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Cited by 144Sleep and related disordersCircadian rhythm and melatoninSleep and Work-Related Fatigue

Smoking, screen-based sedentary behavior, and diet associated with habitual sleep duration and chronotype: data from the UK Biobank

Open access
Patterson, Freda, Malone, Susan Kohl, Lozano, Alicia, Grandner, Michael A., Hanlon, Alexandra L.·2016·Annals of Behavioral Medicine
DOI 10.1007/s12160-016-9797-5PMC PMC5079686
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Abstract

BACKGROUND: Sleep duration has been implicated in the etiology of obesity but less is known about the association between sleep and other behavioral risk factors for cardiovascular disease. PURPOSE: The aim of this study was to examine the associations among sleep duration, chronotype, and physical activity, screen-based sedentary behavior, tobacco use, and dietary intake. METHODS: Regression models were used to examine sleep duration and chronotype as the predictors and cardiovascular risk factors as outcomes of interest in a cross-sectional sample of 439,933 adults enrolled in the UK Biobank project. RESULTS: Short sleepers were 45 % more likely to smoke tobacco than adequate sleepers (9.8 vs. 6.9 %, respectively). Late chronotypes were more than twice as likely to smoke tobacco than intermediate types (14.9 vs. 7.4 %, respectively). Long sleepers reported 0.61 more hours of television per day than adequate sleepers. Early chronotypes reported 0.20 fewer daily hours of computer use per day than intermediate chronotypes. Early chronotypes had 0.25 more servings of fruit and 0.13 more servings of vegetables per day than late chronotypes. CONCLUSIONS: Short and long sleep duration and late chronotype are associated with greater likelihood of cardiovascular risk behaviors. Further work is needed to determine whether these findings are maintained in the context of objective sleep and circadian estimates, and in more diverse samples. The extent to which promoting adequate sleep duration and earlier sleep timing improves heart health should also be examined prospectively.

AI snapshot

Written from the paper’s full text.

TL;DR

In a cross-sectional UK Biobank sample of 439,933 adults, short and long sleep duration and late chronotype were associated with adverse cardiovascular risk behaviors, especially smoking and greater television viewing. The authors conclude sleep duration and timing may be promising behavioral targets, but prospective and objective-measure studies are needed.

Key findings

  • Short sleepers were 45% more likely to smoke than adequate sleepers (9.8% vs. 6.9%), and long sleepers had 36% greater odds of smoking than adequate sleepers (OR = 1.359).
  • Late chronotypes were more than twice as likely to smoke as intermediate types (14.9% vs. 7.4%; OR = 2.126), while early chronotypes had 17% reduced odds of smoking versus intermediate types (OR = 0.833).
  • Long sleepers reported 0.61 more hours of television per day than adequate sleepers; early chronotypes had 0.31 fewer daily hours of computer use and 0.14 fewer daily hours of television than late chronotypes.
  • Early chronotypes had 0.25 more daily servings of fruit and 0.13 more daily servings of vegetables than late chronotypes.

Methods

  • Cross-sectional analysis of UK Biobank baseline data (application #3474), including 439,933 adults aged 40–69 years after excluding missing/unknown sleep duration or chronotype data.
  • Sleep duration was categorized as very short (≤4 h), short (5–6 h), adequate (7–8 h), and long (≥9 h); chronotype was categorized as early, intermediate, and late.
  • General linear and binary logistic regression models examined sleep duration and chronotype as predictors of physical activity, screen-based sedentary behavior, fruit/vegetable intake, and current smoking, adjusted for age, sex, ethnicity, employment, and college attendance.

Limitations

  • Stated: self-reported behavioral data and a cross-sectional design prevent assessment of temporal relationships; sleep duration did not distinguish work days from free days; fruit/vegetable portion sizes used UK rather than USA guidelines; chronotype was self-categorized rather than based on clock times or sleep midpoint.
  • Stated: further work is needed with objective sleep and circadian estimates and in more diverse samples.
  • Evident from the text: the final analytic sample was significantly more likely to be female, white, college attendees, and employed, which may limit generalizability despite adjustment for these variables.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1007/s12160-016-9797-5

Cites

102 of 102 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 77 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Early chronotypes reported 0.20 fewer daily hours of computer use per day than intermediate chronotypes.

