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Energy Expenditure of Sedentary Screen Time Compared With Active Screen Time for Children


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We examined the effect of activity-enhancing screen devices on children's energy expenditure compared with performing the same activities while seated. Our hypothesis was that energy expenditure would be significantly greater when children played activity-promoting video games, compared with sedentary video games. Energy expenditure was measured for 25 children aged 8 to 12 years, 15 of whom were lean, while they were watching television seated, playing a traditional video game seated, watching television while walking on a treadmill at 1.5 miles per hour, and playing activity-promoting video games. Watching television and playing video games while seated increased energy expenditure by 20 +/- 13% and 22 +/- 12% above resting values, respectively. When subjects were walking on the treadmill and watching television, energy expenditure increased by 138 +/- 40% over resting values. For the activity-promoting video games, energy expenditure increased by 108 +/- 40% with the EyeToy (Sony Computer Entertainment) and by 172 +/- 68% with Dance Dance Revolution Ultramix 2 (Konami Digital Entertainment). Energy expenditure more than doubles when sedentary screen time is converted to active screen time. Such interventions might be considered for obesity prevention and treatment.
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DOI: 10.1542/peds.2006-1087
Brian A. Walker, Dieter Heinz and James A. Levine
Lorraine Lanningham-Foster, Teresa B. Jensen, Randal C. Foster, Aoife B. Redmond,
Time for Children
Energy Expenditure of Sedentary Screen Time Compared With Active Screen
located on the World Wide Web at:
The online version of this article, along with updated information and services, is
of Pediatrics. All rights reserved. Print ISSN: 0031-4005. Online ISSN: 1098-4275.
Boulevard, Elk Grove Village, Illinois, 60007. Copyright © 2006 by the American Academy
published, and trademarked by the American Academy of Pediatrics, 141 Northwest Point
publication, it has been published continuously since 1948. PEDIATRICS is owned,
PEDIATRICS is the official journal of the American Academy of Pediatrics. A monthly
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Energy Expenditure of Sedentary Screen Time
Compared With Active Screen Time for Children
Lorraine Lanningham-Foster, PhD
, Teresa B. Jensen, MD
, Randal C. Foster, BS
, Aoife B. Redmond, MBBCh
, Brian A. Walker, DO
Dieter Heinz, MD
, James A. Levine, MD, PhD
Endocrine Research Unit and
Department of Family Medicine, Mayo Clinic, Rochester, Minnesota
The authors have indicated they have no financial relationships relevant to this article to disclose.
OBJECTIVE. We examined the effect of activity-enhancing screen devices on children’s
energy expenditure compared with performing the same activities while seated.
Our hypothesis was that energy expenditure would be significantly greater when
children played activity-promoting video games, compared with sedentary video
METHODS. Energy expenditure was measured for 25 children aged 8 to 12 years, 15
of whom were lean, while they were watching television seated, playing a tradi-
tional video game seated, watching television while walking on a treadmill at 1.5
miles per hour, and playing activity-promoting video games.
RESULTS. Watching television and playing video games while seated increased energy
expenditure by 20 13% and 22 12% above resting values, respectively. When
subjects were walking on the treadmill and watching television, energy expendi-
ture increased by 138 40% over resting values. For the activity-promoting video
games, energy expenditure increased by 108 40% with the EyeToy (Sony
Computer Entertainment) and by 172 68% with Dance Dance Revolution
Ultramix 2 (Konami Digital Entertainment).
CONCLUSIONS. Energy expenditure more than doubles when sedentary screen time is
converted to active screen time. Such interventions might be considered for
obesity prevention and treatment.
Drs Lanningham-Foster and Levine and Mr
Foster had full access to all of the data in
the study and take responsibility for the
integrity of the data and the accuracy of
the data analysis.
