Associations of discretionary screen time with mortality, cardiovascular disease and cancer are attenuated by strength, fitness and physical activity: findings from the UK Biobank study.
Associations of discretionary screen time with mortality, cardiovascular disease and cancer are attenuated by strength, fitness and physical activity: findings from the UK Biobank study.
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DOI：
10.1186/s12916-018-1063-1
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发表时间：
2018-05-24
期刊：
影响因子：
9.3
通讯作者：
Gill JMR
中科院分区：
文献类型：
--
作者：
Celis-Morales CA;Lyall DM;Steell L;Gray SR;Iliodromiti S;Anderson J;Mackay DF;Welsh P;Yates T;Pell JP;Sattar N;Gill JMR
自由支配的屏幕时间（在休闲时间观看电视或电脑屏幕的时间）是导致久坐行为的重要因素，这与死亡率和心血管疾病（CVD）风险增加有关。这项研究的目的是确定屏幕时间与心血管疾病和全因死亡率的关系是否会受到心肺功能，握力或体力活动水平的影响。来自英国生物库的390，089名参与者（54%为女性）被纳入本研究。全因死亡率、CVD和癌症发病率和死亡率是主要结局。自由选择的电视（TV）观看，个人电脑（PC）屏幕时间和整体屏幕时间（TV + PC时间）的暴露变量。握力、健身和体力活动被视为潜在的效果修正因子。在中位5.0年的随访中，共有7420名受试者死亡，22,210例CVD事件（四分位数范围为4.3至5.7;在里程碑分析中从基线排除前2年后）。所有可自由支配的屏幕时间暴露与所有健康结果显著相关。在握力最低三分位数的参与者中，总体自由选择屏幕时间与全因死亡率、心血管疾病和癌症发病率的相关性最强（筛查时间每增加2小时的全因死亡风险比（1.31 [95%置信区间：1.22-1.43]，p < 0.0001; CVD 1.21 [1.13-1.30]，p = 0.0001;癌症发病率1.14 [1.10-1.19]，p < 0.0001），在最高握力三分位数中最弱（全因死亡率1.04 [0.95-1.14]，p = 0.198; CVD 1.05 [0.99-1.11]，p = 0.070;癌症0.98 [0.93-1.05]，p = 0.771）。健身也有类似的趋势（最低适合度三分位数：全因死亡率1.23 [1.13-1.34]，p = 0.002，CVD 1.10 [1.02-1.22]，p = 0.010;最高适合度三分位数：全因死亡率1.12 [0.96-1.28]，p = 0.848和CVD 1.01 [0.96-1.07]，p = 0.570）。体育活动对全因死亡率和癌症发病率也有类似的发现。自由选择屏幕时间与不良健康结果之间的关联在握力、健身和体育活动水平较低的人群中最强，而在握力、健身和体育活动水平最高的人群中则明显减弱。因此，如果这些关联是因果关系，那么减少可自由支配的屏幕时间的健康促进干预措施的最大益处可能会出现在那些力量，健康和身体活动水平低的人中。本文的在线版本（10.1186/s12916-018-1063-1）包含补充材料，可供授权用户使用。
Discretionary screen time (time spent viewing a television or computer screen during leisure time) is an important contributor to total sedentary behaviour, which is associated with increased risk of mortality and cardiovascular disease (CVD). The aim of this study was to determine whether the associations of screen time with cardiovascular disease and all-cause mortality were modified by levels of cardiorespiratory fitness, grip strength or physical activity. In total, 390,089 participants (54% women) from the UK Biobank were included in this study. All-cause mortality, CVD and cancer incidence and mortality were the main outcomes. Discretionary television (TV) viewing, personal computer (PC) screen time and overall screen time (TV + PC time) were the exposure variables. Grip strength, fitness and physical activity were treated as potential effect modifiers. Altogether, 7420 participants died, and there were 22,210 CVD events, over a median of 5.0 years follow-up (interquartile range 4.3 to 5.7; after exclusion of the first 2 years from baseline in the landmark analysis). All discretionary screen-time exposures were significantly associated with all health outcomes. The associations of overall discretionary screen time with all-cause mortality and incidence of CVD and cancer were strongest amongst participants in the lowest tertile for grip strength (all-cause mortality hazard ratio per 2-h increase in screen time (1.31 [95% confidence interval: 1.22–1.43], p < 0.0001; CVD 1.21 [1.13–1.30], p = 0.0001; cancer incidence 1.14 [1.10–1.19], p < 0.0001) and weakest amongst those in the highest grip-strength tertile (all-cause mortality 1.04 [0.95–1.14], p = 0.198; CVD 1.05 [0.99–1.11], p = 0.070; cancer 0.98 [0.93–1.05], p = 0.771). Similar trends were found for fitness (lowest fitness tertile: all-cause mortality 1.23 [1.13–1.34], p = 0.002 and CVD 1.10 [1.02–1.22], p = 0.010; highest fitness tertile: all-cause mortality 1.12 [0.96–1.28], p = 0.848 and CVD 1.01 [0.96–1.07], p = 0.570). Similar findings were found for physical activity for all-cause mortality and cancer incidence. The associations between discretionary screen time and adverse health outcomes were strongest in those with low grip strength, fitness and physical activity and markedly attenuated in those with the highest levels of grip strength, fitness and physical activity. Thus, if these associations are causal, the greatest benefits from health promotion interventions to reduce discretionary screen time may be seen in those with low levels of strength, fitness and physical activity. The online version of this article (10.1186/s12916-018-1063-1) contains supplementary material, which is available to authorized users.
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DOI：
10.1186/1479-5868-8-115
发表时间：
2011-10-21
期刊：
The international journal of behavioral nutrition and physical activity
影响因子：
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