Published Online
on January 11, 2010

A more recent version of this article appeared on January 26, 2010

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Submitted on July 16, 2009
Accepted on November 24, 2009

Television Viewing Time and Mortality. The Australian Diabetes, Obesity and Lifestyle Study (AusDiab)

D. W. Dunstan PhD^*, E. L.M. Barr PhD, G. N. Healy PhD, J. Salmon PhD, J. E. Shaw MD, B. Balkau PhD, D. J. Magliano PhD, A. J. Cameron PhD, P. Z. Zimmet PhD, and N. Owen PhD

From the Baker IDI Heart and Diabetes Institute, Melbourne, Australia (D.W.D., E.L.M.B., G.N.H., J.S., J.E.S., B.B., D.J.M., P.Z.Z., N.O.); Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia (D.W.D., E.L.M.B., J.E.S., D.J.M., P.Z.Z.); Cancer Prevention Research Centre, School of Population Health, University of Queensland, Brisbane, Australia (D.W.D., G.N.H., N.O.); School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia (D.W.D., J.S., A.J.C.); Vario Health Institute, Edith Cowan University, Perth, Australia (D.W.D.); and INSERM U780, Villejuif, University Paris-Sud, Orsay, France (B.B.).

^* To whom correspondence should be addressed. E-mail: david.dunstan{at}bakeridi.edu.au.

Background—Television viewing time, the predominant leisure-time sedentary behavior, is associated with biomarkers of cardiometabolic risk, but its relationship with mortality has not been studied. We examined the associations of prolonged television viewing time with all-cause, cardiovascular disease (CVD), cancer, and non-CVD/noncancer mortality in Australian adults.

Methods and Results—Television viewing time in relation to subsequent all-cause, CVD, and cancer mortality (median follow-up, 6.6 years) was examined among 8800 adults 25 years of age in the Australian Diabetes, Obesity and Lifestyle Study (AusDiab). During 58 087 person-years of follow-up, there were 284 deaths (87 CVD deaths, 125 cancer deaths). After adjustment for age, sex, waist circumference, and exercise, the hazard ratios for each 1-hour increment in television viewing time per day were 1.11 (95% confidence interval [CI], 1.03 to 1.20) for all-cause mortality, 1.18 (95% CI, 1.03 to 1.35) for CVD mortality, and 1.09 (95% CI, 0.96 to 1.23) for cancer mortality. Compared with a television viewing time of <2 h/d, the fully adjusted hazard ratios for all-cause mortality were 1.13 (95% CI, 0.87 to 1.36) for 2 to <4 h/d and 1.46 (95% CI, 1.04 to 2.05) for 4 h/d. For CVD mortality, corresponding hazard ratios were 1.19 (95% CI, 0.72 to 1.99) and 1.80 (95% CI, 1.00 to 3.25). The associations with both cancer mortality and non-CVD/noncancer mortality were not significant.

Conclusions—Television viewing time was associated with increased risk of all-cause and CVD mortality. In addition to the promotion of exercise, chronic disease prevention strategies could focus on reducing sitting time, particularly prolonged television viewing.

Key words: epidemiology • exercise • lifestyle • mortality • obesity • risk factors

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