Television viewing time and weight gain in colorectal cancer survivors: a prospective population-based study



To investigate the prospective relationships between television viewing time and weight gain in the 3 years following colorectal cancer diagnosis for 1,867 colorectal cancer survivors (body mass index (BMI) ≥ 18.5 kg/m2).


BMI, television viewing time, physical activity, and socio-demographic and clinical covariates were assessed at baseline (5 months), 24 months and 36 months post-diagnosis. Multiple linear regression was used to study independent associations between baseline television viewing time and BMI at 24 and 36 months post-diagnosis.


At both follow-up time points, there was a significant increase in mean BMI for participants reporting ≥5 h/day of television viewing compared to those watching <3 h/day at baseline (24 months: 0.72 kg/m2 (0.31, 1.12), p < 0.001; 36 months: 0.61 kg/m2 (0.14, 1.07), p = 0.01), independent of baseline BMI, gender, age, education, marital status, smoking, cancer site, cancer disease stage, treatment mode and co-morbidities. Additional adjustment for baseline physical activity did not change results.


These findings suggest that a greater emphasis on decreasing television viewing time could help reduce weight gain among colorectal cancer survivors. This, in turn, could contribute to a risk reduction for co-morbid conditions such as type 2 diabetes and cardiovascular disease.

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  1. 1.

    Jones LW, Demark-Wahnefried W (2006) Diet, exercise, and complementary therapies after primary treatment for cancer. Lancet Oncol 7(12):1017–1026. doi:10.1016/S1470-2045(06)70976-7

    PubMed  Article  Google Scholar 

  2. 2.

    Dunstan DW, Salmon J, Owen N et al (2004) Physical activity and television viewing in relation to risk of undiagnosed abnormal glucose metabolism in adults. Diabetes Care 27(11):2603–2609. doi:10.2337/diacare.27.11.2603

    PubMed  Article  Google Scholar 

  3. 3.

    Patel AV, Rodriguez C, Pavluck AL, Thun MJ, Calle EE (2006) Recreational physical activity and sedentary behavior in relation to ovarian cancer risk in a large cohort of US women. Am J Epidemiol 163(8):709–716. doi:10.1093/aje/kwj098

    PubMed  Article  Google Scholar 

  4. 4.

    Blanchard C, Stein K, Baker F et al (2004) Association between current lifestyle behaviors and health-related quality of life in breast, colorectal and prostate cancer survivors. Psychology and Health 19(1):1–13. doi:10.1080/08870440310001606507

    Article  Google Scholar 

  5. 5.

    Irwin ML, McTiernan A, Baumgartner RN et al (2005) Changes in body fat and weight after a breast cancer diagnosis: influence of demographic, prognostic, and lifestyle factors. J Clin Oncol 23(4):774–782. doi:10.1200/JCO.2005.04.036

    PubMed  Article  Google Scholar 

  6. 6.

    Ferlay J, Bray F, Pisani P, Parkin D (eds) (2004) GLOBOCAN 2002: cancer incidence, mortality and prevalence worldwide. IARC Press, Lyon

    Google Scholar 

  7. 7.

    Jemal A, Murray T, Ward E et al (2005) Cancer statistics, 2005. CA-A Cancer J Clin 55(1):10–30. doi:10.3322/canjclin.55.1.10

    Article  Google Scholar 

  8. 8.

    Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ (2003) Overweight, obesity, and mortality from cancer in a prospectively studied cohort of US adults. N Engl J Med 348(17):1625–1638. doi:10.1056/NEJMoa021423

    PubMed  Article  Google Scholar 

  9. 9.

    Haydon AMM, MacInnis RJ, English DR, Giles GG (2006) Effect of physical activity and body size on survival after diagnosis with colorectal cancer. Gut 55(1):62–67. doi:10.1136/gut.2005.068189

    PubMed  Article  CAS  Google Scholar 

  10. 10.

    Meyerhardt JA, Heseltine D, Niedzwiecki D et al (2006) Impact of physical activity on cancer recurrence and survival in patients with stage III colon cancer: findings from CALGB 89803. J Clin Oncol 24(22):3535–3541. doi:10.1200/JCO.2006.06.0863

    PubMed  Article  Google Scholar 

  11. 11.

    Meyerhardt JA, Giovannucci EL, Holmes MD et al (2006) Physical activity and survival after colorectal cancer diagnosis. J Clin Oncol 24(22):3527–3534. doi:10.1200/JCO.2006.06.0855

    PubMed  Article  Google Scholar 

  12. 12.

    Dunstan D, Salmon J, Owen N et al (2005) Associations of TV viewing and physical activity with the metabolic syndrome in Australian adults. Diabetologia 48(11):2254–2261. doi:10.1007/s00125-005-1963-4

    PubMed  Article  CAS  Google Scholar 

  13. 13.

    Blanck HM, McCullough ML, Patel AV et al (2007) Sedentary behavior, recreational physical activity, and 7-year weight gain among postmenopausal US women. Obesity 15(6):1578–1588. doi:10.1038/oby.2007.187

    PubMed  Article  Google Scholar 

  14. 14.

