RT Journal Article
SR Electronic
T1 The association between ownership of common household devices and obesity and diabetes in high, middle and low income countries
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP 258
OP 266
DO 10.1503/cmaj.131090
VO 186
IS 4
A1 Scott A. Lear
A1 Koon Teo
A1 Danijela Gasevic
A1 Xiaohe Zhang
A1 Paul P. Poirier
A1 Sumathy Rangarajan
A1 Pamela Seron
A1 Roya Kelishadi
A1 Azmi Mohd Tamil
A1 Annamarie Kruger
A1 Romaina Iqbal
A1 Hani Swidan
A1 Diego Gómez-Arbeláez
A1 Rita Yusuf
A1 Jephat Chifamba
A1 V. Raman Kutty
A1 Kubilay Karsidag
A1 Rajesh Kumar
A1 Wei Li
A1 Andrzej Szuba
A1 Alvaro Avezum
A1 Rafael Diaz
A1 Sonia S. Anand
A1 Annika Rosengren
A1 Salim Yusuf
A1 ,
YR 2014
UL http://www.cmaj.ca/content/186/4/258.abstract
AB Background: Household devices (e.g., television, car, computer) are common in high income countries, and their use has been linked to obesity and type 2 diabetes mellitus. We hypothesized that device ownership is associated with obesity and diabetes and that these effects are explained through reduced physical activity, increased sitting time and increased energy intake.Methods: We performed a cross-sectional analysis using data from the Prospective Urban Rural Epidemiology study involving 153 996 adults from high, upper-middle, lower-middle and low income countries. We used multilevel regression models to account for clustering at the community and country levels.Results: Ownership of a household device increased from low to high income countries (4% to 83% for all 3 devices) and was associated with decreased physical activity and increased sitting, dietary energy intake, body mass index and waist circumference. There was an increased odds of obesity and diabetes with the ownership of any 1 household device compared to no device ownership (obesity: odds ratio [OR] 1.43, 95% confidence interval [CI] 1.32–1.55; diabetes: OR 1.38, 95% CI 1.28–1.50). Ownership of a second device increased the odds further but ownership of a third device did not. Subsequent adjustment for lifestyle factors modestly attenuated these associations. Of the 3 devices, ownership of a television had the strongest association with obesity (OR 1.39, 95% CI 1.29–1.49) and diabetes (OR 1.33, 95% CI 1.23–1.44). When stratified by country income level, the odds of obesity and diabetes when owning all 3 devices was greatest in low income countries (obesity: OR 3.15, 95% CI 2.33–4.25; diabetes: OR 1.97, 95% CI 1.53–2.53) and decreased through country income levels such that we did not detect an association in high income countries.Interpretation: The ownership of household devices increased the likelihood of obesity and diabetes, and this was mediated in part by effects on physical activity, sitting time and dietary energy intake. With increasing ownership of household devices in developing countries, societal interventions are needed to mitigate their effects on poor health.See related editorial by Patrick on page 243 and at www.cmaj.ca/lookup/doi/10.1503/cmaj.140113