Television viewing and risk of mortality: exploring the biological plausibility

Published on Aug 1, 2017in Atherosclerosis4.255
· DOI :10.1016/j.atherosclerosis.2017.06.024
Mark Hamer73
Estimated H-index: 73
(UCL: University College London),
Thomas Yates36
Estimated H-index: 36
(University of Leicester),
Panayotes Demakakos28
Estimated H-index: 28
(UCL: University College London)
Abstract Background and aims Television (TV) viewing is a major component of leisure sedentary time, and has been consistently associated with cardiovascular disease. We examined the extent to which metabolic biomarkers explain the association between TV viewing and mortality. Methods Participants (N = 8,451, aged 64.8 ± 9.9 yrs) were drawn from The English Longitudinal Study of Ageing (ELSA), a national prospective cohort study of community-dwelling men and women living in England. The individual participant data were linked with death records from the National Health Service registries from 2008 to 2012. Cox proportional hazards models were used to estimate the risk of death according to time spent watching TV, with biomarkers added in a stepwise fashion to estimate potential mediation. Results Over an average follow up of 4 years (33,832 person years), there were 370 deaths. In models adjusted for comorbidities, psychosocial factors, and health behaviours including physical activity, there was an association between TV viewing and mortality (≥6 h per day vs.  Conclusions The association between TV viewing and mortality was partly mediated by inflammatory markers, although the relationship remains largely unexplained.
Figures & Tables
  • References (32)
  • Citations (7)
#1Danielle M. Friend (NIH: National Institutes of Health)H-Index: 9
#2Kavya Devarakonda (NIH: National Institutes of Health)H-Index: 2
Last. Alexxai V. Kravitz (NIH: National Institutes of Health)H-Index: 21
view all 13 authors...
Summary Obesity is associated with physical inactivity, which exacerbates the health consequences of weight gain. However, the mechanisms that mediate this association are unknown. We hypothesized that deficits in dopamine signaling contribute to physical inactivity in obesity. To investigate this, we quantified multiple aspects of dopamine signaling in lean and obese mice. We found that D2-type receptor (D2R) binding in the striatum, but not D1-type receptor binding or dopamine levels, was redu...
37 CitationsSource
#1Stuart J. H. Biddle (VU: Victoria University, Australia)H-Index: 85
#2Jason A. Bennie (VU: Victoria University, Australia)H-Index: 13
Last. Jannique G. Z. van Uffelen (VU: Victoria University, Australia)H-Index: 8
view all 8 authors...
Background: Sedentary behaviours (time spent sitting, with low energy expenditure) are associated with deleterious health outcomes, including all-cause mortality. Whether this association can be considered causal has yet to be established. Using systematic reviews and primary studies from those reviews, we drew upon Bradford Hill's criteria to consider the likelihood that sedentary behaviour in epidemiological studies is likely to be causally related to all-cause (premature) mortality. Methods: ...
40 CitationsSource
#1Ulf Ekelund (Norwegian School of Sport Sciences)H-Index: 88
#2Jostein Steene-Johannessen (Norwegian School of Sport Sciences)H-Index: 25
Last. I-Min Lee (Harvard University)H-Index: 98
view all 8 authors...
Summary Background High amounts of sedentary behaviour have been associated with increased risks of several chronic conditions and mortality. However, it is unclear whether physical activity attenuates or even eliminates the detrimental effects of prolonged sitting. We examined the associations of sedentary behaviour and physical activity with all-cause mortality. Methods We did a systematic review, searching six databases (PubMed, PsycINFO, Embase, Web of Science, Sport Discus, and Scopus) from...
576 CitationsSource
Introduction TV viewing is the most prevalent sedentary behavior and is associated with increased risk of cardiovascular disease and cancer mortality, but the association with other leading causes of death is unknown. This study examined the association between TV viewing and leading causes of death in the U.S. Methods A prospective cohort of 221,426 individuals (57% male) aged 50–71 years who were free of chronic disease at baseline (1995–1996), 93% white, with an average BMI of 26.7 (SD=4.4) k...
28 CitationsSource
#1Harri Helajärvi (UTU: University of Turku)H-Index: 5
#2Katja Pahkala (UTU: University of Turku)H-Index: 24
Last. Olli T. Raitakari (TYKS: Turku University Hospital)H-Index: 114
view all 12 authors...