    “Early chronotypes reported 0.20 fewer daily hours of computer use per day than intermediate chronotypes.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The UK Biobank sample is representative of the UK adult population.
  • Findingown data

    Early chronotypes had 0.14 fewer hours of television viewing per day than late chronotypes.

    “early chronotypes had 0.31 fewer hours of computer use and 0.14 fewer hours of television viewing per day than late chronotypes (Table 4).”
    • Also stated in: § Discussion · plain
      “Early chronotypes on average had 0.31 fewer daily hours of computer use and 0.14 fewer hours of television and 0.25 more servings of fruit and 0.13 more servings of vegetables than late chronotypes.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The UK Biobank sample is representative of the UK adult population.
  • Findingown data

    Late chronotype had more than twofold increased odds of being a smoker than intermediate types, independent of sleep duration.

    “Late chronotypes were more than twice as likely to smoke tobacco than intermediate types (14.9 vs. 7.4 %, respectively).”
    • Also stated in: § Tobacco Use and Sleep · plain
      “late chronotype had a more than twofold increased odds of being a smoker than intermediate types (OR=2.126, SE=0.034) (Table 4), independent of sleep duration.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Self-reported current smoking status is a valid measure of tobacco use.
    • Rests on an assumption: The UK Biobank sample is representative of the UK adult population.
  • Findingown data

    Early chronotypes had 0.13 more servings of vegetables per day than late chronotypes.

    “Early chronotypes had 0.25 more servings of fruit and 0.13 more servings of vegetables per day than late chronotypes.”
    • Also stated in: § Discussion · plain
      “Early chronotypes on average had 0.31 fewer daily hours of computer use and 0.14 fewer hours of television and 0.25 more servings of fruit and 0.13 more servings of vegetables than late chronotypes.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The UK Biobank sample is representative of the UK adult population.
    • Rests on an assumption: Self-reported fruit and vegetable intake are valid measures of dietary intake.
  • Findingown data

    Early chronotypes accrued 0.18 more minutes per week of walking than late chronotypes.

    “Similarly, early chronotypes accrued, on average, 0.18 more minutes per week of walking and 0.17 more minutes of moderate activity, and 0.17 more minutes of vigorous activity per week than late chronotypes (Table 4).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The UK Biobank sample is representative of the UK adult population.
  • Classified as probably not a substantial claim. 43
  • May combine two claims. 13

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Short sleepers consumed 0.02 more servings of fruit per day than adequate sleepers.

    “Short sleepers consumed, on average, 0.02 more servings of fruit per day than adequate sleepers.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Self-reported sleep duration is a valid measure of habitual sleep duration.
    • Rests on an assumption: The UK Biobank sample is representative of the UK adult population.
    • Rests on an assumption: Self-reported fruit and vegetable intake are valid measures of dietary intake.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Short sleepers accrued 0.10 more minutes per week of vigorous activity than adequate sleepers.

    “The largest point estimate was noted for vigorous activity whereby short sleepers accrued on average, 0.10 more minutes per week of vigorous activity a week than adequate sleepers.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Self-reported sleep duration is a valid measure of habitual sleep duration.
    • Rests on an assumption: The UK Biobank sample is representative of the UK adult population.

  • May combine two claims.

    Findingown data

    Long sleepers reported more minutes of moderate and vigorous activity than adequate sleepers, although the differences were statistically significant but trivial.

    “Long sleepers reported more minutes of moderate and vigorous activity than did adequate sleepers, although the differences, while statistically significant, were trivial (Table 3).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Self-reported sleep duration is a valid measure of habitual sleep duration.
    • Rests on an assumption: The UK Biobank sample is representative of the UK adult population.

  • May combine two claims.

    Findingown data

    Longer sleep duration and late chronotype were associated with lower daily fruit and vegetable intake.

    “Longer sleep duration and late chronotype were associated with lower daily fruit and vegetable intake, in fact, early chronotypes consumed 0.25 more servings of fruit and 0.133 more servings of vegetables daily than late chronotypes.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Both short and long sleep are associated with higher cigarette consumption.

    “Short sleep is associated with current or former smoking status [31, 32] while both short and long sleep are associated with higher cigarette consumption [31, 33].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [31] Krueger PM, Friedman EM. Sleep duration in the United States: A cross-sectional population-based study. Am J Epidemiol. 2009; 169: 1052-1063. source

      Not checked in the free run.

