Association of Dietary Insulin Index and Insulin Load with Sleep Quality among University Students: A Cross-Sectional Study

Document Type : Research Paper

Authors

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

2 Department of Clinical Psychology, School of Behavior Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.

3 Department of Biostatistics and Epidemiology, School of Public Health, Kashan University of Medical sciences, Kashan, Iran.

4 Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran.

Abstract

Introduction: Inadequate sleep quality is a prevalent health concern worldwide. University students are at a particularly higher risk of experiencing poor sleep quality. Dietary factors can modulate sleep performance. To the best of our knowledge, no study has yet examined the relationship between the dietary insulin index (DII) and dietary insulin load (DIL) with sleep quality among university students. Therefore, this study aimed to investigate the association between DII and DIL and sleep quality among Iranian university students.
Methods: In 2023, this cross-sectional study was conducted among 330 students enrolled at Kashan University of Medical Sciences. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Dietary intake was evaluated through a validated semi-quantitative food frequency questionnaire (FFQ) comprising 117 items. Multivariable regression models were applied to adjust for potential confounding factors, and a P-value of less than 0.05 was considered statistically significant. Results: After adjusting for all potential confounders, participants in the highest quartile of DII had 64% lower odds of experiencing sleep disturbances compared with those in the lowest quartile (OR = 0.36, 95% CI: 0.14–0.88). Similarly, individuals in the fourth quartile of DIL had 65% lower odds of experiencing sleep disturbances compared to those in the first quartile (OR = 0.35, 95% CI: 0.14–0.84). However, no statistically significant associations were observed between DII or DIL and overall sleep quality or its subcomponents. Conclusion: Higher DII and DIL were associated with lower odds of sleep disturbances among university students. These findings suggest a potential role of diet-induced insulin response in regulating sleep health. Further studies with larger sample sizes and more robust designs, such as prospective cohort studies, are warranted to confirm these results. 

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Articles in Press, Accepted Manuscript
Available Online from 01 October 2025
  • Receive Date: 04 August 2025
  • Revise Date: 23 September 2025
  • Accept Date: 01 October 2025