The Interplay between Sleep Quality, Hedonic Hunger, and Adherence to the Mediterranean Diet among Early Adolescents

Aim: This study aimed to evaluate the relationship between sleep quality, hedonic hunger, and adherence to the Mediterranean Diet (MD) in early adolescents and to investigate if hedonic hunger would mediate the influence of sleep quality on adherence to the MD.

Method: A total of 786 middle school students (boys, 51%) aged 10-14 years were included in the study. A self-administered questionnaire was used to collect data. Hedonic hunger was assessed with the "Food Power Scale", sleep quality was evaluated with the "Pittsburgh Sleep Quality Index (PSQI)", and adherence to the MD was assessed with the "Mediterranean Diet Quality Index (KIDMED)". Anthropometric measurements were performed. Dietary intake was evaluated with a 24-hour food consumption record.

Results: Of the adolescents, 63.4% exhibited poor sleep quality, 59.2% had a moderate adherence score to MD, and 31.7% were classified as short sleepers. Adolescents with high hedonic hunger had significantly higher carbohydrates, but lower protein, and fruits. Adolescents with poor sleep quality and short sleep duration showed a lower proportion of daily fruit or fruit juice intake, dairy products for breakfast, daily yogurts and cheese intake, and a higher proportion of sweets or candy. PSQI significantly predicted hedonic hunger (β=0.13) and KIDMED (β=-0.15). Hedonic hunger significantly predicted KIDMED (β=-0.122; p=0.005). Adolescents with short sleep duration (OR= 1.70; 95% CI= 1.21-2.39) were more likely to have obesity/overweight CONCLUSION: The results of the study showed that higher hedonic hunger, lower sleep quality, and short duration are important factors associated with low adherence to the MD in early adolescence. It also showed that hedonic hunger mediates between sleep quality and adherence to the MD. Additionally, short sleep duration increased the risks of obesity in early adolescents.