| Title: | Understanding How Much TV is Too Much A Nonlinear Analysis of the Association Between Television Viewing Time and Adverse Health Outcomes |
| Journal: | Mayo Clinic Proceedings |
| Published: | 23 Jul 2020 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/32713607/ |
| DOI: | https://doi.org/10.1016/j.mayocp.2020.04.035 |
| URL: | https://eprints.gla.ac.uk/214940/7/214940.pdf |
| Citations: | 17 (11 in last 2 years) as of 8 Aug 2024 |
Publication 5945
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Abstract
OBJECTIVE: To inform potential guideline development, we investigated nonlinear associations between television viewing time (TV time) and adverse health outcomes.</p>
METHODS: From 2006 to 2010, 490,966 UK Biobank participants, aged 37 to 73 years, were recruited. They were followed from 2006 to 2018. Nonlinear associations between self-reported TV time (hours per day) and outcomes explored using penalized cubic splines in Cox proportional hazards adjusted for demographics and lifestyle. Population-attributable and potential impact fractions were calculated to contextualize population-level health outcomes associated with different TV time levels. Nonlinear isotemporal substitution analyses were used to investigate substituting TV time with alternative activities. Primary outcomes were mortality: all-cause, cardiovascular disease (CVD) and cancer; incidence: CVD and cancer; secondary outcomes were incident myocardial infarction, stroke, and heart failure and colon, lung, breast, and prostate cancer.</p>
RESULTS: Those with noncommunicable disease (109,867 [22.4%]), CVD (32,243 [6.6%]), and cancer (37,81 [7.7%]) at baseline were excluded from all-cause mortality, CVD, and cancer analyses, respectively. After 7.0 years (mortality) and 6.2 years (disease incidence) mean follow-up, there were 10,306 (2.7%) deaths, 24,388 (5.3%) CVD events, and 39,121 (8.7%) cancer events. Associations between TV time and all-cause and CVD mortality were curvilinear (Pnon-linear ≤.003), with lowest risk observed <2 hours per day. Theoretically, 8.64% (95% confidence interval [CI], 6.60-10.73) of CVD mortality is attributable to TV time. Limiting TV time to 2 hours per day might have prevented, or at least delayed, 7.97% (95% CI, 5.54-10.70) of CVD deaths. Substituting TV time with sleeping, walking, or moderate or vigorous physical activity was associated with reduced risk for all outcomes when baseline levels of substitute activities were low.</p>
CONCLUSION: TV time is associated with numerous adverse health outcomes. Future guidelines could suggest limiting TV time to less than 2 hours per day to reduce most of the associated adverse health events.</p>
23 Keywords
- Adult
- Aged
- Breast Neoplasms
- Cardiovascular Diseases
- Colonic Neoplasms
- Female
- Health Status
- Heart Failure
- Humans
- Incidence
- Lung Neoplasms
- Male
- Middle Aged
- Mortality
- Myocardial Infarction
- Neoplasms
- Proportional Hazards Models
- Prostatic Neoplasms
- Risk Factors
- Screen Time
- Stroke
- Television
- United Kingdom
8 Authors
- Hamish M E Foster
- Frederick K Ho
- Naveed Sattar
- Paul Welsh
- Jill P Pell
- Jason M R Gill
- Stuart R Gray
- Carlos A Celis-Morales
Enabling scientific discoveries that improve human health