Relationship between the compliance of healthy eating index with obsessive compulsive disorder and sleep quality in employees of Ahvaz Water and Power Organization

Zilaee, Marzie; Hosseini, Seyed Ahmad; Akhoundzadeh, Mohammad Reza; Moarefian, Amirabbas; Parvareh, Roozbeh; Khajehzadeh, Sara

doi:10.48311/fsct.2026.83816.0

Relationship between the compliance of healthy eating index with obsessive compulsive disorder and sleep quality in employees of Ahvaz Water and Power Organization

Document Type : Original Research

Authors

Marzie Zilaee ¹

Seyed Ahmad Hosseini ²

Mohammad Reza Akhoundzadeh ³

Amirabbas Moarefian ³

Roozbeh Parvareh ⁴

Sara Khajehzadeh ³

¹ Nutrition and Metabolic Diseases Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

² 1Nutrition and Metabolic Diseases Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

³ Student Research Committee, Ahvaz Jundishapur university of Medical Sciences, Ahvaz, Iran

⁴ 3Student Research Committee, Ahvaz Jundishapur university of Medical Sciences, Ahvaz, Iran

10.48311/fsct.2026.83816.0

Abstract

Usually people spend a significant part of their time at their workplaces with conditions that may reinforce keeping away from healthy behaviors and this can affect their nutrition, sleep quality and obsessive status. The aim of present study was to evaluate the relation between the compliance of healthy eating index with obsessive disorder and sleep quality in employees of Ahvaz Water and Power Organization. A total sample of 340 participants, were recruited from Water and Power Organization of Ahvaz in this observational study. Anthropometric indices were measured based on standard methods. Healthy Eating Index (HEI) was used to assess the quality of diet based on a standard food frequency questionnaire, Pittsburgh Sleep Quality Index (PSQI) questionnaire for sleep quality and Obsessive-Compulsive Inventory-Revised (OCI-R) questionnaire for obsession-Compulsive disorder assessment. Linear regression was used to assess the correlation between HEI with sleep quality and obsessive status. The mean HEI score for the total sample was 55.49±6.09. Also mean score for PSQI and OCD was (7.94±5.53 for PSQI) and (15.10±9.87 for OCI-R), respectively. There were no significant correlations between HEI with sleep quality and OCD (P < 0.05). However the relationship between OCI-R total score with PSQI and gender was significant (OCD was more common in people with poor sleep quality and women). Also there was a significant associations between sleep quality and OCD (subjects with obsessive had poorer sleep quality). The results showed that there were no significant associations between the HEI with sleep quality and OCD in the study population. But participants with OCD had significantly poorer sleep quality and women had significantly higher obsessive scores.

Keywords

Healthy Eating Index

Obsessive Compulsive Disorder

Sleep Quality

Subjects

Food quality control

[1] Hjarnoe L, Leppin A. Health promotion in the Danish maritime setting: challenges and possibilities for changing lifestyle behavior and health among seafarers. BMC public health. 2013;13:1165.

[2] Rongen A, Robroek SJ, van Lenthe FJ, Burdorf A. Workplace health promotion: a meta-analysis of effectiveness. American journal of preventive medicine. 2013;44:406-15.

[3] Pender NJ. Health promotion and disease prevention: toward excellence in nursing practice and education. Nursing Outlook. 1992;40:106.

[4] Ouyang X, Lou Q, Gu L, Mo Y, Nan JH, Kong AP, et al. Cardiovascular disease risk factors are highly prevalent in the office-working population of Nanjing in China. International journal of cardiology. 2012;155:212-6.

[5] Van Duijvenbode D, Hoozemans M, Van Poppel M, Proper K. The relationship between overweight and obesity, and sick leave: a systematic review. International Journal of Obesity. 2009;33:807-16.

[6] Ferrie JE, Head J, Shipley MJ, Vahtera J, Marmot MG, Kivimäki M. BMI, obesity, and sickness absence in the Whitehall II study. Obesity. 2007;15:1554-64.

[7] Berghöfer A, Pischon T, Reinhold T, Apovian CM, Sharma AM, Willich SN. Obesity prevalence from a European perspective: a systematic review. BMC public health. 2008;8:200.

[8] Maes L, Van Cauwenberghe E, Van Lippevelde W, Spittaels H, De Pauw E, Oppert J-M, et al. Effectiveness of workplace interventions in Europe promoting healthy eating: a systematic review. European journal of public health. 2012;22:677-83.

[9] T KENNEDY E, Ohls J, Carlson S, Fleming K. The healthy eating index: design and applications. Journal of the American Dietetic Association. 1995;95:1103-8.

[10] Tande DL, Magel R, Strand BN. Healthy Eating Index and abdominal obesity. Public health nutrition. 2010;13:208-14.

[11] NOORBALA AA, DAMARI B, RIAZI IS. Evaluation of mental disorders incidence trend in Iran. 2014.