    • cites [33] Phillips BA, Danner FJ. Cigarette smoking and sleep disturbance. Arch Intern Med. 1995; 155: 734-737. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The multivariate analyses adjusted for age, sex, ethnicity, employment, and college attendance.

    “Linear regression models of walking, moderate, and vigorous physical activity that adjusted for age, sex, ethnicity, employment, and college attendance showed that overall, short sleepers reported more minutes of physical activity per week than adequate sleepers.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Sedentary behavior is an independent risk factor for cardiovascular disease.

    “The importance of long sleepers reporting significantly more television viewing time lies in the fact that sedentary behavior is an independent risk factor for cardiovascular disease [71, 72].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [71] Dunstan DW, Thorp AA, Healy GN. Prolonged sitting: Is it a distinct coronary heart disease risk factor? Curr Opin Cardiol. 2011; 26: 412-419. source

      Not checked in the free run.

    • cites [72] Wijndaele K, Healy GN, Dunstan DW, et al. Increased cardiometabolic risk is associated with increased TV viewing time. Med Sci Sports Exerc. 2010; 42: 1511-1518. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Chronotype is a demonstrated preference for morning or eveningness that results from endogenous biological rhythms and is influenced by environmental and socio-occupational factors.

    “Chronotype is a demonstrated preference for morning or eveningness that results from endogenous biological rhythms and is influenced by environmental (e.g., light) and socio-occupational (e.g., employment hours) factors [14–16].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [14] Duffy JF, Dijk DJ, Hall EF, et al. Relationship of endogenous circadian melatonin and temperature rhythms to self-reported preference for morning or evening activity in young and older people. J Investig Med. 1999; 47: 141-150.

      Not checked in the free run.

    • cites [15] Duffy JF, Rimmer DW, Czeisler CA. Association of intrinsic circadian period with morningness-eveningness, usual wake time, and circadian phase. Behav Neurosci. 2001; 115: 895-899. source

      Not checked in the free run.

    • cites [16] Roenneberg T, Merrow M. Entrainment of the human circadian clock. Cold Spring Harb Symp Quant Biol. 2007; 72: 293-299. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    These data converge with previous work demonstrating that adequate sleep is associated with beneficial heart health behaviors and extend what is known by suggesting that sleep timing, in particular, late chronotype patterns, are associated with poor heart health behaviors.

    “These data converge with previous work demonstrating that adequate sleep is associated with beneficial heart health behaviors and extend what is known by suggesting that sleep timing, in particular, late chronotype patterns are associated with poor heart health behaviors.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Self-reported sleep duration is a valid measure of habitual sleep duration.
    • Rests on an assumption: Self-reported current smoking status is a valid measure of tobacco use.
    • Rests on an assumption: The UK Biobank sample is representative of the UK adult population.
    • Rests on an assumption: Self-reported fruit and vegetable intake are valid measures of dietary intake.

  • May combine two claims.

    Interpretationown data

    Short and long sleep duration and late chronotype are associated with greater likelihood of cardiovascular risk behaviors.

    “Short and long sleep duration and late chronotype are associated with greater likelihood of cardiovascular risk behaviors.”
    • Also stated in: § Discussion · boosted
      “these population-level data clearly suggest that short and long sleepers and late chronotypes are groups at increased risk for poor cardiovascular health behaviors.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Self-reported sleep duration is a valid measure of habitual sleep duration.
    • Rests on an assumption: Self-reported current smoking status is a valid measure of tobacco use.
    • Rests on an assumption: The UK Biobank sample is representative of the UK adult population.
    • Rests on an assumption: Self-reported fruit and vegetable intake are valid measures of dietary intake.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Higher levels of physical activity have been positively associated with sleep duration in younger and middle-aged men, but showed a curvilinear relationship in those aged 60 years or older.

    “For example, higher levels of physical activity have been positively associated with sleep duration in younger and middle-aged men, but showed a curvilinear relationship in those aged 60 years or older [18].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [18] McClain JJ, Lewin DS, Laposky AD, et al. Associations between physical activity, sedentary time, sleep duration and daytime sleepiness in US adults. Prev Med. 2014; 66: 68-73. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Later meal timing has been associated with resistance to weight loss interventions.

    “This is important because later meal timing has been associated with weight gain [29] as well as resistance to weight loss interventions [30].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [30] Garaulet M, Gomez-Abellan P, Alburquerque-Bejar JJ, et al. Timing of food intake predicts weight loss effectiveness. Int J Obes. 2013; 37: 604-611. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Sleep duration categories were based on previous data linking sleep duration to cardiometabolic disease risk in a US population sample.

