Cited by 117Physical Activity and HealthCardiovascular Health and Risk FactorsNutritional Studies and Diet

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Television Viewing and Incident Cardiovascular Disease: Prospective Associations and Mediation Analysis in the EPIC Norfolk Study

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Wijndaele, Katrien, Brage, Søren, Besson, Hervé, Khaw, Kay-Tee, Sharp, Stephen J., Luben, Robert, Bhaniani, Amit, Wareham, Nicholas J., Ekelund, Ulf·2011·PLoS ONE

DOI 10.1371/journal.pone.0020058PMC PMC3102066

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Abstract

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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Figure 1 Age-adjusted cardiovascular disease event rates per 10,000 person-years by 1-hour increments of television viewing (hours/day). N television categories: 0–0.99: 800; 1–1.99: 2,126; 2–2.99: 3,180; 3–3.99: 3,057; 4–4.99: 2,040; 5–5.99: 926; ≥6: 479.CC BY · PubMed Central

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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: Wijndaele, Katrien
Brage, Søren
Khaw, Kay-Tee
Sharp, Stephen J.
Luben, Robert
Wareham, Nicholas J.
Ekelund, Ulf
Venue: PLoS ONE
Publisher: Public Library of Science (PLoS)
Published: 2011-05-25
Volume: 6
Issue: 5
Pages: e20058
ISSN: 1932-6203 (ISSN-L)
DOI: 10.1371/journal.pone.0020058
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
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (unspecified)
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 › Public Health, Environmental and Occupational Health › 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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Television Viewing and Incident Cardiovascular Disease: Prospective Associations and Mediation Analysis in the EPIC Norfolk Study

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