This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (134)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Humanities  • Medicine and the Media  • Alert me on articles by topic  Social Bookmarking   What's this?

Frank B. Hu, MD; Michael F. Leitzmann, MD; Meir J. Stampfer, MD; Graham A. Colditz, MD; Walter C. Willett, MD; Eric B. Rimm, ScD

Arch Intern Med. 2001;161:1542-1548.

Background  Television (TV) watching, a major sedentary behavior in the United States, has been associated with obesity. We hypothesized that prolonged TV watching may increase risk for type 2 diabetes.

Methods  In 1986, 37 918 men aged 40 to 75 years and free of diabetes, cardiovascular disease, and cancer completed a detailed physical activity questionnaire. Starting from 1988, participants reported their average weekly time spent watching TV on biennial questionnaires.

Results  A total of 1058 cases of type 2 diabetes were diagnosed during 10 years (347 040 person-years) of follow-up. After adjustment for age, smoking, alcohol use, and other covariates, the relative risks (RRs) for type 2 diabetes across increasing quintiles of metabolic equivalent hours (MET-hours) per week were 1.00, 0.78, 0.65, 0.58, and 0.51 (P for trend, <.001). Time spent watching TV was significantly associated with higher risk for diabetes. After adjustment for age, smoking, physical activity levels, and other covariates, the RRs of diabetes across categories of average hours spent watching TV per week (0-1, 2-10, 11-20, 21-40, and >40) were 1.00, 1.66, 1.64, 2.16, and 2.87, respectively (P for trend, <.001). This association was somewhat attenuated after adjustment for body mass index, but a significant positive gradient persisted (RR comparing extreme categories, 2.31; P for trend, .01).

Conclusions  Increasing physical activity is associated with a significant reduction in risk for diabetes, whereas a sedentary lifestyle indicated by prolonged TV watching is directly related to risk. Our findings suggest the importance of reducing sedentary behavior in the prevention of type 2 diabetes.

From the Departments of Nutrition (Drs Hu, Leitzmann, Stampfer, Willett, and Rimm) and Epidemiology (Drs Leitzmann, Stampfer, Colditz, Willett, and Rimm), Harvard School of Public Health, and the Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital (Drs Stampfer, Colditz, Willett, and Rimm), Boston, Mass.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

DASH-Style Diet Associates with Reduced Risk for Kidney Stones
Taylor et al.
J. Am. Soc. Nephrol. 2009;20:2253-2259.
ABSTRACT | FULL TEXT  

Long-chain omega-3 fatty acids, fish intake, and the risk of type 2 diabetes mellitus
Kaushik et al.
Am. J. Clin. Nutr. 2009;90:613-620.
ABSTRACT | FULL TEXT  

Joint Effects of Common Genetic Variants on the Risk for Type 2 Diabetes in U.S. Men and Women of European Ancestry
Cornelis et al.
ANN INTERN MED 2009;150:541-550.
ABSTRACT | FULL TEXT  

TCF7L2, dietary carbohydrate, and risk of type 2 diabetes in US women
Cornelis et al.
Am. J. Clin. Nutr. 2009;89:1256-1262.
ABSTRACT | FULL TEXT  

Plasma C-Peptide Is Inversely Associated with Calcium Intake in Women and with Plasma 25-Hydroxy Vitamin D in Men
Wu et al.
J. Nutr. 2009;139:547-554.
ABSTRACT | FULL TEXT  

Physical Activity and Television Watching in Relation to Risk of Type 2 Diabetes: The Black Women's Health Study
Krishnan et al.
Am J Epidemiol 2009;169:428-434.
ABSTRACT | FULL TEXT  

Effects of Racial Discrimination and Health Behaviors on Mental and Physical Health of Middle-Class African American Men
Sellers et al.
Health Educ Behav 2009;36:31-44.
ABSTRACT  

Cost-effectiveness of interventions promoting physical activity
Muller-Riemenschneider et al.
Br. J. Sports. Med. 2009;43:70-76.
ABSTRACT | FULL TEXT  

