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Emmanuel Stamatakis, 1 Mark Hamer, 1 Gita Mishra 1 1 University College London

Adulthood TV Viewing Relates Independently to Cardiometabolic Risk Profile in Early Middle Age. The 1958 British birth cohort (1981 & 2003 waves). 03/03/2010. AHA

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Emmanuel Stamatakis, 1 Mark Hamer, 1 Gita Mishra 1 1 University College London

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  1. Adulthood TV Viewing Relates Independently to Cardiometabolic Risk Profile in Early Middle Age.The 1958 British birth cohort (1981 & 2003 waves) 03/03/2010. AHA 50th Joint Cardiovascular Disease Epidemiology and Prevention - & - Nutrition, Physical Activity and Metabolism Conference, San Francisco, CA Emmanuel Stamatakis,1 Mark Hamer,1Gita Mishra1 1University College London Department of Epidemiology & Public Health, London, UK

  2. ?

  3. ?

  4. Sedentary behaviour as an “independent” risk marker:

  5. Sedentary behaviour as an “independent” risk marker: Even if you do “enough” of this...

  6. Sedentary behaviour as an “independent” risk marker: ...you may still be at risk if you do “too much” of this Even if you do “enough” of this...

  7. Study aims • To investigate the relationship between TV viewing in early adulthood and cardiometabolic risk profile in early middle age • Is this relationship independent of physical activity participation?

  8. Data source: the 1958 British birth cohort

  9. Data source: the 1958 British birth cohort

  10. Study Design: 1981 (age 23yrs)

  11. Study Design: 1981 (age 23yrs) Exposure Weekly TV Frequency

  12. 2002 (age 44yrs) Study Design: 1981 (age 23yrs) Exposure Weekly TV Frequency

  13. 2002 [N=9,377] Study Design: Outcomes • Cardiometabolic risk markers: • Triglycerides • Total cholesterol • HDL cholesterol • LDL cholesterol • D-dimer • Fibrinogen • vonWillebrand antigen factor • C-reactive protein • BMI • Waist circumference • Systolic blood pressure • Diastolic blood pressure • Glycated haemoglobin (HbA1c) • Insulin Growth Factor 1 • Resting Heart Rate 1981 Exposure Weekly TV Frequency

  14. 2002 [N=9,377] Study Design: Outcomes • Cardiometabolic risk markers: • Triglycerides • Total cholesterol • HDL cholesterol • LDL cholesterol • D-dimer • Fibrinogen • vonWillebrand antigen factor • C-reactive protein • BMI • Waist circumference • Systolic blood pressure • Diastolic blood pressure • Glycated haemoglobin (HbA1c) • Insulin Growth Factor 1 • Resting Heart Rate 1981 Exposure Weekly TV Frequency ?

  15. 2002 [N=9,377] Study Design: Outcomes • Cardiometabolic risk markers: • Triglycerides • Total cholesterol • HDL cholesterol • LDL cholesterol • D-dimer • Fibrinogen • vonWillebrand antigen factor • C-reactive protein • BMI • Waist circumference • Systolic blood pressure • Diastolic blood pressure • Glycated haemoglobin (HbA1c) • Insulin Growth Factor 1 • Resting Heart Rate 1981 Exposure Weekly TV Frequency Covariable • Weekly exercise frequency • Social class Covariables • Daily TV time • Daily physical activity time (EPAQ2) • CVD medication • Smoking * • Alcohol intake • Social class*

  16. 2002 [N=9,377] Study Design: Outcomes • Cardiometabolic risk markers: • Triglycerides • Total cholesterol • HDL cholesterol • LDL cholesterol • D-dimer • Fibrinogen • vonWillebrand antigen factor • C-reactive protein • BMI • Waist circumference • Systolic blood pressure • Diastolic blood pressure • Glycated haemoglobin (HbA1c) • Insulin Growth Factor 1 • Resting Heart Rate 1981 Exposure Weekly TV Frequency Covariables • Weekly exercise frequency • Social class N=5,629 Covariables • Daily TV time • Daily physical activity time (EPAQ2) • CVD medication • Smoking * • Alcohol intake • Social class*

  17. 2002 [N=9,377] Study Design: Outcomes • FACTOR ANALYSIS: • COMPONENT 1 • Triglycerides • HDL cholesterol • BMI • Waist circumference • Systolic BP • Diastolic BP • COMPONENT 2 • vonWillebrand antigen factor • Fibrinogen • D-dimer • C-reactive protein • COMPONENT 3 • Total cholesterol • LDL cholesterol • --------------EXCLUDED-------------------- • -Glycated haemoglobin (HbA1c) • -Insulin Growth Factor 1 • -Resting Heart Rate 1981 Exposure Weekly TV Frequency Covariables • Weekly exercise frequency • Social class N=5,629 Covariables • Daily TV time • Daily physical activity time (EPAQ2) • CVD medication • Smoking * • Alcohol intake • Social class*

  18. FACTOR ANALYSIS* COMPONENTS: • C1 (27% V.E.) • Triglycerides • HDL cholesterol • BMI • Waist circumference • Systolic BP • Diastolic BP • C2 (16% V.E.) • vonWillebrand antigen factor • Fibrinogen • D-dimer • C-reactive protein • C3 (13% V.E.) • Total cholesterol • LDL cholesterol *Principal Component Analysis; factor loading criterion: ≥ 0.35

