Associations of television viewing time with adults' well-being and vitality

Television (TV) viewing, a common leisure-time sedentary behaviour, is associated adversely with cardio-metabolic health, fatigue, depression and mental health. However, associations of TV viewing time with health-related quality of life attributes are less well understood. We examined associations of TV viewing time with physical well-being, mental well-being and vitality in a large population-based sample of Australian adults.

Prevalence and stability of active play, restricted movement and television viewing in infants

This study describes engagement in and stability of physical activity and sedentary behaviours in early life, and assesses associations with sex, maternal education and developmental stage. Maternal-report data at child age 4, 9 and 20 months were collected from 542 families in the Melbourne Infant Feeding Activity and Nutrition Trial Program. Parents estimated average time per day their child spent in active pursuits or pursuits that restricted movement. With increasing age, children generally spent more time in active pursuits and watching television, and less time in situations that restrict movement. Associations were found with age of developmental milestone attainment but not sex or maternal education. Stability over time was strongest for television viewing (β = 0.34–0.38) and time spent outdoors (β = 0.27–0.33). Contrary to guidelines, television viewing increased and showed stability, suggesting a need to target this behaviour very early in life to achieve optimal longer term outcomes.

Tracking of maternal self-efficacy for limiting young children's television viewing and associations with children's television viewing time: a longitudinal analysis over 15-months

BACKGROUND: Mothers' self-efficacy for limiting their children's television viewing is an important correlate of this behaviour in young children. However, no studies have examined how maternal self-efficacy changes over time, which is potentially important during periods of rapid child development. This study examined tracking of maternal self-efficacy for limiting young children's television viewing over 15-months and associations with children's television viewing time. METHODS: In 2008 and 2010, mothers (n = 404) from the Melbourne InFANT Program self-reported their self-efficacy for limiting their child's television viewing at 4- and 19-months of age. Tertiles of self-efficacy were created at each time and categorised into: persistently high, persistently low, increasing or decreasing self-efficacy. Weighted kappa and multinomial logistic regression examined tracking and demographic and behavioural predictors of change in self-efficacy. A linear regression model examined associations between tracking categories and children's television viewing time. RESULTS: Tracking of maternal self-efficacy for limiting children's television viewing was low (kappa = 0.23, p < 0.001). Mothers who had persistently high or increasing self-efficacy had children with lower television viewing time at 19-months (β = -35.5; 95 % CI = -54.4,-16.6 and β = 37.0; 95 % CI = -54.4,-19.7, respectively). Mothers of children with difficult temperaments were less likely to have persistently high self-efficacy. Mothers who met adult physical activity guidelines had 2.5 greater odds of increasing self-efficacy. CONCLUSIONS: Interventions to increase and maintain maternal self-efficacy for limiting children's television viewing time may result in lower rates of this behaviour amongst toddlers. Maternal and child characteristics may need to be considered when tailoring interventions.

Physical activity, television viewing time and 12 year changes in waist circumference

PURPOSE: Both moderate-to-vigorous physical activity (MVPA) and sedentary behavior can be associated with adult adiposity. Much of the relevant evidence is from cross-sectional studies or from prospective studies with relevant exposure measures at a single time point prior to weight gain or incident obesity. This study examined whether changes in MVPA and television (TV) viewing time are associated with subsequent changes in waist circumference, using data from three separate observation points in a large population-based prospective study of Australian adults. METHODS: Data were obtained from the Australian Diabetes, Obesity and Lifestyle study collected in 1999-2000 (baseline), 2004-05 (Wave 2), and 2011-12 (Wave 3). The study sample consisted of adults aged 25 to 74 years at baseline who also attended site measurement at three time points (n=3261). Multilevel linear regression analysis examined associations of initial five-year changes in MVPA and TV viewing time (from baseline to Wave 2) with 12-year change in waist circumference (from baseline to Wave 3), adjusting for well-known confounders. RESULTS: As categorical predictors, increases in MVPA significantly attenuated increases in waist circumference (p for trend< 0.001). TV viewing time change was not significantly associated with changes in waist circumference (p for trend =0.06). Combined categories of MVPA and TV viewing time changes were predictive of waist circumference increases; compared to those who increased MVPA and reduced TV viewing time, those who reduced MVPA and increased TV viewing time had a 2cm greater increase in waist circumference (p=0.001). CONCLUSION: Decreasing MVPA emerged as a significant predictor of increases in waist circumference. Increasing TV viewing time was also influential, but its impact was much weaker than MVPA.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.

