Observational studies of the relationship between TV viewing and health outcomes (overweight/obesity, cholesterol/lipids, blood pressure/hypertension, type 2 diabetes, and metabolic syndrome) in adults are reviewed. Studies indicate that in adults, greater amounts of TV viewing are consistently associated with increased overweight risk, both cross-sectionally and longitudinally, but that results are mixed regarding the relationship between adult TV viewing and other health outcomes. It is theorized that greater TV viewing is related to increased weight status and poorer health outcomes by reducing energy expenditure, predominantly through reducing time spent in physical activity, and increasing energy intake. No randomized trials that manipulated TV viewing time measured the effects of this manipulation on diet and physical activity and then measured future health outcomes in adults. However, experimental studies, predominantly conducted in children, show relationships between TV viewing, energy intake, physical activity, and weight status, which follow the hypothesized mechanisms. Interventions targeting TV viewing in adults appear to be justified, and proposed methods for conducting these interventions, as well as potential barriers to implementing these interventions, are discussed.
Nielsen Media Research.Nielsen Media Research Reports Television's Popularity Is Still Growing. Available at: http://www.nielsenmedia.com/nc/portal/site/Public/menuitem.55dc65b4a7d5adff3f65936147a062a0/?vgnextoid=4156527aacccd010VgnVCM100000ac0a260aRCRD . Accessed February 7, 2008.
2.
US Department of Health and Human Services.The Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity. Rockville, MD: US Department of Health and Human Services, Public Health Service, Office of the Surgeon General; 2001.
3.
Robinson TNTelevision viewing and childhood obesity. Pediatr Clin North Am. 2001;48:1017-1025.
4.
DeMattia L., Lemont L., Meurer L.Do interventions to limit sedentary behaviours change behaviour and reduce childhood obesity? A critical review of the literature. Obes Rev. 2007;8:69-81.
5.
Foster JA, Gore SA, West DSAltering TV viewing habits: an unexplored strategy for adult obesity intervention ? Am J Health Behav. 2006;30:3-14.
6.
Tucker LA, Bagwell M.Relationship between serum cholesterol levels and television viewing in 11,947 employed adults. Am J Health Promot. 1992;6:437-442.
7.
Tucker LA, Bagwell M.Television viewing and obesity in adult females. Am J Public Health. 1991;81:908-911.
8.
Tucker LA, Friedman GMTelevision viewing and obesity in adult males. Am J Public Health. 1989;79:516-518.
9.
Tucker LATelevision viewing and physical fitness in adults. Res Q Exerc Sport. 1990;61:315-320.
10.
Cameron AJ, Welborn TA, Zimmet PZ, et al. Overweight and obesity in Australia: the 1999-2000 Australian Diabetes, Obesity and Lifestyle Study (AusDiab). Med J Aust . 2003;178:427-432.
11.
Salmon J., Bauman A., Crawford D., Timperio A., Owen N.The association between television viewing and overweight among Australian adults participating in varying levels of leisure-time physical activity. Int J Obes Relat Metab Disord. 2000;24:600-606.
12.
Dunstan DW, Salmon J., Owen N., et al. Associations of TV viewing and physical activity with the metabolic syndrome inAustralian adults. Diabetologia. 2005;48:2254-2261.
13.
Dunstan DW, Salmon J., Owen N., et al. Physical activity and television viewing in relation to risk of undiagnosed abnormal glucose metabolism in adults. Diabetes Care. 2004;27:2603-2609.
14.
Parsons TJ, Power C., Manor O.Physical activity, television viewing and body mass index: a cross-sectional analysis from childhood to adulthood in the1958British cohort. Int J Obes (Lond). 2005;29:1212-1221.
15.
Jakes RW, Day NE, Khaw KT, et al. Television viewing and low participation in vigorous recreation are independently associated with obesity and markers of cardiovascular disease risk: EPIC-Norfolk population-based study. Eur J Clin Nutr . 2003;57:1089-1096.
