Associations of chrono-nutrition with sleep and quality of life: The Maastricht Study

Background & aims: Late-night eating may impair sleep quality, with poor sleep negatively affecting quality of life (QoL). As both sleep and eating behaviors are connected to circadian rhythms, interest in "chrono-nutrition", i.e., the timing, frequency and regularity of food consumption, has grown. This study investigated associations between chrono-nutrition and both sleep and QoL in a population-based study enriched with participants with type 2 diabetes. Methods: Cross-sectional data from 3463 participants (51 % women, mean age 63.6 years) of The Maastricht Study were analyzed. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (range 0-21, higher scores indicating worse quality), and QoL via the SF-36 mental and physical functioning subscales (range 0-100, higher scores indicating better functioning). Sleep duration and fragmentation were estimated using activPAL accelerometers. Meal frequency and irregularity, time-window of caloric intake, and interval between last meal and bedtime were assessed via a chrono-nutrition questionnaire. Associations with sleep quality and QoL were analyzed using multiple linear regression; associations with sleep duration (<7,7-9,>9 h) and fragmentation (0,<1,>1 breaks/night) were analyzed using multinomial logistic regression, adjusted for sociodemographic, clinical, and lifestyle factors. Results: Higher meal frequency was associated with poorer sleep quality (B (95%CI), 0.90 (0.33, 1.47) for Q2, 1.02 (0.49, 1.54) for Q3, and 0.68 (0.17, 1.20) for Q4, all vs. Q1), and lower mental functioning (-1.24 (-2.22, -0.25) for Q4vs.Q1). Higher meal irregularity was linearly associated with poorer sleep quality (B: 0.33, 0.20, 0.46) and lower physical functioning (B:-0.43, -0.65, -0.21). A longer time-window of caloric intake was associated with poorer sleep quality (0.57 (0.09, 1.06) for Q3 and 0.49 (-0.02, 0.99) for Q4, vs. Q1) and lower physical functioning (-0.17/hour, -0.32, -0.02) Conversely, a longer time-window between last meal and bedtime was associated with better sleep quality (-0.72 (-1.25, -0.19) for Q2 and -0.85 (-1.31, -0.39) for Q4, vs Q1) and higher mental (0.20/hour longer, 0.00, 0.41) and physical functioning (0.29/hour, 0.11, 0.48). There was no effect modification by glucose metabolism status. Conclusion: Higher meal frequency and irregularity were associated with impaired sleep and lower QoL. A longer interval between the last meal and bedtime may benefit sleep and QoL. (c) 2026 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).