Associations between physical activity, television viewing and postnatal depressive symptoms amongst healthy primiparous mothers

Background: Postnatal depression is a serious illness in new mothers. In the general population, physical activity (PA) has been found to reduce the risk of depression, whilst sedentary behaviour (SB; in particular television viewing) has been linked to higher levels of depressive symptoms, yet little is known regarding associations between PA, SB and postnatal depression. This study aimed to investigate associations between PA, television viewing and postnatal depressive symptoms in healthy primiparous mothers.. Methods: Cross-sectional survey data were provided by 406 first-time mothers (approximately 3-months postpartum) enrolled in the Melbourne InFANT Extend trial (2012/2013). Women self-reported PA (time spent walking for leisure and transport, and other moderate and vigorous PA), television viewing, and depressive symptoms (CES-D 10). Random intercept linear models examined associations between PA, television viewing and depressive symptoms. Results: In crude models total PA was inversely associated with risk of postnatal depressive symptoms (B = -0.122; 95% CI = -0.24, -0.01). In models adjusted for key sociodemographic and behavioural covariates the association did not remain statistically significant. No other associations between PA, television viewing and postnatal depressive symptoms were evident.. Conclusions: Postnatal depressive symptoms may not be related to PA and television viewing in the same way that these behaviours predict depressive symptoms in the general population. Further investigation of the specific domains of PA, as well as different types/contexts of SB and their respective associations with postnatal depressive symptoms is warranted in order to better inform development of targeted interventions aimed at enhancing postnatal mental health..

Television viewing, C-reactive protein, and depressive symptoms in older adults

There is emerging evidence for a link between sedentary behavior and mental health, although the mechanisms remain unknown. We tested if an underlying inflammatory process explains the association between sedentary behavior and depressive symptoms. We conducted a two year follow-up of 4964 (aged 64.5 ± 8.9 years) men and women from the English Longitudinal Study of Ageing, a cohort of community dwelling older adults. Self-reported TV viewing time was assessed at baseline as a marker of leisure time sedentary behavior. The eight-item Centre of Epidemiological Studies Depression (CES-D) scale was administered to measure depressive symptoms at follow-up. At baseline, TV time was associated with C-reactive protein (CRP), adjusted geometric mean CRP values were 2.94 mg/L (<2 h/d TV); 3.04 mg/L (2–4 h/d TV); 3.29 mg/L (4–6 h/d TV); 3.23 mg/L (>6 h/d TV). We observed both a direct association of TV time on CES-D score at follow-up (B = 0.08, 95% CI, 0.05, 0.10) and indirect effects (B = 0.07, 95% CI, 0.05, 0.08). The indirect effects were largely explained through lack of physical activity, smoking, and alcohol, but not by CRP or body mass index.

Television viewing time and 13-year mortality in adults with cardiovascular disease: data from the Australian Diabetes, Obesity and Lifestyle Study (AusDiab)

BACKGROUND: In the general population, excessive sedentary behaviour is associated with increased all-cause mortality. Few studies have examined this relationship in people with cardiovascular disease (CVD). Using a sample of people with CVD who were excluded from an analysis of the Australian Diabetes, Obesity and Lifestyle (AusDiab) study, we examined the relationship between sedentary behaviour and 13-year all-cause mortality.

METHODS: In the original AusDiab study, television viewing time was used as a marker of sedentary behaviour in 609 adults (≥45 years of age) with CVD. During 6,291 person-years of follow-up (median follow-up 13 years), there were 294 deaths (48% of sample). Using the time scale of attained age, the Cox proportional hazards model predicting all-cause mortality adjusted for sex, self-rated general health, leisure-time physical activity, smoking status, education, household income, body mass index, lipid levels, blood pressure, and diabetes mellitus was used.

RESULTS: Compared with a TV viewing time of <2hours per day, the fully adjusted hazard ratios for all-cause mortality were 1.18 (95% CI, 0.88 to 1.57) for ≥2 to <4hours per day and 1.52 (95% CI, 1.09 to 2.13) for >4hours per day.

CONCLUSIONS: Sedentary behaviour was associated with increased risk of all-cause mortality in people with CVD, independent of physical activity and other confounders. In addition to the promotion of regular physical activity, cardiac rehabilitation efforts which also focus on reducing sedentary behaviour may be beneficial.

