Self-reported health behaviors, including sleep, correlate with doctor-informed medical conditions: data from the 2011 health related behaviors survey of U.S. active duty military personnel
Open accessAbstract
BACKGROUND: Health behaviors and cardiometabolic disease risk factors may differ between military and civilian populations; therefore, in U.S. active duty military personnel, we assessed relationships between demographic characteristics, self-reported health behaviors, and doctor-informed medical conditions. METHODS: Data were self-reported by 27,034 active duty military and Coast Guard personnel who responded to the 2011 Department of Defense Health Related Behaviors Survey. Multivariate linear and logistic regressions were used to estimate cross-sectional associations between (1) demographic characteristics (age, sex, service branch, marital status, children, race/ethnicity, pay grade) and self-reported behaviors (exercise, diet, smoking, alcohol, sleep); (2) demographic characteristics and doctor-informed medical conditions (hypertension, hypercholesterolemia, low high density lipoprotein (HDL) cholesterol, hyperglycemia) and overweight/obesity; and (3) behaviors and doctor-informed medical conditions. RESULTS: Among respondents (age 29.9 ± 0.1 years, 14.7% female), females reported higher intake than men of fruit, vegetables, and dairy; those with higher education reported higher intakes of whole grains; those currently married and/or residing with children reported higher intake of starches. Older age and female sex were associated with higher odds (ORs 1.25 to 12.54 versus the youngest age group) of overweight/obesity. Older age and female sex were also associated with lower odds (ORs 0.29 to 0.65 versus male sex) of doctor-informed medical conditions, except for blood glucose, for which females had higher odds. Those currently married had higher odds of high cholesterol and overweight/obesity, and separated/divorced/widowed respondents had higher odds of high blood pressure and high cholesterol. Short sleep duration (< 5 versus 7-8 h/night) was associated with higher odds (ORs 1.36to 2.22) of any given doctor-informed medical condition. Strength training was associated with lower probability of high cholesterol, high triglycerides, and low HDL, and higher probability of overweight/obesity. Dietary factors were variably associated with doctor-informed medical conditions and overweight/obesity. CONCLUSIONS: This study observed pronounced associations between health behaviors-especially sleep-and medical conditions, thus adding to evidence that sleep is a critical, potentially modifiable behavior within this population. When possible, adequate sleep should continue to be promoted as an important part of overall health and wellness throughout the military community.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
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?
Medical doctors and military personnel are at increased risk to report poor sleep compared to the general population.
“Further, compared to the general population, two subgroups are at increased risk to report poor sleep: Medical doctors (47–51), and military personnel (65, 66, 154).”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Sontrop, J. M., Dixon, S. N., Garg, A. X., Jiménez, I. B., Dohein, O., Huang, S. S., & Clark, W. F. (2013) · American Journal of Nephrology · doi:10.1159/000350377 · Cited by 5,903 · see citing works
Mild traumatic brain injury in U.S. soldiers returning from Iraq
Hoge, C. W., McGurk, D., Thomas, J. L., Cox, A. L., Engel, C. C., & Castro, C. A. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa072972 · Cited by 2,775 · see citing works
Changes in diet and lifestyle and long-term weight gain in women and men