    “based on previous data linking sleep duration to cardiometabolic disease risk in a US population sample [44].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [44] Grandner MA, Chakravorty S, Perlis ML, et al. Habitual sleep duration associated with self-reported and objectively determined cardiometabolic risk factors. Sleep Med. 2014; 15: 42-50. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Late chronotypes may have poorer recovery from morning exercise.

    “Early chronotypes perform activities better during the morning hours [21] while late chronotypes may have poorer recovery from morning exercise [22].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22] Sugawara J, Hamada Y, Nishijima T, et al. Diurnal variations of post-exercise parasympathetic nervous reactivation in different chronotypes. Jpn Heart J. 2001; 42: 163-171. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Sedentary behavior is highly associated with higher body mass index and lower activity levels.

    “Sedentary behavior is also highly associated with higher body mass index and lower activity levels [75, 76].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [75] Bann D, Hire D, Manini T, et al. Light intensity physical activity and sedentary behavior in relation to body mass index and grip strength in older adults: Cross-sectional findings from the Lifestyle Interventions and Independence for Elders (LIFE) study. PLoS One. 2015; 10: e0116058. source

      Not checked in the free run.

    • cites [76] Taylor WC, Kimbro RT, Evans-Hudnall G, et al. Sedentary behavior, body mass index, and weight loss maintenance among African American women. Ethn Dis. 2015; 25: 38-45.

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Later meal timing has been associated with weight gain.

    “This is important because later meal timing has been associated with weight gain [29] as well as resistance to weight loss interventions [30].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [29] Gluck ME, Venti CA, Salbe AD, et al. Nighttime eating: Commonly observed and related to weight gain in an inpatient food intake study. Am J Clin Nutr. 2008; 88: 900-905. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Early chronotypes perform activities better during the morning hours.

    “Early chronotypes perform activities better during the morning hours [21] while late chronotypes may have poorer recovery from morning exercise [22].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [21] Brown FM, Neft EE, LaJambe CM. Collegiate rowing crew performance varies by morningness-eveningness. J Strength Cond Res. 2008; 22: 1894-1900. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Participants with missing data for sleep duration or chronotype were excluded, leaving 439,933 participants in the final sample.

    “Participants with responses coded “don't know”, “prefer not to answer”, or missing data for sleep duration or chronotype were excluded leaving 439,933 participants in the final sample.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The UK Biobank sample is representative of the UK adult population.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Ten or more hours of sitting per day increased cardiovascular disease risk by 18% (HR=1.18; 95% CI 1.09-1.29) compared to five or fewer hours.

    “For example, ten or more hours of sitting per day increased cardiovascular diseases risk by 18 % (Hazard ratio = 1.18; 95% CI = 1.09–1.29) as compared to five or fewer hours [73]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [73] Chomistek AK, Manson JE, Stefanick ML, et al. Relationship of sedentary behavior and physical activity to incident cardiovascular disease: Results from the women’s health initiative. J Am Coll Cardiol. 2013; 61: 2346-2354. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Later bedtime, waketime, and midpoint of sleep are associated with lower levels of physical activity.

    “In terms of sleep chronotype, a small number of studies have shown later bedtime, waketime, and midpoint of sleep to be associated with lower levels of physical activity [20].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [20] Shechter A, St-Onge MP. Delayed sleep timing is associated with low levels of free-living physical activity in normal sleeping adults. Sleep Med. 2014; 15: 1586-1589. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Both short and long sleep are predictive of poorer dietary intake.

    “With regard to dietary intake, both short and long sleep are predictive of poorer dietary intake [23, 24].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [23] Grandner MA, Kripke DF, Naidoo N, et al. Relationships among dietary nutrients and subjective sleep, objective sleep, and napping in women. Sleep Med. 2010; 11: 180-184. source

      Not checked in the free run.

    • cites [24] Grandner MA, Jackson N, Gerstner JR, et al. Dietary nutrients associated with short and long sleep duration. Data from a nationally representative sample. Appetite. 2013; 64: 71-80. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductown data

    All multivariate analyses were adjusted for sex, race, college attendance, and employment.