Increased cardio-metabolic risk is associated with increased TV viewing time

Purpose: Television viewing time, independent of leisure-time physical activity, has cross-sectional relationships with the metabolic syndrome and its individual components. We examined whether baseline and five-year changes in self-reported television viewing time are associated with changes in continuous biomarkers of cardio-metabolic risk (waist circumference, triglycerides, high density lipoprotein cholesterol, systolic and diastolic blood pressure, fasting plasma glucose; and a clustered cardio-metabolic risk score) in Australian adults. Methods: AusDiab is a prospective, population-based cohort study with biological, behavioral, and demographic measures collected in 1999–2000 and 2004–2005. Non-institutionalized adults aged ≥ 25 years were measured at baseline (11,247; 55% of those completing an initial household interview); 6,400 took part in the five-year follow-up biomedical examination, and 3,846 met the inclusion criteria for this analysis. Multiple linear regression analysis was used and unstandardized B coefficients (95% CI) are provided. Results: Baseline television viewing time (10 hours/week unit) was not significantly associated with change in any of the biomarkers of cardio-metabolic risk. Increases in television viewing time over five years (10 hours/week unit) were associated with increases in: waist circumference (cm) (men: 0.43 (0.08, 0.78), P = 0.02; women: 0.68 (0.30, 1.05), P <0.001), diastolic blood pressure (mmHg) (women: 0.47 (0.02, 0.92), P = 0.04), and the clustered cardio-metabolic risk score (women: 0.03 (0.01, 0.05), P = 0.007). These associations were independent of baseline television viewing time and baseline and change in physical activity and other potential confounders. Conclusion: These findings indicate that an increase in television viewing time is associated with adverse cardio-metabolic biomarker changes. Further prospective studies using objective measures of several sedentary behaviors are required to confirm causality of the associations found.

The relation between content providers and distributors: Lessons from the regulation of television distribution in the United Kingdom

Using the United Kingdom (UK) as a case study, this article analyses the growing commercial and regulatory significance of broadcaster-distributor relations within the contemporary television industry. The first part of the article argues that despite important changes in broadcast delivery technology, more recently shaped by the growth of the Internet, and the associated growth of options of receiving television content, the traditional delivery platforms (digital terrestrial, satellite and cable) remain by far the preferred choice for viewers in Britain. At the same time, public service broadcasters continue to be the biggest investors in domestic original non-sport content and account for over half of all television viewing. The strength of PSBs in content and their growing reliance on commercial proprietary subscription platforms (cable and satellite) and gradually on the Internet presents challenges in the nexus between broadcasters and distributors. The article focuses on the debate over retransmission fees between PSBs and Sky, and on the question of whether Sky should be required to offer some of its premium content to rival pay-TV platforms. These two examples highlight the impact regulatory intervention can have on the balance of power between broadcasters and distributors. The article concludes that such debates concerning the commercial relations between content providers and distributors will remain pivotal and become more heated given that similar issues are raised in the Internet environment.

Mediators of the relationship between maternal education and children's TV viewing

Background: Maternal education is consistently found to be inversely related to children’s television viewing and is associated with aspects of the family television environment. This study investigates whether family television environment mediates the relationship between maternal education and children’s television viewing.

Methods: Parents of 1484 children reported maternal education, time their child spends watching television, and 21 aspects of the family television environment (potential mediators) during 2002 and 2003. Separate regression analyses were conducted in 2006 for each potential mediator that met two initial conditions for mediation (associated with both maternal education and children’s television viewing (p<0.10)), to assess whether inclusion reduced the association between maternal education and children’s television viewing. Multivariable regression assessed the combined impact of all mediators.

Results: Twelve of 21 potential mediators met the initial conditions for mediation. Inclusion of each resulted in decreased β values (3.2% to 15.2%) for the association between maternal education and television viewing. Number and placement of televisions in the home appeared to have the greatest mediating effect, followed by frequency of eating dinner in front of the television with the child and rules about television viewing during mealtimes. Together, the 12 mediators accounted for more than one-third of the association between maternal education and children’s television viewing time.

Conclusions: This study suggests the strong inverse relationship between maternal education and children’s television viewing is partly mediated by aspects of the family television environment.

Neighborhood walkability and TV viewing time among Australian adults

Background
Built-environment attributes of a neighborhood are associated with participation in physical activity and may also influence time spent in sedentary behaviors. Associations of neighborhood walkability (based on dwelling density, street connectivity, land-use mix, and net retail area) and television viewing time were compared in a large, spatially-derived sample of Australian adults.

