title: Probable insomnia is associated with future total energy intake and diet quality in men.
abstract: Insomnia is associated with several adverse health outcomes. Small clinical studies have suggested that an inferior nutrition status is a potential explanation, but to our knowledge, this possibility has not been examined in a large-scale, population-based cohort study.
  
  
  
  We examined whether individuals with probable insomnia and individual insomnia symptoms had greater energy intake and a lower diet quality as assessed with the use of the Alternate Healthy Eating Index (AHEI) 2 y later.
  
  
  
  A cohort study of 15,273 US men aged 58-93 y who were free of cancer, cardiovascular diseases, and diabetes and were participating in the Health Professionals Follow-Up Study reported information on insomnia symptoms in 2004. Dietary intake was assessed with the use of a food-frequency questionnaire in 2002 and 2006. We calculated the adjusted mean differences of total energy intake in 2006 and the AHEI-component scores and their 95% CIs between subjects with and without probable insomnia in 2004 and also across categories for each insomnia symptom while adjusting for related covariates.
  
  
  
  After dietary intake in 2002, major chronic conditions, and other potential confounders were controlled for, men with probable insomnia had a mean higher consumption of 35.8 kcal/d (95% CI: 17.4, 54.1 kcal/d) and had lower scores in 3 individual AHEI components (trans fat, vegetables, and sodium), which denoted higher consumption of trans fat and sodium and lower intake of vegetables (P ≤ 0.01 for all). For individual insomnia symptoms, nonrestorative sleep and a difficulty maintaining sleep were associated with higher energy intake (P-trend ≤ 0.007 for both). A similar trend was observed in men who had difficulty initiating sleep (P-trend = 0.07). We also observed a significant association between the difficulty of initiating sleep and a lower AHEI score 2 y later (P-trend = 0.004).
  
  
  
  Probable insomnia is associated with higher intakes of total energy, trans fat, and sodium and lower intake of vegetables.
authors.affiliation: Department of Nutritional Sciences, Pennsylvania State University, University Park, PA;
authors.forename: Feon W
authors.identifier: 0000-0001-6413-812X
authors.initials: FW
authors.lastname: Cheng
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, MA;
authors.forename: Yanping
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, MA; and.
authors.forename: John W
authors.initials: JW
authors.lastname: Winkelman
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, MA; The Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
authors.forename: Frank B
authors.initials: FB
authors.lastname: Hu
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, MA; The Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
authors.forename: Eric B
authors.initials: EB
authors.lastname: Rimm
authors.affiliation: Department of Nutritional Sciences, Pennsylvania State University, University Park, PA; xxg14@psu.edu.
authors.forename: Xiang
authors.initials: X
authors.lastname: Gao
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004032:Diet / Q000592:standards; D004034:Diet Surveys; D002149:Energy Intake; D005247:Feeding Behavior; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012890:Sleep; D007319:Sleep Initiation and Maintenance Disorders; D012982:Sodium, Dietary / Q000008:administration & dosage*; D044242:Trans Fatty Acids / Q000008:administration & dosage*; D014481:United States; D014675:Vegetables
chemical_list: D012982:Sodium, Dietary; D044242:Trans Fatty Acids
keywords: cohort; diet quality; energy intake; insomnia; sleep disorders