Associations of chrono-nutrition with sleep and quality of life: The Maastricht Study.
Level 4 - case-series / case-control
Cross-sectional observational study without dramatic effect size.
PubMed 41780086 · doi:10.1016/j.clnu.2026.106593
What was done
Cross-sectional analysis of 3,463 participants (51% women, mean age 63.6 years, enriched with type 2 diabetes) from The Maastricht Study. Meal frequency, meal irregularity, daily caloric intake time-window, and interval between last meal and bedtime were assessed using a chrono-nutrition questionnaire. Outcomes included self-reported sleep quality (Pittsburgh Sleep Quality Index, 0–21), quality of life (SF-36 physical and mental functioning subscales, 0–100), and accelerometer-derived (activPAL) sleep duration and fragmentation. Multivariable linear and multinomial logistic regressions adjusted for sociodemographic, clinical, and lifestyle factors were conducted.
What was found
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; 0.68 [0.17, 1.20] for Q4, all vs. Q1) and lower mental functioning (-1.24 [-2.22, -0.25] for Q4 vs. Q1). Greater 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 caloric intake window was associated with poorer sleep quality (0.57 [0.09, 1.06] for Q3 vs. Q1) and lower physical functioning (-0.17 per hour [-0.32, -0.02]). A longer interval between the last meal and bedtime was associated with better sleep quality (-0.72 [-1.25, -0.19] for Q2; -0.85 [-1.31, -0.39] for Q4, vs. Q1) and higher mental (0.20 per hour [0.00, 0.41]) and physical functioning (0.29 per hour [0.11, 0.48]). No effect modification by glucose metabolism status was found; quantitative results for objective sleep duration and fragmentation were not reported in the abstract.
Why it matters
This study shows that irregular eating patterns and eating close to bedtime are cross-sectionally linked to worse sleep quality and poorer functioning in older adults.
Limits
The cross-sectional design prevents causal inference and cannot rule out reverse causality. Chrono-nutrition measures relied on self-report questionnaires, and the cohort was older and enriched with type 2 diabetes, limiting generalizability.