    “Participants included in the final analysis were significantly more likely to be female, white, college attendees, and employed; thus, all multivariate analyses were adjusted for these variables.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Four or more hours (versus ≤1) of screen-based sedentary behavior per day was associated with an adjusted twofold greater prevalence (PR=2.09; 95% CI 1.16, 3.75) of insulin levels indicative of hyperinsulinemia.

    “while four or more hours (versus ≤1) of screen-based sedentary behavior per day (TV and recreational computer use) was associated with an adjusted twofold greater prevalence (Prevalence Ratio = 2.09; 95 % CI = 1.16, 3.75) of insulin levels indicative of hyperinsulinemia (N20 μU/mL) [74].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [74] Ford ES, Li C, Zhao G, et al. Sedentary behavior, physical activity, and concentrations of insulin among US adults. Metabolism. 2010; 59: 1268-1275. source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    Participants included in the final analysis were significantly more likely to be female, white, college attendees, and employed.

    “Participants included in the final analysis were significantly more likely to be female, white, college attendees, and employed; thus, all multivariate analyses were adjusted for these variables.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The UK Biobank sample is representative of the UK adult population.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Data from the American Time Use Survey showed an inverse relationship between sleep duration and amount of time spent watching television.

    “while data from the American Time Use Survey showed an inverse relationship between sleep duration and amount of time spent watching television [70]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [70] Basner M, Spaeth AM, Dinges DF. Sociodemographic characteristics and waking activities and their role in the timing and duration of sleep. Sleep. 2014; 37: 1889-1906. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    One other study found long sleep duration to be associated with more television viewing than adequate sleep.

    “One other study also found long sleep duration to be associated with more television viewing than adequate sleep [69]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [69] Hale L. Who has time to sleep? J Public Health (Oxf). 2005; 27: 205-211. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Late chronotypes eat fewer fruits and vegetables and more saturated fats than early chronotypes.

    “Chronotype has been shown to influence dietary intake such that late chronotypes consume more calories in the evening [25], eat fewer fruits and vegetables and more saturated fats [25–28] than early chronotypes.”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [25] Baron KG, Reid KJ, Kern AS, et al. Role of sleep timing in caloric intake and BMI. Obesity (Silver Spring). 2011; 19: 1374-1381. source

      Not checked in the free run.

    • cites [26] Kanerva N, Kronholm E, Partonen T, et al. Tendency toward eveningness is associated with unhealthy dietary habits. Chronobiol Int. 2012; 29: 920-927. source

      Not checked in the free run.

    • cites [27] Schubert E, Randler C. Association between chronotype and the constructs of the three-factor-eating-questionnaire. Appetite. 2008; 51: 501-505. source

      Not checked in the free run.

    • cites [28] Lucassen EA, Zhao X, Rother K, et al. Evening chronotype is associated with changes in eating behavior, more sleep apnea, and increased stress hormones in short sleeping obese individuals. PLoS One. 2013; 8: e56519. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Low levels of physical activity have been associated with sleep disorders.

    “Low levels of physical activity have been associated with sleep disorders [19].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19] Farnsworth JL, Kim Y, Kang M. Sleep disorders, physical activity, and sedentary behavior among U.S. adults: National Health and Nutrition Examination Survey. J Phys Act Health. 2015. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Higher levels of physical activity were observed in younger and middle-aged women who achieved at least 8 hours of sleep per day.

    “Higher levels of physical activity were observed in younger and middle-aged women who achieved at least 8 hours of sleep per day [18].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [18] McClain JJ, Lewin DS, Laposky AD, et al. Associations between physical activity, sedentary time, sleep duration and daytime sleepiness in US adults. Prev Med. 2014; 66: 68-73. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Exposure to ambient light at night from urban lighting promotes lateness.

    “For example, increasing light exposure in the natural environment shifts sleep timing earlier [91], while exposure to ambient light at night either from ereaders [92] or urban lighting [93] promotes “lateness.””
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [93] de la Iglesia HO, Fernandez-Duque E, Golombek DA, et al. Access to electric light is associated with shorter sleep duration in a traditionally hunter-gatherer community. J Biol Rhythm. 2015; 30: 342-350. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A recent meta-analysis showed that adults consuming five daily servings of fruit and vegetables (~400 g) had a 15% reduced risk of CVDs compared to adults who did not eat any fruit and vegetables over a 10.5-year follow-up.

