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The Association Between Ownership of Common Household Devices and Obesity and Diabetes in High, Middle and Low Income Countries Publisher Pubmed



Lear SA1 ; Teo K2 ; Gasevic D3 ; Zhang X2 ; Poirier PP4 ; Rangarajan S2 ; Seron P5 ; Kelishadi R6 ; Tamil AM7 ; Kruger A8 ; Iqbal R9 ; Swidan H10 ; Gomezarbelaez D11 ; Yusuf R12 Show All Authors
Authors
  1. Lear SA1
  2. Teo K2
  3. Gasevic D3
  4. Zhang X2
  5. Poirier PP4
  6. Rangarajan S2
  7. Seron P5
  8. Kelishadi R6
  9. Tamil AM7
  10. Kruger A8
  11. Iqbal R9
  12. Swidan H10
  13. Gomezarbelaez D11
  14. Yusuf R12
  15. Chifamba J13
  16. Kutty VR14
  17. Karsidag K15
  18. Kumar R16
  19. Li W17
  20. Szuba A18
  21. Avezum A19
  22. Diaz R20
  23. Anand SS2
  24. Rosengren A21
  25. Yusuf S2
Show Affiliations
Authors Affiliations
  1. 1. Faculty of Health Sciences, Simon Fraser University and Division of Cardiology, Providence Health Care, Vancouver, BC, Canada
  2. 2. Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada
  3. 3. Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
  4. 4. Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Quebec City, QC, Canada
  5. 5. Department of Internal Medicine, Universidad de la Frontera, Temuco, Chile
  6. 6. Isfahan Cardiovascular Research Institute, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  7. 7. Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
  8. 8. Afrika-Eenheid Vir Transdissiplinere Gesondheidsnavorsing, Fakulteit Gesondheidswetenskappe, Noordwes-Universiteit, Potchefstroom, South Africa
  9. 9. Department of Community Health Sciences and Medicine, Aga Khan University, Karachi, Pakistan
  10. 10. Dubai Medical College and Primary Health Care Sector, Dubai Health Authority, Dubai, United Arab Emirates
  11. 11. Departamento de Investigacion, Fundacion Oftalmologica de Santander, Universidad de Santander, Bucaramanga, Santander, Colombia
  12. 12. School of Life Sciences and Centre for Health, Population and Development, Independent University, Bangladesh, Dhaka, Bangladesh
  13. 13. Department of Physiology, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
  14. 14. Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
  15. 15. Division of Endocrinology and Metabolism, Department of Internal Medicine, Stanbul University, Istanbul, Turkey
  16. 16. School of Public Health, Post-Graduate Institute of Medical Education and Research, Chandigarh, India
  17. 17. Medical Research and Biometrics Center, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China
  18. 18. Department of Internal Medicine, Wroclaw Medical University, Wroclaw, Poland
  19. 19. Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil
  20. 20. Estudios Clinicos Latinoamerica ECLA, Rosario, Santa Fe, Argentina
  21. 21. Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

Source: CMAJ. Canadian Medical Association Journal Published:2014


Abstract

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. © 2014 Canadian Medical Association or its licensors.
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