fat intake and total sleep quality score, stratified by sex
Table 4.
Sex Model First tertile (ref.) Second tertile (OR, 95% CI) Third tertile (OR, 95% CI)
Percentage of fat intake Tertiles of fat intake ˂33.7 (n=631) 33.7–40.14 (n=631) ˃40.14 (n=630)
 Male Crude model 1.00 1.02 (0.70–1.49) 0.88 (0.67–1.16)
Adjusted model 1.00 1.00 (0.67–1.63) 0.97 (0.70–1.32)
 Female Crude model 1.00 0.90 (0.63–1.25) 1.32 (1.03–1.69)
Adjusted model 1.00 0.98 (0.67–1.40) 1.37 (1.04–1.82)
Tertiles of PUFA percentage from energy ˂11.96 (n=631) 11–14.74 (n=630) ˃14.74 (n=630)
 Male Crude model 1.00 0.97 (0.66–1.40) 0.97 (0.73–1.27)
Adjusted model 1.00 0.92 (0.60–1.39) 1.03 (0.75–1.43)
 Female Crude model 1.00 0.99 (0.70–1.53) 1.32 (1.03–1.69)
Adjusted model 1.00 0.97 (0.66–1.40) 1.41 (1.07–1.87)
Tertiles of MUFA percentage from energy ˂8.65 (n=631) 8.65–10.70 (n=630) ˃10.7 (n=630)
 Male Crude model 1.00 0.91 (0.62–1.32) 0.86 (0.65–1.13)
Adjusted model 1.00 0.99 (0.64–1.49) 0.92 (0.66–1.25)
 Female Crude model 1.00 1.01 (0.71–1.41) 1.29 (1.01–1.68)
Adjusted model 1.00 1.12 (0.78–1.64) 1.44 (1.09–1.91)
Tertiles of SFA percentage from energy ˂7.61 (n=631) 7.61–9.46 (n=631) ˃9.46 (n=630)
 Male Crude model 1.00 0.97 (0.66–1.40) 0.89 (0.67–1.17)
Adjusted model 1.00 1 (0.67–1.56) 1 (0.73–1.37)
 Female Crude model 1.00 0.92 (0.65–1.28) 1.28 (1.003–1.64)
Adjusted model 1.00 0.92 (0.63–1.32) 1.33 (1.01–1.77)
Tertiles of animal fat (g/d) ˂6.33 (n=631) 6.33–9.57 (n=631) ˃9.57 (n=630)
 Male Crude model 1.00 0.77 (0.52–1.11) 0.96 (0.72–1.27)
Adjusted model 1.00 0.90 (0.57–1.41) 1.03 (0.74–1.46)
 Female Crude model 1.00 0.79 (0.56–1.11) 1.61 (1.24–2.07)
Adjusted model 1.00 0.85 (0.57–1.24) 1.58 (1.18–2.11)
Tertiles of vegetable oil (g/d) ˂31.43 (n=628) 31.43–47.63 (n=665) ˃47.63 (n=628)
 Male Crude model 1.00 0.93 (0.63–1.34) 0.87 (0.65–1.15)
Adjusted model 1.00 1.11 (0.69–1.82) 0.90 (0.63–1.29)
 Female Crude model 1.00 0.72 (0.51–1.02) 1 (0.77–1.28)
Adjusted model 1.00 1 (0.64–1.56) 1.09 (0.79–1.52)
Tertiles of PUFA/SFA ˂1.40 (n=631) 1.40–1.73 (n=631) ˃1.73 (n=630)
 Male Crude model 1.00 1.04 (0.71–1.52) 1.04 (0.78–1.37)
Adjusted model 1.00 0.97 (0.63–1.46) 0.99 (0.72–1.36)
 Female Crude model 1.00 0.94 (0.67–1.32) 1.02 (1.03–1.12)
Adjusted model 1.00 0.92 (0.63–1.33) 1.10 (0.84–1.44)
Tertiles of PUFA+MUFA/SFA ˂27.67 (n=631) 27.67–40.93 (n=631) ˃40.93 (n=630)
 Male Crude model 1.00 0.81 (0.56–1.18) 0.75 (0.56,0.99)
Adjusted model 1.00 0.89 (0.53–1.49) 0.74 (0.50–1.08)
 Female Crude model 1.00 1.08 (0.52,1.04) 1.10 (0.86,1.41)
Adjusted model 1.00 0.98 (0.60–1.58) 1.46 (0.02–2.09)

Obtained from the ordinal regression test.

Ref., reference; OR, odds ratio; CI, confidence interval; adjusted model, adjusted for age, energy intake, physical activity, marital status, socioeconomic status, education and body mass index; PUFA, polyunsaturated fatty acid; MUFA, monounsaturated fatty acid; SFA, saturated fatty acid.