    “In terms of relating fruit and vegetable intake to risk for cardiovascular disease, a recent meta-analysis showed that adults consuming five daily servings of fruit and vegetables (∼400 g) had a 15 % reduced risk of CVDs, while those consuming 2.5 daily servings (∼200 g) had a 8 % reduced risk of CVDs compared to adults who did not eat any fruit and vegetables over a 10.5-year follow-up period [78”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [78] Zhan J, Liu YJ, Cai LB, et al. Fruit and vegetable consumption and risk of cardiovascular disease: A meta-analysis of prospective cohort studies. Crit Rev Food Sci Nutr. 2015. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Street noise relates to poorer sleep quality.

    “Noise from air conditioning and fans [94] and street noise relate to poorer sleep quality [94, 95] while improvements in urban housing quality [96] also improve sleep.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [94] Kayaba M, Ihara T, Kusaka H, et al. Association between sleep and residential environments in the summertime in Japan. Sleep Med. 2014; 15: 556-564. source

      Not checked in the free run.

    • cites [95] Persson Waye K. Effects of low frequency noise on sleep. Noise Health. 2004; 6: 87-91.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The study used self-report behavioral data.

    “Main limitations include the use of self-report behavioral data and a cross-sectional design that prevents consideration of the temporal relationship between these variables.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A recent meta-analysis showed that adults consuming 2.5 daily servings of fruit and vegetables (~200 g) had an 8% reduced risk of CVDs compared to adults who did not eat any fruit and vegetables over a 10.5-year follow-up.

    “In terms of relating fruit and vegetable intake to risk for cardiovascular disease, a recent meta-analysis showed that adults consuming five daily servings of fruit and vegetables (∼400 g) had a 15 % reduced risk of CVDs, while those consuming 2.5 daily servings (∼200 g) had a 8 % reduced risk of CVDs compared to adults who did not eat any fruit and vegetables over a 10.5-year follow-up period [78”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [78] Zhan J, Liu YJ, Cai LB, et al. Fruit and vegetable consumption and risk of cardiovascular disease: A meta-analysis of prospective cohort studies. Crit Rev Food Sci Nutr. 2015. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Portion size for fruit and vegetable intake used UK (not USA) guidelines.

    “These data should also be interpreted with consideration of the fact that the sleep duration variable did not distinguish between work days and free days [13] and that portion size for fruit and vegetable intake used UK (not USA) guidelines.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Conscientiousness is negatively associated with body mass index.

    “Given that conscientiousness has been positively associated with habitual physical activity [83] and negatively associated with body mass index [84] and current tobacco use [85], it could be argued that personality characteristics are an integral part of explaining the variance in chronotype and positive health behaviors.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [84] Mottus R, McNeill G, Jia X, et al. The associations between personality, diet and body mass index in older people. Health Psychol. 2013; 32: 353-360. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Conscientiousness is negatively associated with current tobacco use.

    “Given that conscientiousness has been positively associated with habitual physical activity [83] and negatively associated with body mass index [84] and current tobacco use [85], it could be argued that personality characteristics are an integral part of explaining the variance in chronotype and positive health behaviors.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [85] Terracciano A, Costa PT Jr. Smoking and the five-factor model of personality. Addiction. 2004; 99: 472-481. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Exposure to ambient light at night from ereaders promotes lateness.

    “For example, increasing light exposure in the natural environment shifts sleep timing earlier [91], while exposure to ambient light at night either from ereaders [92] or urban lighting [93] promotes “lateness.””
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [92] Chang AM, Aeschbach D, Duffy JF, et al. Evening use of light-emitting eReaders negatively affects sleep, circadian timing, and next-morning alertness. Proc Natl Acad Sci U S A. 2015; 112: 1232-1237. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Chronotype was estimated using self-categorization and not clock times that would have allowed identification of the sleep mid-point.

    “Moreover, choronotype was estimated using self-categorization and not clock times that would have allowed the identification of the sleep mid-point [97].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [97] Burgess HJ, Savic N, Sletten T, et al. The relationship between the dim light melatonin onset and sleep on a regular schedule in young healthy adults. Behav Sleep Med. 2003; 1: 102-114. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Interpretationnone given

    The current study is one of the first large-scale population studies to concurrently evaluate the association between sleep duration and chronotype with physical activity, screen-based sedentary behavior, tobacco use, and dietary intake.

