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Television Viewing Time and Mortality: The Australian Diabetes, Obesity and Lifestyle Study (AusDiab)
Abstract
Background— Television viewing time, the predominant leisure-time sedentary behavior, is associated with biomarkers of cardiometabolic risk, but its relationship with mortality has not been studied. We examined the associations of prolonged television viewing time with all-cause, cardiovascular disease (CVD), cancer, and non-CVD/noncancer mortality in Australian adults. Methods and Results— Television viewing time in relation to subsequent all-cause, CVD, and cancer mortality (median follow-up, 6.6 years) was examined among 8800 adults ≥25 years of age in the Australian Diabetes, Obesity and Lifestyle Study (AusDiab). During 58 087 person-years of follow-up, there were 284 deaths (87 CVD deaths, 125 cancer deaths). After adjustment for age, sex, waist circumference, and exercise, the hazard ratios for each 1-hour increment in television viewing time per day were 1.11 (95% confidence interval [CI], 1.03 to 1.20) for all-cause mortality, 1.18 (95% CI, 1.03 to 1.35) for CVD mortality, and 1.09 (95% CI, 0.96 to 1.23) for cancer mortality. Compared with a television viewing time of <2 h/d, the fully adjusted hazard ratios for all-cause mortality were 1.13 (95% CI, 0.87 to 1.36) for ≥2 to <4 h/d and 1.46 (95% CI, 1.04 to 2.05) for ≥4 h/d. For CVD mortality, corresponding hazard ratios were 1.19 (95% CI, 0.72 to 1.99) and 1.80 (95% CI, 1.00 to 3.25). The associations with both cancer mortality and non-CVD/noncancer mortality were not significant. Conclusions— Television viewing time was associated with increased risk of all-cause and CVD mortality. In addition to the promotion of exercise, chronic disease prevention strategies could focus on reducing sitting time, particularly prolonged television viewing.
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“Dunstan et al. (151) found that each 1-hour increase in TV viewing time was associated with 11% and 18% increased risks of all-cause and CVD mortality, respectively, in 20,000 Australian men and women.”
From Lack of Exercise Is a Major Cause of Chronic Diseases (2012) · cites this paper as [151]
In the citing paper
“all-cause and CVD mortalities increased 46% and 80%, respectively for TV viewing time >4hr/day as compared to <2 hrs/day, which were independent of smoking, blood pressure, cholesterol, diet, waist circumference, and leisure-time exercise.”
From Lack of Exercise Is a Major Cause of Chronic Diseases (2012) · cites this paper as [151]
In the citing paper
“These results were obtained for a total population of 372,550 compiled from seven surveys covering six countries (Australia, Canada, Norway, Spain, UK and USA) [3,17,18,24,25,27,33].”
From Prevalence of Sedentary Behavior in Older Adults: A Systematic Review (2013) · cites this paper as [17]
In the citing paper
“Fifty six percent of the older population report watching over 2 h of TV per day, 54.2% report over 3 h and 15.1% report over 4 h.”
From Prevalence of Sedentary Behavior in Older Adults: A Systematic Review (2013) · cites this paper as [17]
In the citing paper
“It would appear there is little difference in report by gender (1.6 ± 1.6%) [3,17,18].”
From Prevalence of Sedentary Behavior in Older Adults: A Systematic Review (2013) · cites this paper as [17]
In the citing paper
“Fifty six percent of the older population report watching over 2 h of TV per day, 54.2% report over 3 h and 15.1% report over 4 h.”
From Prevalence of Sedentary Behavior in Older Adults: A Systematic Review (2013) · cites this paper as [17]
In the citing paper
“On average 61.5% females reported more than 4 h of sitting compared to males at 63.5% [3,17,18].”
From Prevalence of Sedentary Behavior in Older Adults: A Systematic Review (2013) · cites this paper as [17]
In the citing paper
“Report of TV viewing by gender was less common, the average difference between gender report was 1.8 ± 1.4% [16,17,21,23].”
From Prevalence of Sedentary Behavior in Older Adults: A Systematic Review (2013) · cites this paper as [17]
In the citing paper
“Fifty six percent of the older population report watching over 2 h of TV per day, 54.2% report over 3 h and 15.1% report over 4 h.”
From Prevalence of Sedentary Behavior in Older Adults: A Systematic Review (2013) · cites this paper as [17]
In the citing paper
“The detrimental health effect of sitting too much is independent of the person’s activity level.”