[12] Kessler RC, Wang PS. The descriptive epidemiology of commonly occurring mental disorders in the United States. Annu Rev Public Health. 2008;29:115-29.

[13] Merikangas K. Clinical features of anxiety disorders. Comprehensive textbook of psychiatry. 2004;8:1104-26.

[14] Hibar DP, Stein JL, Renteria ME, Arias-Vasquez A, Desrivières S, Jahanshad N, et al. Common genetic variants influence human subcortical brain structures. Nature. 2015;520:224-9.

[15] Mohammadi MR, Ghanizadeh A, Rahgozar M, Noorbala AA, Davidian H, Afzali HM, et al. Prevalence of obsessive-compulsive disorder in Iran. BMC Psychiatry. 2004;4:2.

[16] Karamustafalıoglu K. Obsessive compulsive disorder. Galenos Monthly Medical Journal. 2006;9:53-66.

[17] Subramaniam M, Soh P, Vaingankar JA, Picco L, Chong SA. Quality of life in obsessive-compulsive disorder: impact of the disorder and of treatment. CNS drugs. 2013;27:367-83.

[18] van Grootheest DS, Cath DC, Beekman AT, Boomsma DI. Twin studies on obsessive–compulsive disorder: a review. Twin Research and Human Genetics. 2005;8:450-8.

[19] Jahangard L, Fadaei V, Sajadi A, Haghighi M, Ahmadpanah M, Matinnia N, et al. Patients with OCD report lower quality of life after controlling for expert-rated symptoms of depression and anxiety. Psychiatry research. 2018;260:318-23.

[20] De Croon EM, Sluiter JK, Blonk RW, Broersen JP, Frings-Dresen MH. Stressful work, psychological job strain, and turnover: a 2-year prospective cohort study of truck drivers. Journal of applied psychology. 2004;89:442.

[21] Doi Y. An epidemiologic review on occupational sleep research among Japanese workers. Industrial health. 2005;43:3-10.

[22] Doi Y, Minowa M, Tango T. Impact and correlates of poor sleep quality in Japanese white-collar employees. Sleep. 2003;26:467-71.

[23] Leigh JP. Employee and job attributes as predictors of absenteeism in a national sample of workers: the importance of health and dangerous working conditions. Social Science & Medicine. 1991;33:127-37.

[24] Linton SJ, Bryngelsson L. Insomnia and its relationship to work and health in a working-age population. Journal of Occupational Rehabilitation. 2000;10:169-83.

[25] Walsh J, Benca R, Bonnet M. Insomnia: Assessment and Management in Primary Care. American Family Physician. 1999;59:3029-38.

[26] Roth T, Ancoli-Israel S. Daytime consequences and correlates of insomnia in the United States: results of the 1991 National Sleep Foundation Survey. II. Sleep: Journal of Sleep Research & Sleep Medicine. 1999.

[27] Lamberg L. Promoting adequate sleep finds a place on the public health agenda. JAMA. 2004;291:2415-7.

[28] MOHAMMADI A, Zamani R, Fata L. Validation of the Persian version of the obsessive-compulsive inventory-revised in a student sample. 2008.

[29] Esfahani FH, Asghari G, Mirmiran P, Azizi F. Reproducibility and relative validity of food group intake in a food frequency questionnaire developed for the Tehran Lipid and Glucose Study. Journal of epidemiology. 2010;20:150-8.

[30] Guenther PM, Reedy J, Krebs-Smith SM. Development of the healthy eating index-2005. Journal of the American Dietetic Association. 2008;108:1896-901.

[31] Bowman SA, Lino M, Gerrior SA, Basiotis PP. The healthy eating index: 1994-96. 1998.

[32] Ainsworth BE, Haskell WL, Herrmann SD, Meckes N, Bassett Jr DR, Tudor-Locke C, et al. 2011 Compendium of Physical Activities: a second update of codes and MET values. Medicine & science in sports & exercise. 2011;43:1575-81.

[33] Khakpouri S, Safari M, Ghazizadeh H, Parizadeh SMR, Nematy M, Tayefi M, et al. The relationship between the healthy eating index and an alternate healthy eating index with the risk factors for cardiovascular disease in a population from northeastern Iran. Translational Metabolic Syndrome Research. 2019;2:1-6.

[34] Rasouli HR, Mohammadi F, Farajzadeh MA, Aliakbar A. Association between Dietary Pattern and Mental Health among Military Personnel.

[35] Schultz NS, Chui KK, Economos CD, Lichtenstein AH, Volpe SL, Sacheck JM. Impact of physical activity, diet quality and stress on cardiometabolic health in school employees. Preventive Medicine Reports. 2020;20:101243.

[36] Ghasemi S, Parastouei K, Sepandi M, Jayervand H. The relationship between diet quality and depression in Baqiyatallah Al-Azam Hospital staff. Journal of Military Health Promotion. 2020;1:104-10.

[37] Jacka FN, Pasco JA, Mykletun A, Williams LJ, Hodge AM, O'Reilly SL, et al. Association of Western and traditional diets with depression and anxiety in women. American journal of psychiatry. 2010;167:305-11.