Physical Activity and Diabetes: Opportunities for Prevention Through Policy
Deshpande et al.
ptjournal 2008;88:1425-1435.
ABSTRACT | FULL TEXT  

Determinants of 24-hour Urinary Oxalate Excretion
Taylor and Curhan
CJASN 2008;3:1453-1460.
ABSTRACT | FULL TEXT  

25-Hydroxyvitamin D and Risk of Myocardial Infarction in Men: A Prospective Study
Giovannucci et al.
Arch Intern Med 2008;168:1174-1180.
ABSTRACT | FULL TEXT  

A Review of TV Viewing and Its Association With Health Outcomes in Adults
Williams et al.
AMERICAN JOURNAL OF LIFESTYLE MEDICINE 2008;2:250-259.
ABSTRACT  

Setting the stage: possible mechanisms by which acute contraction restores insulin sensitivity in muscle
Thyfault
Am. J. Physiol. Regul. Integr. Comp. Physiol. 2008;294:R1103-R1110.
ABSTRACT | FULL TEXT  

Recommendations for Treatment of Child and Adolescent Overweight and Obesity
Spear et al.
Pediatrics 2007;120:S254-S288.
ABSTRACT | FULL TEXT  

Interaction between dietary fat intake and the cholesterol ester transfer protein TaqIB polymorphism in relation to HDL-cholesterol concentrations among US diabetic men
Li et al.
Am. J. Clin. Nutr. 2007;86:1524-1529.
ABSTRACT | FULL TEXT  

Role of Low Energy Expenditure and Sitting in Obesity, Metabolic Syndrome, Type 2 Diabetes, and Cardiovascular Disease
Hamilton et al.
Diabetes 2007;56:2655-2667.
ABSTRACT | FULL TEXT  

Physical Activity: The Role of Physical Activity and Fitness in the Prevention and Management of Type 2 Diabetes Mellitus
Zoeller
AMERICAN JOURNAL OF LIFESTYLE MEDICINE 2007;1:344-350.
ABSTRACT  

Cigarette Smoking Status and the Association between Media Use and Overweight and Obesity
Yore et al.
Am J Epidemiol 2007;166:795-802.
ABSTRACT | FULL TEXT  

Association of Television Viewing With Fasting and 2-h Postchallenge Plasma Glucose Levels in Adults Without Diagnosed Diabetes
Dunstan et al.
Diabetes Care 2007;30:516-522.
ABSTRACT | FULL TEXT  

Physical Activity of Moderate Intensity and Risk of Type 2 Diabetes: A systematic review
Jeon et al.
Diabetes Care 2007;30:744-752.
ABSTRACT | FULL TEXT  

Serum Adiponectin and Renal Dysfunction in Men With Type 2 Diabetes
Lin et al.
Diabetes Care 2007;30:239-244.
ABSTRACT | FULL TEXT  

Lifestyle Interventions Are Cost-Effective in People With Different Levels of Diabetes Risk: Results from a modeling study
Jacobs-van der Bruggen et al.
Diabetes Care 2007;30:128-134.
ABSTRACT | FULL TEXT  

Physical activity and the incidence of type 2 diabetes in the Shanghai women's health study
Villegas et al.
Int J Epidemiol 2006;35:1553-1562.
ABSTRACT | FULL TEXT  

Total energy expenditure in the Yakut (Sakha) of Siberia as measured by the doubly labeled water method.
Snodgrass et al.
Am. J. Clin. Nutr. 2006;84:798-806.
ABSTRACT | FULL TEXT  

Television Viewing and Pedometer-Determined Physical Activity Among Multiethnic Residents of Low-Income Housing
Bennett et al.
AJPH 2006;96:1681-1685.
ABSTRACT | FULL TEXT  

Variant of Transcription Factor 7-Like 2 (TCF7L2) Gene and the Risk of Type 2 Diabetes in Large Cohorts of U.S. Women and Men
Zhang et al.
Diabetes 2006;55:2645-2648.
ABSTRACT | FULL TEXT  

