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: 9.18). 02/2011; 40(1):150-9. DOI: 10.1093/ije/dyq105
Source: PubMed


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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    • "Women are also less likely than men to meet physical activity guidelines, placing them at an increased risk for negative health consequences associated with both prolonged sitting and inactivity (U.S. Centers for Disease Control and Prevention, 2012). Furthermore, multiple studies demonstrate stronger associations between time spent viewing television and poorer cardiometabolic biomarkers for women than for men (Dunstan et al., 2005; Dunstan et al., 2007; Healy et al., 2007; Wijndaele et al., 2011), substantiating the need to better understand sedentary time among women. "
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    ABSTRACT: Sedentary behavior is associated with negative health consequences independent of physical activity levels. Evidence suggests the work environment promotes sedentary behavior regardless of sector, and that employees with occupations requiring longer sitting times differ only marginally in leisure sitting time from those with more active occupations. Because physical activity opportunities may be limited across many work settings, leisure sedentary time may be more easily replaced with physical activity. Understanding correlates of leisure sedentary behaviors could inform interventions, specifically for women who are among the least active in America. Female employees at two universities completed online surveys (n = 156; mean age, 45.12 [SD = 12.5]; mean BMI, 26.7 kg/m(2) [SD = 5.9]; mean work hours/week, 43.7 [SD = 9.4]). Bivariate correlations and two hierarchical regression analyses were conducted to examine personal and behavioral correlates of weekday and weekend leisure sitting time. Final regression models revealed that greater weekday leisure sitting time (R(2) = 0.307) was related with being older (p = .006), having fewer children (p = .001), self-reporting poorer health (p = .006), and greater weekend sitting time (p < .001). Greater weekend leisure sitting time (R(2) = 0.261) was related with greater work-related sitting time (p = .020) and greater weekday leisure sitting time (p < .001). Physical activity was not related with weekday or weekend leisure sitting time. The most prominent correlates of leisure sitting time were other types of sedentary behaviors. This suggests that sedentary time in one segment of life predicts time spent sitting in other areas of life. Future interventions should target decreasing sedentary behaviors during leisure time specifically, in addition to increasing physical activity behavior. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
    No preview · Article · Aug 2015 · Women s Health Issues
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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.
    Full-text · Article · Sep 2014 · Preventive Medicine
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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.
    Full-text · Article · Sep 2014 · BMC Public Health
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