    “The current study is one of the first large-scale population studies to concurrently evaluate the association between the sleep metrics of duration and chronotype with physical activity, screen-based sedentary behavior, tobacco use, and dietary intake.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Noise from air conditioning and fans relates to poorer sleep quality.

    “Noise from air conditioning and fans [94] and street noise relate to poorer sleep quality [94, 95] while improvements in urban housing quality [96] also improve sleep.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [94] Kayaba M, Ihara T, Kusaka H, et al. Association between sleep and residential environments in the summertime in Japan. Sleep Med. 2014; 15: 556-564. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationown data

    Promoting adequate sleep and earlier wake/sleep timing may be a necessary precursor in the MHBC sequence of achieving optimal change in tobacco, activity, and dietary behaviors.

    “On this basis, it could be argued that promoting adequate sleep and earlier wake/sleep timing may be a necessary precursor in the MHBC sequence of achieving optimal change in tobacco, activity, and dietary behaviors.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Improvements in urban housing quality improve sleep.

    “Noise from air conditioning and fans [94] and street noise relate to poorer sleep quality [94, 95] while improvements in urban housing quality [96] also improve sleep.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [96] Simonelli G, Leanza Y, Boilard A, et al. Sleep and quality of life in urban poverty: The effect of a slum housing upgrading program. Sleep. 2013; 36: 1669-1676. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationown data

    Short and long sleepers and late chronotypes may benefit from clinical and population level approaches to encourage adequate sleep duration and earlier sleep/wake timing.

    “Collectively, our data show that short and long sleepers (i.e., non-adequate sleepers) and late chronotypes may benefit from clinical and population level approaches to encourage adequate sleep duration and earlier sleep/wake timing.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Sleep is associated with cardiovascular morbidity and mortality.

    “Sleep is associated with cardiovascular morbidity and mortality [90] and this population analysis has shown that sleep is significantly associated with all three of the main risk behaviors for poor heart health.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [90] Cappuccio FP, Cooper D, D’Elia L, et al. Sleep duration predicts cardiovascular outcomes: A systematic review and meta-analysis of prospective studies. Eur Heart J. 2011; 32: 1484-1492. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Previous studies have shown late chronotypes to have a tendency for a higher body mass index.

    “Consistent with these data, previous studies have also shown late chronotypes to have less healthful dietary habits and a tendency for a higher body mass index (BMI) [27, 77].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [27] Schubert E, Randler C. Association between chronotype and the constructs of the three-factor-eating-questionnaire. Appetite. 2008; 51: 501-505. source

      Not checked in the free run.

    • cites [77] Sato-Mito N, Sasaki S, Murakami K, et al. The midpoint of sleep is associated with dietary intake and dietary behavior among young Japanese women. Sleep Med. 2011; 12: 289-294. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationown data

    Consideration of how environment structures can be manipulated to promote better sleep may be important for better cardiovascular health.

    “Given the current data showing the vulnerability of long sleepers and late chronotypes to poor heart health behaviors, consideration of how environment structures can be manipulated to promote better sleep may be important for better cardiovascular health.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

    Interpretationown data

    These results represent a novel and important contribution to this literature.

    “Nevertheless, these results showing that long sleepers and late chronotypes are more vulnerable to negative heart health behaviors represent a novel and important contribution to this literature.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Previous studies have shown late chronotypes to have less healthful dietary habits.

    “Consistent with these data, previous studies have also shown late chronotypes to have less healthful dietary habits and a tendency for a higher body mass index (BMI) [27, 77].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [27] Schubert E, Randler C. Association between chronotype and the constructs of the three-factor-eating-questionnaire. Appetite. 2008; 51: 501-505. source

      Not checked in the free run.

    • cites [77] Sato-Mito N, Sasaki S, Murakami K, et al. The midpoint of sleep is associated with dietary intake and dietary behavior among young Japanese women. Sleep Med. 2011; 12: 289-294. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Conscientiousness is positively associated with habitual physical activity.

    “Given that conscientiousness has been positively associated with habitual physical activity [83] and negatively associated with body mass index [84] and current tobacco use [85], it could be argued that personality characteristics are an integral part of explaining the variance in chronotype and positive health behaviors.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [83] Courneya KS, Hellsten LA. Personality correlates of exercise behavior, motives, barriers and preferencs: An application of the five-factor model. Personal Individ Differ. 1998; 24: 625-633. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Increasing light exposure in the natural environment shifts sleep timing earlier.

