Understanding How Much TV is Too Much: A Nonlinear Analysis of the Association Between Television Viewing Time and Adverse Health Outcomes
Understanding How Much TV is Too Much: A Nonlinear Analysis of the Association Between Television Viewing Time and Adverse Health Outcomes
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DOI：
10.1016/j.mayocp.2020.04.035
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发表时间：
2020-11-01
影响因子：
8.9
通讯作者：
Celis-Morales, Carlos A.
中科院分区：
文献类型：
--
作者：
Foster, Hamish M. E.;Ho, Frederick K.;Celis-Morales, Carlos A.
目的：为了告知潜在的指导方针的发展，我们调查了电视观看时间（电视时间）和不良健康outcomes.Methods之间的非线性关联：从2006年到2010年，490,966英国生物银行参与者，年龄在37至73岁，被招募。他们从2006年到2018年被跟踪。自我报告的电视时间（每天小时数）和结果之间的非线性关系，采用惩罚三次样条在人口统计学和生活方式调整的考克斯比例风险中进行研究。计算人口归因和潜在影响分数，以将与不同电视时间水平相关的人口水平健康结果联系起来。非线性等时替代分析被用来调查替代电视时间与替代活动。主要结局为死亡率：全因心血管疾病（CVD）和癌症;发病率：CVD和癌症;次要结局为心肌梗死、卒中和心力衰竭以及结肠癌、肺癌、乳腺癌和前列腺癌。基线时患有非传染性疾病（109，867 [22.4%]）、CVD（32，243 [6.6%]）和癌症（37，81 [7.7%]）的患者分别从全因死亡率、CVD和癌症分析中排除。平均随访7.0年（死亡率）和6.2年（疾病发生率）后，有10，306例（2.7%）死亡，24，388例（5.3%）CVD事件和39，121例（8.7%）癌症事件。TV时间与全因死亡率和CVD死亡率呈曲线相关（P非线性相关（P
Objective: To inform potential guideline development, we investigated nonlinear associations between television viewing time (TV time) and adverse health outcomes.Methods: From 2006 to 2010, 490,966 UK Biobank participants, aged 37 to 73 years, were recruited. They were followed from 2006 to 2018. Nonlinear associations between self-reported TV time (hours per day) and outcomes explored using penalized cubic splines in Cox proportional hazards adjusted for demographics and lifestyle. Population-attributable and potential impact fractions were calculated to contextualize population-level health outcomes associated with different TV time levels. Nonlinear isotemporal substitution analyses were used to investigate substituting TV time with alternative activities. Primary outcomes were mortality: all-cause, cardiovascular disease (CVD) and cancer; incidence: CVD and cancer; secondary outcomes were incident myocardial infarction, stroke, and heart failure and colon, lung, breast, and prostate cancer.Results: Those with noncommunicable disease (109,867 [22.4%]), CVD (32,243 [6.6%]), and cancer (37,81 [7.7%]) at baseline were excluded from all-cause mortality, CVD, and cancer analyses, respectively. After 7.0 years (mortality) and 6.2 years (disease incidence) mean follow-up, there were 10,306 (2.7%) deaths, 24,388 (5.3%) CVD events, and 39,121 (8.7%) cancer events. Associations between TV time and all-cause and CVD mortality were curvilinear (Pnon-linear