Key Words
physical activity, obesity, indirect
calorimetry, television, video games
REE—resting energy expenditure
Accepted for publication Jul 13, 2006
Address correspondence to James A. Levine,
MD, PhD, Endocrine Research Unit, 5-194
Joseph, Mayo Clinic, 200 First St, SW,
Rochester, MN 55905. E-mail: levine.james@
PEDIATRICS (ISSN Numbers: Print, 0031-4005;
Online, 1098-4275). Copyright © 2006 by the
American Academy of Pediatrics
PEDIATRICS Volume 118, Number 6, December 2006 e1831
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BESITY PREVALENCE AMONG children is at the high-
est levels measured; presently 15% of US boys and
girls 6 to 11 years of age are overweight.
Obesity among
children has increased more rapidly in the past 30 years.
Obesity is a global epidemic with unheralded health
These increasing obesity rates have been
blamed, in part, on increasing sedentariness.
Sitting in
front of a television, video game, or computer screen has
been associated consistently with low levels of physical
Weekly screen time for children is as high as 55
and the average home in the United States
has a television on for 8 hours per day.
Although many
programs have attempted to separate children from the
screen, these activities are highly valued and children
are resistant to relinquishing them.
An alternative ap-
proach is to examine whether sedentary screen time can
be converted into active screen time.
Several activity-promoting video games directed at
children exist and have the potential to promote physical
activity during screen time.
A key question is whether
these activities are sufficiently exothermic to result in
increased energy expenditure. On one hand, if these
activity-promoting maneuvers increase energy expendi-
ture only minimally, then their applicability for revers-
ing sedentariness would be limited and these approaches
would offer false promise. On the other hand, if ap-
proaches to render screen time active increase energy
expenditure substantially, then they could become po-
tent tools for reversing sedentariness while permitting
highly valued screen-based activities. In this study, we
examined the energy expenditures of approaches that
render screen time active and compared these values
with values for activities performed seated among chil-
Twenty-five healthy children (12 boys and 13 girls) of
varying heights and weights were recruited (Table 1).
Ten children (5 boys and 5 girls) with mild obesity (85th
percentile BMI 99th percentile) were recruited
(Table 1). The remaining children (7 boys and 8 girls)
were of normal weight (5th percentile BMI 85th
percentile). The children underwent clinical evaluations
and physical examinations. Each child’s weight and
height were measured with a calibrated digital scale
(Scale-Tronix 5005 stand-on scale; Scale-Tronix, White
Plains, NY) and a fixed stadiometer, respectively. BMI
percentiles and z scores were determined by using Cen-
ters for Disease Control and Prevention growth charts.
Children who had acute or chronic diseases or were
receiving any medications were excluded. The study was
approved by the Mayo Clinic Pediatric and Adolescent
Medicine Research Committee and the institutional re-
view board. Informed written assent was obtained from
the children, and informed written consent was ob-
tained from the parents.
Energy Expenditure
Energy expenditure was measured by using a high-pre-
cision, flow-over, indirect calorimeter built specifically
for use with children (Columbus Instruments, Colum-
bus, OH).
Expired air was collected with a dilution
facemask that was designed for use with children and
that covered the entire face. A primary gas standard
(0.50% carbon dioxide, 20.5% oxygen, and balanced
nitrogen) was used for gas calibrations before each mea-
TABLE 1 Characteristics of Lean and Overweight Study Participants and Mean Energy Expenditure
During Each Activity
(n 25)
(n 15)
(n 10)
Age, mean SD, y 9.7 1.6 9.9 1.7 9.4 1.5
Height, mean SD, cm 144.2 11.2 145.9 12.8 141.7 8.5
Gender, male/female, n 12/13 7/8 5/5
Weight, mean SD, kg 40.8 10.1 37.9 9.5 45.3 9.7
BMI, mean SD, kg/m
20 418 223 4
BMI percentile, mean SD 71.5 24.7 57.6 23.2 91.7 4.5
BMI z score, mean SD 0.73 0.97 0.15 0.77 1.60 0.46
Energy expenditure, mean SD, kJ/h per kg
body weight
REE 6.47 1.18 6.93 1.22 5.80 0.67
Sitting and watching television 7.73 1.43 8.19 1.47 6.97 1.05
Walking and watching television 15.08 2.10 14.95 2.18 15.25 2.14
Playing sedentary video game 7.85 1.51 8.36 1.68 7.14 0.97
Playing activity-promoting video game EyeToy 13.61 4.20 14.57 4.62 12.18 3.15
Playing activity-promoting video game Dance
Dance Revolution
17.26 4.28 16.76 3.99 18.10 4.75
Significantly lower, compared with lean children, P .02.