Mozaffarian, D., Hao, T., Rimm, E. B., Willett, W. C., & Hu, F. B. (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1014296 · Cited by 2,527 · see citing works
Eckel, R. H., Jakicic, J. M., Ard, J. D., de Jesus, J. M., Miller, N. H., Hubbard, V. S., Lee, I.-M., Lichtenstein, A. H., Loria, C. M., Millen, B. E., et al. (2014) · Circulation · doi:10.1161/01.cir.0000437740.48606.d1 · Cited by 2,261 · see citing works
Malik, V. S., Pan, A., Willett, W. C., & Hu, F. B. (2013) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.113.058362 · Cited by 1,668 · see citing works
Sleep duration and risk of type 2 diabetes: a meta-analysis of prospective studies
Shan, Z., Ma, H., Xie, M., Yan, P., Guo, Y., Bao, W., Rong, Y., Jackson, C. L., Hu, F. B., & Liu, L. (2015) · Diabetes Care · doi:10.2337/dc14-2073 · Cited by 902 · see citing works
The Prevention or Delay of Type 2 Diabetes
American Diabetes Association, & National Institute of Diabetes, D. A. K. D. (2003) · Diabetes Care · doi:10.2337/diacare.26.2007.s62 · Cited by 520 · see citing works
Roth, T. G., Coulouvrat, C., Hajak, G., Lakoma, M. D., Sampson, N. A., Shahly, V., Shillington, A. C., Stephenson, J. J., Walsh, J. K., & Kessler, R. C. (2011) · Biological Psychiatry · doi:10.1016/j.biopsych.2010.10.023 · Cited by 477 · see citing works
Sugar-sweetened and artificially sweetened beverage consumption and risk of type 2 diabetes in men
de Koning, L., Malik, V., Rimm, E. B., Willett, W. C., & Hu, F. B. (2011) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.110.007922 · Cited by 461 · see citing works
Meng, L., Zheng, Y., & Hui, R. (2013) · Hypertension Research · doi:10.1038/hr.2013.70 · Cited by 370 · see citing works
Changes in diet, physical activity, and supplement use among adults diagnosed with cancer
Patterson, R. E., Neuhouser, M. L., Hedderson, M. M., Schwartz, S. M., Standish, L. J., & Bowen, D. J. (2003) · Journal of the American Dietetic Association · doi:10.1053/jada.2003.50045 · Cited by 319 · see citing works
McHill, A. W., & Wright, K. P. (2017) · Obesity Reviews · doi:10.1111/obr.12503 · Cited by 316 · see citing works
American Diabetes Association (2014) · Diabetes Care · doi:10.2337/dc15-s007 · Cited by 262 · see citing works
Metabolic effects of sleep disruption, links to obesity and diabetes
Nedeltcheva, A. V., & Scheer, F. A. J. L. (2014) · Current Opinion in Endocrinology, Diabetes & Obesity · doi:10.1097/med.0000000000000082 · Cited by 249 · see citing works
Marital Trajectories and Mortality Among US Adults
Dupre, M. E., Beck, A. N., & Meadows, S. O. (2009) · American Journal of Epidemiology · doi:10.1093/aje/kwp194 · Cited by 198 · see citing works
Sleep Disorders in US Military Personnel
Mysliwiec, V., Gill, J., Lee, H., Baxter, T., Pierce, R., Barr, T. L., Krakow, B., & Roth, B. J. (2013) · Chest · doi:10.1378/chest.13-0088 · Cited by 184 · see citing works
Risk for suicidal behaviors associated with PTSD, depression, and their comorbidity in the U.S. Army
Ramsawh, H. J., Fullerton, C. S., Mash, H. B. H., Ng, T. H. H., Kessler, R. C., Stein, M. B., & Ursano, R. J. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.03.016 · Cited by 181 · see citing works
2011 Health Related Behaviors Survey of Active Duty Military Personnel
Barlas, F. M., Higgins, W., Pflieger, J. C., et al. (2013) · doi:10.21236/ada582287 · Cited by 173 · see citing works
A brief introduction to the military workplace culture
Redmond, S. A., Wilcox, S. L., Campbell, S., Kim, A., Finney, K., Barr, K., & Hassan, A. M. (2015) · WORK: A Journal of Prevention, Assessment & Rehabilitation · doi:10.3233/wor-141987 · Cited by 169 · see citing works
Residual sleep disturbances following PTSD treatment in active duty military personnel.