16.
Bertrais S., Beyeme-Ondoua JP, Czernichow S., Galan P., Hercberg S., Oppert JMSedentary behaviors, physical activity, and metabolic syndrome in middle-aged French subjects. Obes Res. 2005;13:936-944.
17.
Viner RM, Cole TJTelevision viewing in early childhood predicts adult body mass index. J Pediatr. 2005;147:429-435.
18.
Vioque J., Torres A., Quiles J.Time spent watching television, sleep duration and obesity in adults living in Valencia, Spain. Int J Obes Relat Metab Disord. 2000;24:1683-1688.
19.
Jacoby E., Goldstein J., Lopez A., Nunez E., Lopez T.Social class, family, and life-style factors associated with overweight and obesity among adults in Peruvian cities. Prev Med. 2003;37:396-405.
20.
Hancox RJ, Milne BJ, Poulton R.Association between child and adolescent television viewing and adult health: a longitudinal birth cohort study. Lancet. 2004;364:257-262.
21.
Kantachuvessiri A., Sirivichayakul C., KaewKungwal J., Tungtrongchitr R., Lotrakul M.Factors associated with obesity among workers in a metropolitan waterworks authority. Southeast Asian J Trop Med Public Health. 2005;36:1057-1065.
22.
Ford ES, Kohl HW III, Mokdad AH, Ajani UASedentary behavior, physical activity, and the metabolic syndrome among U.S. adults. Obes Res. 2005;13:608-614.
23.
Bowman SATelevision-viewing characteristics of adults: correlations to eating practices and overweight and health status. Prev Chronic Dis.2006;3:A38.
24.
Ching PL, Willett WC, Rimm EB, Colditz GA, Gortmaker SL, Stampfer MJActivity level and risk of overweight in male health professionals. Am J Public Health. 1996;86:25-30.
25.
Koh-Banerjee P., Chu NF, Spiegelman D., et al. Prospective study of the association of changes in dietary intake, physical activity, alcohol consumption, and smoking with 9-y gain in waist circumference among 16 587 US men. Am J Clin Nutr. 2003;78:719-727.
26.
Coakley EH, Rimm EB, Colditz G., Kawachi I., Willett W.Predictors of weight change in men: results from the Health Professionals Follow-up Study. Int J Obes Relat Metab Disord. 1998;22:89-96.
27.
Fung TT, Hu FB, Yu J., et al. Leisure-time physical activity, television watching, and plasma biomarkers of obesity and cardiovascular disease risk. Am J Epidemiol. 2000;152:1171-1178.
28.
Hu FB, Leitzmann MF, Stampfer MJ, Colditz GA, Willett WC, Rimm EBPhysical activity and television watching in relation to risk for type 2 diabetes mellitus in men. Arch Intern Med. 2001;161:1542-1548.
29.
Holmes MD, Stampfer MJ, Wolf AM, et al. Can behavioral risk factors explain the difference in body mass index between African-American and European-American women? Ethn Dis. 1998;8:331-339.
30.
Hu FB, Li TY, Colditz GA, Willett WC, Manson JETelevision watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women. JAMA. 2003;289:1785-1791.
31.
Zhang C., Solomon CG, Manson JE, Hu FBA prospective study of pregravid physical activity and sedentary behaviors in relation to the risk for gestational diabetes mellitus. Arch Intern Med. 2006;166:543-548.
32.
Fitzgerald SJ, Kriska AM, Pereira MA, de Courten MPAssociations among physical activity, television watching, and obesity in adult Pima Indians. Med Sci Sports Exerc. 1997;29:910-915.
33.
Crawford DA , Jeffery RW, French SATelevision viewing, physical inactivity and obesity. Int J Obes Relat Metab Disord. 1999 ;23:437-440.
34.