Significantly lower, compared with lean children, P .03.
Significantly lower, compared with lean children, P .05.
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surement. Data were collected every 30 seconds and
stored on a personal computer. Weekly alcohol burn
experiments showed carbon dioxide and oxygen recov-
eries of 99%.
Video Game Systems and Games
In the children’s study, 2 video game systems were used
(PlayStation 2; Sony Computer Entertainment, San Ma-
teo, CA, and Xbox; Microsoft, Redmond, WA). Three
video games were used, namely, 1 video game played
while seated and 2 activity-promoting video games. The
video game that was played while seated used a hand-
held controller connected by a cable to the game system
(PlayStation 2) and was called Disney’s Extreme Skate
Adventure (Activision, Los Angeles, CA). The first activ-
ity-promoting video game used a small USB camera
(EyeToy; Sony) to place the child into the game, to catch
objects interactively, for example (Nicktoons Movin’;
THQ, Calabasas Hills, CA; PlayStation 2 format). The
second activity-promoting video game used a floor
dance pad as the game controller, with children dancing
in a certain format to gain points (Dance Dance Revo-
lution Ultramix 2; Konami Digital Entertainment, Red-
wood City, CA; Xbox format).
All of the games were rated E (for everyone) by the
Entertainment Software Rating Board and were shown
to the parents for approval during the screening visit.
During the study, all children played the same video
games with the same game settings. (1) For Disney’s
Extreme Skate Adventure, all children played with the
character Woody and started the game in Andy’s room.
(2) For Nicktoons Movin’, all children played the Jelly-
fish Jam game repeatedly. (3) For Dance Dance Revolu-
tion Ultramix 2, all children played to the song “Samba”
in the training mode, with the game speed set at level 3.
First, children attended a screening visit, in which chil-
dren and parents were familiarized with the calorimeter
and all procedures. On the day of the study, children
were asked to come to the General Clinical Research
Center. Children were instructed to arrive after 5
hours of fasting, although they were allowed water.
The child rested in a dimly lit room for 30 minutes.
Resting energy expenditure (REE) was then measured
for 20 minutes by using indirect calorimetry, as de-
scribed above. During the REE measurement, the child
was awake, semirecumbent (10° head bed tilt), lightly
clothed, and in thermal comfort (68 –74°F), in a dimly lit
room. The child was encouraged not to talk or to move
during the REE measurement.
After measurement of REE, the child was given a
snack, to reduce hunger and irritation. After the snack,
the child was directed to sit motionless for 15 minutes
while being supervised. Children watched an age-appro-
priate videotape while sitting. Energy expenditure was
then measured for 15 minutes as described above. The
indirect calorimeter mask was removed, and the child
was allowed to rest for 5 minutes.
The child was allowed to play the traditional video
game (Disney’s Extreme Skate Adventure) for 3 min-
utes, to become familiar with the game. Energy expen-
diture was then measured for 15 minutes while the child
played the traditional video game while seated. The
calorimeter mask was removed, and the child was al-
lowed to rest for 5 minutes.
The child then watched a videotape (rated G) while
walking on a treadmill at 1.5 miles/hour. This is a ve-
locity that we showed previously was an enjoyable self-
selected velocity for children of this age.
Energy expen-
diture was measured for 15 minutes as described above.
The child then rested for 5 minutes.
