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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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slide1

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

sedentary behaviour as an independent risk marker1
Sedentary behaviour as an “independent” risk marker:

Even if you do “enough” of this...

sedentary behaviour as an independent risk marker2
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...

study aims
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?
study design
Study Design:

1981

(age 23yrs)

study design1
Study Design:

1981

(age 23yrs)

Exposure

Weekly TV Frequency

study design2

2002

(age 44yrs)

Study Design:

1981

(age 23yrs)

Exposure

Weekly TV Frequency

study design3

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

study design4

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

?

study design5

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*
study design6

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*
study design7

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*
factor analysis components
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

factor analysis components1
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

factor analysis components2
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

factor analysis components3
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

factor analysis components4
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

slide35

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

Adjusted for: sex, smoking, social class, alcohol, CVD medication

slide36

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

Adjusted for: sex, smoking, social class, alcohol, CVD medication,physical activity (age 23 & 44)

slide37

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 )

slide38

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 )

slide39

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 )

slide40

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 )

slide41

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 )

slide42

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 )

slide43

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 )

sensitivity analysis active 1 participants n 1228
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

study limitations
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
conclusions
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?
slide50

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]

acknowledgments funding
Acknowledgments & Funding
  • This analysis was funded by a National Institute for Health Research (UK) personal Fellowship.
  • The 1958 British Birth Cohort was funded by:
    • Wellcome Trust
    • Department of Health and Social Security
    • Department of Education and Science
    • Department of Employment
    • Manpower Services Commission
    • Department of the Environment
    • Medical Research Council
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