Cross-sectional study of diet, physical activity, television viewing and sleep duration in 233110 adults from the UK Biobank; the behavioural phenotype of cardiovascular disease and type 2 diabetes

Objectives Simultaneously define diet, physical activity, television (TV) viewing, and sleep duration across cardiometabolic disease groups, and investigate clustering of non-diet lifestyle behaviours. Design Cross-sectional observational study. Setting 22 UK Biobank assessment centres across the UK. Participants 502664 adults aged 37-63years old, 54% women. 4 groups were defined based on disease status; No disease' (n=103993), cardiovascular disease' (CVD n=113469), Type 2 diabetes without CVD' (n=4074) and Type 2 diabetes + CVD' (n=11574). Main outcomes Diet, physical activity, TV viewing and sleep duration. Results People with CVD' report low levels of physical activity (<918 METmin/week, OR (95% CI) 1.23 (1.20 to 1.25)), high levels of TV viewing (>3h/day; 1.42 (1.39 to 1.45)), and poor sleep duration (<7, >8h/night; 1.37 (1.34 to 1.39)) relative to people without disease. People with Type 2 diabetes + CVD' were more likely to report low physical activity (1.71 (1.64 to 1.78)), high levels of TV viewing (1.92 (1.85 to 1.99)) and poor sleep duration (1.52 (1.46 to1.58)) relative to people without disease. Non-diet behaviours were clustered, with people with CVD' or Type 2 diabetes + CVD' more likely to report simultaneous low physical activity, high TV viewing and poor sleep duration than those without disease (2.15 (2.03 to 2.28) and 3.29 (3.02 to 3.58), respectively). By contrast, 3 in 4 adults with Type 2 diabetes', and 2 in 4 adults with CVD' have changed their diet in the past 5years, compared with only 1 in 4 in the No disease' group. Models were adjusted for gender, age, body mass index, Townsend Deprivation Index, ethnicity, alcohol intake, smoking and meeting fruit/vegetable guidelines. Conclusions Low physical activity, high TV and poor sleep duration are prominent unaddressed high-risk characteristics of both CVD and type 2 diabetes, and are likely to be clustered together.