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Cited by 873Physical Activity and HealthNutritional Studies and DietMedia Influence and Health

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

Open access
Grøntved, Anders·2011·JAMA
DOI 10.1001/jama.2011.812PMC PMC4324728
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Abstract

CONTEXT: 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. OBJECTIVE: 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. DATA SOURCES AND STUDY SELECTION: 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 EXTRACTION: Data were extracted independently by each author and summary estimates of association were obtained using a random-effects model. DATA SYNTHESIS: 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. CONCLUSION: Prolonged TV viewing was associated with increased risk of type 2 diabetes, cardiovascular disease, and all-cause mortality.

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  • Intensive versus conventional treatment in the DCCT was associated with a 57% reduced risk of the composite endpoint of nonfatal myocardial infarction, stroke, and cardiovascular death (P=0.02).

    “and a 57% reduced risk of the composite end point (P=0.02; included nonfatal MI, stroke, and CVD death).71”

    From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [71]

  • In the DCCT/EDIC long-term follow-up, intensive versus conventional treatment in the DCCT was associated with a 42% reduced risk of cardiovascular disease (P=0.02).

    “Long-term follow-up data from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study Research Group showed that intensive versus conventional treatment in the Diabetes Control and Complications Trial was associated with a 42% reduced risk of CVD (P=0.02)”

    From Heart Disease and Stroke Statistics—2013 Update: A Report From the American Heart Association (2013) · cites this paper as [71]

  • A growing body of literature suggests high sitting time is associated with higher risk of adverse health outcomes, including cardiovascular disease, type 2 diabetes, cancer and mortality, even after adjustment for moderate-to-vigorous physical activity.

    “A growing body of literature suggests high sitting time is associated with higher risk of adverse health outcomes, including cardiovascular disease, type 2 diabetes, cancer and mortality, even after adjustment for moderate-to-vigorous physical activity[8-13].”

    From Daily Sitting Time and All-Cause Mortality: A Meta-Analysis (2013) · cites this paper as [13]

  • Grøntved and Hu found a pooled hazard ratio of 1.13 per 2-hour increase in TV-viewing per day for all-cause mortality.

    “They found a pooled hazard ratio of 1.13 per 2-hour increase in TV-viewing per day for all-cause mortality.”

    From Daily Sitting Time and All-Cause Mortality: A Meta-Analysis (2013) · cites this paper as [13]

  • The main limitation is the small number of studies included, though greater than some previous meta-analyses.

    “The main limitation of this meta-analysis is the small number of studies included, although this was greater than in some previous meta-analyses[13,15].”

    From Daily Sitting Time and All-Cause Mortality: A Meta-Analysis (2013) · cites this paper as [13]

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Authors
Grøntved, A.
Affiliations
University of Southern Denmark (DK)
Corresponding author
Grøntved, Anders
ORCID
Grøntved, Anders
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
2011-06-15
Volume
305
Issue
23
Pages
2448
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.2011.812
PMC
PMC4324728
OpenAlex
W2046082414
Cited by
873
References
34
Citations by year
2026: 17 · 2025: 21 · 2024: 45 · 2023: 42 · 2022: 42 · 2021: 60 · 2020: 62 · 2019: 101 · 2018: 54 · 2017: 75 · 2016: 78 · 2015: 83 · 2014: 61 · 2013: 65 · 2012: 59
FWCI
42.11
Type
journal article
Language
en
Open access
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion)
Funders
National Institute of Diabetes and Digestive and Kidney Diseases (R01DK058845, P30DK046200, P30 DK-46200, DK58845)
Topics
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Social Sciences › Arts and Humanities › Literature and Literary Theory › Media Influence and Health
Keywords
television viewing, sedentary behavior, type 2 diabetes, cardiovascular disease, all-cause mortality, prospective cohort, relative risk, linear dose-response relationship, health risk assessment, physical inactivity, cardiovascular risk factors, diabetes risk factors, mortality risk assessment
MeSH terms
Adult, Aged, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Diet, Humans, Middle Aged, Mortality, Prospective Studies, Television, Time Factors, Exercise, Risk Assessment, Young Adult, Sedentary Behavior

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