Physical Activity and Television Watching in Relation to Risk for Type 2 Diabetes Mellitus in Men
Open accessAbstract
BACKGROUND: Television (TV) watching, a major sedentary behavior in the United States, has been associated with obesity. We hypothesized that prolonged TV watching may increase risk for type 2 diabetes. METHODS: In 1986, 37 918 men aged 40 to 75 years and free of diabetes, cardiovascular disease, and cancer completed a detailed physical activity questionnaire. Starting from 1988, participants reported their average weekly time spent watching TV on biennial questionnaires. RESULTS: A total of 1058 cases of type 2 diabetes were diagnosed during 10 years (347 040 person-years) of follow-up. After adjustment for age, smoking, alcohol use, and other covariates, the relative risks (RRs) for type 2 diabetes across increasing quintiles of metabolic equivalent hours (MET-hours) per week were 1.00, 0.78, 0.65, 0.58, and 0.51 (P for trend, <.001). Time spent watching TV was significantly associated with higher risk for diabetes. After adjustment for age, smoking, physical activity levels, and other covariates, the RRs of diabetes across categories of average hours spent watching TV per week (0-1, 2-10, 11-20, 21-40, and >40) were 1.00, 1.66, 1.64, 2.16, and 2.87, respectively (P for trend, <.001). This association was somewhat attenuated after adjustment for body mass index, but a significant positive gradient persisted (RR comparing extreme categories, 2.31; P for trend,.01). CONCLUSIONS: Increasing physical activity is associated with a significant reduction in risk for diabetes, whereas a sedentary lifestyle indicated by prolonged TV watching is directly related to risk. Our findings suggest the importance of reducing sedentary behavior in the prevention of type 2 diabetes.
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In several studies, associations between sedentary behaviour and increased risks persisted even among persons active enough to meet physical activity recommendations.
“In several studies, investigators reported on the persistence of these associations even among persons active enough to meet physical activity recommendations.[13-20]”
From Using accelerometers to measure physical activity in large-scale epidemiological studies: issues and challenges (2014) · cites this paper as [13]
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Dietary pattern, inflammation, and incidence of type 2 diabetes in women
Schulze, M. B., Hoffmann, K., Manson, J. E., Willett, W. C., Meigs, J. B., Weikert, C., Heidemann, C., Colditz, G. A., & Hu, F. B. (2005) · American Journal of Clinical Nutrition · doi:10.1093/ajcn.82.3.675 · Cited by 462 · see citing works
Self-citationSugar-sweetened and artificially sweetened beverage consumption and risk of type 2 diabetes in men
de Koning, L., Malik, V., Rimm, E. B., Willett, W. C., & Hu, F. B. (2011) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.110.007922 · Cited by 461 · see citing works
Self-citationWhite rice, brown rice, and risk of type 2 diabetes in US men and women
Sun, Q. (2010) · Archives of Internal Medicine · doi:10.1001/archinternmed.2010.109 · Cited by 459 · see citing works
Body-Mass Index and Mortality among Adults with Incident Type 2 Diabetes
Tobias, D. K., Pan, A., Jackson, C. L., O’Reilly, É. J., Ding, E. L., Willett, W. C., Manson, J. E., & Hu, F. B. (2014) · New England Journal of Medicine · doi:10.1056/nejmoa1304501 · Cited by 429 · see citing works
Self-citationProctor, M. H., Moore, L. L., Gao, D., Cupples, L. A., Bradlee, M. L., Hood, M. Y., & Ellison, R. C. (2003) · International Journal of Obesity · doi:10.1038/sj.ijo.0802294 · Cited by 420 · see citing works
Associations of TV viewing and physical activity with the metabolic syndrome in Australian adults
Dunstan, D. W., Salmon, J., Owen, N. G., Armstrong, T., Zimmet, P., Welborn, T. A., Cameron, A. J., Dwyer, T., Jolley, D., & Shaw, J. E. (2005) · Diabetologia · doi:10.1007/s00125-005-1963-4 · Cited by 417 · see citing works
Lee, I.-M., & Shiroma, E. J. (2014) · British Journal of Sports Medicine · doi:10.1136/bjsports-2013-093154 · Cited by 415 · see citing works
Bhupathiraju, S. N., Tobias, D. K., Malik, V. S., Pan, A., Hruby, A., Manson, J. E., Willett, W. C., & Hu, F. B. (2014) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.113.079533 · Cited by 402 · see citing works
Self-citationKolhar, M., Kazi, R. N. A., & Alameen, A. A. M. (2021) · Saudi Journal of Biological Sciences · doi:10.1016/j.sjbs.2021.01.010 · Cited by 397 · see citing works
Dietary pattern, inflammation, and incidence of type 2 diabetes in women
Schulze, M. B., Hoffmann, K., Manson, J. E., Willett, W. C., Meigs, J. B., Weikert, C., Heidemann, C., Colditz, G. A., & Hu, F. B. (2005) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/82.3.675 · Cited by 457 · see citing works
Self-citationHu, G., Qiao, Q., Silventoinen, K., Eriksson, J. G., Jousilahti, P., Lindström, J., Valle, T. T., Nissinen, A. M., & Tuomilehto, J. O. (2003) · Diabetologia · doi:10.1007/s00125-003-1031-x · Cited by 380 · see citing works
Lepp, A., Barkley, J. E., Sanders, G. J., Rebold, M. J., & Gates, P. (2013) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/1479-5868-10-79 · Cited by 378 · see citing works
Physical activity and the risk of Parkinson disease
Chen, H., Zhang, S. M., Schwarzschild, M. A., Hernán, M. A., & Ascherio, A. (2005) · Neurology · doi:10.1212/01.wnl.0000151960.28687.93 · Cited by 371 · see citing works
Dairy consumption and risk of type 2 diabetes: 3 cohorts of US adults and an updated meta-analysis
Chen, M., Sun, Q., Giovannucci, E., Mozaffarian, D., Manson, J. E., Willett, W. C., & Hu, F. B. (2014) · BMC Medicine · doi:10.1186/s12916-014-0215-1 · Cited by 370 · see citing works
Self-citationStolk, L., Perry, J. R. B., Chasman, D. I., He, C., Mangino, M., Sulem, P., Barbalić, M., Broer, L., Byrne, E. M., Ernst, F. D., et al. (2012) · Nature Genetics · doi:10.1038/ng.1051 · Cited by 367 · see citing works
Adiponectin and Future Coronary Heart Disease Events Among Men With Type 2 Diabetes
Schulze, M. B., Shai, I., Rimm, E. B., Li, T., Rifai, N., & Hu, F. B. (2005) · Diabetes · doi:10.2337/diabetes.54.2.534 · Cited by 365 · see citing works
Self-citationPhysical activity, sedentary behavior, and health: Paradigm paralysis or paradigm shift?