The child was then allowed to play the first activity-
promoting video game (Nicktoons Movin’) for 3 minutes
for familiarization. Energy expenditure was measured
for 15 minutes while the child played the game. After a
5-minute rest, the second activity-promoting video
game (Dance Dance Revolution Ultramix 2) was played.
After 3 minutes for familiarization, energy expenditure
was measured for 15 minutes while the child played the
game. Children were allowed to drink water during the
rest period.
Statistical Analyses
Values are expressed as mean SD. Height, weight, age,
gender, BMI, and energy expenditure were calculated
for each participant. To address our hypothesis that en-
ergy expenditure would be significantly greater when
children played interactive video games, compared with
sedentary video games, energy expenditures determined
by using indirect calorimetry while children played the 3
video games were compared numerically. To compare
changes in energy expenditure, analyses of variance
with posthoc paired t tests (Tukey-Kramer) were used.
Statistical analyses were conducted with StatView 5.0
(SAS Institute, Cary, NC).
All children in the study tolerated the protocol well and
enjoyed participating in the study. Characteristics of the
children are presented in Table 1. For the entire group,
the children (10 2 years of age; 12 boys and 13 girls)
were of varying height (144 11 cm) and weight (41
10 kg); BMI was 20 4 kg/m
. Fifteen of the children
were considered lean, according to their BMI (15th per-
centile BMI 85th percentile; mean BMI percentile:
58 23; mean BMI z score: 0.15 0.77), and 10
children were overweight or at risk for overweight (BMI
of 85th percentile; mean BMI percentile: 92 5; mean
BMI z score: 1.6 0.5). Twenty-two children were
white/not of Hispanic origin, 2 children were Asian, and
1 child was black/not of Hispanic origin.
PEDIATRICS Volume 118, Number 6, December 2006 e1833
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Values for REE and expenditure during the various
activities (adjusted for body weight) are shown in Table
1 and Fig 1. All activities showed increased energy ex-
penditure over REE. Seated television watching and
video gaming were associated with increases of 50 29
kJ/hour (P .0001) and 55 29 kJ/hour (P .0001),
respectively, in energy expenditure over rest (Fig 1).
Walking while watching television increased energy
expenditure by 353 118 kJ/hour (P .00001) in
comparison with REE and by 302 105 kJ/hour (P
.00001) in comparison with sitting and watching televi-
sion. Activity-promoting video games were associated
with a far larger increase in energy expenditure, com-
pared with playing a video game while seated. For the
EyeToy, energy expenditure increased 273 101 kJ/
hour above REE (P .00001). For the Dance Dance
Revolution Ultramix 2, energy expenditure increased
382 181 kJ/hour above REE (P .00001). There were
significantly greater increases in energy expenditure for
the EyeToy and Dance Dance Revolution Ultramix 2,
compared with sitting and watching television and seat-
based video gaming (P .00001). Therefore, activity-
promoting video games are associated with substantial
increases in energy expenditure, compared with seat-
based screen activities. There were no significant differ-
ences in energy expenditure based on gender or age.
To address the hypothesis that lean children expend
more energy in playing activity-promoting video games,
compared with overweight children, we compared the
energetic responses to these seat-based and activity-pro-
moting video games between lean and overweight chil-
dren. In absolute terms, the obese children had signifi-
cantly greater increases in energy expenditure in
response to the activity-promoting video games (Fig 1).
When the data were corrected for body weight, over-
weight children had significantly lower energy expendi-
ture for resting (lean: 7.1 1.3 kJ/hour per kg body
weight; overweight: 5.9 0.8 kJ/hour per kg body
weight; P .02), sitting and watching television (lean:
8.4 1.7 kJ/hour per kg body weight; overweight: 7.1
1.3 kJ/hour per kg body weight; P .03), and sitting and
playing the traditional video game (lean: 8.4 1.7 kJ/
hour per kg body weight; overweight: 7.1 0.8 kJ/hour
per kg body weight; P .05) (Table 1). However the
energetic responses were not significantly different be-
tween the groups for walking and watching television or
playing the activity-promoting video games (Table 1). It
was clear that the increase in energy expenditure asso-
ciated with activity-promoting video games was intact in
Obesity rates in children and adults have reached un-
precedented levels. Obesity-associated chronic diseases,
such as type 2 diabetes mellitus, are now commonly
being diagnosed in children and are increasing in inci-
dence in adults. One factor that is thought to be impor-
tant in obesity pathogenesis is low activity levels or low
non-exercise activity thermogenesis.