Common variants of the endothelial nitric oxide synthase gene and the risk of coronary heart disease among u.s. Diabetic men.
Zhang et al.
Diabetes 2006;55:2140-2147.
ABSTRACT | FULL TEXT  

Antihypertensive Medications and the Risk of Incident Type 2 Diabetes
Taylor et al.
Diabetes Care 2006;29:1065-1070.
ABSTRACT | FULL TEXT  

When Children Eat What They Watch: Impact of Television Viewing on Dietary Intake in Youth
Wiecha et al.
Arch Pediatr Adolesc Med 2006;160:436-442.
ABSTRACT | FULL TEXT  

A prospective study of pregravid physical activity and sedentary behaviors in relation to the risk for gestational diabetes mellitus.
Zhang et al.
Arch Intern Med 2006;166:543-548.
ABSTRACT | FULL TEXT  

World-wide rises in obesity: minimal hopes of control
Walker and Wadee
The Journal of the Royal Society for the Promotion of Health 2006;126:16-17.
 

Physical Activity and Life Expectancy With and Without Diabetes: Life table analysis of the Framingham Heart Study
Jonker et al.
Diabetes Care 2006;29:38-43.
ABSTRACT | FULL TEXT  

Dietary pattern, inflammation, and incidence of type 2 diabetes in women
Schulze et al.
Am. J. Clin. Nutr. 2005;82:675-684.
ABSTRACT | FULL TEXT  

Epidemiological evidence for the role of physical activity in reducing risk of type 2 diabetes and cardiovascular disease
Bassuk and Manson
J. Appl. Physiol. 2005;99:1193-1204.
ABSTRACT | FULL TEXT  

Toenail Selenium and Cardiovascular Disease in Men with Diabetes
Rajpathak et al.
J. Am. Coll. Nutr. 2005;24:250-256.
ABSTRACT | FULL TEXT  

Interactions between the -514C->T polymorphism of the hepatic lipase gene and lifestyle factors in relation to HDL concentrations among US diabetic men
Zhang et al.
Am. J. Clin. Nutr. 2005;81:1429-1435.
ABSTRACT | FULL TEXT  

Dietary Glycemic Index, Glycemic Load, Cereal Fiber, and Plasma Adiponectin Concentration in Diabetic Men
Qi et al.
Diabetes Care 2005;28:1022-1028.
ABSTRACT | FULL TEXT  

The +276 Polymorphism of the APM1 Gene, Plasma Adiponectin Concentration, and Cardiovascular Risk in Diabetic Men
Qi et al.
Diabetes 2005;54:1607-1610.
ABSTRACT | FULL TEXT  

Comparison of abdominal adiposity and overall obesity in predicting risk of type 2 diabetes among men
Wang et al.
Am. J. Clin. Nutr. 2005;81:555-563.
ABSTRACT | FULL TEXT  

Physical activity and the risk of Parkinson disease
Chen et al.
Neurology 2005;64:664-669.
ABSTRACT | FULL TEXT  

Adiponectin and Future Coronary Heart Disease Events Among Men With Type 2 Diabetes
Schulze et al.
Diabetes 2005;54:534-539.
ABSTRACT | FULL TEXT  

Obesity, Weight Gain, and the Risk of Kidney Stones
Taylor et al.
JAMA 2005;293:455-462.
ABSTRACT | FULL TEXT  

Effects of exercise and diet on chronic disease
Roberts and Barnard
J. Appl. Physiol. 2005;98:3-30.
ABSTRACT | FULL TEXT  

Physical Activity in the Prevention of Type 2 Diabetes: The Finnish Diabetes Prevention Study
Laaksonen et al.
Diabetes 2005;54:158-165.
ABSTRACT | FULL TEXT  

Physical Activity and Television Viewing in Relation to Risk of Undiagnosed Abnormal Glucose Metabolism in Adults
Dunstan et al.
Diabetes Care 2004;27:2603-2609.
ABSTRACT | FULL TEXT  

