Television viewing time independently predicts all-cause and cardiovascular mortality: The EPIC Norfolk study

MRC Epidemiology Unit, Cambridge, UK.
International Journal of Epidemiology (Impact Factor: 9.2). 02/2011; 40(1):150-9. DOI: 10.1093/ije/dyq105
Source: PubMed

ABSTRACT Television viewing (TV), a highly prevalent behaviour, is associated with higher cardiovascular risk independently of physical activity. The relationship with mortality, however, is relatively unknown.
We examined the prospective relationship between TV time and all-cause, cardiovascular and cancer mortality in a population-based cohort [The European Prospective Investigation into Cancer and Nutrition (EPIC), Norfolk] of 13 197 men and women {age [SD (standard deviation)]: 61.5 ± 9.0 years}. Participants were free from stroke, myocardial infarction and cancer at baseline in 1998-2000 and were followed up for death ascertainment until 2009 (9.5 ± 1.6 years). TV time, total physical activity energy expenditure (PAEE), education level, smoking status, alcohol consumption, anti-hypertensive and lipid-lowering medication use, participant and family history of disease and total energy intake were self-reported; height and weight were measured by standardized procedures. Hazard ratios (HRs) [95% confidence interval (CI)] for mortality were estimated per 1-h/day increase in TV.
Each 1-h/day increase in TV time was associated with increased hazard of all-cause (HR = 1.04, 95% CI = 1.01-1.09; 1270 deaths) and cardiovascular (HR = 1.07, 95% CI = 1.01-1.15; 373 deaths), but not cancer mortality (HR = 1.04, 95% CI = 0.98-1.10; 570 deaths). This was independent of gender, age, education, smoking, alcohol, medication, diabetes history, family history of cardiovascular disease and cancer, body mass index (BMI) and PAEE. They were similar when stratified by gender, age, education, BMI and PAEE. The population-attributable fraction for all-cause mortality comparing the highest TV tertile (>3.6 h/day) with the lowest (<2.5 h/day) was 5.4%.
These findings suggest that public health recommendations should consider advising a reduction in TV time, a predominant leisure activity in modern society, in addition to advocating physical activity.

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    • "Sedentary behaviours—defined by low energy expenditure (ranging from 1.0 to 1.5 metabolic equivalents) in a sitting or reclining position (Owen, 2012; Sedentary Behaviour Research N, 2012)—have emerged as an additional element with concerns about physical activity and health. Television (TV) viewing time, a common leisure-time sedentary behaviour, has been associated with major chronic diseases and adverse cardio-metabolic health outcomes (Thorp et al., 2010; Wijndaele et al., 2010), decreased life expectancy (Veerman et al., 2011) and all-cause and cardiovascular mortality (Dunstan et al., 2010; Grontved and Hu, 2011; Wijndaele et al., 2011). Despite increasing evidence on the detrimental health consequences of high volumes of TV viewing time, little is known about the relationships of TV viewing time with health-related quality of life. "
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    ABSTRACT: Objective: Television (TV) viewing, a common leisure-time sedentary behaviour, is associated adversely with cardio-metabolic health, fatigue, depression and mental health. However, associations of TV viewing time with health-related quality of life attributes are less well understood. We examined associations of TV viewing time with physical well-being, mental well-being and vitality in a large population-based sample of Australian adults. Method: The study sample comprised 4,483 men and 5,424 women (mean age 51. ±. 14. years) from the Australian Diabetes, Obesity and Lifestyle study (1999-2000). Multiple linear regressions examined associations of TV viewing time (h/day) with the SF-36v1 physical and mental health component summary scores and the vitality sub-score, adjusting for leisure-time physical activity and waist circumference. Results: Each 1-h/day increment in TV viewing time was associated with lower physical (-. 0.56 [95% CI: -. 0.77, -. 0.34]) and mental (-. 0.41 [-. 0.70, -. 0.12]) component summary scores and vitality (-. 0.51 [-. 0.81, -. 0.21]). Associations remained significant after adjustment for leisure-time physical activity and waist circumference. There was a gender interaction for the association of TV viewing time with vitality (significant in men only). Conclusions: TV viewing time is associated adversely with physical well-being, mental well-being and vitality. Further studies are required to better understand potential causal relationships and variations by gender and leisure-time physical activity.
    Preventive Medicine 09/2014; DOI:10.1016/j.ypmed.2014.09.007 · 2.93 Impact Factor
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    • "Atherosclerosis j o u r n a l h o m e p a g e : w w w . e l s e v i e r. co m / l o c a t e / a t h e r o s c l e r o s i s greater benefits of activity amongst obese groups for type 2 diabetes [20] or coronary heart disease [2] [5]. Research is scarce on whether benefits of activity vary for obese and non-obese groups across multiple CVD and diabetes biomarkers and whether there are corresponding patterns for sedentary behaviour. "
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    ABSTRACT: Objective A key public health priority is to minimise obesity-related health consequences. We aim to establish whether physical activity (PA) or less sedentary behaviour ameliorate associations of obesity with biomarkers for cardiovascular disease (CVD) and type 2 diabetes. Methods Data on obesity (33 y), PA (42 y), TV-viewing and health biomarkers (45 y) are from the 1958 British birth cohort (N = 9377). Results Obesity was associated with an adverse biomarker profile for CVD and type 2 diabetes. For PA, men active ≥1/week had 1.09% (0.28, 1.90) lower diastolic blood pressure (DBP) than less active men; triglycerides were 2.08% (0.52, 3.64) lower per unit higher PA (on 4-point scale). TV-viewing was independently associated with several biomarkers, e.g. per unit higher TV-viewing (on 4-point scale) DBP was raised by 0.50% (0.09, 0.90) and triglycerides by 3.61% (1.58, 5.64). For both TV-viewing and PA, associations with HbA1c were greatest for the obese (pinteraction ≤ 0.04): compared to a reference value of 5.20 HbA1c% in non-obese men viewing 0–1 h/day, HbA1c% differed little for those viewing >3 h/day; among obese men HbA1c% was 5.36 (5.22, 5.51) and 5.65 (5.53, 5.76), for 0–1 and >3 h/day respectively. For PA in non-obese men, the reduction associated with activity ≥1/week was negligible compared to a reference value of 5.20 HbA1c% for those less active; but there was a reduction among obese men, HbA1c% was 5.50 (5.40, 5.59) vs 5.66 (5.55, 5.77) respectively. Conclusion Reduced TV-viewing and prevention of infrequent activity have greatest beneficial associations for glucose metabolism among the obese, with benefits for other biomarkers across obese and non-obese groups.
    Atherosclerosis 04/2014; 233(2):363–369. DOI:10.1016/j.atherosclerosis.2014.01.032 · 3.97 Impact Factor
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    • "Sedentary behaviour refers not only to physical inactivity, but also to a set of daily activities with low energy expenditure such as playing videogames, using computers, driving, sitting or watching television. Sedentarism has been identified as an independent risk factor for all-cause mortality (Patel et al., 2010, Wijndaele et al., 2011b, Warren et al., 2010, van der Ploeg et al., 2012) as well as for type 2 diabetes, cardiovascular diseases, or metabolic syndrome (Thorp et al. 2011, 2010, Wijndaele et al., 2011a, 2009). Moreover, several studies have explored the relationship between sedentarism and weight or obesity, and have concluded that a sedentary lifestyle is strongly associated with both obesity and higher body weight (Hu et al., 2003, Inoue et al., 2012, Martinez-Gonzalez et al., 1999). "
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    Transport Policy 03/2014; 32:165-171. DOI:10.1016/j.tranpol.2014.01.012 · 1.72 Impact Factor
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