It is recognized
that an important factor in understanding sedentariness
is the many hours each day that people engage in seated
screen-based activities, such as television watching,
video gaming, and operating a computer. Our objective
in this study was to examine the energetic implications
of converting seat-based screen time to activity-based
screen time. Activity-promoting video games and tread-
mill television and computer use more than doubled
energy expenditure, compared with the chair-based
equivalents. We suggest that activity-promoting video
gaming and computer use is one potential approach for
reversing sedentariness.
Low activity levels that are coupled to, on average, 8
hours of screen time per day are widely recognized as
major factors in obesity. Many attempts have been made
to promote activity at home, at school, and in the work-
Part of the problem is that children value screen-
Mean energetic increases above resting values for sitting
and watching a videotape or playing each video game
for lean (n 15) and overweight (n 10) children. Val-
ues with different letters indicate significant differences
in energetic increases. Values with the same letter were
not significantly different. Values are mean SEM.
nificantly greater increase above resting values than sit-
ting and watching a videotape or playing a traditional
video game (P .00001).
Significantly greater increase
above resting values than sitting and watching a video-
tape or playing a traditional video game (P .0001) or
playing with the EyeToy.
Significantly greater increase
above resting values than sitting and watching a video-
tape or playing an traditional video game (P .0001),
playing with the EyeToy (P .002), or walking and
watching television (P .003).
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based activities; therefore, attempts to have children re-
place their gaming with less-valued activities, such as
walking in the park, often fail.
If sedentary screen
time could be converted effectively to activity, then this
could be an effective approach for promoting physical
activity. Our question was whether activity-promoting
screen time increases energy expenditure substantially,
because this might prompt studies to examine these
modalities for weight loss.
Although our data demonstrated clearly that activity-
promoting screen time increases energy expenditure in
children dramatically, the study has limitations. First,
this was not a long-term weight loss study. Our goal was
to evaluate the energetic potential of converting seden-
tary screen time to activity-promoting screen time. We
think that these data are sufficiently robust to warrant
prospective, randomized studies in this area. Second, the
experiments were conducted in a laboratory, rather than
at home. We do not think that a home-based study
would have altered substantially our primary finding
that activity-promoting screen time doubles energy ex-
penditure, compared with seat-based screen time. Our
study was relatively small; however, it was conducted
very carefully, so that a larger study would have been
unlikely to alter the primary findings. We did not ran-
domize the order of the study protocol between study
participants. Randomization of the protocol activities
would have extended the length of the study protocol
from 3 hours to 6 hours, making it more difficult for
young children to participate. Finally, the children re-
ceived a small snack, which might have increased energy
expenditure above REE by 5%. This was ethically
mandatory to prevent the children from feeling exces-
sively hungry. It did not affect our primary results. De-
spite the limitations, it is clear that activity-promoting
video games can increase screen-associated energy ex-
penditure dramatically.
Activity-promoting video games have the potential to
increase energy expenditure in children to a degree sim-
ilar to that of traditional playtime.
Classic behavior
models and large numbers of video-gaming units and
computers suggest that children are spending more time
in front of screens than they did previously. Further-
more, projections indicate that screen time for children
is likely to continue to increase, rather than decrease.