Table 5.
Investigating the association between the quantity and quality of fat intake with the subjective sleep quality in the participants in the study
Table 5.
Models First tertile (ref.) Second tertile (OR, 95% CI) Third tertile (OR, 95% CI) p-trend
Tertiles of fat percentage from energy ˂33.7 (n=631) 33.7–40.14 (n=631) ˃40.14 (n=630)
 Crude model 1.00 0.80 (0.60–1.06) 1.05 (0.80–1.06) 0.68
 Model 1 1.00 0.88 (0.66–1.17) 1.06 (0.80–1.40) 0.66
 Model 2 1.00 0.95 (0.69–1.30) 1.19 (0.87–1.63) 0.27
 Model 3 1.00 0.85 (0.62–1.17) 1.15 (0.84–1.57) 0.36
Tertiles of PUFA percentage from energy ˂11.96 (n=631) 11–14.74 (n=630) ˃14.74 (n=630)
 Crude model 1.00 1.01(0.76–1.35) 1.20 (0.91–1.59) 0.18
 Model 1 1.00 0.98 (0.73–1.31) 1.14 (0.86–1.51) 0.34
 Model 2 1.00 1.13 (0.82–1.55) 1.24 (0.90–1.70) 0.18
 Model 3 1.00 1.13 (0.82–1.55) 1.24 (0.90–1.71) 0.17
Tertiles of MUFA percentage from energy ˂8.65 (n=631) 8.65–10.70 (n=630) ˃10.7 (n=630)
 Crude model 1.00 0.82 (0.62–1.09) 1.02 (0.78–1.35) 0.84
 Model 1 1.00 0.82 (0.61–1.09) 1.05 (0.79–1.39) 0.72
 Model 2 1.00 0.85 (0.61–1.16) 1.14 (0.84–1.55) 0.40
 Model 3 1.00 0.84 (0.61–1.15) 1.13 (0.83–1.54) 0.43
Tertiles of SFA percentage from energy ˂7.61 (n=631) 7.61–9.46 (n=631) ˃9.46 (n=630)
 Crude model 1.00 0.89 (0.67–1.18) 1.04 (0.79–1.38) 0.73
 Model 1 1.00 0.88 (0.66–1.17) 1.06 (0.80–1.40) 0.66
 Model 2 1.00 0.95 (0.69–1.30) 1.19 (0.87–1.30) 0.27
 Model 3 1.00 0.94 (0.68–1.28) 1.18 (0.86–1.62) 0.29
Tertiles of animal fat (g/d) ˂6.33 (n=631) 6.33–9.57 (n=631) ˃9.57 (n=630)
 Crude model 1.00 1.13 (0.86–1.49) 0.98 (0.73–1.30) 0.89
 Model 1 1.00 1.20 (0.90–1.59) 1.15 (0.84–1.59) 0.34
 Model 2 1.00 1.25 (0.91–1.70) 1.17 (0.82–1.67) 0.33
 Model 3 1.00 1.17 (0.85–1.61) 0.98 (0.73–1.30) 0.61
Tertiles of vegetable oil (g/d) ˂31.43 (n=628) 31.43–47.63 (n=665) ˃47.63 (n=628)
 Crude model 1.00 0.83 (0.63–1.10) 0.81 (0.61–1.06) 0.13
 Model 1 1.00 0.87 (0.65–1.17) 0.85 (0.59–1.22) 0.36
 Model 2 1.00 0.91 (0.66–1.26) 0.86 (0.57–1.29) 0.46
 Model 3 1.00 0.91 (0.66–1.26) 0.87 (0.58–1.31) 0.51
Tertiles of PUFA/SFA ˂1.40 (n=631) 1.40–1.73 (n=631) ˃1.73 (n=630)
 Crude model 1.00 0.83 (0.62–1.01) 1.14 (0.87–1.50) 0.32
 Model 1 1.00 0.79 (0.59–1.05) 1.05 (0.80–1.39) 0.65
 Model 2 1.00 0.79 (0.57–1.09) 1 (0.73–1.36) 0.93
 Model 3 1.00 0.80 (0.58–1.10) 1.01 (0.74–1.39) 0.86
Tertiles of PUFA+MUFA/SFA ˂27.67 (n=631) 27.67–40.93 (n=631) ˃40.93 (n=630)
 Crude model 1.00 0.84 (0.64–1.11) 0.77 (0.58–1.02) 0.07
 Model 1 1.00 0.86 (0.64–1.15) 0.77 (0.52–1.14) 0.18
 Model 2 1.00 0.86 (0.62–1.18) 0.75 (0.49–1.16) 0.19
 Model 3 1.00 0.85 (0.61–1.18) 0.75 (0.49–1.16) 0.19

Obtained from the binary regression test.

Ref., reference; OR, odds ratio; CI, confidence interval; model 1, adjusted for age, sex, and energy intake; model 2, in addition to previous items, adjusted for physical activity, marital status, socioeconomic status, and education; model 3, in addition to the previous models, adjusted for body mass index; PUFA, polyunsaturated fatty acid; MUFA, monounsaturated fatty acid; SFA, saturated fatty acid.

