Television Viewing and Risk of Type 2 Diabetes, Cardiovascular Disease, and All-Cause Mortality A Meta-analysis

Institute of Sport Science and Clinical Biomechanics, Department of Exercise Epidemiology, Center of Research in Childhood Health, University of Southern Denmark, Odense.
JAMA The Journal of the American Medical Association (Impact Factor: 35.29). 06/2011; 305(23):2448-55. DOI: 10.1001/jama.2011.812
Source: PubMed


Prolonged television (TV) viewing is the most prevalent and pervasive sedentary behavior in industrialized countries and has been associated with morbidity and mortality. However, a systematic and quantitative assessment of published studies is not available.
To perform a meta-analysis of all prospective cohort studies to determine the association between TV viewing and risk of type 2 diabetes, fatal or nonfatal cardiovascular disease, and all-cause mortality.
Relevant studies were identified by searches of the MEDLINE database from 1970 to March 2011 and the EMBASE database from 1974 to March 2011 without restrictions and by reviewing reference lists from retrieved articles. Cohort studies that reported relative risk estimates with 95% confidence intervals (CIs) for the associations of interest were included.
Data were extracted independently by each author and summary estimates of association were obtained using a random-effects model.
Of the 8 studies included, 4 reported results on type 2 diabetes (175,938 individuals; 6428 incident cases during 1.1 million person-years of follow-up), 4 reported on fatal or nonfatal cardiovascular disease (34,253 individuals; 1052 incident cases), and 3 reported on all-cause mortality (26,509 individuals; 1879 deaths during 202,353 person-years of follow-up). The pooled relative risks per 2 hours of TV viewing per day were 1.20 (95% CI, 1.14-1.27) for type 2 diabetes, 1.15 (95% CI, 1.06-1.23) for fatal or nonfatal cardiovascular disease, and 1.13 (95% CI, 1.07-1.18) for all-cause mortality. While the associations between time spent viewing TV and risk of type 2 diabetes and cardiovascular disease were linear, the risk of all-cause mortality appeared to increase with TV viewing duration of greater than 3 hours per day. The estimated absolute risk differences per every 2 hours of TV viewing per day were 176 cases of type 2 diabetes per 100,000 individuals per year, 38 cases of fatal cardiovascular disease per 100,000 individuals per year, and 104 deaths for all-cause mortality per 100,000 individuals per year.
Prolonged TV viewing was associated with increased risk of type 2 diabetes, cardiovascular disease, and all-cause mortality.

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    • "Mental Health and Physical Activity (Bowman, 2006; Fung et al., 2000; Jakes et al., 2003; Marshall, Biddle, Gorely, Cameron, & Murdey, 2004), neck and low back pain (Kuster, 2004), metabolic syndrome (Dunstan et al., 2005; Gao, Nelson, & Tucker, 2007; Wijndaele et al., 2009), atherosclerosis (Kronenberg et al., 2000), sleep problems (Basner & Dinges, 2009) and others (Dunstan, Howard, Healy, & Owen, 2012; Grontved & Hu, 2011). "
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    ABSTRACT: Background Time spent watching TV by Europeans has been calculated to be 22.1 h per week on average and it has shown to be correlated with a series of physical and mental problems in adults. Very little research is available in population over 65. This study aimed at evaluating the association between TV viewing and mental disorders and cognitive performance, taking into account the general physical activity level and socio-demographic characteristics in Europe. Methods Within the MentDis-ICF65+ study, a subsample of 1383 subjects aged 65-84 years were assessed by the Composite International Diagnostic Interview (CIDI65+) and the International Physical Activity Questionnaire (IPAQ) for physical activity evaluation. Time spent in watching TV was assessed through a self report instrument. Results Forty-three per cent of the total sample watched TV for 5-7 days a week for 2 or more hours every day. Females, people who lived alone, older subjects and those with lower education significantly watched TV for a longer time. Stepwise multiple regression showed statistically significant inverse correlation between Mini-Mental State Examination scores and TV viewing time (p < 0.001). Apart from a negative association with Major Depressive Disorder, no particular associations were found between TV viewing and psychopathological diagnoses. Conclusions Given the relationship of time spending watching TV with cognitive impairment, awareness should be raised about the possible negative effects of TV viewing on the elderly and programs to reduce TV viewing time should be set up.
    Mental Health and Physical Activity 12/2014; 8. DOI:10.1016/j.mhpa.2014.11.002
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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±14years) 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 · 3.09 Impact Factor
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    • "A growing body of evidence suggests that sedentary behavior (time spent sitting or reclining) is independently associated with all-cause and cardiovascular mortality [1–4], cardiovascular disease [5, 6], type 2 diabetes [7, 8], and some cancers [9]. Sedentary behavior appears to have physiological consequences, distinct from the effects associated with an absence of moderate- to vigorous-intensity physical activity, that may further contribute to chronic disease risk [10, 11]. "
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    ABSTRACT: Background Most sedentary behavior measures focus on occupational or leisure-time sitting. Our aim was to develop a comprehensive measure of adult sedentary behavior and establish its measurement properties. Method The SIT-Q was developed through expert review (n???=???7), cognitive interviewing (n???=???11) and pilot testing (n???=???34). A convenience sample of 82 adults from Calgary, Alberta, Canada, participated in the measurement property study. Test-retest reliability was assessed by intraclass correlation coefficients (ICCs) comparing two administrations of the SIT-Q conducted one month apart. Convergent validity was established using Spearman???s rho, by comparing the SIT-Q estimates of sedentary behaviour with values derived from a 7-Day Activity Diary. Results The SIT-Q exhibited good face validity and acceptability during pilot testing. Within the measurement property study, the ICCs for test-retest reliability ranged from 0.31 for leisure-time computer use to 0.86 for occupational sitting. Total daily sitting demonstrated substantial correlation (ICC???=???0.65, 95% CI: 0.49, 0.78). In terms of convergent validity, correlations varied from 0.19 for sitting during meals to 0.76 for occupational sitting. For total daily sitting, estimates derived from the SIT-Q and 7 Day Activity Diaries were moderately correlated (?????=???0.53, p???<???0.01). Conclusion The SIT-Q has acceptable measurement properties for use in epidemiologic studies.
    BMC Public Health 09/2014; 14(1):899. DOI:10.1186/1471-2458-14-899 · 2.26 Impact Factor
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