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Aims To explore the quantitative dose–response association of total sedentary behaviour and television viewing with overweight/obesity, type 2 diabetes and hypertension in a meta‐analysis. Materials and methods We searched three databases to identify English‐language reports that assessed the association of total sedentary behaviour or television viewing with the aforementioned health outcomes. Restricted cubic splines were used to evaluate possible linear or non‐linear associations of total sedentary behaviour and television viewing with these health outcomes. Results We included 48 articles (58 studies) with a total of 1 071 967 participants in the meta‐analysis; 21 (six cohort and 15 cross‐sectional) studies examined the association of total sedentary behaviour with overweight/obesity, 23 (13 cohort and 10 cross‐sectional) studies examined the association with type 2 diabetes and 14 (one cohort and 13 cross‐sectional) studies examined the association with hypertension. We found linear associations between total sedentary behaviour and type 2 diabetes (Pnon‐linearity = 0.190) and hypertension (Pnon‐linearity = 0.225) and a non‐linear association between total sedentary behaviour and overweight/obesity (Pnon‐linearity = 0.003). For each 1‐h/d increase in total sedentary behaviour, the risk increased by 5% for type 2 diabetes and 4% for hypertension. We also found linear associations between television viewing and type 2 diabetes (Pnon‐linearity = 0.948) and hypertension (Pnon‐linearity = 0.679) and a non‐linear association for overweight/obesity (Pnon‐linearity = 0.007). For each 1‐h/d increase in television viewing, the risk increased by 8% for type 2 diabetes and 6% for hypertension. Conclusions High levels of total sedentary behaviour and television viewing were associated with overweight/obesity, type 2 diabetes and hypertension.

Background The evidence of the association between Chinese visceral adiposity index (CVAI) and risk of type 2 diabetes mellitus (T2DM) is limited. We explored the association of CVAI with T2DM and directly compared with the predictive power of CVAI with other visceral obesity indices (visceral adiposity index, waist to height ratio, waist circumference and body mass index) based on a large prospective study. Methods We conducted a population‐based study of 12 237 Chinese participants. Cox proportional‐hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between CVAI and T2DM. Results During follow‐up (median: 6.01 years), the incidence of T2DM was 3.29, 7.34, 12.37 and 23.72 per 1000 person‐years for quartiles 1, 2, 3 and 4 of CVAI, respectively. The risk of T2DM was increased with quartiles 2, 3 and 4 vs quartile 1 of CVAI (HR 2.12 [95% CI 1.50‐3.00], 2.94 [2.10‐4.13] and 5.01 [3.57‐7.04], Ptrend < 0.001). Per‐SD increase in CVAI was associated with a 72% increased risk of T2DM (HR 1.72 [95% CI 1.56‐1.88]). Sensitivity analyses did not alter the association. The area under receiver operating characteristic curve was significantly higher for CVAI than other visceral obesity indices (all P <.001). Similar results were observed in stratified analyses by sex. Conclusions Our findings show a positive association between CVAI and risk of T2DM. CVAI has the best performance in predicting incident T2DM, so the index might be a reliable and applicable indicator identifying people at high risk of T2DM.

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