Introduction. Both sedentary behaviour and fatty liver are associated with increased risk of obesity and non-communicable diseases, but their relationship remains unknown. We investigated the relationship of television (TV) viewing time with serum gamma-glutamyltransferase (GGT) and Fatty Liver Index (FLI), and ultrasonographically assessed liver fat.Methods. A total of 1,367 adults of the population-based Cardiovascular Risk in Young Finns study (748 women, 619 men, aged 34–49 years) had fastin...
8 CitationsSource
#1Lee Smith (UCL: University College London)H-Index: 22
#2Benjamin Gardner (UCL: University College London)H-Index: 33
Last. Mark Hamer (UCL: University College London)H-Index: 73
view all 3 authors...
Background To identify, using a longitudinal data set, parental and childhood correlates of adult television (TV) viewing time at 32-year follow-up. Method Data were derived from the 1970 British Cohort Study, a longitudinal observational study of 17 248 British people born in a single week of 1970. The present analyses incorporated data from the age 10 and 42-year surveys. When participants were aged 10 years, their mothers provided information on how often participants watched TV and played sp...
34 CitationsSource
#1Mark Hamer (UCL: University College London)H-Index: 73
#2Lee Smith (UCL: University College London)H-Index: 22
Last. Emmanuel StamatakisH-Index: 66
view all 3 authors...
Abstract Objective Inflammatory processes are putative mechanisms underlying the detrimental health effects of sedentary behaviour but no long-term prospective data are available. We examined the longitudinal association between TV viewing, physical activity and inflammatory markers over a 4-year follow-up period. Methods Participants were 3612 men and women (mean age 64.1 ± 8.2 years) from the English Longitudinal Study of Ageing. Self-reported daily TV viewing was measured at baseline and 2 ye...
11 CitationsSource
#1Bethany Howard (Monash University)H-Index: 10
#2Beverley Balkau (Baker IDI Heart and Diabetes Institute)H-Index: 109
Last. David W. DunstanH-Index: 78
view all 7 authors...
Background/aim Sedentary behaviour is associated with increased risk for all-cause and cardiovascular mortality. Plasma fibrinogen and C reactive protein (CRP)—key inflammatory and/or haemostatic markers—may contribute to this association; however, few studies have examined their relationships with sedentary behaviours. We examined associations of overall sitting and TV viewing time with fibrinogen and high-sensitivity CRP (hsCRP). Methods Plasma fibrinogen and hsCRP were measured in 3086 Austra...
21 CitationsSource
#1Mark Hamer (UCL: University College London)H-Index: 73
#2Cesar de Oliveira (UCL: University College London)H-Index: 24
Last. Panayotes Demakakos (UCL: University College London)H-Index: 28
view all 3 authors...
Background The activity patterns of older adults include more light/mild-intensity or "non-exercise" activity and less moderate- to vigorous-intensity activity. The health benefits of this type of activity pattern remain unclear. Purpose To examine dose–response associations between physical activity and survival using time-varying analysis to understand the importance of "non-exercise" activity for survival in older adults. Methods Participants (N=10,426) were drawn from The English Longitudina...
53 CitationsSource
#1Daniela Schmid (University of Regensburg)H-Index: 14
#2Michael F. Leitzmann (University of Regensburg)H-Index: 85
Results Data from 43 observational studies including a total of 68 936 cancer cases were analyzed. Comparing the highest vs lowest levels of sedentary time, the relative risks (RRs) for colon cancer were 1.54 (95% confidence interval [CI] = 1.19 to 1.98) for TV viewing time, 1.24 (95% CI = 1.09 to 1.41) for occupational sitting time, and 1.24 (95% CI = 1.03 to 1.50) for total sitting time. For endometrial cancer, the relative risks were 1.66 (95% CI = 1.21 to 2.28) for TV viewing time and 1.32 (...
142 CitationsSource
Cited By7
#1Takaaki Ikeda (YU: Yamagata University)H-Index: 1
#2Sumito Inoue (YU: Yamagata University)H-Index: 19
Last. Ichiei NaritaH-Index: 35
view all 15 authors...
Pneumonia-related mortality is expected to increase in aging societies. This prospective cohort study examined whether daily walking (1 hour/day) could reduce pneumonia-related mortality among older people who lacked other exercise habits. We analysed data from Japanese Specific Health Checkup across 82 municipalities in 7 prefectures among participants aged ≥65 years who participated in daily walking but did not regularly engage in other forms of exercise (n = 132,448). Information on walking h...