From A Community-Based Physical Activity Counselling Program for People With Knee Osteoarthritis: Feasibility and Preliminary Efficacy of the Track-OA Study (2017) · cites this paper as [16]
In the citing paper
“Studies have indicated that a sedentary lifestyle (ie, too much sitting) is a predictor of poor health outcomes [14-18].”
From A Community-Based Physical Activity Counselling Program for People With Knee Osteoarthritis: Feasibility and Preliminary Efficacy of the Track-OA Study (2017) · cites this paper as [16]
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Self-citationUsing the SenseCam to Improve Classifications of Sedentary Behavior in Free-Living Settings
Kerr, J., Marshall, S. J., Godbole, S. V., Chen, J. M., Legge, A., Doherty, A., Kelly, P., Oliver, M., Badland, H. M., & Foster, C. E. (2013) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2012.11.004 · Cited by 181
Managing Sedentary Behavior to Reduce the Risk of Diabetes and Cardiovascular Disease
Dempsey, P. C., Owen, N. G., Biddle, S., & Dunstan, D. W. (2014) · Current Diabetes Reports · doi:10.1007/s11892-014-0522-0 · Cited by 189
Self-citationChau, J. Y., Grunseit, A., Midthjell, K., Holmen, J., Holmen, T. L., Bauman, A. E., & Van der Ploeg, H. P. (2015) · British Journal of Sports Medicine · doi:10.1136/bjsports-2012-091974 · Cited by 173
Physical activity and cancer prevention: a systematic review of clinical trials
Winzer, B., Whiteman, D. C., Reeves, M. M., & Paratz, J. D. (2011) · Cancer Causes & Control · doi:10.1007/s10552-011-9761-4 · Cited by 177
Prolonged sitting: is it a distinct coronary heart disease risk factor?
Dunstan, D. W., Thorp, A. A., & Healy, G. N. (2011) · Current Opinion in Cardiology · doi:10.1097/hco.0b013e3283496605 · Cited by 166
Self-citationEvaluation of sit-stand workstations in an office setting: a randomised controlled trial
Graves, L., Murphy, R., Shepherd, S. O., Cabot, J., & Hopkins, N. D. (2015) · BMC Public Health · doi:10.1186/s12889-015-2469-8 · Cited by 168
Self-Reported Sitting Time and Markers of Inflammation, Insulin Resistance, and Adiposity
Yates, T., Khunti, K., Wilmot, E. G., Brady, E., Webb, D., Srinivasan, B., Henson, J., Talbot, D., & Davies, M. J. (2012) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2011.09.022 · Cited by 147
Pereira, S. M. P., Ki, M., & Power, C. (2012) · PLoS ONE · doi:10.1371/journal.pone.0031132 · Cited by 178
Schmid, D., Ricci, C., & Leitzmann, M. F. (2015) · PLoS ONE · doi:10.1371/journal.pone.0119591 · Cited by 168
Effects of breaking up prolonged sitting on skeletal muscle gene expression
Latouche, C., Jowett, J. B. M., Carey, A. L., Bertovic, D. A., Owen, N. G., Dunstan, D. W., & Kingwell, B. A. (2012) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00978.2012 · Cited by 157
Self-citationBeddhu, S., Wei, G., Marcus, R. L., Chonchol, M., & Greene, T. (2015) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.08410814 · Cited by 146
Time for a view on screen time
Sigman, A. (2012) · Archives of Disease in Childhood · doi:10.1136/archdischild-2012-302196 · Cited by 172
Marshall, S. J., & Ramirez, E. R. (2011) · American Journal of Lifestyle Medicine · doi:10.1177/1559827610395487 · Cited by 156
Treadmill desks: A 1‐year prospective trial
Koepp, G. A., Manohar, C. U., MCCRADY-SPITZER, S. K., Ben‐Ner, A., Hamann, D. J., Runge, C. F., & Levine, J. A. (2013) · Obesity · doi:10.1002/oby.20121 · Cited by 149
Relationship of Television Time with Accelerometer-Derived Sedentary Time: NHANES
CLARK, B. K., HEALY, G. N., WINKLER, E. A. H., GARDINER, P. A., SUGIYAMA, T., DUNSTAN, D. W., MATTHEWS, C. E., & OWEN, N. (2011) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e3182019510 · Cited by 136
“TV viewing is a highly prevalent leisure-time behavior (4, 12, 36) and has been shown to have strong and consistent detrimental associations with cardio-metabolic risk biomarkers and health outcomes, including premature mortality (13-15, 19-22).”
