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BMC Geriatrics

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Open Access 01-12-2021 | Research

Sleep duration, vegetable consumption and all-cause mortality among older adults in China: a 6-year prospective study

Authors: Chen Bai, Muqi Guo, Yao Yao, John S. Ji, Danan Gu, Yi Zeng

Published in: BMC Geriatrics | Issue 1/2021

Abstract

Background

Sleep duration and vegetable consumption are associated with mortality at old age (termed as sleep-mortality linkage and vegetable-mortality linkage, respectively). Yet, little is known about the interplay of sleep duration and vegetable consumption on mortality.

Methods

A dataset of nationwide longitudinal survey with 13,441 participants aged 65 years or older recruited in 2008 and followed up till 2014 was used. Sleep duration was classified into five groups (≤5, 6, 7–8, 9, and ≥ 10 h/day). Vegetable consumption was classified as either high frequency (eating vegetables almost daily) or low frequency. We used parametric Weibull hazard regression models to estimate associations of sleep duration and frequency of vegetable consumption with mortality, adjusting for demographics, socioeconomic factors, family/social support, health practice, and health conditions.

Results

Over the six-year study period, when only demographics were present, participants sleeping ≤5, 6, 9, and ≥ 10 h/day had relative hazard (RH) of mortality 1.18 (p < 0.001), 1.14(p < 0.01), 1.06 (p > 0.1), and 1.30 (p < 0.001), respectively, compared to those sleeping 7–8 h/day. The HRs were attenuated to 1.08 (p < 0.05), 1.08 (p < 0.05), 1.09 (p < 0.1), 1.18(p < 0.001), respectively, when all other covariates were additionally adjusted for. High frequency of eating vegetables was associated with 22% lower risk of mortality (RH= 0.78, p < 0.001) compared to low frequency in the demographic model, and with 9% lower risk (RH = 0.91, p < 0.05) in the full model. Subpopulation and interaction analyses show that the sleeping-mortality linkage was stronger in female, urban, oldest-old (aged ≥80), and illiterate participants compared to their respective male, rural, young-old, and literate counterparts. High frequency of vegetable intakes could offset the higher mortality risk in participants with short-sleeping duration, but low frequency of eating vegetables could exacerbate mortality risk for participants with either short or long sleep duration; and except for few cases, these findings held in subpopulations.

Conclusions

Too short and too long sleep durations were associated with higher mortality risk, and infrequent vegetable consumption could exacerbate the risk, although frequent vegetable intake could offset the risk for short sleep duration. The relationship between these two lifestyles and mortality was complex and varied among subpopulations.

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Reid KJ, Martinovich Z, Finkel S, Statsinger J, Golden R, Harter K, et al. Sleep: a marker of physical and mental health in the elderly. Am J Geriatric Psychiatry. 2006;14(10):860–6. https://doi.org/10.1097/01.JGP.0000206164.56404.ba.

Cappuccio FP, D'Elia L, Strazzullo P, Miller MA. Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies. Sleep. 2010;33(5):585–92. https://doi.org/10.1093/sleep/33.5.585.CrossRefPubMedPubMedCentral

Silva AA, de Mello RGB, Schaan CW, Fuchs FD, Redline S, Fuchs SC. Sleep duration and mortality in the older adults: a systematic review with meta-analysis. BMJ Open. 2016;6(2):e008119.CrossRef

Cai H, Shu X, Xiang Y, Yang G, Li H, Ji B, et al. Sleep duration and mortality: a prospective study of 113,138 middle-aged and older adults Chinese men and women. Sleep. 2015;38(4):529–36. https://doi.org/10.5665/sleep.4564.CrossRefPubMedPubMedCentral

Kurina LM, McClintock MK, Chen J, Waite LJ, Thisted RA, Lauderdale DS. Sleep duration and all-cause mortality: a critical review of measurement and associations. Ann Epidemiol. 2013;23(6):361–70. https://doi.org/10.1016/j.annepidem.2013.03.015.CrossRefPubMedPubMedCentral

Huang Y, Wahlqvist ML, Lee M. Sleep quality in the survival of elderly Taiwanese: roles for dietary diversity and pyridoxine in men and women. J Am Coll Nutr. 2013;32(6):417–27. https://doi.org/10.1080/07315724.2013.848158.CrossRefPubMed

Kim S, DeRoo LA, Sandler DP. Eating patterns and nutritional characteristics associated with sleep duration. Public Health Nutr. 2011;14(5):889–95. https://doi.org/10.1017/S136898001000296X.CrossRefPubMed

Trichopoulou A, Kouris-Blazos A, Wahlqvist ML, Gnardellis C, Lagiou P, Polychronopoulos E, et al. Diet and overall survival in older adults people. BMJ. 1995;311(7018):1457–60. https://doi.org/10.1136/bmj.311.7018.1457.