Katzmarzyk, P. T. (2010) · Diabetes · doi:10.2337/db10-0822 · Cited by 365 · see citing works
DASH-Style Diet Associates with Reduced Risk for Kidney Stones
Taylor, E. N., Fung, T. T., & Curhan, G. C. (2009) · Journal of the American Society of Nephrology · doi:10.1681/asn.2009030276 · Cited by 364 · see citing works
When Children Eat What They Watch
Wiecha, J. L., Peterson, K. E., Ludwig, D. S., Kim, J., Sobol, A. M., & Gortmaker, S. L. (2006) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.160.4.436 · Cited by 346 · see citing works
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Joosten, M. M., Pai, J. K., Bertoia, M. L., Rimm, E. B., Spiegelman, D. L., Mittleman, M. A., & Mukamal, K. J. (2012) · JAMA · doi:10.1001/jama.2012.13415 · Cited by 338 · see citing works
Self-citationPRIMARY PREVENTION OF DIABETES: What Can Be Done and How Much Can Be Prevented?
Schulze, M. B., & Hu, F. B. (2004) · Annual Review of Public Health · doi:10.1146/annurev.publhealth.26.021304.144532 · Cited by 330 · see citing works
Self-citationTanasescu, M., Leitzmann, M. F., Rimm, E. B., & Hu, F. B. (2003) · Circulation · doi:10.1161/01.cir.0000066906.11109.1f · Cited by 329 · see citing works
Self-citationSedentary lifestyle and risk of obesity and type 2 diabetes
Hu, F. B. (2003) · Lipids · doi:10.1007/s11745-003-1038-4 · Cited by 324 · see citing works
Self-citationLifestyle and the Prevention of Type 2 Diabetes: A Status Report
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Body Size and 24-Hour Urine Composition
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Cahill, L. E., Chiuve, S. E., Mekary, R. A., Jensen, M. K., Flint, A. J., Hu, F. B., & Rimm, E. B. (2013) · Circulation · doi:10.1161/circulationaha.113.001474 · Cited by 317 · see citing works
Self-citationClark, B., Sugiyama, T., Healy, G. N., Salmon, J., Dunstan, D. W., & Owen, N. G. (2008) · Obesity Reviews · doi:10.1111/j.1467-789x.2008.00508.x · Cited by 316 · see citing works
A 2-wk reduction of ambulatory activity attenuates peripheral insulin sensitivity
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Zhang, C., Solomon, C. G., Manson, J. E., & Hu, F. B. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.5.543 · Cited by 306 · see citing works
Self-citationOptimal dietary patterns for prevention of chronic disease
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Self-citationRecommendations to increase physical activity in communities
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Physical activity in obesity and metabolic syndrome
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Sedentary Behavior in Dutch Workers
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Long-term effectiveness of interventions promoting physical activity: a systematic review
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Self-citationImpact of Television Viewing Patterns on Fruit and Vegetable Consumption Among Adolescents
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Lifestyle behaviors associated with lower risk of having the metabolic syndrome
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- Authors
- Hu, F. B., Leitzmann, M. F., Stampfer, M. J., Colditz, G. A., Willett, W. C., & Rimm, E. B.
- Affiliations
- Harvard University (US)
- Brigham and Women's Hospital (US)
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2001-06-25
- Volume
- 161
- Issue
- 12
- Pages
- 1542
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W2034114152
- Cited by
- 828
- References
- 42
- Citations by year
- 2026: 9 · 2025: 10 · 2024: 16 · 2023: 20 · 2022: 20 · 2021: 35 · 2020: 36 · 2019: 27 · 2018: 36 · 2017: 40 · 2016: 38 · 2015: 56 · 2014: 55 · 2013: 44 · 2012: 56
- FWCI
- 12.36
- Type
- journal article
- Language
- en
- Open access
- green
- nrs.harvard.edu
- Licence
- cc-by
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Funders
- National Heart, Lung, and Blood Institute (R01HL035464, HL35464)
- National Cancer Institute (CA-55075)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- type 2 diabetes, television viewing, sedentary behavior, physical activity, diabetes risk, men, body mass index, metabolic equivalent hours, diabetes prevention
- MeSH terms
- Adult, Aged, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Health Surveys, Humans, Life Style, Male, Middle Aged, Probability, Surveys and Questionnaires, Risk Factors, Television, United States, Health Behavior, Exercise, Comorbidity, Incidence, Confidence Intervals, Age Distribution, Risk Assessment
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