Table 6.
Associations between the sleep onset latency component and indices of quantity and quality of dietary fat intake
Table 6.
Model First tertile (ref.) Second tertile (OR, 95% CI) Third tertile (OR, 95% CI) p-trend
Tertiles of fat percentage from energy ˂33.7 (n=631) 33.7–40.14 (n=631) ˃40.14 (n=630)
 Crude model 1.00 1.03 (0.82–1.29) 1.18 (0.94–1.48) 0.15
 Model 1 1.00 1.06 (0.83–1.34) 1.24 (0.98–1.57) 0.06
 Model 2 1.00 1.08 (0.83–1.40) 1.25 (0.96–1.63) 0.08
 Model 3 1.00 1.08 (0.83–1.40) 1.25 (0.96–1.63) 0.08
Tertiles of PUFA percentage from energy ˂11.96 (n=631) 11–14.74 (n=630) ˃14.74 (n=630)
 Crude model 1.00 1.17 (0.92–1.47) 1.44 (1.15–1.82) 0.001
 Model 1 1.00 1.12 (0.88–1.42) 1.39 (1.1–1.76) 0.006
 Model 2 1.00 1.22 (0.94–1.58) 1.40 (1.08–1.83) 0.01
 Model 3 1.00 1.22 (0.94–1.58) 1.40 (1.08–1.83) 0.01
Tertiles of MUFA percentage from energy ˂8.65 (n=631) 8.65–10.70 (n=630) ˃10.7 (n=630)
 Crude model 1.00 1.04 (0.83–1.31) 1.11 (0.89–1.40) 0.33
 Model 1 1.00 1.06 (0.83–1.34) 1.22 (0.96–1.54) 0.10
 Model 2 1.00 1.16 (0.89–1.51) 1.29 (0.99–1.67) 0.05
 Model 3 1.00 1.15 (0.89–1.50) 1.27 (0.98–1.65) 0.06
Tertiles of SFA percentage from energy ˂7.61 (n=631) 7.61–9.46 (n=631) ˃9.46 (n=630)
 Crude model 1.00 1.21 (0.96–1.52) 1.04 (0.83–1.31) 0.70
 Model 1 1.00 1.24 (0.98–1.56) 1.12 (0.88–1.42) 0.33
 Model 2 1.00 1.25 (0.96–1.61) 1.18 (0.90–1.53) 0.21
 Model 3 1.00 1.24 (0.96–1.60) 1.16 (0.89–1.52) 0.24
Tertiles of animal fat (g/d) ˂6.33 (n=631) 6.33–9.57 (n=631) ˃9.57 (n=630)
 Crude model 1.00 0.99 (0.78–1.24) 0.91 (0.72–1.15) 0.47
 Model 1 1.00 1.07 (0.85–1.36) 1.17 (0.90–1.52) 0.23
 Model 2 1.00 1.14 (0.88–1.47) 1.27 (0.95–1.70) 0.09
 Model 3 1.00 1.09 (0.83–1.42) 1.21 (0.90–1.64) 0.19
Tertiles of vegetable oil (g/d) ˂31.43 (n=628) 31.43–47.63 (n=665) ˃47.63 (n=628)
 Crude model 1.00 0.85 (0.67–1.07) 0.93 (0.74–1.17) 0.54
 Model 1 1.00 0.98 (0.77–1.26) 1.17 (0.86–1.58) 0.33
 Model 2 1.00 0.97 (0.74–1.27) 1.22 (0.87–1.70) 0.27
 Model 3 1.00 0.97 (0.74–1.27) 1.21 (0.87–1.70) 0.27
Tertiles of PUFA/SFA ˂1.40 (n=631) 1.40–1.73 (n=631) ˃1.73 (n=630)
 Crude model 1.00 1.26 (1.002–1.58) 1.34 (1.07–1.69) 0.01
 Model 1 1.00 1.16 (0.92–1.48) 1.17 (0.93–1.49) 0.17
 Model 2 1.00 1.14 (0.88–1.48) 1.15 (0.88–1.49) 0.30
 Model 3 1.00 1.16 (0.89–1.51) 1.17 (0.90–1.53) 0.24
Tertiles PUFA+MUFA/SFA ˂27.67 (n=631) 27.67–40.93 (n=631) ˃40.93 (n=630)
 Crude model 1.00 0.84 (0.67–1.06) 0.88 (0.70–1.10) 0.28
 Model 1 1.00 0.94 (0.73–1.20) 1.07 (0.77–1.47) 0.74
 Model 2 1.00 0.89 (0.68–1.17) 1.11 (0.78–1.58) 0.64
 Model 3 1.00 0.88 (0.67–1.16) 1.11 (0.78–1.58) 0.64

Obtained from the binary regression test.

Ref., reference; OR, odds ratio; CI, confidence interval; model 1, adjusted for age, sex, and energy intake; model 2, in addition to the previous models, adjusted for physical activity, marital status, socioeconomic status, and education; model 3, in addition to the previous models, adjusted for body mass index; PUFA, polyunsaturated fatty acid; MUFA, monounsaturated fatty acid; SFA, saturated fatty acid.