Bennett GG, Wolin KY, Viswanath K., Askew S., Puleo E., Emmons KMTelevision viewing and pedometer-determined physical activity among multiethnic residents of low-income housing. Am J Public Health. 2006;96:1681-1685.
35.
Johnson KM, Nelson KM, Bradley KATelevision viewing practices and obesity among women veterans. J Gen Intern Med. 2006;21(suppl 3):S76-S81.
36.
Gustat J., Srinivasan SR, Elkasabany A., Berenson GSRelation of self-rated measures of physical activity to multiple risk factors of insulin resistance syndrome in young adults: the Bogalusa Heart Study. J Clin Epidemiol. 2002;55:997-1006.
37.
Liebman M., Pelican S., Moore SA, et al. Dietary intake, eating behavior, and physical activity-related determinants of high body mass index in rural communities in Wyoming, Montana, and Idaho. Int J Obes Relat Metab Disord. 2003;27:684-692.
38.
Sidney S., Sternfeld B., Haskell WL, Jacobs DR Jr, Chesney MA, Hulley SBTelevision viewing and cardiovascular risk factors in young adults: the CARDIA study. Ann Epidemiol. 1996;6:154-159.
39.
Kronenberg F., Pereira MA, Schmitz MK, et al. Influence of leisure time physical activity and television watching on atherosclerosis risk factors in the NHLBI Family Heart Study. Atherosclerosis. 2000;153:433-443.
40.
Jeffery RW, French SAEpidemic obesity in the United States: are fast foods and television viewing contributing? Am J Public Health. 1998;88:277-280.
41.
Gortmaker SL, Dietz WH Jr, Cheung LWInactivity, diet, and the fattening of America. J Am Diet Assoc. 1990;90: 1247-1252, 1255.
42.
Wood PD, Stefanick ML, Dreon DM, et al. Changes in plasma lipids and lipoproteins in overweight men during weight loss through dieting as compared with exercise. N Engl J Med. 1988;319:1173-1179.
43.
Mertens IL, Van Gaal LFOverweight, obesity, and blood pressure: the effects of modest weight reduction . Obes Res. 2000;8:270-278.
44.
Sullivan PW , Morrato EH, Ghushchyan V., Wyatt HR, Hill JOObesity, inactivity, and the prevalence of diabetes and diabetes-related cardiovascular comorbidities in the U.S., 2000-2002. Diabetes Care. 2005;28:1599-1603.
45.
Baron RM, Kenny DAThe moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986;51:1173-1182.
46.
Kraemer HC, Wilson GT, Fairburn CG, Agras WSMediators and moderators of treatment effects in randomized clinical trials . Arch Gen Psychiatry. 2002;59:877-883.
47.
Yancey AK, Wold CM, McCarthy WJ, et al. Physical inactivity and overweight among Los Angeles County adults. Am J Prev Med. 2004;27:146-152.
48.
Buckworth J. , Nigg C.Physical activity, exercise, and sedentary behavior in college students. J Am Coll Health. 2004;53:28-34.
49.
Buchowski MS , Sun M.Energy expenditure, television viewing and obesity. Int J Obes Relat Metab Disord. 1996 ;20:236-244.
50.
Ainsworth BE , Haskell WL, Whitt MC, et al. Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc.2000;32(suppl): S498-S504.
51.
Cooper TV, Klesges LM, DeBon M., Klesges RC, Shelton MLAn assessment of obese and non obese girls' metabolic rate during television viewing, reading, and resting. Eat Behav. 2006;7:105-114.
52.
Epstein LH, Valoski AM, Vara LS, et al. Effects of decreasing sedentary behavior and increasing activity on weight change in obese children. Health Psychol. 1995;14:109-115.
Ford BS, McDonald TE, Owens AS, Robinson TNPrimary care interventions to reduce television viewing in African-American children. Am J Prev Med. 2002;22:106-109.
55.
Robinson TNReducing children's television viewing to prevent obesity: a randomized controlled trial. JAMA. 1999;282:1561-1567.
