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Television Viewing and Risk of Type 2 Diabetes, Cardiovascular Disease, and All-Cause Mortality: A Meta-analysis
Open accessAbstract
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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“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 citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“The findings of this meta-analysis are consistent with a meta-analysis of three studies on TV-viewing and mortality[13], which showed a pooled HR for all cause mortality of 1.13 per two hour increase of TV-viewing.”
From Daily Sitting Time and All-Cause Mortality: A Meta-Analysis (2013) · cites this paper as [13]
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Metadata
- 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
- 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
- green
- www.ncbi.nlm.nih.gov
- 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 › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Social Sciences › Communication › 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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