Table 7.
Associations between sleep duration and indices of quantity and quality of dietary fat intake
Table 7.
Model First tertile (ref.) Second tertile (OR, 95% CI) Third tertile (OR, 95% CI) p-trend
Tertiles of fat percentage from energy ˂33.7 (n=631) 33.7–40.14 (n=631) ˃40.14 (n=630)
 Crude model 1.00 0.76 (0.57–1.00) 0.73 (0.55–0.96) 0.02
 Model 1 1.00 0.82 (0.62–1.09) 0.81 (0.61–1.08) 0.14
 Model 2 1.00 0.82 (0.60–1.11) 0.83 (0.61–1.13) 0.22
 Model 3 1.00 0.82 (0.60–1.11) 0.82 (0.60–1.12) 0.20
Tertiles of PUFA percentage from energy ˂11.96 (n=631) 11–14.74 (n=630) ˃14.74 (n=630)
 Crude model 1.00 0.84 (0.64–1.11) 0.93 (0.70–1.22) 0.61
 Model 1 1.00 0.87 (0.66–1.16) 0.98 (0.74–1.30) 0.91
 Model 2 1.00 0.94 (0.69–1.28) 1.08 (0.8–1.47) 0.59
 Model 3 1.00 0.95 (0.69–1.29) 1.08 (0.79–1.47) 0.62
Tertiles of MUFA percentage from energy ˂8.65 (n=631) 8.65–10.70 (n=630) ˃10.7 (n=630)
 Crude model 1.00 0.88 (0.67–1.16) 0.71 (0.54–0.95) 0.02
 Model 1 1.00 0.95 (0.72–1.25) 0.80 (0.60–1.07) 0.15
 Model 2 1.00 0.98 (0.73–1.32) 0.84 (0.61–1.15) 0.29
 Model 3 1.00 0.97 (0.72–1.32) 0.82 (0.60–1.13) 0.20
Tertiles of SFA percentage from energy ˂7.61 (n=631) 7.61–9.46 (n=631) ˃9.46 (n=630)
 Crude model 1.00 0.73 (0.56–0.97) 0.73 (0.55–0.96) 0.02
 Model 1 1.00 0.76 (0.58–1.01) 0.81 (0.61–1.08) 0.14
 Model 2 1.00 0.74 (0.55–1) 0.84 (0.61–1.14) 0.23
 Model 3 1.00 0.73 (0.54–0.99) 0.82 (0.60–1.12) 0.19
Tertiles of animal fat (g/d) ˂6.33 (n=631) 6.33–9.57 (n=631) ˃9.57 (n=630)
 Crude model 1.00 1.03 (0.78–1.36) 1.04 (0.78–1.38) 0.76
 Model 1 1.00 1.05 (0.79–1.39) 1.11 (0.81–1.52) 0.49
 Model 2 1.00 0.98 (0.72–1.34) 1.07 (0.76–1.51) 0.67
 Model 3 1.00 0.94 (0.68–1.29) 1.02 (0.71–1.45) 0.91
Tertiles of vegetable oil (g/d) ˂31.43 (n=628) 31.43–47.63 (n=665) ˃47.63 (n=628)
 Crude model 1.00 0.57 (0.43–0.76) 0.82 (0.63–1.07) 0.14
 Model 1 1.00 0.60 (0.45–0.82) 0.81 (0.57–1.16) 0.16
 Model 2 1.00 0.62 (0.45–0.86) 0.77 (0.52–1.13) 0.12
 Model 3 1.00 0.62 (0.45–0.86) 0.76 (0.52–1.12) 0.10
Tertiles of PUFA/SFA ˂1.40 (n=631) 1.40–1.73 (n=631) ˃1.73 (n=630)
 Crude model 1.00 0.91 (0.69–1.20) 1.01 (0.77–1.33) 0.91
 Model 1 1.00 0.87 (0.65–1.16) 0.96 (0.72–1.28) 0.81
 Model 2 1.00 0.88 (0.64–1.20) 0.96 (0.70–1.31) 0.83
 Model 3 1.00 0.89 (0.65–1.12) 0.98 (0.72–1.34) 0.94
Tertiles PUFA+MUFA/SFA ˂27.67 (n=631) 27.67–40.93 (n=631) ˃40.93 (n=630)
 Crude model 1.00 0.67 (0.50–0.89) 0.84 (0.64–1.01) 0.20
 Model 1 1.00 0.68 (0.51–0.93) 0.81 (0.55–1.18) 0.19
 Model 2 1.00 0.70 (0.51–0.97) 0.74 (0.49–1.11) 0.10
 Model 3 1.00 0.69 (0.50–0.95) 0.74 (0.49–1.12) 0.10

Obtained from the binary regression test.

Ref., reference; OR, odds ratio; CI, confidence interval; model 1, adjusted for age, sex, and energy intake; model 2, in addition to the previous models, adjusted for physical activity, marital status, socioeconomic status, and education; model 3, in addition to the previous models, adjusted for body mass index; PUFA, polyunsaturated fatty acid; MUFA, monounsaturated fatty acid; SFA, saturated fatty acid.

