Even though binge-watching television is linked to numerous forms of morbidity and even mortality, it has become a new national pastime. According to one poll, 60% of American adults who watch TV on demand said they binge-watch at least once a week, 28% said they binge-watch several times per week, and 15% reported they binge each day. Binge-watching is commonly defined as watching at least two or more consecutive episodes of a show, but it could include watching a whole season—13 back-to-back episodes of Breaking Bad, for example—in one marathon viewing session. And for most Americans, there’s no better place to binge-watch than Netflix, which currently has 60.62 million US subscribers. Specifically, of the 1 billion hours Americans spent watching TV in 2018, 10% was spent watching Netflix. However, given the link between binge-watching and various health problems, and given the fact that Netflix represents a very large source of binge-friendly TV, can one argue that Netflix is harmful—even mortally dangerous—to our health? ‘Netflix and kill’ Wait a minute… Why pick on Netflix when there are also other streaming services like Amazon Prime, Hulu, and soon-to-be-launched Disney+ and AppleTV+? The answer is that Netflix releases whole seasons of its original shows all at once. Unlike traditional television channels where episodes air weekly (so you had to wait a whole week to find out if Fonzie survived his motorcycle jump across Arnold’s parking lot), Netflix unloads a full season of Stranger Things or Orange Is the New Black in one fell swoop. Sure, you can binge past seasons or an entire previously-run series on Hulu, but Hulu's new shows generally appear on an episodic basis, typically once a week. Amazon, like Netflix, also drops entire seasons all at once. But Netflix has more than three times the original content as Amazon, and much of it with higher critical ratings. ‘Consequences can be lethal’ OK, so Netflix is the mother of all binge channels. So what? What’s the big deal? With the potential health consequences of binge-watching and the millions of Americans who are doing it, it could be a big deal—it could mean a good deal more morbidity and even mortality from hours and hours of sedentary TV viewing. Consider the following findings: In adults aged 50 and older, watching TV for more than 3.5 hours per day is associated with a dose-response decline in verbal memory over 6 years. The more TV you watch, the greater the decline. “Those who watch television for more than 3.5 hours per day experience on average an 8% to 10% decrease in verbal memory over the same period,” said lead author and senior research fellow Daisy Fancourt, PhD, Research Department of Behavioural Science and Health, University College London, London, United Kingdom. Watching TV frequently is associated with an increased risk for venous thromboembolism (VTE). Specifically, people who said they watch TV “very often” had a 71% greater risk for VTE compared with people who said they “never or seldom” watch TV. Higher BMI mitigated this link by approximately 25% but did not explain the entire association. Even among individuals with a high level of physical activity, those who watched TV very often had an increased risk of VTE compared with those who seldom watched TV. “These results suggest that even individuals who regularly engage in physical activity should not ignore the potential harms of prolonged sedentary behaviors such as TV viewing,” researchers recommended. Every additional hour per day spent watching TV is associated with a 12% increased risk of mortality related to inflammatory diseases, including lower respiratory diseases, influenza/pneumonia, Alzheimer disease, Parkinson disease, motor neuron disease, diabetes, and kidney disease. “This is consistent with the hypothesis that high TV viewing may be associated with a chronic inflammatory state,” the authors concluded. Longer time spent watching TV is associated with an increased risk of all-cause mortality and cardiovascular disease mortality. Specifically, middle-aged adults (age 45-75) who watched 5 or more hours of TV per day had an increased risk of all-cause mortality compared with those who watched less than 1 hour per day, with a 19% increase in men and a 32% increase in women. The increased risks for cardiovascular disease were similar, with 20% increased risk in men and 33% increased risk in women. Could too much TV actually kill you? Emergency medicine physician Alan Lucerna, DO, reported the case of a woman who had both deep vein thrombosis and pulmonary emboli after watching TV for nearly 2 days straight. Fortunately, she survived. “Technology was created to make our lives better,” Dr. Lucerna said. “But in the case of prolonged TV watching, the consequences can be lethal.” The picture is not so clear But don’t cancel your Netflix subscription just yet. It’s important to note that in many of these studies, and studies like them, researchers looked at TV watching as a proxy for sedentary behavior. Sedentary behavior has been linked with numerous health problems, including inflammatory diseases, cardiovascular disease, diabetes, cognitive decline, and death. But other sedentary activities, such as using the internet or sitting while working, have not shown this association. It seems counterintuitive, but studies in adults have established that TV time is poorly correlated to sitting time. The truth is, researchers don’t yet know if the health risks linked with binge-watching are due to just sitting and watching TV or are due to other factors. “Besides not reflecting sitting time, TV time is confounded by factors that are strong determinants of poor health outcomes but are not always accounted for, such as dietary intake and TV time snacking, socioeconomic status, and mental health,” wrote public health researchers. To cloud the picture even further, consider the study described above on the association between watching TV and inflammatory diseases: After adjusting for leisure-time physical activity, the researchers found that the link between TV watching and increased inflammatory disease mortality risk disappeared. TV is very educational So, does all this mean that Netflix is not killing us slowly? The short answer is: It’s difficult to say just yet. The long answer is: Much more research is needed. In the meantime, it’s probably best to err on the side of caution: Hit the pause button during binge-watching to take activity breaks, and don’t gorge on unhealthy snacks while you gorge on your favorite shows. “[One] thing is clear: regularly interrupting sedentary time with short bouts of activity is unlikely to induce harm and could very possibly result in improvements in postprandial concentrations of lipid species associated with inflammation and antioxidant capacity, blood pressure, endothelial function, telomere length, appetite, energy balance, mood, and fatigue,” wrote the authors of an editorial article on the topic. Or perhaps cut back on regular binge-watching, keeping it just for special occasions. You might even take some TV-watching advice from Groucho Marx, who said: “I must say I find television very educational. The minute somebody turns it on, I go into the library and read a good book.” Source