Methods
Neighborhood-level variables (walkability and socioeconomic status [SES]) were calculated in 154 Australian census collection districts using Geographic Information Systems. Individual-level variables (TV viewing time, time spent in leisure-time physical activity, height, weight, and sociodemographic variables) were collected from adults living in urban areas of Adelaide, Australia using a mail survey (N=2224) in 2003–2004. Multilevel linear regression analysis was conducted in 2006 separately for men and women to examine variations in TV viewing time across tertiles of walkability.

Results
Neighborhood walkability was negatively associated with TV viewing time in women, but not in men. After controlling for neighborhood SES, body mass index, physical activity, and sociodemographic variables, women living in medium- and high-walkable neighborhoods reported significantly less TV viewing time per day (14 minutes and 17 minutes, respectively) compared to those residing in low-walkable neighborhoods.

Conclusions
Built-environment attributes of neighborhoods that are related to physical activity also may play an important role in influencing sedentary behavior, particularly among women. Considering the effects of prolonged sedentary time on health risks, which are independent of physical activity, there is the need for further research to explore how environmental characteristics may contribute to the amount of time spent in sedentary behavior.

Television, computer use and body mass index in Australian primary school children

Objective: To investigate relationships between children's body mass index (BMI) and parent reports of children's television and video game/computer habits, controlling for other potential risk factors for paediatric obesity.

Methods: Child BMI was calculated from measured height and weight collected in 1997 as part of a large, representative, cross-sectional study of children in Victoria, Australia. Parents reported the amount of time children watched television and used video games/computers, children's eating and activity habits, parental BMI and sociodemographic details.

Results: A total of 2862 children aged 5−13 years participated. Child mean BMI z-score was significantly related to television (F = 10.2₃, P < 0.001) but not video game/computer time (F = 2.2₃, P = 0.09), but accounted for only 1 and 0.2% of total BMI variance, respectively. When parental BMI, parental education, number of siblings, food intake, organized exercise and general activity level were included, television ceased to be independently significantly related to child BMI. Using adjusted logistic regression, the odds of being overweight and obese generally increased with increasing television viewing. No relationship was found for video game/computer use.
Conclusions: A small proportion of variance in child BMI was related to television, but not video game/computer time. This was far outweighed by the influence of other variables. Causal pathways are likely to be complex and interrelated.

Television time and continuous metabolic risk in physically active adults

Purpose: Among Australian adults who met the public health guideline for the minimum health-enhancing levels of physical activity, we examined the dose-response associations of television-viewing time with continuous metabolic risk variables.

Methods: Data were analyzed on 2031 men and 2033 women aged >= 25 yr from the 1999-2000 Australian Diabetes, Obesity and Lifestyle study without clinically diagnosed diabetes or heart disease, who reported at least 2.5 h·wk-1 of moderate- to vigorous-intensity physical activity. Waist circumference, resting blood pressure, and fasting and 2-h plasma glucose, triglycerides, and high-density-lipoprotein cholesterol (HDL-C) were measured. The cross-sectional associations of these metabolic variables with quartiles and hours per day of self-reported television-viewing time were examined separately for men and for women. Analyses were adjusted for age, education, income, smoking, diet quality, alcohol intake, parental history of diabetes, and total physical activity time, as well as menopausal status and current use of postmenopausal hormones for women.

Results: Significant, detrimental dose-response associations of television-viewing time were observed with waist circumference, systolic blood pressure, and 2-h plasma glucose in men and women, and with fasting plasma glucose, triglycerides, and HDL-C in women. The associations were stronger in women than in men, with significant gender interactions observed for triglycerides and HDL-C. Though waist circumference attenuated the associations, they remained statistically significant for 2-h plasma glucose in men and women, and for triglycerides and HDL-C in women.

Conclusions: In a population of healthy Australian adults who met the public health guideline for physical activity, television-viewing time was positively associated with a number of metabolic risk variables. These findings support the case for a concurrent sedentary behavior and health guideline for adults, which is in addition to the public health guideline on physical activity.

Developments in web technology : enhancing the viewing spectacle of sport

This case examines the introduction of technology through the World Wide Web and the impact it has had on the viewing of particular sports, in particular on the way in which this web-based technology is enhancing the television viewing experience.