Pruiksma, K. E., Taylor, D. J., Wachen, J. S., Mintz, J., Young‐McCaughan, S., Peterson, A. L., Yarvis, J. S., Borah, E. V., Dondanville, K. A., Litz, B. T., et al. (2016) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/tra0000150 · Cited by 164 · see citing works
An Occupational Mental Health Model for the Military
Adler, A. B., & Castro, C. A. (2012) · Military Behavioral Health · doi:10.1080/21635781.2012.721063 · Cited by 161 · see citing works
Jean-Louis, G., Williams, N. J., Sarpong, D., Pandey, A., Youngstedt, S., Zizi, F., & Ogedegbe, G. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-290 · Cited by 158 · see citing works
Sleep duration and body mass index and waist circumference among Us adults
Ford, E. S., Li, C., Wheaton, A. G., Chapman, D. P., Perry, G. S., & Croft, J. B. (2013) · Obesity · doi:10.1002/oby.20558 · Cited by 156 · see citing works
Nettleton, J. A., Steffen, L. M., Schulze, M. B., Jenny, N. S., Barr, R. G., Bertoni, A. G., & Jacobs, D. R. (2007) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/85.6.1615 · Cited by 140 · see citing works
Twardella, D., Loew, M., Rothenbacher, D., Stegmaier, C., Ziegler, H., & Brenner, H. (2006) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2005.05.003 · Cited by 133 · see citing works
Longitudinal Changes in Lifestyle Behaviors and Health Status in Colon Cancer Survivors
Satia, J. A., Campbell, M. K., Galanko, J. A., James, A. S., Carr, C., & Sandler, R. S. (2004) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.1022.13.6 · Cited by 131 · see citing works
The influence of marital status on the use of breast, cervical, and colorectal cancer screening
Hanske, J., Meyer, C. P., Sammon, J. D., Choueiri, T. K., Menon, M., Lipsitz, S. R., Noldus, J., Nguyen, P. L., Sun, M., & Trinh, Q. (2016) · Preventive Medicine · doi:10.1016/j.ypmed.2016.05.017 · Cited by 130 · see citing works
Overweight and Obesity in Military Personnel: Sociodemographic Predictors
Smith, T. J., Marriott, B. P., Dotson, L., Bathalon, G. P., Funderburk, L., White, A., Hadden, L. S., & Young, A. (2012) · Obesity · doi:10.1038/oby.2012.25 · Cited by 117 · see citing works
Self-citationSmoking and Weight Change After New Health Diagnoses in Older Adults
Keenan, P. S. (2009) · Archives of Internal Medicine · doi:10.1001/archinternmed.2008.557 · Cited by 111 · see citing works
McEvoy, C. T., Cardwell, C. R., Woodside, J. V., Young, I. S., Hunter, S. J., & McKinley, M. C. (2014) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2014.05.001 · Cited by 109 · see citing works
Changes in Overall Diet Quality and Subsequent Type 2 Diabetes Risk: Three U.S. Prospective Cohorts
Ley, S. H., Pan, A., Li, Y., Manson, J. E., Willett, W. C., Sun, Q., & Hu, F. B. (2016) · Diabetes Care · doi:10.2337/dc16-0574 · Cited by 105 · see citing works
Overweight and Obesity Trends Among Active Duty Military Personnel
Reyes-Guzman, C. M., Bray, R. M., Forman‐Hoffman, V. L., & Williams, J. G. (2014) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2014.08.033 · Cited by 100 · see citing works
Economic Conditions of Military Families
Hosek, J. R., & Wadsworth, S. M. (2013) · The Future of Children · doi:10.1353/foc.2013.0009 · Cited by 85 · see citing works
Ma, J., Jacques, P. F., Meigs, J. B., Fox, C. S., Rogers, G. T., Smith, C. E., Hruby, A., Saltzman, E. J., & McKeown, N. M. (2016) · Journal of Nutrition · doi:10.3945/jn.116.234047 · Cited by 83 · see citing works
Self-citationLYYTIKÄINEN, P., RAHKONEN, O., LAHELMA, E., & LALLUKKA, T. (2011) · Journal of Sleep Research · doi:10.1111/j.1365-2869.2010.00903.x · Cited by 81 · see citing works
Lane, M. E., Hourani, L. L., Bray, R. M., & Williams, J. G. (2012) · American Journal of Public Health · doi:10.2105/ajph.2011.300280 · Cited by 81 · see citing works
Sleep as a component of the performance triad: the importance of sleep in a military population.
Lentino, C. V., Purvis, D. L., Murphy, K. J., & Deuster, P. A. (2013) · PubMed · Cited by 80 · see citing works
Park, S., Xu, F. Z., Town, M., & Blanck, H. M. (2016) · MMWR Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6507a1 · Cited by 78 · see citing works
Marital Status, Self-Rated Health, and Mortality
Zheng, H., & Thomas, P. A. (2013) · Journal of Health and Social Behavior · doi:10.1177/0022146512470564 · Cited by 76 · see citing works
Purvis, D. L., Lentino, C. V., Jackson, T. K., et al. (2015) · PubMed · Cited by 74 · see citing works
4. Prevention or Delay of Type 2 Diabetes
American Diabetes Association (2015) · Diabetes Care · doi:10.2337/dc16-s007 · Cited by 70 · see citing works
Bachelors, Divorcees, and Widowers: Does Marriage Protect Men from Type 2 Diabetes?