Physical Activity/Exercise and Type 2 Diabetes
Sigal et al.
Diabetes Care 2004;27:2518-2539.
FULL TEXT  

Lower Toenail Chromium in Men With Diabetes and Cardiovascular Disease Compared With Healthy Men
Rajpathak et al.
Diabetes Care 2004;27:2211-2216.
ABSTRACT | FULL TEXT  

Sugar-Sweetened Beverages, Weight Gain, and Incidence of Type 2 Diabetes in Young and Middle-Aged Women
Schulze et al.
JAMA 2004;292:927-934.
ABSTRACT | FULL TEXT  

Glycemic index, glycemic load, and dietary fiber intake and incidence of type 2 diabetes in younger and middle-aged women
Schulze et al.
Am. J. Clin. Nutr. 2004;80:348-356.
ABSTRACT | FULL TEXT  

Non-HDL Cholesterol and Apolipoprotein B Predict Cardiovascular Disease Events Among Men With Type 2 Diabetes
Jiang et al.
Diabetes Care 2004;27:1991-1997.
ABSTRACT | FULL TEXT  

Relationship Between Adiponectin and Glycemic Control, Blood Lipids, and Inflammatory Markers in Men With Type 2 Diabetes
Schulze et al.
Diabetes Care 2004;27:1680-1687.
ABSTRACT | FULL TEXT  

Exercise Preferences and Barriers in Urban African Americans With Type 2 Diabetes
Wanko et al.
The Diabetes Educator 2004;30:502-513.
 

Physical Activity, Body Mass Index, and Risk of Type 2 Diabetes in Patients With Normal or Impaired Glucose Regulation
Hu et al.
Arch Intern Med 2004;164:892-896.
ABSTRACT | FULL TEXT  

Plasma Adiponectin Levels and Risk of Myocardial Infarction in Men
Pischon et al.
JAMA 2004;291:1730-1737.
ABSTRACT | FULL TEXT  

C-Reactive Protein and Incident Cardiovascular Events Among Men With Diabetes
Schulze et al.
Diabetes Care 2004;27:889-894.
ABSTRACT | FULL TEXT  

Dietary iron intake and blood donations in relation to risk of type 2 diabetes in men: a prospective cohort study
Jiang et al.
Am. J. Clin. Nutr. 2004;79:70-75.
ABSTRACT | FULL TEXT  

Impact of Television Viewing Patterns on Fruit and Vegetable Consumption Among Adolescents
Boynton-Jarrett et al.
Pediatrics 2003;112:1321-1326.
ABSTRACT | FULL TEXT  

Sexual Function in Men Older Than 50 Years of Age: Results from the Health Professionals Follow-up Study
Bacon et al.
ANN INTERN MED 2003;139:161-168.
ABSTRACT | FULL TEXT  

Inactivity and Inaction: We Can't Afford Either
Chakravarthy and Booth
Arch Pediatr Adolesc Med 2003;157:731-732.
FULL TEXT  

Physical Activity in Relation to Cardiovascular Disease and Total Mortality Among Men With Type 2 Diabetes
Tanasescu et al.
Circulation 2003;107:2435-2439.
ABSTRACT | FULL TEXT  

Television Watching and Other Sedentary Behaviors in Relation to Risk of Obesity and Type 2 Diabetes Mellitus in Women
Hu et al.
JAMA 2003;289:1785-1791.
ABSTRACT | FULL TEXT  

Pre-diabetes: to treat or not to treat?
Ferrannini
British Journal of Diabetes & Vascular Disease 2003;3:S2-S5.
ABSTRACT  

Shaping Environments for Reductions in Type 2 Diabetes Risk Behaviors: A Look at CVD and Cancer Interventions
Miller et al.
Diabetes Spectr. 2002;15:176-182.
ABSTRACT | FULL TEXT  

An Obligation for Primary Care Physicians to Prescribe Physical Activity to Sedentary Patients to Reduce the Risk of Chronic Health Conditions
Chakravarthy et al.
Mayo Clin Proc. 2002;77:165-173.
ABSTRACT