Screen-based entertainment time, all-cause mortality, and cardiovascular events : Population-based study with ongoing mortality and hospital events follow-up
Journal article
Stamatakis, Emmanuel, Hamer, Mark and Dunstan, David. (2011). Screen-based entertainment time, all-cause mortality, and cardiovascular events : Population-based study with ongoing mortality and hospital events follow-up. Journal of the American College of Cardiology. 57(3), pp. 292 - 299. https://doi.org/10.1016/j.jacc.2010.05.065
Authors | Stamatakis, Emmanuel, Hamer, Mark and Dunstan, David |
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Abstract | Objectives: The aim of this study was to examine the independent relationships of television viewing or other screen-based entertainment (“screen time”) with all-cause mortality and clinically confirmed cardiovascular disease (CVD) events. A secondary objective was to examine the extent to which metabolic (body mass index, high-density lipoprotein and total cholesterol) and inflammatory (C-reactive protein) markers mediate the relationship between screen time and CVD events. Background: Although some evidence suggests that prolonged sitting is linked to CVD risk factor development regardless of physical activity participation, studies with hard outcomes are scarce. Methods: A population sample of 4,512 (1,945 men) Scottish Health Survey 2003 respondents (≥35 years) were followed up to 2007 for all-cause mortality and CVD events (fatal and nonfatal combined). Main exposures were interviewer-assessed screen time ( < 2 h/day; 2 to < 4 h/day; and ≥4 h/day) and moderate to vigorous intensity physical activity. Results: Two hundred fifteen CVD events and 325 any-cause deaths occurred during 19,364 follow-up person-years. The covariable (age, sex, ethnicity, obesity, smoking, social class, long-standing illness, marital status, diabetes, hypertension)-adjusted hazard ratio (HR) for all-cause mortality was 1.52 (95% confidence interval [CI]: 1.06 to 2.16) and for CVD events was 2.30 (95% CI: 1.33 to 3.96) for participants engaging in ≥4 h/day of screen time relative to < 2 h/day. Adjusting for physical activity attenuated these associations only slightly (all-cause mortality: HR: 1.48, 95% CI: 1.04 to 2.13; CVD events: HR: 2.25, 95% CI: 1.30 to 3.89). Exclusion of participants with CVD events in the first 2 years of follow-up and previous cancer registrations did not change these results appreciably. Approximately 25% of the association between screen time and CVD events was explained collectively by C-reactive protein, body mass index, and high-density lipoprotein cholesterol. Conclusions: Recreational sitting, as reflected by television/screen viewing time, is related to raised mortality and CVD risk regardless of physical activity participation. Inflammatory and metabolic risk factors partly explain this relationship. |
Year | 2011 |
Journal | Journal of the American College of Cardiology |
Journal citation | 57 (3), pp. 292 - 299 |
ISSN | 0735-1097 |
Digital Object Identifier (DOI) | https://doi.org/10.1016/j.jacc.2010.05.065 |
Open access | Open access |
Page range | 292 - 299 |
Research Group | Mary MacKillop Institute for Health Research |
Publisher's version |
https://acuresearchbank.acu.edu.au/item/86844/screen-based-entertainment-time-all-cause-mortality-and-cardiovascular-events-population-based-study-with-ongoing-mortality-and-hospital-events-follow-up
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