Self-citationQi, Q., Li, Y., Chomistek, A. K., Kang, J. H., Curhan, G. C., Pasquale, L. R., Willett, W. C., Rimm, E. B., Hu, F. B., & Qi, L. (2012) · Circulation · doi:10.1161/circulationaha.112.098061 · Cited by 140
Kim, Y.-J., Wilkens, L. R., Park, S., Goodman, M. T., Monroe, K. R., & Kolonel, L. N. (2013) · International Journal of Epidemiology · doi:10.1093/ije/dyt108 · Cited by 142
Engagement, enjoyment, and energy expenditure during active video game play.
Lyons, E., Tate, D. F., Ward, D. S., Ribisl, K. M., Bowling, J. M., & Kalyanaraman, S. (2013) · Health Psychology · doi:10.1037/a0031947 · Cited by 132
Standing and Mortality in a Prospective Cohort of Canadian Adults
Katzmarzyk, P. T. (2013) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000000198 · Cited by 135
Manns, P. J., Dunstan, D. W., Owen, N. G., & Healy, G. N. (2011) · Physical Therapy · doi:10.2522/ptj.20110284 · Cited by 136
Self-citationStamatakis, E., Hamer, M., Tilling, K., & Lawlor, D. A. (2012) · International Journal of Epidemiology · doi:10.1093/ije/dys077 · Cited by 128
Inoue, S., Sugiyama, T., Takamiya, T., Oka, K., Owen, N., & Shimomitsu, T. (2012) · Journal of Epidemiology · doi:10.2188/jea.je20110054 · Cited by 128
Self-citationSitting-time and 9-year all-cause mortality in older women
Pavey, T., Peeters, G. M. E. E., & Brown, W. J. (2012) · British Journal of Sports Medicine · doi:10.1136/bjsports-2012-091676 · Cited by 134
Cameron, A. J., Magliano, D. J., Dunstan, D. W., Zimmet, P., Hesketh, K. D., Peeters, A., & Shaw, J. E. (2011) · International Journal of Obesity · doi:10.1038/ijo.2011.103 · Cited by 128
Self-citationOjo, S. O., Bailey, D. P., Brierley, M. L., Hewson, D. J., & Chater, A. M. (2019) · BMC Public Health · doi:10.1186/s12889-019-7468-8 · Cited by 117
Too much sitting and all-cause mortality: is there a causal link?
Biddle, S., Bennie, J. A., Bauman, A. E., Chau, J. Y., Dunstan, D. W., Owen, N. G., Stamatakis, E., & van Uffelen, J. G. Z. (2016) · BMC Public Health · doi:10.1186/s12889-016-3307-3 · Cited by 139
Self-citationEffects of Substituting Sedentary Time with Physical Activity on Metabolic Risk
HAMER, M., STAMATAKIS, E., & STEPTOE, A. (2014) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000000317 · Cited by 125
Metadata
- Authors
- Dunstan, D. W., Barr, E. L. M., Healy, G. N., Salmon, J., Shaw, J. E., Balkau, B., Magliano, D. J., Cameron, A. J., Zimmet, P. Z., & Owen, N.
- Affiliations
- Université Paris-Sud (FR)
- ORCID
- Venue
- Circulation
- Published
- 2010-01-26
- Volume
- 121
- Issue
- 3
- Pages
- 384-391
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2109444109
- Cited by
- 825
- References
- 40
- Citations by year
- 2026: 5 · 2025: 18 · 2024: 36 · 2023: 28 · 2022: 31 · 2021: 37 · 2020: 45 · 2019: 55 · 2018: 49 · 2017: 54 · 2016: 48 · 2015: 73 · 2014: 69 · 2013: 75 · 2012: 77
- FWCI
- 59.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Research Bank (Australian Catholic University) (submittedVersion)
- Deakin Research Online (Deakin University) (submittedVersion)
- eSpace (Curtin University) (submittedVersion)
- Swinburne figshare (Swinburne University of Technology) (submittedVersion)
- 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
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- television viewing time, sedentary behavior, all-cause mortality, cardiovascular mortality, cancer mortality, sitting time, leisure-time physical activity, cardiometabolic risk, AusDiab
- MeSH terms
- Adult, Aged, Australia, Cardiovascular Diseases, Diabetes Mellitus, Female, Follow-Up Studies, Humans, Life Style, Male, Middle Aged, Neoplasms, Obesity, Risk Factors, Television, Cohort Studies, Exercise, Risk Reduction Behavior
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