Table 8.
Associations between the sleep efficiency component and indices of the quantity and quality of fat
Table 8.
Model First tertile (ref.) Second tertile (OR, 95% CI) Third tertile (OR, 95% CI) p-trend
Tertiles of fat percentage from energy ˂33.7 (n=631) 33.7–40.14 (n=631) ˃40.14 (n=630)
 Crude model 1.00 0.82 (0.55–1.21) 1.01 (0.70–1.48) 0.91
 Model 1 1.00 0.84 (0.56–1.25) 1.08 (0.74–1.59) 0.66
 Model 2 1.00 0.87 (0.57–1.35) 1.06 (0.69–1.63) 0.77
 Model 3 1.00 0.87 (0.57–1.35) 1.04 (0.68–1.60) 0.85
Tertiles of PUFA percentage from energy ˂11.96 (n=631) 11–14.74 (n=630) ˃14.74 (n=630)
 Crude model 1.00 0.79 (0.53–1.17) 1.02 (0.70–1.48) 0.88
 Model 1 1.00 0.75 (0.50–1.12) 0.96 (0.65–1.41) 0.88
 Model 2 1.00 0.81 (0.52–1.26) 1.03 (0.67–1.58) 0.85
 Model 3 1.00 0.81 (0.52–1.26) 1.02 (0.66–1.56) 0.92
Tertiles of MUFA percentage from energy ˂8.65 (n=631) 8.65–10.70 (n=630) ˃10.7 (n=630)
 Crude model 1.00 1.17 (0.80–1.71) 0.89 (0.59–1.32) 0.57
 Model 1 1.00 1.20 (0.82–1.77) 0.98 (0.65–1.48) 0.97
 Model 2 1.00 1.22 (0.80–1.85) 0.98 (0.63–1.54) 0.99
 Model 3 1.00 1.04 (0.66–1.63) 1.26(0.81–1.95) 0.89
Tertiles of SFA percentage from energy ˂7.61 (n=631) 7.61–9.46 (n=631) ˃9.46 (n=630)
 Crude model 1.00 0.92 (0.62–1.36) 1.01 (0.69–1.49) 0.91
 Model 1 1.00 0.94 (0.63–1.39) 1.12 (0.75–1.65) 0.56
 Model 2 1.00 0.97 (0.63–1.48) 1.04 (0.67–1.61) 0.84
 Model 3 1.00 0.96 (0.63–1.47) 1.01 (0.65–1.57) 0.94
Tertiles of animal fat (g/d) ˂6.33 (n=631) 6.33–9.57 (n=631) ˃9.57 (n=630)
 Crude model 1.00 1.19 (0.82–1.74) 0.86 (0.57–1.30) 0.49
 Model 1 1.00 1.29 (0.87–1.89) 1.06 (0.67–1.67) 0.70
 Model 2 1.00 1.28 (0.84–1.95) 0.96 (0.58–1.58) 0.97
 Model 3 1.00 1.24 (0.80–1.91) 0.92 (0.55–1.53) 0.79
Tertiles of vegetable oil (g/d) ˂31.43 (n=628) 31.43–47.63 (n=665) ˃47.63 (n=628)
 Crude model 1.00 0.51 (0.34–0.76) 0.79 (0.55–1.14) 0.18
 Model 1 1.00 0.58 (0.38–0.90) 0.92 (0.57–1.51) 0.55
 Model 2 1.00 1.04 (0.63–1.72) 1.35 (0.85–2.12) 0.92
 Model 3 1.00 0.69 (0.43–1.11) 1.12 (0.66–1.92) 0.81
Tertiles of PUFA/SFA ˂1.40 (n=631) 1.40–1.73 (n=631) ˃1.73 (n=630)
 Crude model 1.00 0.61 (0.41–0.90) 0.83 (0.57–1.20) 0.31
 Model 1 1.00 0.54 (0.36–0.81) 0.70 (0.48–1.02) 0.06
 Model 2 1.00 0.60 (0.39–0.94) 0.79 (0.52–1.21) 0.31
 Model 3 1.00 0.62 (0.40–0.96) 0.82 (0.54–1.25) 0.39
Tertiles PUFA+MUFA/SFA ˂27.67 (n=631) 27.67–40.93 (n=631) ˃40.93 (n=630)
 Crude model 1.00 0.60 (0.40–0.89) 0.78 (0.54–1.12) 0.16
 Model 1 1.00 0.67 (0.44–1.02) 0.88 (0.51–1.50) 0.47
 Model 2 1.00 0.69 (0.44–1.10) 0.94 (0.53–1.67) 0.68
 Model 3 1.00 0.67 (0.42–1.07) 0.95 (0.53–1.68) 0.68

Obtained from the binary regression test.

Ref., reference; OR, odds ratio; CI, confidence interval; model 1, adjusted for age, sex, and energy intake; model 2, in addition to the previous models, adjusted for physical activity, marital status, socioeconomic status, and education; model 3, in addition to the previous models, adjusted for body mass index; PUFA, polyunsaturated fatty acid; MUFA, monounsaturated fatty acid; SFA, saturated fatty acid.