We think that converting seat-based screen time to ac-
tivity-associated screen time is an essential approach for
promoting an active environment that is also fun for
This work was supported by National Institutes of Health
grants DK50456, DK56650, DK63226, DK66270, and
M01-RR00585. Support was also provided by the Mayo
Clinic Department of Family Medicine Small Grants Pro-
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PEDIATRICS Volume 118, Number 6, December 2006 e1835
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DOI: 10.1542/peds.2006-1087
Brian A. Walker, Dieter Heinz and James A. Levine
Lorraine Lanningham-Foster, Teresa B. Jensen, Randal C. Foster, Aoife B. Redmond,
Time for Children
Energy Expenditure of Sedentary Screen Time Compared With Active Screen
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... The users' feedback suggested that designing different games on the device could provide users with a better experience. Moreover, when a virtual game projection is more natural, it can not only improve the user experience but also enhance the enjoyment of the virtual game [74,75]. By adding competitions and a reward mechanism, the proposed system could provide users with an incentive to persevere and complete tasks. ...
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Macao is a tourist city. It is home to the Ruins of Saint Paul’s, a unique 100-year-old landmark, which is still standing with manual maintenance, even after three fires and reconstruction events. Therefore, the continuous preservation of its culture, heritage education, and construction are important issues for Macao. With the development of digital technology in recent years, users can quickly search historical sites and save two-dimensional and three-dimensional images and videos through smartphones. These methods also enhance the communication power of culture. Virtual browsing on a smartphone requires computing power and storage space; yet, virtual reality devices are not widely used. Therefore, augmented reality and virtual reality are rarely used simultaneously for three-dimensional interactive guided tours and operation experiences on the same theme. However, by quickly creating virtual reality scenarios and preserving historical sites on mobile devices, 4DAGE’s 4DKanKan technology can provide augmented reality and metaverse virtual reality experiences. 4DKanKan can also integrate mobile guides and navigation software to connect mobile devices and assist in cultural inheritance and conduct sustainable education. This research linked this technology to the web by incorporating augmented reality and virtual reality technology to make designs and discussed the influences among service design, behavioral intentions, and learning effects. We collated and analyzed relevant data and text materials through systematic testing, observation, operation processes, and semi-structured interviews. The PLS multigroup structural model was used to explore and analyze the degree of influence and explanatory power of system quality, information quality, behavioral intention, and learning effects among themselves. The results of this study show that most users accepted the proposed innovative mode of operation and found it to be interesting and fun. Augmented reality is not limited by space or time; however, virtual reality devices taking too long to operate, switching too frequently, and having too many functional interfaces can cause operational problems. This study identified and modified the influencing factors and problems of the proposed system, with the aim of continuing to expand the applications of 4DKanKan to other cultural attractions or museums in the future. In addition, the research results can provide a reference for the sustainable development of related cultural sites.
... 6 Exergame play doubled energy expenditure when compared with sedentary screen time for 8 to 12 year old children who played EyeToy and DDR. 10 Exergame play also increases heart rate, a facet of aerobic activity needed for physical fitness. 6 DDR play doubled resting level heart rates during a 45-min period. ...
Background: Digital games, a winning combination of gaming with exercise, known as exergames, can improve youths' health status. The prevalence of overweight children and adolescents has increased drastically over the past several decades due to physical inactivity and sedentary video gaming. This increase is troubling given the potentially numerous adverse health implications. 1 Transforming sedentary video game play into active exergame play could increase caloric expenditure and provide psychosocial and cognitive benefits by increasing self-esteem, social interaction, motivation and visuospatial skills. This article summarizes the literature on exergames, showing the potential of exergames to improve the physical health, as well as transfer effects that may benefit related social, cognitive and academic outcomes.
New approaches are needed to address low physical activity levels among older adults and to promote daily physical activity tailored to their interests and abilities. This study aimed to review the current literature analyzing the physiological demands of exergames in older adults. A systematic database search was conducted in October 2020 and March 2022. A total of 3,540 studies were screened, and 16 were incorporated into the data analysis. The studies included 527 participants, 61% female, with a mean age of 72.3 ± 4.7 years. Analyzed physiological parameters included mean heart rate, rate of perceived exertion, and metabolic equivalents or oxygen uptake. Exergames are capable of offering light- to moderate-intensity activity for older adults (mean heart rate: 108 ± 9.1 bpm; mean rate of perceived exertion: 11.5 ± 1.8; metabolic equivalents: 2.7 ± 0.7). Although implications are positive, high diversity was found in the study design according to intervention duration and assessment of physiological parameters.