    “For example, increasing light exposure in the natural environment shifts sleep timing earlier [91], while exposure to ambient light at night either from ereaders [92] or urban lighting [93] promotes “lateness.””
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [91] Wright KP Jr, McHill AW, Birks BR, et al. Entrainment of the human circadian clock to the natural light–dark cycle. Curr Biol. 2013. source

      Not checked in the free run.

51 of 51

  • The paper relies on this without support.

    Self-reported sleep duration is a valid measure of habitual sleep duration.

    “Sleep duration was assessed with the survey item “About how many hours sleep do you get in every 24 h? (Please include naps.)””
    “Further work is needed to determine whether these findings are maintained in the context of objective sleep and circadian estimates”

  • The paper relies on this without support.

    Self-reported current smoking status is a valid measure of tobacco use.

    “Self-reported current smoking status was evaluated using a single item: “About how many cigarettes did you smoke on average each day?””

  • The paper relies on this without support.

    The UK Biobank sample is representative of the UK adult population.

    “population data from the United Kingdom (UK) Biobank (application # 3474) were analyzed.”
    “in a population sample of 439,933 adults.”

  • The paper relies on this without support.

    Self-reported fruit and vegetable intake are valid measures of dietary intake.

    “To evaluate fruit intake, participants were asked to consider their dietary intake in the last year and to answer: “About how many pieces of FRESH fruit would you eat per DAY?””
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • In UK Biobank, adults with a morning chronotype consume a mean of 0.25 more servings of fruit and 0.13 more servings of vegetables per day than adults with an evening chronotype.

    “Comparable with findings in adolescents and young adults, data from the UK Biobank project demonstrate that adults with a morning chronotype consume a mean of 0.25 more servings of fruit and 0.13 more servings of vegetables/d, as assessed through the use of 24-h recalls, than do adults with an evening chronotype (75).”

    From Chronotype: Implications for Epidemiologic Studies on Chrono-Nutrition and Cardiometabolic Health (2019) · cites this paper as [75]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Very short sleep has two different cutoffs

    Minor

    The measures define very short sleep as four hours or fewer, while the analysis defines it as fewer than four hours. The definitions differ for participants reporting exactly four hours.

  • Weekly walking minutes converted to the wrong number of hours

    Minor

    328.5 minutes is 5.475 hours, or about 5.5 hours, not 6.3 hours.

    Reported 6.3 · recomputed 5.475

  • Direction of the sleep-duration association with vegetable intake changes

    Minor

    The results say longer sleep duration was positively associated with vegetable intake, but the discussion says it was associated with lower vegetable intake.

3 of 3

Cites

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Related

Authors
Patterson, F., Malone, S. K., Lozano, A., Grandner, M. A., & Hanlon, A. L.
Affiliations
  • University of Delaware (US)
  • University of Pennsylvania (US)
  • Drexel University (US)
  • University of Arizona (US)
Corresponding author
Patterson, Freda
ORCID
Venue
Annals of Behavioral Medicine
Publisher
Oxford University Press (OUP)
Published
2016-04-07
Volume
50
Issue
5
Pages
715-726
ISSN
  • 0742-5554 (ISSN-L)
  • 0883-6612
  • 1532-4796
DOI
10.1007/s12160-016-9797-5
PMC
PMC5079686
OpenAlex
W2319834262
Semantic Scholar
ce0f61feec47bd22721c1d553e6f2806c1e6a522
Cited by
144
References
102
Citations by year
2026: 3 · 2025: 7 · 2024: 16 · 2023: 17 · 2022: 24 · 2021: 30 · 2020: 11 · 2019: 15 · 2018: 12 · 2017: 8 · 2016: 1
FWCI
17.08
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (unspecified)
Locations
  • Annals of Behavioral Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
Robert Wood Johnson Foundation (US) (69251)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
Keywords
sleep duration, chronotype, screen-based sedentary behavior, tobacco use, smoking, diet, fruit and vegetable intake, cardiovascular risk factors, physical activity, television viewing, computer use, sleep timing, obesity
MeSH terms
Aged, Cardiovascular Diseases, Circadian Rhythm, Cross-Sectional Studies, Diet, Female, United Kingdom, Humans, Male, Middle Aged, Risk Factors, Sleep, Smoking, Exercise, Sedentary Behavior

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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