Table 9.
Associations between the component sleep disturbance and indices of the quantity and quality of fat intake
Table 9.
Model First tertile (ref.) Second tertile (OR, 95% CI) Third tertile (OR, 95% CI) p-trend
Tertiles of fat percentage from energy ˂33.7 (n=631) 33.7–40.14 (n=631) ˃40.14 (n=630)
 Crude model 1.00 1.03 (0.82–1.28) 1.23 (0.98–1.53) 0.06
 Model 1 1.00 1.06 (0.84–1.34) 1.33 (1.06–1.68) 0.01
 Model 2 1.00 1.11 (0.86–1.43) 1.35 (1.04–1.74) 0.02
 Model 3 1.00 1.26 (0.56–2.82) 1.39 (0.62–3.09) 0.02
Tertiles of PUFA percentage from energy ˂11.96 (n=631) 11–14.74 (n=630) ˃14.74 (n=630)
 Crude model 1.00 1.09 (0.87–1.37) 1.29 (1.03–1.61) 0.02
 Model 1 1.00 1.07 (0.85–1.35) 1.28 (1.01–1.61) 0.03
 Model 2 1.00 1.11 (0.86–1.43) 1.27 (0.98–1.64) 0.06
 Model 3 1.00 1.12 (0.86–1.44) 1.27 (0.98–1.64) 0.06
Tertiles of MUFA percentage from energy ˂8.65 (n=631) 8.65–10.70 (n=630) ˃10.7 (n=630)
 Crude model 1.00 1.004 (0.80–1.25) 1.10 (0.88–1.37) 0.37
 Model 1 1.00 1.02 (0.81–1.28) 1.23 (0.97–1.54) 0.07
 Model 2 1.00 1.12 (0.87–1.45) 1.27 (0.99–1.65) 0.06
 Model 3 1.00 1.11 (0.86–1.44) 1.26 (0.97–1.63) 0.07
Tertiles of SFA percentage from energy ˂7.61 (n=631) 7.61–9.46 (n=631) ˃9.46 (n=630)
 Crude model 1.00 1.14 (0.92–1.43) 1.12 (0.90–1.40) 0.29
 Model 1 1.00 1.17 (0.93–1.47) 1.24 (0.98–1.56) 0.06
 Model 2 1.00 1.24 (0.96–1.60) 1.31 (1.01–1.69) 0.03
 Model 3 1.00 1.23 (0.95–1.58) 1.29 (1.001–1.67) 0.04
Tertiles of animal fat (g/d) ˂6.33 (n=631) 6.33–9.57 (n=631) ˃9.57 (n=630)
 Crude model 1.00 1.20 (0.96–1.50) 1.08 (0.86–1.35) 0.51
 Model 1 1.00 0.31 (1.04–1.65) 1.38 (1.07–1.79) 0.01
 Model 2 1.00 1.43 (1.11–1.84) 1.45 (1.09–1.93) 0.008
 Model 3 1.00 1.35 (1.04–1.76) 1.37 (1.02–1.83) 0.03
Tertiles vegetable oil (g/d) ˂31.43 (n=628) 31.43–47.63 (n=665) ˃47.63 (n=628)
 Crude model 1.00 0.94 (0.75–1.17) 0.85 (0.68–1.06) 0.15
 Model 1 1.00 1.05 (0.82–1.33) 0.95 (0.71–1.28) 0.80
 Model 2 1.00 1.05 (0.80–1.36) 0.97 (0.70–1.34) 0.90
 Model 3 1.00 1.04 (0.80–1.36) 0.97 (0.70–1.34) 0.90
Tertiles PUFA/SFA ˂1.40 (n=631) 1.40–1.73 (n=631) ˃1.73 (n=630)
 Crude model 1.00 0.99 (0.79–1.24) 1.22 (0.98–1.52) 0.07
 Model 1 1.00 0.92 (0.73–1.16) 0.83 (0.66–1.05) 0.49
 Model 2 1.00 0.88 (0.68–1.13) 1.03 (0.79–1.33) 0.78
 Model 3 1.00 0.89 (0.69–1.15) 1.05 (0.81–1.36) 0.66
Tertiles PUFA+MUFA/SFA ˂27.67 (n=631) 27.67–40.93 (n=631) ˃40.93 (n=630)
 Crude model 1.00 0.86 (0.69–1.07) 0.81 (0.65–1.01) 0.06
 Model 1 1.00 0.92 (0.72–1.17) 0.88 (0.64–1.20) 0.41
 Model 2 1.00 0.86 (0.66–1.13) 0.89 (0.63–1.26) 0.49
 Model 3 1.00 0.85 (0.65–1.11) 0.89 (0.63–1.26) 0.47

Obtained from the binary regression test.

Ref., reference; OR, odds ratio; CI, confidence interval; model 1, adjusted for age, sex, and energy intake; model 2, in addition to the previous models, adjusted for physical activity, marital status, socioeconomic status, and education; model 3, in addition to the previous models, adjusted for body mass index; PUFA, polyunsaturated fatty acid; MUFA, monounsaturated fatty acid; SFA, saturated fatty acid.

