Television viewing time independently predicts all-cause and cardiovascular mortality: the EPIC Norfolk Study
Abstract
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 (>3.6 h/day) with the lowest (<2.5 h/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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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 [17]
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- Authors
- Wijndaele, K., Brage, S., Besson, H., Khaw, K.-T., Sharp, S. J., Luben, R., Wareham, N. J., & Ekelund, U.
- Affiliations
- University of Cambridge (GB)
- Corresponding author
- Ekelund, Ulf
- ORCID
- Venue
- International Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2010-06-23
- Volume
- 40
- Issue
- 1
- Pages
- 150-159
- ISSN
- 0300-5771 (ISSN-L)
- 1464-3685
- OpenAlex
- W2168453242
- Cited by
- 278
- References
- 39
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 5 · 2023: 4 · 2022: 11 · 2021: 7 · 2020: 14 · 2019: 20 · 2018: 13 · 2017: 33 · 2016: 21 · 2015: 26 · 2014: 27 · 2013: 30 · 2012: 30
- FWCI
- 19.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- British Heart Foundation
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- television viewing, screen time, all-cause mortality, cardiovascular mortality, cancer mortality, physical activity energy expenditure, cardiovascular risk, population attributable fraction, EPIC-Norfolk cohort
- MeSH terms
- Aged, Alcohol Drinking, Antihypertensive Agents, Hypolipidemic Agents, Cardiovascular Diseases, Educational Status, Energy Metabolism, Europe, Female, Humans, Male, Middle Aged, Motor Activity, Neoplasms, Prospective Studies, Risk Factors, Smoking, Television, Body Mass Index, Proportional Hazards Models, Genetic Predisposition to Disease
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