Olaya B, Moneta MV, Lara E, Miret M, Martín-María N, Moreno-Agostino D, et al. Fruit and vegetable consumption and potential moderators associated with all-cause mortality in a representative sample of Spanish older adults. Nutrients. 2019;11(8):1794. https://doi.org/10.3390/nu11081794.

10.

Nguyen B, Bauman A, Gale J, Banks E, Kritharides L, Ding D. Fruit and vegetable consumption and all-cause mortality: evidence from a large Australian cohort study. Int J Behav Nutr Phys Act. 2016;13(1):9. https://doi.org/10.1186/s12966-016-0334-5.CrossRefPubMedPubMedCentral

11.

Nagura J, Iso H, Watanabe Y, Maruyama K, Date C, Toyoshima H, et al. Fruit, vegetable and bean intake and mortality from cardiovascular disease among Japanese men and women: the JACC study. Br J Nutr. 2009;102(2):285–92. https://doi.org/10.1017/S0007114508143586.

12.

Campanini MZ, Guallar-Castillón P, Rodríguez-Artalejo F, Lopez-Garcia E. Mediterranean Diet and Changes in Sleep Duration and Indicators of Sleep Quality in Older Adults. Sleep. 2017;40:3.CrossRef

13.

Noorwali EA, Cade JE, Burley VJ, Hardie LJ. The relationship between sleep duration and fruit/vegetable intakes in UK adults: a cross-sectional study from the National Diet and nutrition survey. BMJ Open. 2018;8(4):e020810. https://doi.org/10.1136/bmjopen-2017-020810.CrossRefPubMedPubMedCentral

14.

Noorwali E, Hardie L, Cade J. Fruit and Vegetable Consumption and Their Polyphenol Content Are Inversely Associated with Sleep Duration: Prospective Associations from the UK Women's Cohort Study. Nutrients. 2018;10(11):1803.CrossRef

15.

Liu X, Liu L. Sleep habits and insomnia in a sample of elderly persons in China. Sleep. 2005:224.

16.

Sun X, Ma T, Yao S, Chen Z, Xu W, Jiang X, et al. Associations of sleep quality and sleep duration with frailty and pre-frailty in an elderly population Rugao longevity and ageing study. BMC Geriatr. 2020;20(1):9. https://doi.org/10.1186/s12877-019-1407-5.CrossRefPubMedPubMedCentral

17.

Lan T, Lan T, Wen C, Lin Y, Chuang Y. Nighttime sleep, Chinese afternoon nap, and mortality in the elderly. Sleep. 2007;30(9):1105–10. https://doi.org/10.1093/sleep/30.9.1105.CrossRefPubMedPubMedCentral

18.

Qiu L, Sautter J, Liu Y, Gu D. Age and gender differences in linkages of sleep with subsequent mortality and health among very old Chinese. Sleep Med. 2011;12(10):1008–17. https://doi.org/10.1016/j.sleep.2011.04.014.CrossRefPubMedPubMedCentral

19.

Umberson D, Karas Montez J. Social relationships and health: A flashpoint for health policy. J Health Soc Behav, 2010; 51(1_suppl): S54–S66. doi:https://doi.org/10.1177/0022146510383501

20.

Short SE, Mollborn S. Social determinants and health behaviors: conceptual frames and empirical advances. Curr Opin Psychol. 2015;5:78–84. https://doi.org/10.1016/j.copsyc.2015.05.002.CrossRefPubMedPubMedCentral

21.

Lippke S. Modelling and supporting complex behavior change related to obesity and diabetes prevention and management with the compensatory carry-over action model. J Diab Obes. 2014;1:1–5. https://doi.org/10.15436/2376-0494.14.009.CrossRef

22.

Lo Y, Chang Y, Wahlqvist ML, Huang H, Lee M. Spending on vegetable and fruit consumption could reduce all-cause mortality among older adults. Nutr J. 2012;11(113):1–9. https://doi.org/10.1186/1475-2891-11-113.CrossRef

23.