56.
Epstein LH, Roemmich JN, Paluch RA, Raynor HAInfluence of changes in sedentary behavior on energy and macro-nutrient intake in youth. Am J Clin Nutr. 2005;81:361-366.
57.
Epstein LH, Roemmich JN, Paluch RA, Raynor HAPhysical activity as a substitute for sedentary behavior in youth. Ann Behav Med. 2005;29:200-209.
58.
Bellisle F. , Dalix AM, Slama G.Non food-related environmental stimuli induce increased meal intake in healthy women: comparison of television viewing versus listening to a recorded story in laboratory settings. Appetite . 2004;43:175-180.
59.
Hetherington MM, Anderson AS, Norton GN, Newson L.Situational effects on meal intake: a comparison of eating alone and eating with others. Physiol Behav. 2006;88:498-505.
60.
Blass EM, Anderson DR, Kirkorian HL, Pempek TA, Price I., Koleini MFOn the road to obesity: television viewing increases intake of high-density foods. Physiol Behav. 2006;88:597-604.
61.
Francis LA, Birch LLDoes eating during television viewing affect preschool children's intake? J Am Diet Assoc. 2006;106:598-600.
62.
Byrd-Bredbenner C., Grasso D.Prime-time health: an analysis of health content in television commercials broadcast during programs viewed heavily by children . Int J Health Educ. 1999;2:159-169.
63.
Harrison K. , Marske ALNutritional content of foods advertised during the television programs children watch most. Am J Public Health . 2005;95:1568-1574.
64.
Lank NH, Vickery CE, Cotugna N., Shade DDFood commercials during television soap operas: what is the nutrition message ? J Community Health. 1992;17:377-384.
65.
Borzekowski DL, Robinson TNThe 30-second effect: an experiment revealing the impact of television commercials on food preferences of preschoolers. J Am Diet Assoc. 2001;101:42-46.
66.
Taras HL, Sallis JF, Patterson TL, Nader PR, Nelson JATelevision's influence on children's diet and physical activity. J Dev Behav Pediatr. 1989;10(4):176-180.
67.
Falcigia GA , Gussow J.Television commercials and eating behavior of obese and normal-weight women. J Nutritional Educ. 1980;12:196-199.
68.
Gore SA, Foster JA, DiLillo VG, Kirk K., Smith West D.Television viewing and snacking. Eat Behav. 2003;4:399-405.
69.
Epstein LH, Paluch RA, Kilanowski CK, Raynor HAThe effect of reinforcement or stimulus control to reduce sedentary behavior in the treatment of pediatric obesity. Health Psychol. 2004;23:371-380.
70.
Epstein LH, Paluch RA, Raynor HASex differences in obese children and siblings in family-based obesity treatment . Obes Res. 2001;9:746-753.
71.
Gorin AA, Raynor H., Chula-Maguire K., Wing RRDecreasing household television time: a pilot study of a combined behavioral and environmental intervention. Behav Intervent. 2006;21:273-280.
72.
Epstein LH, Saelens BE, Myers MD, Vito D.Effects of decreasing sedentary behaviors on activity choice in obese children . Health Psychol. 1997;16(2):107-113.
73.
Faith MS, Berman N., Heo M., et al. Effects of contingent television on physical activity and television viewing in obese children. Pediatrics. 2001 ;107:1043-1048.
74.
Goldfield GS , Legg C.Dietary restraint, anxiety, and the relative reinforcing value of snack food in non-obese women. Eat Behav . 2006;7:323-332.
75.
Roemmich JN , Gurgol CM, Epstein LHOpen-loop feedback increases physical activity of youth. Med Sci Sports Exerc. 2004;36:668-673.
76.
Caspersen CJ , Pereira MA, Curran KMChanges in physical activity patterns in the United States, by sex and cross-sectional age. Med Sci Sports Exerc. 2000;32:1601-1609.
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