title: Television screen time, but not computer use and reading time, is associated with cardio-metabolic biomarkers in a multiethnic Asian population: a cross-sectional study.
abstract: BACKGROUND
  Recent evidence shows that sedentary behaviour may be an independent risk factor for cardiovascular diseases, diabetes, cancers and all-cause mortality. However, results are not consistent and different types of sedentary behaviour might have different effects on health. Thus the aim of this study was to evaluate the association between television screen time, computer/reading time and cardio-metabolic biomarkers in a multiethnic urban Asian population. We also sought to understand the potential mediators of this association.
  
  
  METHODS
  The Singapore Prospective Study Program (2004-2007), was a cross-sectional population-based study in a multiethnic population in Singapore. We studied 3305 Singaporean adults of Chinese, Malay and Indian ethnicity who did not have pre-existing diseases and conditions that could affect their physical activity. Multiple linear regression analysis was used to assess the association of television screen time and computer/reading time with cardio-metabolic biomarkers [blood pressure, lipids, glucose, adiponectin, C reactive protein and homeostasis model assessment of insulin resistance (HOMA-IR)]. Path analysis was used to examine the role of mediators of the observed association.
  
  
  RESULTS
  Longer television screen time was significantly associated with higher systolic blood pressure, total cholesterol, triglycerides, C reactive protein, HOMA-IR, and lower adiponectin after adjustment for potential socio-demographic and lifestyle confounders. Dietary factors and body mass index, but not physical activity, were potential mediators that explained most of these associations between television screen time and cardio-metabolic biomarkers. The associations of television screen time with triglycerides and HOMA-IR were only partly explained by dietary factors and body mass index. No association was observed between computer/ reading time and worse levels of cardio-metabolic biomarkers.
  
  
  CONCLUSIONS
  In this urban Asian population, television screen time was associated with worse levels of various cardio-metabolic risk factors. This may reflect detrimental effects of television screen time on dietary habits rather than replacement of physical activity.
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Republic of Singapore.
authors.forename: Ei Ei Khaing
authors.initials: EE
authors.lastname: Nang
authors.forename: Agus
authors.initials: A
authors.lastname: Salim
authors.forename: Yi
authors.initials: Y
authors.lastname: Wu
authors.forename: E Shyong
authors.initials: ES
authors.lastname: Tai
authors.forename: Jeannette
authors.initials: J
authors.lastname: Lee
authors.forename: Rob M
authors.initials: RM
authors.lastname: Van Dam
mesh_terms: D052242:Adiponectin / Q000097:blood; D000328:Adult; D044466:Asian People; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood / Q000208:ethnology / Q000209:etiology*; D002681:China; D002784:Cholesterol / Q000097:blood; D003201:Computers; D003430:Cross-Sectional Studies; D004032:Diet; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006801:Humans; D007194:India; D007333:Insulin Resistance; D016014:Linear Models; D008296:Malaysia; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011932:Reading; D057185:Sedentary Behavior / Q000208:ethnology*; D012846:Singapore; D013690:Television; D014280:Triglycerides / Q000097:blood
chemical_list: D052242:Adiponectin; D015415:Biomarkers; D001786:Blood Glucose; D014280:Triglycerides; D002097:C-Reactive Protein; D002784:Cholesterol