Shi Z, Zhang T, Byles J, Martin S, Avery JC, Taylor AW. Food habits, lifestyle factors and mortality among oldest old Chinese: the Chinese longitudinal healthy longevity survey (CLHLS). Nutrients. 2015;7(9):7562–79. https://doi.org/10.3390/nu7095353.CrossRefPubMedPubMedCentral

24.

Lee Y, Chang Y, Lee Y, Shelley M, Liu C. Dietary patterns with fresh fruits and vegetables consumption and quality of sleep among older adults in mainland China. Sleep Biol Rhythms. 2018;16(3):293–305. https://doi.org/10.1007/s41105-018-0163-9.CrossRef

25.

Zeng Y, Feng Q, Gu D, Vaupel JW. Demographics, phenotypic health characteristics and genetic analysis of centenarians in China. Mechanisms Ageing Dev. 2017; 165(Pt B): 86–97.

26.

Gu D. General data quality assessment of the CLHLS. In: Yi Z, Poston DL, Vlosky DA, Gu D, editors. Healthy longevity in China: demographic, socioeconomic, and psychological dimensions. Dordrecht: Springer Netherlands; 2008. p. 39–60. https://doi.org/10.1007/978-1-4020-6752-5_3.

27.

Gu D, Feng Q, Chen H, Zeng Y (2020). Chinese longitudinal healthy longevity survey. In D Gum Dupre ME. (eds.) Encyclopedia of gerontology and population aging. Cham: Springer. https://doi.org/10.1007/978-3-319-69892-2_968-1.

28.

Essien SK, Feng CX, Sun W, Farag M, Li L, Gao Y. Sleep duration and sleep disturbances in association with falls among the middle-aged and older adults in China: a population-based nationwide study. BMC Geriatr. 2018). https://doi.org/10.1186/s12877-018-0889-x;18(1):196.CrossRef

29.

Lo JC, Groeger JA, Cheng GH, Dijk D, Chee MWL. Self-reported sleep duration and cognitive performance in older adults: a systematic review and meta-analysis. Sleep Med. 2016;17:87–98. https://doi.org/10.1016/j.sleep.2015.08.021.CrossRefPubMed

30.

Nunes J, Jean-Louis G, Zizi F, Casimir GJ, von Gizycki H, Brown CD, et al. Sleep duration among black and white Americans: results of the National Health Interview Survey. J Natl Med Assoc. 2008;100(3):317–22. https://doi.org/10.1016/S0027-9684(15)31244-X.

31.

Aili K, Åström-Paulsson S, Stoetzer U, Svartengren M, Hillert L. Reliability of actigraphy and subjective sleep measurements in adults: the design of sleep assessments. J Clin Sleep Med. 2017;13(1):39–47. https://doi.org/10.5664/jcsm.6384.CrossRefPubMedPubMedCentral

32.

Patterson RE, Emond JA, Natarajan L, Wesseling-Perry K, Kolonel LN, Jardack P, et al. Short sleep duration is associated with higher energy intake and expenditure among African-American and non-Hispanic White adults. J Nutr. 2014;144(4):461–6. https://doi.org/10.3945/jn.113.186890.

33.

Magee CA, Holliday EG, Attia J, Kritharides L, Banks E. Investigation of the relationship between sleep duration, all-cause mortality, and preexisting disease. Sleep Med. 2013;14(7):591–6. https://doi.org/10.1016/j.sleep.2013.02.002.CrossRefPubMed

34.

Štefan L, Radman I, Podnar H, Vrgoč G. Sleep duration and sleep quality associated with dietary index in free-living very old adults. Nutrients. 2018;10(1748):1–8. https://doi.org/10.3390/nu10111748.CrossRef

35.

Jackson CL, Patel SR, Jackson WB, Lutsey PL, Redline S. Agreement between self-reported and objectively measured sleep duration among white, black, Hispanic, and Chinese adults in the United States: multi-ethnic study of atherosclerosis. Sleep. 2018;41(6):1–12. https://doi.org/10.1093/sleep/zsy057.CrossRef

36.

Owusu JT, Wennberg AMV, Holingue CB, Tzuang M, Abeson KD, Spira AP. Napping characteristics and cognitive performance in older adults. Int J Geriatr Psychiatr. 2019;34(1):87–96. https://doi.org/10.1002/gps.4991.CrossRef

37.

Zonoozi S, Ramsay SE, Papacosta O, Lennon L, Ellins EA, Halcox JPJ, et al. Self-reported sleep duration and napping, cardiac risk factors and markers of subclinical vascular disease: cross-sectional study in older men. BMJ Open. 2017;7(6):e016396. https://doi.org/10.1136/bmjopen-2017-016396.