Table 10.
Associations between sleep medication and indices of quantity and quality of fat intake
Table 10.
Model First tertile (ref.) Second tertile (OR, 95% CI) Third tertile (OR, 95% CI) p-trend
Tertiles of fat percentage from energy ˂33.7 (n=631) 33.7–40.14 (n=631) ˃40.14 (n=630)
 Crude model 1.00 1.07 (0.63–1.80) 1.51 (0.93–2.46) 0.08
 Model 1 1.00 1.26 (0.74–2.16) 1.86 (1.12–3.07) 0.01
 Model 2 1.00 1.26 (0.68–2.33) 2.01 (1.14–3.56) 0.01
 Model 3 1.00 1.26 (0.68–2.33) 2.01 (1.14–3.56) 0.01
Tertiles of PUFA percentage from energy ˂11.96 (n=631) 11–14.74 (n=630) ˃14.74 (n=630)
 Crude model 1.00 0.96 (0.56–1.64) 1.63 (1.01–2.63) 0.03
 Model 1 1.00 1.07 (0.62–1.85) 1.84 (1.12–3.03) 0.01
 Model 2 1.00 1.28 (0.68–2.43) 2.40 (1.34–4.29) 0.002
 Model 3 1.00 1.28 (0.68–2.43) 2.40 (1.34–4.30) 0.002
Tertiles of MUFA percentage from energy ˂8.65 (n=631) 8.65–10.70 (n=630) ˃10.7 (n=630)
 Crude model 1.00 1.66 (0.98–2.80) 1.71 (1.02–2.88) 0.04
 Model 1 1.00 1.52 (0.90–2.58) 1.97 (1.17–3.30) 0.01
 Model 2 1.00 1.61 (0.88–2.95) 2.13 (1.17–3.87) 0.01
 Model 3 1.00 1.62 (0.88–2.97) 2.14 (1.18–3.87) 0.01
Tertiles of SFA percentage from energy ˂7.61 (n=631) 7.61–9.46 (n=631) ˃9.46 (n=630)
 Crude model 1.00 1.66 (0.98–2.80) 1.71 (1.02–2.88) 0.04
 Model 1 1.00 1.74 (1.02–2.95) 1.98 (1.16–3.36) 0.01
 Model 2 1.00 1.52 (0.84–2.73) 1.73 (0.95–3.14) 0.06
 Model 3 1.00 1.52 (0.85–2.74) 1.74 (0.96–3.15) 0.06
Tertiles of animal fat (g/d) ˂6.33 (n=631) 6.33–9.57 (n=631) ˃9.57 (n=630)
 Crude model 1.00 0.95 (0.57–1.55) 1.10 (0.67–1.79) 0.68
 Model 1 1.00 1.04 (0.62–1.73) 1.34 (0.78–2.32) 0.28
 Model 2 1.00 1.03 (0.58–1.84) 1.16 (0.62–2.19) 0.63
 Model 3 1.00 1.06 (0.58–1.91) 1.19 (0.62–2.28) 0.58
Tertiles vegetable oil (g/d) ˂31.43 (n=628) 31.43–47.63 (n=665) ˃47.63 (n=628)
 Crude model 1.00 1.08 (0.67–1.74) 0.84 (0.51–1.39) 0.52
 Model 1 1.00 1.24 (0.74–2.07) 1.11 (0.58–2.13) 0.67
 Model 2 1.00 1.46 (0.80–2.66) 1.62 (0.78–3.37) 0.18
 Model 3 1.00 1.46 (0.80–2.66) 1.62 (0.78–3.37) 0.18
Tertiles PUFA/SFA ˂1.40 (n=631) 1.40–1.73 (n=631) ˃1.73 (n=630)
 Crude model 1.00 0.90 (0.55–1.47) 0.93 (0.57,1.51) 0.78
 Model 1 1.00 0.86 (0.52–1.42) 0.90 (0.55–1.49) 0.70
 Model 2 1.00 0.96 (0.54–1.72) 1.07 (0.60–1.89) 0.81
 Model 3 1.00 0.96 (0.54–1.72) 1.06 (0.59–1.88) 0.82
Tertiles PUFA+MUFA/SFA ˂27.67 (n=631) 27.67–40.93 (n=631) ˃40.93 (n=630)
 Crude model 1.00 1.18 (0.73–1.91) 0.93 (0.56–1.54) 0.78
 Model 1 1.00 1.37 (0.81–2.32) 1.38 (0.68–2.77) 0.32
 Model 2 1.00 1.76 (0.95–3.26) 1.98 (0.89–4.38) 0.07
 Model 3 1.00 1.76 (0.95–3.26) 1.97 (0.89–4.36) 0.07

Obtained from the binary regression test.

Ref., reference; OR, odds ratio; CI, confidence interval; model 1, adjusted for age, sex, and energy intake; model 2, in addition to the previous models, adjusted for physical activity, marital status, socioeconomic status, and education; model 3, in addition to the previous models, adjusted for body mass index; PUFA, polyunsaturated fatty acid; MUFA, monounsaturated fatty acid; SFA, saturated fatty acid.