[38] Taylor AM, Holscher HD. A review of dietary and microbial connections to depression, anxiety, and stress. Nutritional neuroscience. 2020;23:237-50.

[39] Xu F, Chong B-Q, Cai T, Zhang J-L, Lv J. Associations between major dietary patterns and anxiety in middle-aged adults in eastern China. Public health nutrition. 2020:1-9.

[40] Nasir Y, Rahimi M-H, Molahosseini M, Yekaninejad S, Maghbooli Z, Mirzaei K. The association of major dietary patterns with depression, anxiety and stress in apparently healthy adults. Journal of Nutritional Sciences and Dietetics. 2016.

[41] Yannakoulia M, Panagiotakos DB, Pitsavos C, Tsetsekou E, Fappa E, Papageorgiou C, et al. Eating habits in relations to anxiety symptoms among apparently healthy adults. A pattern analysis from the ATTICA Study. Appetite. 2008;51:519-25.

[42] Kamali M, Dastsouz F, Sadeghi F, Amanat S, Akhlaghi M. Associations between Western and Mediterranean-type dietary patterns and anxiety and stress. Acta Alimentaria. 2016;45:398-405.

[43] Kris-Etherton PM, Petersen KS, Hibbeln JR, Hurley D, Kolick V, Peoples S, et al. Nutrition and behavioral health disorders: depression and anxiety. Nutrition Reviews. 2020.

[44] Sadeghi O, Keshteli AH, Afshar H, Esmaillzadeh A, Adibi P. Adherence to Mediterranean dietary pattern is inversely associated with depression, anxiety and psychological distress. Nutritional neuroscience. 2019:1-12.

[45] Gibson-Smith D, Bot M, Brouwer IA, Visser M, Penninx BW. Diet quality in persons with and without depressive and anxiety disorders. Journal of Psychiatric Research. 2018;106:1-7.

[46] Ohayon MM. Epidemiology of insomnia: what we know and what we still need to learn. Sleep medicine reviews. 2002;6:97-111.

[47] Asghari A, Kamrava SK, Ghalehbaghi B, Nojomi M. Subjective sleep quality in urban population. Archives of Iranian medicine. 2012;15:95-8.

[48] Zeitlhofer J, Schmeiser‐Rieder A, Tribl G, Rosenberger A, Bolitschek J, Kapfhammer G, et al. Sleep and quality of life in the Austrian population. Acta Neurologica Scandinavica. 2000;102:249-57.

[49] Doi Y, Minowa M, Uchiyama M, Okawa M. Subjective sleep quality and sleep problems in the general Japanese adult population. Psychiatry and Clinical Neurosciences. 2001;55:213-5.

[50] Roodbandi ASJ, Feyzi V, KHANJANI N, MOGHADAM SR, BAFGHI MS, MOGHADASI M, et al. Sleep quality and sleepiness: a comparison between nurses with and without shift work, and university employees. International Journal of Occupational Hygiene. 2016;8:230-6.

[51] Ghalichi L, Pournik O, Ghaffari M, Vingard E. Sleep quality among health care workers. Archives of Iranian medicine. 2013;16:0-.

[52] Paknahad Z, Yazdanpanah L, Maracy MR, Moravejolahkami AR, Javad-Mousavi SA, Nemati A. Association of dietary quality indices with sleep quality in chronic obstructive pulmonary disease patients. Nutrition & Food Science. 2020.

[53] Abramson KH. Understanding the Association Between Nutrition and Depression by Assessing Diet Quality, Omega-3, Cholesterol, and Sleep Quality in College Students. 2017.

[54] Van Lee L, Chia A-R, Loy SL, Colega M, Tham EK, Cai S, et al. Sleep and dietary patterns in pregnancy: findings from the GUSTO cohort. International journal of environmental research and public health. 2017;14:1409.

[55] Díaz-Román A, Perestelo-Pérez L, Buela-Casal G. Sleep in obsessive–compulsive disorder: a systematic review and meta-analysis. Sleep medicine. 2015;16:1049-55.

[56] Nota JA, Sharkey KM, Coles ME. Sleep, arousal, and circadian rhythms in adults with obsessive–compulsive disorder: A meta-analysis. Neuroscience & Biobehavioral Reviews. 2015;51:100-7.

[57] Bobdey M, Fineberg N, Gale T, Patel A, Davies H. Reported sleep patterns in obsessive compulsive disorder (OCD). International Journal of Psychiatry in Clinical Practice. 2002;6:15-21.

[58] Segalàs C, Labad J, Salvat-Pujol N, Real E, Alonso P, Bertolín S, et al. Sleep disturbances in obsessive-compulsive disorder: influence of depression symptoms and trait anxiety. BMC psychiatry. 2021;21:1-10.

[59] Greco RL. Relationship Between Obsessive-compulsive Symptomatology, Depression, and Sleep Quality: Pepperdine University; 2020.