38.

Zeng Y, Poston DL Jr, Vlosky DA, Gu D. Healthy Longevity in China: Demographic, Socioeconomic, and Psychological Dimensions. Netherlands: Springer; 2008.

39.

Hirshkowitz M, Whiton K, Albert SM, Alessi C, Bruni O, DonCarlos L, et al. National sleep foundation’s sleep time duration recommendations: methodology and results summary. Sleep Health. 2015;1(1):40–3. https://doi.org/10.1016/j.sleh.2014.12.010.

40.

Mello Rodrigues V, Bray J, Fernandes AC, Luci Bernardo G, Hartwell H, Secchi Martinelli S, et al. Vegetable consumption and factors associated with increased intake among college students: a scoping review of the last 10 years. Nutrients. 2019;11(7):1634. https://doi.org/10.3390/nu11071634.

41.

Stea TH, Nordheim O, Bere E, Stornes P, Eikemo TA. Fruit and vegetable consumption in Europe according to gender, educational attainment and regional affiliation—a crosssectional study in 21 European countries. PLoS One. 2020;15(5):e0232521 https://doi.org/10.1371/journal.pone.0232521.CrossRef

42.

Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. JAMA. 1963;185:914.CrossRef

43.

An R, Liu GG. Cognitive impairment and mortality among the oldest-old Chinese. Int J Geriatr Psychiatr. 2016;31(12):1345–53. https://doi.org/10.1002/gps.4442.CrossRef

44.

Luo Y, Zhang Z, Gu D. Education and mortality among older adults in China. Soc Sci Med. 2015;127:134–42. https://doi.org/10.1016/j.socscimed.2014.09.039.CrossRefPubMed

45.

Stata Bookstore: An introduction to survival analysis using Stata, Revised Third Edition. https://www.stata.com/bookstore/survival-analysis-stata-introduction/. Accessed 11 Apr 2020.

46.

Solon G, Haider SJ, Wooldridge JM. What are we weighting for? J Hum Resour. 2015;50(2):301–16. https://doi.org/10.3368/jhr.50.2.301.CrossRef

47.

Winship C, Radbill L. Sampling weights and regression analysis. Sociol Methods Res. 1994;23(2):230–57. https://doi.org/10.1177/0049124194023002004.CrossRef

48.

Castro-Costa É, Me D, Ferri CP, Uchôa E, Joa F, Rocha FL, et al. Association between sleep duration and all-cause mortality in old age: 9-year follow-up of the Bambuí cohort study, Brazil. J Sleep Res. 2011;20(2):303–10. https://doi.org/10.1111/j.1365-2869.2010.00884.x.CrossRefPubMed

49.

Cohen-Mansfield J, Perach R. Sleep duration, nap habits, and mortality in older persons. Sleep. 2012;35(7):1003–9. https://doi.org/10.5665/sleep.1970.CrossRefPubMedPubMedCentral

50.

Mesas AE, López-García E, León-Muñoz LM, Guallar-Castillón P, Rodríguez-Artalejo F. Sleep duration and mortality according to health status in older adults. J Am Geriatr Soc. 2010;58(10):1870–7. https://doi.org/10.1111/j.1532-5415.2010.03071.x.CrossRefPubMed

51.

Lee JSW, Auyeung TW, Leung J, Chan D, Kwok T, Woo J, et al. Long sleep duration is associated with higher mortality in older people independent of frailty: a 5-year cohort study. J Am Med Dir Assoc. 2014;15(9):649–54. https://doi.org/10.1016/j.jamda.2014.05.006.

52.

Ikehara S, Iso H, Date C, Kikuchi S, Watanabe Y, Wada Y, et al. Association of Sleep Duration with mortality from cardiovascular disease and other causes for Japanese men and women: the JACC study. Sleep. 2009;32(3):295–301. https://doi.org/10.1093/sleep/32.3.295.

53.

Patel SR, Ayas NT, Malhotra MR, White DP, Schernhammer ES, Speizer FE, et al. A prospective study of sleep duration and mortality risk in women. Sleep. 2004;27(3):440–4.39. https://doi.org/10.1093/sleep/27.3.440.

54.

Aune D, Giovannucci E, Boffetta P, Fadnes LT, Keum N, Norat T, et al. Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality-a systematic review and dose-response meta-analysis of prospective studies. Int J Epidemiol. 2017;46(3):1029–56. https://doi.org/10.1093/ije/dyw319.