Table 11.
Associations between daytime dysfunction and indices of the quantity and quality of dietary fat intake
Table 11.
Model First tertile (ref.) Second tertile (OR, 95% CI) Third tertile (OR, 95% CI) p-trend
Tertiles of fat percentage from energy ˂33.7 (n=631) 33.7–40.14 (n=631) ˃40.14 (n=630)
 Crude model 1.00 0.81(0.60–1.09) 0.92 (0.69–1.24) 0.61
 Model 1 1.00 0.85 (0.62–1.15) 1.03 (0.76–1.39) 0.85
 Model 2 1.00 0.90 (0.64–1.25) 1.09 (0.78–1.52) 0.60
 Model 3 1.00 0.90 (0.65–1.26) 1.10 (0.78–1.53) 0.59
Tertiles of PUFA percentage from energy ˂11.96 (n=631) 11–14.74 (n=630) ˃14.74 (n=630)
 Crude model 1.00 0.92 (0.68–1.25) 1.15 (0.86–1.55) 0.31
 Model 1 1.00 0.90 (0.66–1.23) 1.14 (0.84–1.54) 0.37
 Model 2 1.00 1.03 (0.73,1.44) 1.25 (0.89–1.75) 0.17
 Model 3 1.00 1.04 (0.74–1.46) 1.26 (0.90–1.77) 0.17
Tertiles of MUFA percentage from energy ˂8.65 (n=631) 8.65–10.70 (n=630) ˃10.7 (n=630)
 Crude model 1.00 1.15 (0.85–1.55) 1.11 (0.82–1.49) 0.35
 Model 1 1.00 1.01 (0.74–1.36) 1.004 (0.73–1.36) 0.97
 Model 2 1.00 1.08 (0.77–1.50) 1.10 (0.79–1.55) 0.54
 Model 3 1.00 1.05 (0.76–1.47) 1.09 (0.77–1.53) 0.60
Tertiles of SFA percentage from energy ˂7.61 (n=631) 7.61–9.46 (n=631) ˃9.46 (n=630)
 Crude model 1.00 0.83 (0.62–1.12) 0.88 (0.65–1.18) 0.38
 Model 1 1.00 0.85 (0.62–1.15) 0.98 (0.72–1.33) 0.91
 Model 2 1.00 0.83 (0.60–1.16) 1.04 (0.74–1.45) 0.83
 Model 3 1.00 0.83 (0.59–1.16) 1.01 (0.72–1.42) 0. 1
Tertiles of animal fat (g/d) ˂6.33 (n=631) 6.33–9.57 (n=631) ˃9.57 (n=630)
 Crude model 1.00 1.07 (0.79–1.43) 0.91 (0.67–1.23) 0.55
 Model 1 1.00 1.16 (0.86–1.58) 1.19 (0.84–1.67) 0.30
 Model 2 1.00 1.17 (0.84–1.63) 1.24 (0.85–1.81) 0.24
 Model 3 1.00 1.08 (0.77–1.51) 1.15 (0.79–1.69) 0.45
Tertiles vegetable oil (g/d) ˂31.43 (n=628) 31.43–47.63 (n=665) ˃47.63 (n=628)
 Crude model 1.00 0.57 (0.42–0.78) 0.77 (0.58–1.02) 0.06
 Model 1 1.00 0.69 (0.50–0.96) 1.01 (0.69–1.49) 0.83
 Model 2 1.00 0.78 (0.55–1.11) 1.14 (0.75–1.75) 0.67
 Model 3 1.00 0.79 (0.56–1.13) 1.16 (0.75–1.78) 0.64
Tertiles PUFA/SFA ˂1.40 (n=631) 1.40–1.73 (n=631) ˃1.73 (n=630)
 Crude model 1.00 0.86 (0.64–1.16) 1.07 (0.79–1.43) 0.64
 Model 1 1.00 0.78 (0.57–1.07) 0.92 (0.68 ،1.24) 0.62
 Model 2 1.00 0.80 (0.57–1.12) 0.90 (0.64–1.25) 0.56
 Model 3 1.00 0.82 (0.58–1.15) 0.93 (0.66–1.30) 0.71
Tertiles PUFA+MUFA/SFA ˂27.67 (n=631) 27.67–40.93 (n=631) ˃40.93 (n=630)
 Crude model 1.00 0.61 (0.45–0.83) 0.78 (0.59–1.04) 0.08
 Model 1 1.00 0.73 (0.52–1.01) 1.07 (0.70–1.63) 0.97
 Model 2 1.00 0.72 (0.51–1.03) 1.10 (0.69–1.73) 0.93
 Model 3 1.00 0.71 (0.49–1.01) 1.12 (0.71–1.78) 0.87

Obtained from the binary regression test.

Ref., reference; OR, odds ratio; CI, confidence interval; model 1, adjusted for age, sex, and energy intake; model 2, in addition to the previous models, adjusted for physical activity, marital status, socioeconomic status, and education; model 3, in addition to the previous models, adjusted for body mass index; PUFA, polyunsaturated fatty acid; MUFA, monounsaturated fatty acid; SFA, saturated fatty acid.

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Association of quantity and quality of fat intake with sleep quality: a cross-sectional study in Iran
Osong Public Health Res Perspect. 2026;17(2):165-181.   Published online March 11, 2026
DOI: https://doi.org/10.24171/j.phrp.2025.0289
Download Citation

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Association of quantity and quality of fat intake with sleep quality: a cross-sectional study in Iran
Osong Public Health Res Perspect. 2026;17(2):165-181.   Published online March 11, 2026
DOI: https://doi.org/10.24171/j.phrp.2025.0289
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