Television Viewing and Risk of Type 2 Diabetes, Cardiovascular Disease, and All-Cause Mortality: A Meta-Analysis

Study Questions:

Is prolonged television (TV) viewing associated with increased morbidity and mortality?


This meta-analysis included articles identified through searches of the MEDLINE database from 1970 to March 2011, and the EMBASE database from 1974 to March 2011. For inclusion, articles had to be published in English, have a prospective study design (including cohort, case-cohort, and nested case-control), and a study population which was apparently healthy at baseline.


A total of eight studies were included, of which four reported results on type 2 diabetes, which included 175,938 individuals and 6,428 incident cases during 1.1 million person-years of follow-up. Four studies reported on fatal or nonfatal cardiovascular disease (34,253 individuals; 1,052 incident cases). Three studies reported on all-cause mortality (26,509 individuals; 1,879 deaths during 202,353 person-years of follow-up). The pooled relative risks per 2 hours of TV viewing per day were 1.20 (95% confidence interval [CI], 1.14-1.27) for type 2 diabetes, 1.15 (95% CI, 1.06-1.23) for fatal or nonfatal cardiovascular disease, and 1.13 (95% CI, 1.07-1.18) for all-cause mortality. The associations between time spent viewing TV and risk of type 2 diabetes and cardiovascular disease were linear; however, the risk of all-cause mortality appeared to increase with TV viewing duration of greater than 3 hours per day. The estimated absolute risk differences per every 2 hours of TV viewing per day were 176 cases of type 2 diabetes per 100,000 individuals per year, 38 cases of fatal cardiovascular disease per 100,000 individuals per year, and 104 deaths for all-cause mortality per 100,000 individuals per year.


The authors concluded that prolonged TV viewing was associated with increased risk of type 2 diabetes, cardiovascular disease, and all-cause mortality.


Given the prevalence of TV watching among residents of industrialized countries, clinicians are recommended to advise patients regarding the risk of sedentary behaviors such as TV watching.

Clinical Topics: Diabetes and Cardiometabolic Disease

Keywords: Television, Follow-Up Studies, Morbidity, Developed Countries, Diabetes Mellitus, Type 2, Cardiovascular Diseases, Sedentary Lifestyle

< Back to Listings