  19. FACTOR ANALYSIS* COMPONENTS: • C1 (27% V.E.) • Triglycerides • HDL cholesterol • BMI • Waist circumference • Systolic BP • Diastolic BP • C2 (16% V.E.) • vonWillebrand antigen factor • Fibrinogen • D-dimer • C-reactive protein • C3 (13% V.E.) • Total cholesterol • LDL cholesterol Metabolic *Principal Component Analysis; factor loading criterion: ≥ 0.35

  20. FACTOR ANALYSIS* COMPONENTS: • C1 (27% V.E.) • Triglycerides • HDL cholesterol • BMI • Waist circumference • Systolic BP • Diastolic BP • C2 (16% V.E.) • vonWillebrand antigen factor • Fibrinogen • D-dimer • C-reactive protein • C3 (13% V.E.) • Total cholesterol • LDL cholesterol Metabolic Haemostatic/inflammatory *Principal Component Analysis; factor loading criterion: ≥ 0.35

  21. FACTOR ANALYSIS* COMPONENTS: • C1 (27% V.E.) • Triglycerides • HDL cholesterol • BMI • Waist circumference • Systolic BP • Diastolic BP • C2 (16% V.E.) • vonWillebrand antigen factor • Fibrinogen • D-dimer • C-reactive protein • C3 (13% V.E.) • Total cholesterol • LDL cholesterol Metabolic Haemostatic/inflammatory Cholesterol component *Principal Component Analysis; factor loading criterion: ≥ 0.35

  22. FACTOR ANALYSIS COMPONENTS: • C1 (27% V.E.) • Triglycerides • HDL cholesterol • BMI • Waist circumference • Systolic BP • Diastolic BP • C2 (16% V.E.) • vonWillebrand antigen factor • Fibrinogen • D-dimer • C-reactive protein • C3 (13% V.E.) • Total cholesterol • LDL cholesterol Metabolic Haemostatic/inflammatory Cholesterol component Not fitting in any component EXCLUDED: -Glycated haemoglobin -Insulin Growth Factor 1 -Resting Heart Rate

  23. Results: TV at 23yrs  Risk factor components at 44yrs

  24. Results: TV at 23yrs  Risk factor components at 44yrs

  25. Results: TV at 23yrs  Risk factor components at 44yrs

  26. Results: TV at 23yrs  Risk factor components at 44yrs

  27. Results: TV at 23yrs  Risk factor components at 44yrs

  28. Results: TV at 23yrs  Risk factor components at 44yrs

  29. Results: TV at 23yrs  Risk factor components at 44yrs Adjusted for: sex

  30. Results: TV at 23yrs  Risk factor components at 44yrs Adjusted for: sex, smoking, social class, alcohol, CVD medication

  31. Results: TV at 23yrs  Risk factor components at 44yrs Adjusted for: sex, smoking, social class, alcohol, CVD medication,physical activity (age 23 & 44)

  32. Results: TV at 23yrs  Risk factor components at 44yrs Adjusted for: sex, smoking, social class, alcohol, CVD medication,physical activity (age 23 & 44), daily TV time (age 44 )

  33. Results: TV at 23yrs  Risk factor components at 44yrs *Adjusted for: sex, smoking, social class, alcohol, CVD medication,physical activity (age 23 & 44), daily TV time (age 44 )

  34. Results: TV at 23yrs  Risk factor components at 44yrs *Adjusted for: sex, smoking, social class, alcohol, CVD medication,physical activity (age 23 & 44), daily TV time (age 44 )

  35. Results: TV at 23yrs  Risk factor components at 44yrs *Adjusted for: sex, smoking, social class, alcohol, CVD medication,physical activity (age 23 & 44), daily TV time (age 44 )

  36. Results: TV at 23yrs  Risk factor components at 44yrs *Adjusted for: sex, smoking, social class, alcohol, CVD medication,physical activity (age 23 & 44), daily TV time (age 44 )

  37. Results: TV at 23yrs  Risk factor components at 44yrs *Adjusted for: sex, smoking, social class, alcohol, CVD medication,physical activity (age 23 & 44), daily TV time (age 44 )

  38. Results: TV at 23yrs  Risk factor components at 44yrs N.S. *Adjusted for: sex, smoking, social class, alcohol, CVD medication,physical activity (age 23 & 44), daily TV time (age 44 )

  39. Sensitivity analysis: active1participants (N=1228) 1≥1/wk sport at age 23 AND meeting the moderate to vigorous physical activity guidelines at age 44 yrs

  40. Sensitivity analysis: Non-overweight at baseline (23yrs)(N=4783)

  41. Sensitivity analysis: Overweight at baseline (23yrs)(N=772)

  42. Study limitations • Crude TV measurement at baseline: what does it capture exactly? • Frequency only? • Increased tendency to be sedentary in general? • Larger volumes of TV viewing? • Dietary confounding? (see e.g. ClelandVJ, et al. Am J ClinNutr2008; 87,:1148-55] • TV is only a partial (i.e. incomplete) indicator of sedentary behaviour • Self-reported physical activity measures

  43. Does TV frequency at 23yrs predict TV time at 44yrs?

  44. Conclusions • TV habits in early adulthood may predict an adverse cardiometabolic risk profile in early middle age independently of physical activity • Sedentary behaviour affects CV health through metabolic & haemostatic pathways?

  45. The extent to which certain biological risk factors explain the association between TV & other screen-based entertainment time and CVD fatal/nonfatal events. Prospective study (4.5yrs follow up), N=1928 Scottish adults >35yrs [Stamatakis E, Hamer M, Dunstan DW. Under revision]

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