    Hu FB, Li TY, Colditz GA, Willett WC, Manson JE (2003) Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women. JAMA 289(14):1785–1791. doi:10.1001/jama.289.14.1785

    PubMed  Article  Google Scholar 

  15. 15.

    Hamilton MT, Hamilton DG, Zderic TW (2007) Role of low energy expenditure and sitting in obesity, metabolic syndrome, type 2 diabetes, and cardiovascular disease. Diabetes 56(11):2655–2667. doi:10.2337/db07-0882

    PubMed  Article  CAS  Google Scholar 

  16. 16.

    Owen N, Leslie E, Salmon J, Fotheringham MJ (2000) Environmental determinants of physical activity and sedentary behavior. Exerc Sport Sci Rev 28(4):153–158

    PubMed  CAS  Google Scholar 

  17. 17.

    Salmon J, Owen N, Crawford D, Bauman A, Sallis JF (2003) Physical activity and sedentary behavior: a population-based study of barriers, enjoyment, and preference. Health Psychol 22(2):178–188. doi:10.1037/0278-6133.22.2.178

    PubMed  Article  Google Scholar 

  18. 18.

    Healy GN, Dunstan DW, Salmon J, Shaw JE, Zimmet PZ, Owen N (2008) Television time and continuous metabolic risk in physically active adults. Med Sci Sports Exerc 40(4):639–645. doi:10.1249/MSS.0b013e3181607421

    PubMed  Article  Google Scholar 

  19. 19.

    Lynch BM, Baade P, Fritschi L et al (2007) Modes of presentation and pathways to diagnosis of colorectal cancer in Queensland. Med J Aust 186(6):288–291

    PubMed  Google Scholar 

  20. 20.

    Australian Institute of Health and Welfare (2003) The active Australia survey. A guide and manual for implementation, analysis and reporting. AIHW, Canberra

    Google Scholar 

  21. 21.

    Bauman A, Armstrong T, Davies J et al (2003) Trends in physical activity participation and the impact of integrated campaigns among Australian adults, 1997–99. Aust N Z J Public Health 27(1):76–79. doi:10.1111/j.1467-842X.2003.tb00384.x

    PubMed  Article  Google Scholar 

  22. 22.

    Department of Health and Aged Care (1999) National physical activity guidelines for Australians. Australian Government, Canberra

    Google Scholar 

  23. 23.

    Ragland DR (1992) Dichotomizing continuous outcome variables—dependence of the magnitude of association and statistical power on the cutpoint. Epidemiology 3(5):434–440. doi:10.1097/00001648-199209000-00009

    PubMed  Article  CAS  Google Scholar 

  24. 24.

    International Agency for Research on Cancer (2001) Weight control and physical activity. IARC Press, Lyon

    Google Scholar 

  25. 25.

    Barnett AG, van der Pols JC, Dobson AJ (2005) Regression to the mean: what it is and how to deal with it. Int J Epidemiol 34(1):215–220. doi:10.1093/ije/dyh299

    PubMed  Article  Google Scholar 

  26. 26.

    Foster JA, Gore SA, West DS (2006) Altering TV viewing habits: an unexplored strategy for adult obesity intervention? Am J Health Behav 30(1):3–14

    PubMed  Google Scholar 

  27. 27.

    Healy GN, Wijndaele K, Dunstan DW et al (2008) Objectively measured sedentary time, physical activity, and metabolic risk: the Australian diabetes, obesity and lifestyle study (AusDiab). Diabetes Care 31(2):369–371. doi:10.2337/dc07-1795

    PubMed  Article  Google Scholar 

  28. 28.

    Dunstan DW, Salmon J, Healy GN et al (2007) Association of television viewing with fasting and 2-h postchallenge plasma glucose levels in adults without diagnosed diabetes. Diabetes Care 30(3):516–522. doi:10.2337/dc06-1996

    PubMed  Article  CAS  Google Scholar 

  29. 29.

    Larsen JK, Ouwens M, Engels R, Eisinga R, van Strien T (2008) Validity of self-reported weight and height and predictors of weight bias in female college students. Appetite 50:386–389

    PubMed  Google Scholar 

  30. 30.

    Healy GN, Dunstan DW, Salmon J et al (2008) Breaks in sedentary time: beneficial associations with metabolic risk. Diabetes Care 34(4):661–666. doi:10.2337/dc07-2046

    Article  Google Scholar 

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This project was funded by the Cancer Council Queensland. Owen is supported by a Queensland Health Core Research Infrastructure grant and by NHMRC Program Grant funding (#301200). Dunstan is supported by a Victorian Health Promotion Foundation Public Health Research Fellowship.

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Correspondence to Joanne F. Aitken.

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Wijndaele, K., Lynch, B.M., Owen, N. et al. Television viewing time and weight gain in colorectal cancer survivors: a prospective population-based study. Cancer Causes Control 20, 1355–1362 (2009).

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  • Colorectal neoplasms
  • Body mass index
  • Health behavior
  • Longitudinal studies