55.

Wang X, Ouyang Y, Liu J, Zhu M, Zhao G, Bao W, et al. Fruit and vegetable consumption and mortality from all causes, cardiovascular disease, and cancer: systematic review and dose-response meta-analysis of prospective cohort studies. BMJ. 2014;349(3):g4490. https://doi.org/10.1136/bmj.g4490.

56.

Gu D, Sautter J, Pipkin R, Zeng Y. Sociodemographic and health correlates of sleep quality and duration among very old Chinese. Sleep. 2010;33(5):601–10. https://doi.org/10.1093/sleep/33.5.601.CrossRefPubMedPubMedCentral

57.

Grandner MA, Drummond SPA. Who are the long sleepers? Towards an understanding of the mortality relationship. Sleep Med Rev. 2007;11(5):341–60. https://doi.org/10.1016/j.smrv.2007.03.010.CrossRefPubMedPubMedCentral

58.

Besedovsky L, Lange T, Born J. Sleep and immune function. Pflugers Arch. 2011;463(1):121–37. https://doi.org/10.1007/s00424-011-1044-0.CrossRefPubMedPubMedCentral

59.

Kripke DF, Garfinkel L, Wingard DL, Klauber MR, Marler MR. Mortality associated with sleep duration and insomnia. Arch Gen Psychiatry. 2002;59(2):131–6. https://doi.org/10.1001/archpsyc.59.2.131.CrossRefPubMed

60.

Guo J, Fei Y, Li J, Zhang L, Luo Q, Chen G. Gender- and age-specific associations between sleep duration and prevalent hypertension in middle-aged and elderly Chinese: a cross-sectional study from CHARLS 2011–2012. BMJ Open. 2016;6(9):e011770. https://doi.org/10.1136/bmjopen-2016-011770.CrossRefPubMedPubMedCentral

61.

Suzuki E, Yorifuji T, Ueshima K, Takao S, Sugiyama M, Ohta T, et al. Sleep duration, sleep quality and cardiovascular disease mortality among the elderly: a population-based cohort study. Prev Med. 2009;49(2):135–41. https://doi.org/10.1016/j.ypmed.2009.06.016.

62.

Zhang S, Xie L, Yu H, Zhang W, Qian B. Association between nighttime-daytime sleep patterns and chronic diseases in Chinese elderly population: a community-based cross-sectional study. BMC Geriatr. 2019;19(1):124–10. https://doi.org/10.1186/s12877-019-1136-9.CrossRefPubMedPubMedCentral

63.

Lee PMY, Tse LA. Association between sleep duration, bed time and obesity in community-dwelling Hong Kong Chinese elderly: a population-based study. Sleep Med. 2019;64:S219.

64.

Meerlo P, Sgoifo A, Suchecki D. Restricted and disrupted sleep: Effects on autonomic function, neuroendocrine stress systems and stress responsivity. Sleep Med Rev. 2007, 2008;12(3):197–210.

65.

Iimuro S, Yoshimura Y, Umegaki H, Sakurai T, Araki A, Ohashi Y, et al. Dietary pattern and mortality in Japanese elderly patients with type 2 diabetes mellitus: does a vegetable- and fish-rich diet improve mortality? An explanatory study. Geriatr Gerontol Int. 2012;12:59–67. https://doi.org/10.1111/j.1447-0594.2011.00813.x.

66.

Anderson JW, Baird P, Davis RH, et al. Health benefits of dietary fibre. Nutr Rev. 2009;67:188–205.CrossRef

67.

Noorwali E, Hardie L, Cade J. Bridging the reciprocal gap between sleep and fruit and vegetable consumption: a review of the evidence, potential mechanisms, implications, and directions for future work. Nutrients. 2019;11(6):1382. https://doi.org/10.3390/nu11061382.CrossRefPubMedCentral

68.

Tan X, Chapman CD, Cedernaes J, Benedict C. Association between long sleep duration and increased risk of obesity and type 2 diabetes: a review of possible mechanisms. Sleep Med Rev. 2018;40:127–34. https://doi.org/10.1016/j.smrv.2017.11.001.CrossRefPubMed

69.

Chapman CD, Nilsson EK, Nilsson VC, Cedernaes J, Rangtell FH, et al. Acute sleep deprivation increases food purchasing in men. Obesity. 2013;21(12):E555–60. https://doi.org/10.1002/oby.20579.CrossRefPubMed

70.

