Television Viewing and Incident Cardiovascular Disease: Prospective Associations and Mediation Analysis in the EPIC Norfolk Study
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BACKGROUND: Although television viewing time is detrimentally associated with intermediate cardiovascular risk factors, the relationship with incident total (i.e. combined fatal and non-fatal) cardiovascular disease (CVD), non-fatal CVD and coronary heart disease is largely unknown. This study examined whether television viewing time is associated with these three outcomes, independently of physical activity energy expenditure and other confounding variables. METHODOLOGY/PRINCIPAL FINDINGS: A population-based cohort of 12,608 men and women (aged 61.4±9.0), free from stroke, myocardial infarction and cancer at baseline in 1998-2000 were followed up until 2007 (6.9±1.9 years). Participants self-reported education, smoking, alcohol use, antihypertensive, lipid lowering and antidepressant medication, disease history, total energy intake, sleep duration, physical activity and television viewing. BMI, waist circumference, blood pressure, triglycerides, HDL cholesterol and glycated haemoglobin (HbA(1c)) were measured by standardized procedures; a clustered metabolic risk score was constructed. Every one hour/day increase in television viewing was associated with an increased hazard for total (HR = 1.06, 95%CI = 1.03-1.08; 2,620 cases), non-fatal CVD (HR = 1.06, 95%CI = 1.03-1.09; 2,134 cases), and coronary heart disease (HR = 1.08, 95%CI = 1.03-1.13; 940 cases), independent of gender, age, education, smoking, alcohol, medication, diabetes status, CVD family history, sleep duration and physical activity energy expenditure. Energy intake, BMI, waist circumference, blood pressure, triglycerides, HDL cholesterol, HbA(1c) and the clustered metabolic risk score only partially mediated these associations. CONCLUSIONS: These results indicate that the most prevalent leisure time (sedentary) behaviour, television viewing, independently contributes to increased CVD risk. Recommendations on reducing television viewing time should be considered.
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The average difference between genders in TV viewing report was 1.8 ± 1.4%.
“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 [16]
Wijndaele et al. reported the largest gender difference, with 3.7% more females reporting >3.6 h TV viewing daily.
“The largest gender difference reported by Wijndaele, et al. [16] where 3.7% more females reported levels of >3.6 h TV viewing daily.”
From Prevalence of Sedentary Behavior in Older Adults: A Systematic Review (2013) · cites this paper as [16]
The EPIC survey found that 32.5% of older adults reported TV viewing over 3.6 h per day.
“The EPIC survey reported by tertiles and found that 32.5% reported TV viewing over 3.6 h per day [16].”
From Prevalence of Sedentary Behavior in Older Adults: A Systematic Review (2013) · cites this paper as [16]
TV viewing is correlated with negative health outcomes, such as cardiovascular disease, mortality and being overweight or obese.
“TV viewing has also been well correlated with negative health outcomes, such as cardiovascular disease, mortality and being overweight or obese [16,19,22,30].”
From Prevalence of Sedentary Behavior in Older Adults: A Systematic Review (2013) · cites this paper as [16]
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- Authors
- Wijndaele, K., Brage, S., Besson, H., Khaw, K.-T., Sharp, S. J., Luben, R., Bhaniani, A., Wareham, N. J., & Ekelund, U.
- Affiliations
- Research Foundation - Flanders (BE)
- MRC Epidemiology Unit (GB)
- University of Cambridge (GB)
- Corresponding author
- Ekelund, Ulf
- ORCID
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2011-05-25
- Volume
- 6
- Issue
- 5
- Pages
- e20058
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC3102066
- OpenAlex
- W2037124155
- Cited by
- 117
- References
- 32
- Citations by year
- 2025: 4 · 2024: 5 · 2023: 10 · 2022: 5 · 2021: 6 · 2020: 4 · 2019: 5 · 2018: 4 · 2017: 4 · 2016: 13 · 2015: 16 · 2014: 10 · 2013: 19 · 2012: 10
- FWCI
- 8.95
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institute for Health and Care Research
- British Heart Foundation
- European Commission
- Medical Research Council
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Keywords
- television viewing, sedentary behavior, cardiovascular disease, coronary artery disease, incident cardiovascular disease, mediation analysis, metabolic risk score, physical activity, EPIC-Norfolk cohort
- MeSH terms
- Activities of Daily Living, Aged, Cardiovascular Diseases, Coronary Disease, Energy Metabolism, Europe, Female, Humans, Male, Middle Aged, Prospective Studies, Risk Factors, Television, Time Factors, Cohort Studies, Proportional Hazards Models
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