Background: Acquiring motor skills is fundamental for children's development since it is linked to cognitive development. However, access to early detection of motor development delays is limited. Aim: This review explores the use and potential of motion-based technology (MBT) as a complement to support and increase access to motor screening in developing children. Methods: Six databases were searched following the PRISMA guidelines to search, select, and assess relevant works where MBT recognised the execution of children's motor skills. Results: 164 studies were analysed to understand the type of MBT used, the motor skills detected, the purpose of using MBT and the age group targeted. Conclusions: There is a gap in the literature aiming to integrate MBT in motor skills development screening and assessment processes. Depth sensors are the prevailing technology offering the largest detection range for children from age 2. Nonetheless, the motor skills detected by MBT represent about half of the motor skills usually observed to screen and assess motor development. Overall, research in this field is underexplored. The use of multimodal approaches, combining various motion-based sensors, may support professionals in the health domain and increase access to early detection programmes.
Exergaming is a fun, engaging, and interactive form of exercise that may help older adults overcome some of the traditional exercise barriers and improve adherence by providing therapeutic applications for balance recovery and functional mobility. The goal of this systematic review is to summarise the effects of exergames on older adults' mobility and balance. Exergames, or digital games that combine exercise and gameplay, can improve youth health while also providing social and academic benefits. Playing exergames raises caloric expenditure, heart rate, and coordination. Exergame play may have psychosocial and cognitive effects such as increased self-esteem, social interaction, motivation, attention, and visual-spatial skills. In this study the literature on exergames, with a focus on physical education classes and the potential of exergames to improve students' physical health, as well as transfer effects that may benefit related physical, social, and academic outcomes.
Growing concerns about children's sedentary behavior and health have drawn attention to their screen behaviors at home. However, this work leans on a deterministic and essentializing view of children, screen devices, and the home, such that it tends to equate any time spent on screens with being sedentary, device presence with increased use where children are passive receptors of screen influence, and the home as a place where parents control their children's screen use. This paper shows instead that children's screen use at home needs to be understood as a sociomaterial assemblage that is dynamic and contingent, and that affect is central to these assemblages. The paper draws on a mixed-methods exploratory study conducted with 6–12 year old children in their homes in Sweden, using accelerometry and observational data to note the children's movement behaviors as well as their screen activities. The findings show that children are both sedentary and active while using screens, questioning the idea of screen time as necessarily sedentary. Moreover, children's screen practice assemblages at home are composed of various elements that come together in dynamic and highly situated ways, challenging the device and parental influence narrative. The paper shows how we need to pay attention to the ways in which these assemblages come together and children's actual performances of screen practices in order to move beyond the predominant discourse surrounding screen time.
The aim of the present study was to examine the efficacy of Active Video Games (AVGs) in creating an effective learning experience for undergraduate students. Students enrolled on a Level 5 (i.e. Year 2) sport psychology module (N=74) participated in four practical seminars demonstrating the impact of four psychological factors (e.g. anxiety) on sports performance. Students engaged in two seminars which included an AVG task (e.g. Wii Sports), and two sessions which included a non-AVG task (e.g. Quoits). Immediately after the conclusion of each practical session, students were asked to provide qualitative comments to describe and explain their experience of the seminar. Content analysis of students’ comments revealed four major themes: session approach, session experience, learning experience, and session feedback. Each theme is defined and discussed in relation to the efficacy of AVGs as a resource in the teaching of undergraduate sport psychology. The authors also reflect on their experience of adopting the innovative approach and highlight some of the potential challenges practitioners may face when attempting to integrate AVGs into their learning activities.
