BACKGROUND: Insulin resistance and associated metabolic health symptoms remain a primary global health concern. In addition to healthy dietary and nutritional programs, sleep duration is closely related to and has been linked to healthy metabolism. This study aimed to determine the link between insulin resistance and sleep duration and the dietary intake of live microbes. METHODS: Data were collected from 15,927 participants in the National Health and Nutrition Examination Survey database from 2005 to 2018
this sample is equivalent to 209,316,590 individuals in the United States. The participants were categorized according to their consumption of foods containing live microbes: low, medium, high, and medium-high. The relationship between diets containing live microbes and the triglyceride-glucose index was analysed using a weighted multivariate linear regression model with a multistage sampling approach. The individuals were deemed to have insulin resistance if their homeostatic model assessment score for insulin resistance was ≥ 2. The relationship between diets containing live microbes and insulin resistance status was assessed using weighted multivariate logistic regression analyses. The mediating role of sleep duration on the relationship between diets containing live microbes and the triglyceride-glucose index was also examined. RESULTS: After accounting for potential confounders, diets containing live microbes at medium and medium-high levels were significantly associated with a reduced triglyceride-glucose index. The medium and medium-high levels of live microbial intake were also associated with a lower risk of insulin resistance. Within the 6-9 hours' sleep duration range, the indirect effect of medium and medium-high levels of live microbes on the triglyceride-glucose index was observed, accounting for 2.95% and 6.08% of the overall change, respectively. CONCLUSIONS: This study suggests an association between a diet rich in medium and medium-high viable microbes, lower triglyceride-glucose index values, and a reduced risk of developing insulin resistance. Additionally, a sleep duration of 6-9 h may mediate this association.