Moving Beyond the Stigma: Systematic Review of Video Games and Their Potential to Combat Obesity

Increasing epidemic proportions of overweight children in the United States presents formidable challenges for education and healthcare. Given the popularity and pervasiveness of video gaming culture in North American children, the perfect opportunity arises to investigate the potential of video games to promote healthful behaviour. Our objective was to systematically review the literature for possible benefits of active and educational video games targeting diet and physical activity in children. A review of English-language journal articles from 1998 to 2011 using EMBASE and PubMed was conducted. Thirty-four studies concerned with children, video games, physical, and/or nutritional outcomes were included. Results of these studies that showed some benefit (increased physical activity and nutritional knowledge as a result of gaming) demonstrate the possibility of video games to combat childhood obesity—looking beyond the stigma attached to gaming.

[1]  Rachel Hayes Polon,et al.  Dietary Guidelines for Americans, 2010 , 2013 .

[2]  Ann E. Maloney,et al.  A Pilot of a Video Game (DDR) to Promote Physical Activity and Decrease Sedentary Screen Time , 2008, Obesity.

[3]  L. Andersen,et al.  Physical activity, fitness and health in children , 2011, Scandinavian journal of medicine & science in sports.

[4]  N. Krebs,et al.  Assessment of Child and Adolescent Overweight and Obesity , 2007, Pediatrics.

[5]  Gareth Stratton,et al.  Energy expenditure in adolescents playing new generation computer games , 2008, BMJ : British Medical Journal.

[6]  L. Lemura,et al.  Factors that alter body fat, body mass, and fat-free mass in pediatric obesity. , 2002, Medicine and science in sports and exercise.

[7]  Heibatollah Baghi,et al.  Childhood Obesity Study: A Pilot Study of the Effect of the Nutrition Education Program Color My Pyramid , 2009, The Journal of school nursing : the official publication of the National Association of School Nurses.

[8]  N. Cable,et al.  Comparison of energy expenditure in adolescents when playing new generation and sedentary computer games: cross sectional study , 2007, BMJ : British Medical Journal.

[9]  B. Fernhall,et al.  Evaluation of the Energy Cost of Playing a Dance Simulation Video Game in Overweight and Non-Overweight Children and Adolescents , 2005, International journal of sports medicine.

[10]  SoJung Lee,et al.  Physical activity and abdominal obesity in youth. , 2009, Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme.

[11]  Katherine M Flegal,et al.  Obesity and socioeconomic status in children and adolescents: United States, 2005-2008. , 2010, NCHS data brief.

[12]  Ralph Maddison,et al.  Feasibility, design and conduct of a pragmatic randomized controlled trial to reduce overweight and obesity in children: The electronic games to aid motivation to exercise (eGAME) study , 2009, BMC public health.

[13]  Marilyn Frenn,et al.  Changing the tide: an Internet/video exercise and low-fat diet intervention with middle-school students. , 2005, Applied nursing research : ANR.

[14]  K. Short,et al.  Playing Active Video Games Increases Energy Expenditure in Children , 2009, Pediatrics.

[15]  Stewart Trost,et al.  Evidence based physical activity for school-age youth. , 2005, The Journal of pediatrics.

[16]  Marilene Calderaro Munguba,et al.  The application of an occupational therapy nutrition education programme for children who are obese. , 2008, Occupational therapy international.

[17]  Tom Baranowski,et al.  The Fun, Food, and Fitness Project (FFFP): the Baylor GEMS pilot study. , 2003, Ethnicity & disease.

[18]  Willem van Mechelen,et al.  The motivation of children to play an active video game. , 2008, Journal of science and medicine in sport.

[19]  T. Baranowski,et al.  Squire's quest: intervention changes occurred at lunch and snack meals , 2005, Appetite.

[20]  Kevin Patrick,et al.  Randomized controlled trial of a primary care and home-based intervention for physical activity and nutrition behaviors: PACE+ for adolescents. , 2006, Archives of pediatrics & adolescent medicine.

[21]  R. Wahl,et al.  Nutrition in the adolescent. , 1999, Pediatric annals.

[22]  K. Steinbeck,et al.  The importance of physical activity in the prevention of overweight and obesity in childhood: a review and an opinion , 2001, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[23]  Kristine A. Madsen,et al.  Feasibility of a dance videogame to promote weight loss among overweight children and adolescents. , 2007, Archives of pediatrics & adolescent medicine.

[24]  Janice Baranowski,et al.  Squire's Quest! Dietary outcome evaluation of a multimedia game. , 2003, American journal of preventive medicine.

[25]  E. Biddiss,et al.  Active video games to promote physical activity in children and youth: a systematic review. , 2010, Archives of pediatrics & adolescent medicine.

[26]  A. Daley Can Exergaming Contribute to Improving Physical Activity Levels and Health Outcomes in Children? , 2009, Pediatrics.

[27]  B. Hacking,et al.  Health consequences of obesity , 2003, Archives of disease in childhood.

[28]  D. Southard,et al.  Promoting physical activity in children with MetaKenkoh. , 2006, Clinical and investigative medicine. Medecine clinique et experimentale.

[29]  M C Turnin,et al.  Evaluation of microcomputer nutritional teaching games in 1,876 children at school. , 2001, Diabetes & metabolism.

