Television Viewing Time, Physical Activity, and Mortality Among African Americans

Abstract

BackgroundProlonged television viewing time, a marker of sedentary activity, is independently associated with increased all-cause mortality; however, this association has rarely been studied in African Americans. The objective of our study was to examine the association between television viewing time and mortality among African Americans by using data from the Jackson Heart Study (JHS).MethodsWe studied 5,289 participants from the JHS study who reported television viewing time (h/day) in the JHS baseline questionnaire from 2000 through 2004. Using multivariable Cox regression models adjusted for age, sex, smoking, alcohol use, physical activity, nutrition, prevalent coronary heart disease, chronic kidney disease, diabetes, and hypertension, we computed hazard ratios to examine the association between television viewing time (≤2 h/day, 2–4 h/day, and ≥4 h/day) and mortality.ResultsParticipants had a mean age of 55 years, and 64% were women. After a median follow-up of 9.9 years (interquartile range, 9.0–10.7), 615 deaths occurred (data analysis conducted in 2017). Hazard ratios for mortality were 1.08 (0.86–1.37) for television time of 2 to 4 hours per day and 1.48 (95% CI: 1.19–1.83) for television time of greater than or equal to 4 hours per day when compared with those who watched television less than 2 hours per day (P trend = .002). When we restricted analyses to those who performed leisure-time activities, the hazard ratios for mortality were 1.10 (95% CI, 0.84–1.45) for television viewing of 2 to 4 hours per day and 1.45 (95% CI, 1.13–1.86) for more than 4 hours per day compared with the less than 2 hours per day.ConclusionOur findings suggest that greater television viewing time, even among those who perform leisure-time physical activities, is associated with increased all-cause mortality among African Americans. Thus, it may serve as an indicator of a sedentary lifestyle with potential for intervention.

Sedentary Behavior and Health: Update from the 2018 Physical Activity Guidelines Advisory Committee

“…Diaz and colleagues reported that the positive associations of sedentary time and bout duration with all-cause mortality did not vary by age, sex, race, BMI or moderate-to-vigorous physical activity (27). Further, Imran et al reported that in African Americans the results were similar when they excluded those with high and low BMI, those with low leisure physical activity, and those without a high school diploma (24). Theou and colleagues reported a significant association between accelerometer-derived sedentary time and all-cause mortality in NHANES; the association was statistically significant in physically inactive adults but not in physically active adults (31).…”

“…All studies used prospective cohort designs, with follow-up periods ranging from 2.3 to 19.4 years. The sedentary exposures varied across studies: five studies used self-reported sitting time (17)(18)(19)(20)(21), seven studies used self-reported TV viewing time (17,18,(22)(23)(24)(25)(26), and five studies used accelerometer-derived estimates of sedentary time (27)(28)(29)(30)(31). All studies included an estimate of duration of sedentary behavior (sedentary time) as an exposure, while three studies also included a marker of bouts or breaks in sedentary time as an exposure (27)(28)(29).…”

“…Seven studies reported on the association between sedentary behavior and all-cause mortality (Table 3) (21,23,24,27,(29)(30)(31). Six of the studies reported a statistically significant association (21,23,24,27,29,31). For example, an analysis from the Women's Health Initiative reported a significant (p<0.05) association between self-reported daily sitting time and all-cause mortality (odds ratio for dying before age 85 for ≥10 h/day versus < 5 h/day = 1.16 (95% CI: 1.04-1.29)) over 13.7 years of follow-up (21).…”

“…For example, an analysis from the Women's Health Initiative reported a significant (p<0.05) association between self-reported daily sitting time and all-cause mortality (odds ratio for dying before age 85 for ≥10 h/day versus < 5 h/day = 1.16 (95% CI: 1.04-1.29)) over 13.7 years of follow-up (21). Two additional studies, one from the United Kingdom and one among African Americans, demonstrated significant associations between daily TV viewing and all-cause mortality (23,24 (24). Three studies that used accelerometer-derived estimates of sedentary time as the exposure reported a significant association with all-cause mortality (27,29,31), while one did not (30).…”

Sedentary Lifestyle: Overview of Updated Evidence of Potential Health Risks

“…In a study analyzing the mortality rates of people with >10 hours and <5 hours of sitting times a day, the sitting time was significantly correlated with all-cause mortality (odds ratio [OR], 1.16; 95% CI, 1.04– 1.29; P<0.05) [ 25 ]. In a study that examined the correlation between the television viewing time and all-cause mortality, the people who watched television for ≥6 hours a day had a two-fold higher all-cause mortality risk compared to the people who watched television for <2 hours a day (hazard ratio [HR], 1.98; 95% CI, 1.25–3.15) [ 26 ] whereas the people who watched television for ≥4 hours a day had a 1.5 times higher all-cause mortality risk compared to the people who watched TV for <2 hours a day (HR, 1.48; 95% CI, 1.19–1.83) [ 27 ].…”