The Relationship between Plant-Based Diet Indices and Sleep Health in Older Adults: The Mediating Role of Depressive Symptoms and Anxiety

Background: The goal of our research was to determine the effects of plant-based dietary patterns on sleep health among older adults and to examine the parallel mediated effects of anxiety and depression. Methods: This investigation utilized data obtained from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS) and contained 6853 participants. Logistic regression and the restricted cubic splines (RCSs) model were employed to examine how plant-based dietary patterns affect sleep health. Additionally, Amos 26.0 was used to construct a structural equation model to examine the parallel mediated effects of anxiety and depression. Results: A higher plant-based diet index (PDI) was connected to higher odds of better sleep quality (OR = 1.209, 95% CI: 1.039-1.407) and sleep duration (OR = 1.241, 95% CI: 1.072-1.437). Conversely, an elevated unhealthy plant-based diet index (uPDI) was correlated with a lower likelihood of sleep quality (OR = 0.678, 95% CI: 0.574-0.800) and sleep duration (OR = 0.762, 95% CI: 0.647-0.896). The RCSs regression further identified a significant dose-response relationship. Mediation analysis confirmed that anxiety and depression partially mediate the relationship between plant-based diets and sleep health. Conclusions: Our study exhibited significant correlations between plant-based diets and sleep health in the elderly. Depression and anxiety were determined as parallel mediators between plant-based diets and sleep health. Controlling early dietary patterns and affective disorder could help improve sleep quality in older adults.