[30]  J. Levine,et al.  Energy Expenditure of Sedentary Screen Time Compared With Active Screen Time for Children , 2006, Pediatrics.

[31]  T. Baranowski,et al.  Video game play, child diet, and physical activity behavior change a randomized clinical trial. , 2011, American journal of preventive medicine.

[32]  Deborah I Thompson,et al.  Playing for real: video games and stories for health-related behavior change. , 2008, American journal of preventive medicine.

[33]  Ralph Maddison,et al.  Energy expended playing video console games: an opportunity to increase children's physical activity? , 2007, Pediatric exercise science.

[34]  J. Salmon,et al.  Promoting physical activity participation among children and adolescents. , 2007, Epidemiologic reviews.

[35]  Thomas L McKenzie,et al.  Direct observation of children's preferences and activity levels during interactive and online electronic games. , 2010, Journal of physical activity & health.

[36]  Ralph Maddison,et al.  Couch potatoes to jumping beans: A pilot study of the effect of active video games on physical activity in children , 2008, The international journal of behavioral nutrition and physical activity.

[37]  Janice Baranowski,et al.  In Pursuit of Change: Youth Response to Intensive Goal Setting Embedded in a Serious Video Game , 2007, Journal of diabetes science and technology.

[38]  G. Stratton,et al.  The contribution of upper limb and total body movement to adolescents’ energy expenditure whilst playing Nintendo Wii , 2008, European Journal of Applied Physiology.

[39]  H C Kemper,et al.  Tracking of activity and fitness and the relationship with cardiovascular disease risk factors. , 2000, Medicine and science in sports and exercise.

[40]  A. Kriska,et al.  Relation between the changes in physical activity and body-mass index during adolescence: a multicentre longitudinal study , 2005, The Lancet.

[41]  R. Uauy,et al.  Obesity in children and young people: a crisis in public health. , 2004, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[42]  L. DeMattia,et al.  Childhood Obesity Prevention: Successful Community-Based Efforts , 2008 .

[43]  Trish Gorely,et al.  Critical hours: physical activity and sedentary behavior of adolescents after school. , 2008, Pediatric exercise science.

[44]  William Neal,et al.  Effects of an exercise intervention using Dance Dance Revolution on endothelial function and other risk factors in overweight children. , 2009, International journal of pediatric obesity : IJPO : an official journal of the International Association for the Study of Obesity.

[45]  Risto Telama,et al.  Physical activity from childhood to adulthood: a 21-year tracking study. , 2005, American journal of preventive medicine.

[46]  ROBIN R. MELLECKER,et al.  The feasibility of ambulatory screen time in children. , 2009, International journal of pediatric obesity : IJPO : an official journal of the International Association for the Study of Obesity.

[47]  B. Haddock,et al.  The Addition of a Video Game to Stationary Cycling: The Impact on Energy Expenditure in Overweight Children. , 2009, The open sports sciences journal.

[48]  R Bethene Ervin,et al.  Dietary intake of ten key nutrients for public health, United States: 1999-2000. , 2003, Advance data.

[49]  Deborah I Thompson,et al.  Serious Video Games for Health: How Behavioral Science Guided the Development of a Serious Video Game , 2010, Simulation & gaming.

[50]  E. Vandewater,et al.  Linking obesity and activity level with children's television and video game use. , 2004, Journal of adolescence.

[51]  R. Mellecker,et al.  Energy expenditure and cardiovascular responses to seated and active gaming in children. , 2008, Archives of pediatrics & adolescent medicine.

[52]  Tim Olds,et al.  Video Center Games: Energy Cost and Children's Behaviors , 2001 .

[53]  P. Derfler,et al.  The United States Department of Agriculture , 1872, Nature.

[54]  Scott Owens,et al.  Effects of exercise intensity on cardiovascular fitness, total body composition, and visceral adiposity of obese adolescents. , 2002, The American journal of clinical nutrition.

[55]  Ann E. Maloney,et al.  Parental and Environmental Factors Associated with Physical Activity Among Children Participating in an Active Video Game , 2009, Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association.

[56]  Leonard H. Epstein,et al.  Choice of interactive dance and bicycle games in overweight and nonoverweight youth , 2007, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[57]  S. Griffin,et al.  Effectiveness of interventions to promote physical activity in children and adolescents: systematic review of controlled trials , 2009 .

[58]  Lynda R Hardy,et al.  Overweight in children: definitions, measurements, confounding factors, and health consequences. , 2004, Journal of pediatric nursing.

[59]  Jacob E. Barkley,et al.  Motivation and Physiologic Responses of Playing a Physically Interactive Video Game Relative to a Sedentary Alternative in Children , 2010, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[60]  Leon Straker,et al.  Effect of screen-based media on energy expenditure and heart rate in 9- to 12-year-old children. , 2007, Pediatric exercise science.

[61]  Yan Liu,et al.  Boy Scout 5-a-Day Badge: outcome results of a troop and Internet intervention. , 2009, Preventive medicine.

[62]  Sandra L. Calvert,et al.  Tipping the balance: use of advergames to promote consumption of nutritious foods and beverages by low-income African American children. , 2009, Archives of pediatrics & adolescent medicine.

[63]  A. Rocchini,et al.  Childhood obesity and a diabetes epidemic. , 2002, The New England journal of medicine.

[64]  Julian McDougall,et al.  Children, video games and physical activity: An exploratory study , 2008 .