Video game playing increases food intake in adolescents: A randomized crossover study

Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada.
American Journal of Clinical Nutrition (Impact Factor: 6.77). 06/2011; 93(6):1196-203. DOI: 10.3945/ajcn.110.008680
Source: PubMed


Video game playing has been linked to obesity in many observational studies. However, the influence of this sedentary activity on food intake is unknown.
The objective was to examine the acute effects of sedentary video game play on various components of energy balance.
With the use of a randomized crossover design, 22 healthy, normal-weight, male adolescents (mean ± SD age: 16.7 ± 1.1 y) completed two 1-h experimental conditions, namely video game play and rest in a sitting position, followed by an ad libitum lunch. The endpoints were spontaneous food intake, energy expenditure, stress markers, appetite sensations, and profiles of appetite-related hormones.
Heart rate, systolic and diastolic blood pressures, sympathetic tone, and mental workload were significantly higher during the video game play condition than during the resting condition (P < 0.05). Although energy expenditure was significantly higher during video game play than during rest (mean increase over resting: 89 kJ; P < 0.01), ad libitum energy intake after video game play exceeded that measured after rest by 335 kJ (P < 0.05). A daily energy surplus of 682 kJ (163 kcal) over resting (P < 0.01) was observed in the video game play condition. The increase in food intake associated with video game play was observed without increased sensations of hunger and was not compensated for during the rest of the day. Finally, the profiles of glucose, insulin, cortisol, and ghrelin did not suggest an up-regulation of appetite during the video game play condition.
A single session of video game play in healthy male adolescents is associated with an increased food intake, regardless of appetite sensations. The trial was registered at as NCT01013246.

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    • "Irrespective of energy expenditure, it can be hypothesized that active games may influence energy balance through reduced energy intake. Energy intake, especially the intake of snacks and sugar-sweetened beverages, is positively associated with time spent in sedentary screen activities such as watching TV en playing non-active games [16,27-30]. If active games can result in a decrease in sedentary time, it might simultaneously result in a lower energy intake. "
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    ABSTRACT: Background Excessive body weight, low physical activity and excessive sedentary time in youth are major public health concerns. A new generation of video games, the ones that require physical activity to play the games –i.e. active games- may be a promising alternative to traditional non-active games to promote physical activity and reduce sedentary behaviors in youth. The aim of this manuscript is to describe the design of a study evaluating the effects of a family oriented active game intervention, incorporating several motivational elements, on anthropometrics and health behaviors in adolescents. Methods/Design The study is a randomized controlled trial (RCT), with non-active gaming adolescents aged 12 – 16 years old randomly allocated to a ten month intervention (receiving active games, as well as an encouragement to play) or a waiting-list control group (receiving active games after the intervention period). Primary outcomes are adolescents’ measured BMI-SDS (SDS = adjusted for mean standard deviation score), waist circumference-SDS, hip circumference and sum of skinfolds. Secondary outcomes are adolescents’ self-reported time spent playing active and non-active games, other sedentary activities and consumption of sugar-sweetened beverages. In addition, a process evaluation is conducted, assessing the sustainability of the active games, enjoyment, perceived competence, perceived barriers for active game play, game context, injuries from active game play, activity replacement and intention to continue playing the active games. Discussion This is the first adequately powered RCT including normal weight adolescents, evaluating a reasonably long period of provision of and exposure to active games. Next, strong elements are the incorporating motivational elements for active game play and a comprehensive process evaluation. This trial will provide evidence regarding the potential contribution of active games in prevention of excessive weight gain in adolescents.
    Full-text · Article · Mar 2014 · BMC Public Health
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    • "There is mixed evidence as to feelings of presence and engagement during motion-controlled video games as compared to typical video games [14-18], and little is known about narrative transportation. Previous studies have compared sedentary gaming to no stimulus [19,20] and to gaming while walking on a treadmill [21], but we are unaware of TV or gaming studies that have measured or compared the effects of different types of distraction. "
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    ABSTRACT: Background Watching television and playing video games increase energy intake, likely due to distraction from satiety cues. A study comparing one hour of watching TV, playing typical video games, or playing motion-controlled video games found a difference across groups in energy intake, but the reasons for this difference are not clear. As a secondary analysis, we investigated several types of distraction to determine potential psychosocial mechanisms which may account for greater energy intake observed during sedentary screen time as compared to motion-controlled video gaming. Methods Feelings of enjoyment, engagement (mental immersion), spatial presence (the feeling of being in the game), and transportation (immersion in a narrative) were investigated in 120 young adults aged 18 – 35 (60 female). Results Only narrative transportation was associated with total caloric intake (ρ = .205, P = .025). Transportation was also higher in the TV group than in the gaming groups (P = .002) and higher in males than in females (P = .003). Transportation mediated the relationship between motion-controlled gaming (as compared to TV watching) and square root transformed energy intake (indirect effect = −1.34, 95% confidence interval −3.57, −0.13). No other distraction-related variables were associated with intake. Conclusions These results suggest that different forms of distraction may differentially affect eating behavior during screen time, and that narrative appears to be a particularly strong distractor. Future studies should further investigate the effects of narrative on eating behavior.
    Full-text · Article · May 2013 · International Journal of Behavioral Nutrition and Physical Activity
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    • "It is impossible based on this study design to determine potential effects of game play on subsequent energy intake and expenditure. Play of video games with a traditional controller has been found to increase food consumption after a play session [25]; thus, it is possible that later increases in energy intake could erase the expenditure benefits of motion-controlled action gaming and result in overall positive energy balance. Results should also be generalized with caution due to possible differences between eligible participants who completed the study and those who did not attend their appointment or who were eligible but not asked to participate because recruitment goals (i.e., 100 participants, 50 per gender) were reached. "
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    ABSTRACT: Sports- and fitness-themed video games using motion controllers have been found to produce physical activity. It is possible that motion controllers may also enhance energy expenditure when applied to more sedentary games such as action games. Young adults (N = 100) were randomized to play three games using either motion-based or traditional controllers. No main effect was found for controller or game pair (P > .12). An interaction was found such that in one pair, motion control (mean [SD] 0.96 [0.20] kcal · kg(-1) · hr(-1)) produced 0.10 kcal · kg(-1) · hr(-1) (95% confidence interval 0.03 to 0.17) greater energy expenditure than traditional control (0.86 [0.17] kcal · kg(-1) · hr(-1), P = .048). All games were sedentary. As currently implemented, motion control is unlikely to produce moderate intensity physical activity in action games. However, some games produce small but significant increases in energy expenditure, which may benefit health by decreasing sedentary behavior.
    Full-text · Article · Jan 2012 · Journal of obesity
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