Journal
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
Volume 40, Issue 1, Pages 150-159Publisher
OXFORD UNIV PRESS
DOI: 10.1093/ije/dyq105
Keywords
Cardiovascular diseases; epidemiology; exercise; mortality; television
Categories
Funding
- Cancer Research Campaign
- Medical Research Council
- Stroke Association
- British Heart Foundation
- Department of Health
- Europe Against Cancer Programme Commission of the European Union
- Ministry of Agriculture, Fisheries and Food
- Medical Research Council [G1000143, MC_U106179473, G0401527, MC_U106179471] Funding Source: researchfish
- MRC [MC_U106179473] Funding Source: UKRI
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Background 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. Methods 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. Results 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 (> 3.6h/day) with the lowest (< 2.5h/day) was 5.4%. Conclusions 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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