Television- and Screen-Based Activity and Mental Well-Being in Adults

doi:10.1016/j.amepre.2009.12.030

American Journal of Preventive Medicine

Volume 38, Issue 4, April 2010, Pages 375-380

https://doi.org/10.1016/j.amepre.2009.12.030 Get rights and content

Background

Sedentary behavior is emerging as an independent risk factor for physical health, although there is no existing evidence regarding mental well-being.

Purpose

This study aimed to examine the association between recreational sedentary behavior (based on TV- and screen-based entertainment [TVSE] time) and mental health in a representative sample of adults.

Methods

Participants were 3920 men and women (mean age 51.0±15.8 years) from the 2003 Scottish Health Survey. The General Health Questionnaire (GHQ-12) and the mental health component of the 12-Item Short-Form Survey Instrument (MCS-12) were administered to obtain information on current mental health. Self-reported TVSE time, physical activity, and physical function was also measured. Analyses were conducted in 2009.

Results

Approximately 25% of participants engaged in at least 4 hours/day of TVSE. In general linear models, TVSE time per week was independently associated with GHQ-12 score (higher scores represent worse mental health status) after adjustment for age, gender, physical activity, physical function, area deprivation level, smoking, alcohol, fruit and vegetable intake, and BMI. After full adjustment, participants in the group with the highest TVSE level (>4 hours/day) had an increase in GHQ-12 score of 0.28 (95% CI=0.05, 0.51) compared with participants in the group with the lowest TVSE level (≤2 hours/day). In stratified analyses, the association between TVSE time and GHQ-12 score persisted across all physical activity levels. Similar associations were observed using the MCS-12.

Conclusions

Sedentary behavior in leisure time is independently associated with poorer mental health scores in a representative population sample.

Introduction

There is extensive evidence linking physical activity with better mental health,1, 2, 3, 4, 5, 6 and individuals with psychiatric illness are less likely to be physically active.⁷ Mental health, however, has gained little attention in relation to sedentary behavior. The current guidelines for physical activity and health⁸ do not explicitly provide recommendations on sedentary behavior, although emerging evidence9, 10, 11, 12, 13 has suggested that it is an independent risk factor for physical health. For example, in a representative sample of the Canadian population,⁹ there was a dose–response relationship between sitting time and all-cause mortality, and numerous studies10, 11, 12, 13 have demonstrated associations between sedentary behavior and metabolic risk factors. All of these associations persist after adjustments for physical activity, thus suggesting that sedentary behavior and physical activity are separate constructs and not functional opposites. Metabolic risk factors often coexist with poor mental health,14, 15 and it is therefore possible that sedentary behavior is also a risk factor for psychological morbidity. We previously demonstrated¹⁶ an independent association between sedentary behavior during leisure time (indexed from TV- and screen-based entertainment [TVSE] time) and psychological health in young children; thus, the aim of the present study was to examine this association among adults. Because sedentary behavior may partly reflect physical dysfunction, which also correlates highly with mental health,¹⁷ physical function was considered as a potential confounder in all of the current analyses.

Section snippets

Study Design and Participants

The Scottish Health Survey (SHS)¹⁸ is a periodic survey (conducted typically every 3–5 years) that draws a nationally representative sample of the general population living in households. The sample was drawn using multistage stratified probability sampling with postcode sectors selected at the first stage and household addresses selected at the second stage. Stratification was based on geographic areas and not on individual characteristics of the population. The present analyses included data

Results

TV- and screen-based entertainment time was normally distributed, and approximately 25% of the sample reported more than 4 hours of TVSE per day. The overall health profile of the sample was poor: 66% were classified as overweight or obese based on BMI measures, 75.6% did not adhere to five or more daily servings of fruit and vegetables, and 23.6% were current smokers. Participants reporting high TVSE levels were older, had higher levels of deprivation, poorer physical function, lower physical

Discussion

We found an independent association between leisure-time sedentary behavior (indexed by TVSE time) and lower scores on two measures of mental health. Importantly, this finding was independent of potential confounders such as physical activity level and physical function. We are unaware of any previous work that has examined the association between sedentary behavior in leisure time and mental health in adults. A recent study²³ found a longitudinal association between TV viewing and development

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Empirical evidence points to sedentary behavior as a ubiquitous health-related risk factor. Given the increasing number of mental disorders, a growing body of studies now focuses on the relationship between sedentary behavior and mental health. However, momentary interactions between sedentary bouts, mood, and type of cognitive load in daily life are highly understudied.
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Research articleTelevision- and Screen-Based Activity and Mental Well-Being in Adults

Background

Purpose

Methods

Results

Conclusions

Introduction

Section snippets

Study Design and Participants

Results

Discussion

Am J Prev Med

Psychoneuroendocrinology

J Clin Epidemiol

Brain Behav Immun

Prev Med

Physical activity reduces the risk of subsequent depression for older adults

Am J Epidemiol

Physical activity and depressive symptoms: the NHANES I Epidemiologic Follow-up Study

Am J Epidemiol

Physical activity and depression: evidence from the Alameda County Study

Am J Epidemiol

Physical activity and personal characteristics associated with depression and suicide in American college men

Acta Psychiatr Scand Suppl

Psychiatric hospital admissions, behavioral risk factors, and all-cause mortality: the Scottish health survey

Arch Intern Med

Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association

Circulation

Sitting time and mortality from all causes, cardiovascular disease, and cancer

Med Sci Sports Exerc

Role of low energy expenditure and sitting in obesity, metabolic syndrome, type 2 diabetes, and cardiovascular disease

Diabetes

Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women

JAMA

Objectively measured sedentary time, physical activity, and metabolic risk: the Australian Diabetes, Obesity and Lifestyle Study (AusDiab)

Diabetes Care

Research article
Television- and Screen-Based Activity and Mental Well-Being in Adults