#1Mark Hamer (UCL: University College London)H-Index: 73
#2Ding Ding (USYD: University of Sydney)H-Index: 34
Last. Emmanuel Stamatakis (USYD: University of Sydney)H-Index: 66
view all 5 authors...
Aims Sedentary behaviour (particularly television (TV) viewing) is thought to be a risk factor for cardiovascular disease. We employed a negative control outcome to explore whether the association between TV viewing and heart disease mortality is explained by confounding. Methods The sample was drawn from the UK Biobank study and comprised 479 658 participants (aged 56.5±8.0 years; 45.7% men) followed up over a mean of 10.4 years. TV viewing was measured from self-report. Results There were 1437...
1 CitationsSource
#1I-Fan Shih (UCLA: University of California, Los Angeles)H-Index: 4
#2Mary N. Haan (UCSF: University of California, San Francisco)H-Index: 55
Last. Beate Ritz (UCLA: University of California, Los Angeles)H-Index: 66
view all 6 authors...
: A higher level of physical activity (PA) is associated with decreased risk of mortality, dementia, and depression, yet the mechanisms involved are not well understood, and little evidence exists for Mexican Americans. With data from the Sacramento Area Latino Study on Aging (1998-2007), we used Cox proportional hazards regression to separately evaluate associations of baseline PA level with mortality, dementia/cognitive impairment without dementia (CIND), and depressive symptoms, and we estima...
#1Hisato Takagi (Kitasato University)H-Index: 3
#2Yosuke Hari (Kitasato University)H-Index: 3
Last. Tomo Ando (DMC: Detroit Medical Center)H-Index: 10
view all 5 authors...
Abstract To determine whether television (TV) viewing is associated with cardiovascular disease (CVD) risk, we performed a meta-analysis of currently available prospective cohort studies. We systematically searched PubMed and Web of Science through April 2019. Eligible for inclusion in the present meta-analysis was a prospective cohort study investigating the association of TV viewing time with CVD risk (CVD prevalence, CVD incidence, cardiovascular events, and cardiovascular mortality). From ea...
1 CitationsSource
#1Susanna C. Larsson (KI: Karolinska Institutet)H-Index: 62
#2Alicja Wolk (KI: Karolinska Institutet)H-Index: 116
Abstract Objective To examine the association between sedentary leisure-time and all-cause mortality and differences in survival time. Design Prospective cohort study. Methods Information on sedentary leisure-time, defined as TV viewing and/or sitting reading, was collected from 72 003 Swedish adults who were 45–83 (median 60) years of age and completed a self-administered questionnaire at baseline and were followed up for 17 years through linkage with the Swedish Death Register. Results The ass...
1 CitationsSource
#1Emmanuel Stamatakis (USYD: University of Sydney)H-Index: 66
#2Ulf Ekelund (Norwegian School of Sport Sciences)H-Index: 88
Last. I-Min LeeH-Index: 98
view all 6 authors...
Sedentary behaviour (SB) has been proposed as an ‘independent’ risk factor for chronic disease risk, attracting much research and media attention. Many countries have included generic, non-quantitative reductions in SB in their public health guidelines and calls for quantitative SB targets are increasing. The aim of this narrative review is to critically evaluate key evidence areas relating to the development of guidance on sitting for adults. We carried out a non-systematic narrative evidence s...
19 CitationsSource
#1Gary O'Donovan (Lboro: Loughborough University)H-Index: 18
#2Mark Hamer (Lboro: Loughborough University)H-Index: 73
Abstract The longitudinal association between physical activity and lung function is unclear. Therefore, we examined said association over eight years. This study included data from 2966 participants in English Longitudinal Study of Ageing (63 ± 7 years [mean ± SD]), a prospective study of initially healthy, community dwelling adults. Physical activity was assessed using an interview and lung function using a spirometer at baseline (2004–5) and follow-up (2012 − 13). General linear regression wa...
3 CitationsSource
#1Mark HamerH-Index: 73
#2Thomas YatesH-Index: 36
Last. Panayotes DemakakosH-Index: 28
view all 4 authors...
This paper was published in the journal Atherosclerosis and the definitive published version is available at
1 CitationsSource