Wurtman RJ, Wurtman JJ, Regan MM, McDermott JM, Tsay RH, Breu JJ. Effects of normal meals rich in carbohydrates or proteins on plasma tryptophan and tyrosine ratios. Am J Clin Nutr. 2003;77(1):128–32. https://doi.org/10.1093/ajcn/77.1.128.CrossRefPubMed

71.

Lana A, Struijk EA, Arias-Fernandez L, Graciani A, Mesas AE, Rodriguez-Artalejo F, et al. Habitual meat consumption and changes in sleep duration and quality in older adults. Aging Dis. 2019;10(2):267–77. https://doi.org/10.14336/AD.2018.0503.

72.

Dashti HS, Scheer FAJL, Jacques PF, Lamon-Fava S, Ordovás JM. Short sleep duration and dietary intake: epidemiologic evidence, mechanisms, and health implications. Adv Nutr. 2015;6(6):648–59. https://doi.org/10.3945/an.115.008623.CrossRefPubMedPubMedCentral

73.

Kromhout D, Bloemberg B, Feskens E, Menotti A, Nissinen A. Saturated fat, vitamin C and smoking predict long-term population all-cause mortality rates in the seven countries study. Int J Epidemiol. 2000;29(2):260–5. https://doi.org/10.1093/ije/29.2.260.CrossRefPubMed

74.

Tucker KL, Hallfrisch J, Qiao N, Muller D, Andres R, Fleg JL, et al. The combination of high fruit and vegetable and low saturated fat intakes is more protective against mortality in aging men than is either alone : the Baltimore longitudinal study of aging. J Nutr. 2005;135(3):556–61. https://doi.org/10.1093/jn/135.3.556.

75.

Barker M, St-Onge M, Seixas A, Killgore WD, Wills CC, Grandner MA. 0140 dietary macronutrients and sleep duration, sleep disturbance, and daytime fatigue. Sleep. 2020;43(Supplement_1):A55–6.CrossRef

76.

St-Onge MP, Roberts A, Shechter A, Choudhury AR. Fiber and saturated fat are associated with sleep arousals and slow wave sleep. J Clin Sleep Med. 2016;12(1):19–24. https://doi.org/10.5664/jcsm.5384.CrossRefPubMedPubMedCentral

77.

St-Onge MP, Crawford A, Aggarwal B. Plant-based diets: reducing cardiovascular risk by improving sleep quality? Curr Sleep Med Rep. 2018;4(1):74–8. https://doi.org/10.1007/s40675-018-0103-x.CrossRefPubMedPubMedCentral

78.

Åkerstedt T, Ghilotti F, Grotta A, Bellavia A, Lagerros YT, Bellocco R. Sleep duration, mortality and the influence of age. Eur J Epidemiol. 2017;32(10):881–91. https://doi.org/10.1007/s10654-017-0297-0.CrossRefPubMedPubMedCentral

79.

Liu TZ, Xu C, Rota M, Cai H, Zhang C, Shi MJ, et al. Sleep duration and risk of all-cause mortality: a flexible, non-linear, meta-regression of 40 prospective cohort studies. Sleep Med Rev. 2017;32:28–36. https://doi.org/10.1016/j.smrv.2016.02.005.

80.

Yang L, Yang H, He M, Pan A, Li X, Min X, et al. Longer sleep duration and midday napping are associated with a higher risk of CHD incidence in middle-aged and older Chinese: the Dongfeng-Tongji cohort study. Sleep. 2016;39(3):645–52. https://doi.org/10.5665/sleep.5544.

81.

Jiang CQ, Xu L, Lam TH, Jin YL, Sen Zhang W, Zhu F, et al. Glycemic measures and risk of mortality in older Chinese: the Guangzhou biobank cohort study. J Clin Endocrinol Metab. 2020;105(3):e181–90. https://doi.org/10.1210/clinem/dgz173.

82.

Liu Y, Zang Y, Yang Y. China’s rural revitalization and development: theory, technology and management. J Geogr Sci. 2020;30(12):1923–42. https://doi.org/10.1007/s11442-020-1819-3.CrossRef

Title: Sleep duration, vegetable consumption and all-cause mortality among older adults in China: a 6-year prospective study
Authors: Chen Bai
Muqi Guo
Yao Yao
John S. Ji
Danan Gu
Yi Zeng
Publication date: 01-12-2021
Publisher: BioMed Central
Published in: BMC Geriatrics / Issue 1/2021
Electronic ISSN: 1471-2318
DOI: https://doi.org/10.1186/s12877-021-02278-8

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