CMAJ. 2014 Mar 4;186(4):258-66. doi: 10.1503/cmaj.131090. Epub 2014 Feb 10.
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.
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.
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.
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.
家庭设备（如电视、汽车、电脑）在高收入国家很常见，其使用与肥胖和 2 型糖尿病有关。我们假设设备拥有量与肥胖和糖尿病有关，这些影响通过减少体力活动、增加坐着时间和增加能量摄入来解释。
我们使用来自高、上中等、中下等和低收入国家的前瞻性城市农村流行病学研究的数据进行了横断面分析。我们使用多层次回归模型来解释社区和国家层面的聚类。
家庭设备的拥有量从低收入国家到高收入国家逐渐增加（所有 3 种设备的比例从 4%增加到 83%），与体力活动减少和坐着时间增加、饮食能量摄入、体重指数和腰围增加有关。与没有设备相比，拥有任何 1 种家庭设备与肥胖和糖尿病的发生几率增加有关（肥胖：比值比[OR]1.43，95%置信区间[CI]1.32-1.55；糖尿病：OR1.38，95%CI1.28-1.50）。拥有第 2 种设备会进一步增加这种几率，但拥有第 3 种设备则不会。随后调整生活方式因素适度减弱了这些关联。在这 3 种设备中，拥有电视与肥胖（OR1.39，95%CI1.29-1.49）和糖尿病（OR1.33，95%CI1.23-1.44）的关联最强。按国家收入水平分层，在低收入国家，同时拥有 3 种设备时肥胖和糖尿病的几率最高（肥胖：OR3.15，95%CI2.33-4.25；糖尿病：OR1.97，95%CI1.53-2.53），随着国家收入水平的降低，这种关联逐渐减弱，以至于在高收入国家没有发现这种关联。
家庭设备的拥有量增加了肥胖和糖尿病的可能性，这部分是通过对体力活动、坐着时间和饮食能量摄入的影响来介导的。随着发展中国家家庭设备拥有量的增加，需要采取社会干预措施来减轻其对健康不良的影响。