Cornelis, M. C., Chiuve, S. E., Glymour, M. M., Chang, S.-C., Tchetgen, E. J. T., Liang, L., Koenen, K. C., Rimm, E. B., Kawachi, I. I., & Kubzansky, L. D. (2014) · PLoS ONE · doi:10.1371/journal.pone.0106720 · Cited by 67 · see citing works
Hawkes, A. L., Lynch, B. M., Youlden, D. R., Owen, N. G., & Aitken, J. F. (2008) · Supportive Care in Cancer · doi:10.1007/s00520-008-0421-5 · Cited by 65 · see citing works
Snacking patterns, diet quality, and cardiovascular risk factors in adults
Nicklas, T. A., O’Neil, C. E., & Fulgoni, V. L. I. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-388 · Cited by 63 · see citing works
Trends in SSBs and snack consumption among children by age, body weight, and race/ethnicity
Bleich, S. N., & Wolfson, J. A. (2015) · Obesity · doi:10.1002/oby.21050 · Cited by 52 · see citing works
Smith, T. J., Dotson, L., Young, A. J., White, A., Hadden, L. S., Bathalon, G. P., Funderburk, L., & Marriott, B. P. (2013) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2013.03.002 · Cited by 47 · see citing works
Self-citationChronic Disease and Lifestyle Transitions
van Gool, C. H., Kempen, G. I. J. M., Penninx, B. W. J. H., Deeg, D. J. H., & van Eijk, J. T. M. (2007) · Journal of Aging and Health · doi:10.1177/0898264307300189 · Cited by 38 · see citing works
Does Marriage Protect Health? A Birth Cohort Comparison*
Tumin, D. (2017) · Social Science Quarterly · doi:10.1111/ssqu.12425 · Cited by 34 · see citing works
Stressors afflicting families during military deployment.
Nola, G. M. D. (2008) · PubMed · Cited by 33 · see citing works
Associations between Mental Health Disorders and Body Mass Index among Military Personnel
Smith, T. J., White, A., Hadden, L. S., Young, A. J., & Marriott, B. P. (2014) · American Journal of Health Behavior · doi:10.5993/ajhb.38.4.6 · Cited by 27 · see citing works
Self-citationPoor sleep after military deployment: associations with mental health difficulties
Hunt, E. J. F., Greenberg, N. L., & Jones, N. (2016) · Occupational Medicine · doi:10.1093/occmed/kqw116 · Cited by 15 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Bai, W., Gui, Z., Chen, M.-Y., Zhang, Q., Lam, M. I., Si, T. L., Zheng, W.-Y., Liu, Y.-F., Su, Z., Cheung, T., et al. (2023) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2023.101840 · Cited by 43 · see citing works
Sadeghi-Bahmani, D., Rigotti, V., Stanga, Z., Lang, U. E., Blais, R. K., Kelley, M. L., & Brand, S. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1390636 · Cited by 6 · see citing works
- Authors
- Hruby, A., Lieberman, H. R., & Smith, T. J.
- Affiliations
- U.S. Army Research Institute of Environmental Medicine (US)
- Corresponding author
- Smith, Tracey J.
- Venue
- BMC Public Health
- Published
- 2018-07-11
- Volume
- 18
- Issue
- 1
- Pages
- 853-853
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC6042384
- OpenAlex
- W2878806420
- Cited by
- 15
- References
- 51
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 2 · 2022: 5 · 2021: 2 · 2020: 1 · 2019: 2 · 2018: 1
- FWCI
- 2.29
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Public Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- OSTI OAI (U.S. Department of Energy Office of Scientific and Technical Information) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Medical Research and Materiel Command
- Topics
- Health Sciences › Health Professions › General Health Professions › Health and Lifestyle Studies
- Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Performance
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- active duty military personnel, sleep duration, health behavior, cardiometabolic risk factors, overweight and obesity, hypertension, hypercholesterolemia, HDL cholesterol, hyperglycemia, dietary intake, physical activity, smoking, alcohol consumption, sex differences, marital status, military health, resistance training, fruit and vegetable intake, whole grain intake
- MeSH terms
- Adult, Age Factors, Aged, Cross-Sectional Studies, Diet, Female, Health Status, Health Surveys, Humans, Male, Middle Aged, Military Personnel, Physicians, Sex Factors, Sleep, Smoking, United States, Health Behavior, Exercise, Logistic Models, Marital Status, Young Adult, Self Report
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.
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.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