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OBJECTIVES. This study assessed the claim that children's television use interferes with time spent in more developmentally appropriate activities. METHODS. Data came from the first wave of the Child Development Supplement, a nationally representative sample of children aged 0 to 12 in 1997 (N = 1712). Twenty-four-hour time-use diaries from 1 randomly chosen weekday and 1 randomly chosen weekend day were used to assess children's time spent watching television, time spent with parents, time spent with siblings, time spent reading ( or being read to), time spent doing homework, time spent in creative play, and time spent in active play. Ordinary least squares multiple regression was used to assess the relationship between children's television use and time spent pursuing other activities. RESULTS. Results indicated that time spent watching television both with and without parents or siblings was negatively related to time spent with parents or siblings, respectively, in other activities. Television viewing also was negatively related to time spent doing homework for 7- to 12-year-olds and negatively related to creative play, especially among very young children (younger than 5 years). There was no relationship between time spent watching television and time spent reading (or being read to) or to time spent in active play. CONCLUSIONS. The results of this study are among the first to provide empirical support for the assumptions made by the American Academy of Pediatrics in their screen time recommendations. Time spent viewing television both with and without parents and siblings present was strongly negatively related to time spent interacting with parents or siblings. Television viewing was associated with decreased homework time and decreased time in creative play. Conversely, there was no support for the widespread belief that television interferes with time spent reading or in active play.
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We examined the effect of television viewing on resting metabolic rate (RMR) in a cohort of 9 obese and 18 nonobese girls aged 10.4 +/- 1.1 y. RMR was measured while girls watched television, read, or sat quietly for 15 min. Movement was assessed by using activity monitors and a manual count of movements observed on a videotape. Absolute RMR was greater for the obese girls, but no significant treatment effect existed for absolute RMR within either group. Although measured activity did not differ, observed movements were greater when the girls were sitting quietly. Total observed and measured movements were significantly correlated with the CV of the minute-by-minute RMR. These results suggest that television viewing does not alter RMR. Although children appear to fidget more when sitting quietly than when they read or watch television, fidgeting appears to affect the minute-to-minute variation of RMR rather than the level of resting energy expenditure.
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Elevated television (TV) viewing and physical inactivity promote obesity in children. Thus, changes in physical activity and sedentary behavior seem critical to treating childhood obesity. PRESENT STUDY: Using a randomized, 2-arm design, this pilot study tested the effects of contingent TV on physical activity and TV viewing in 10 obese children. TV viewing was contingent on pedaling a stationary cycle ergometer for experimental participants but was not contingent on pedaling for control participants. The study was conducted over 12 weeks, including a 2-week baseline period. Multivariate analyses indicated that the intervention significantly increased pedaling and reduced TV-viewing time. During the treatment phase, the experimental group pedaled 64.4 minutes per week on average, compared with 8.3 minutes by controls. The experimental group watched 1.6 hours of TV per week on average, compared with 21.0 hours per week on average by controls during this phase. Secondary analyses indicated that the experimental group showed significantly greater reductions in total body fat and percent leg fat. Total pedaling time during intervention correlated with greater reductions in percent body fat (r = -0.68). Contingencies in the home environment can be arranged to modify physical activity and TV viewing and may have a role in treating childhood obesity. Contingent TV may be one method to help achieve this goal.
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The obesity epidemic shows no signs of abating. There is an urgent need to push back against the environmental forces that are producing gradual weight gain in the population. Using data from national surveys, we estimate that affecting energy balance by 100 kilocalories per day (by a combination of reductions in energy intake and increases in physical activity) could prevent weight gain in most of the population. This can be achieved by small changes in behavior, such as 15 minutes per day of walking or eating a few less bites at each meal. Having a specific behavioral target for the prevention of weight gain may be key to arresting the obesity epidemic.
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The prevalence of overweight and obesity has increased markedly in the last 2 decades in the United States. To update the US prevalence estimates of overweight in children and obesity in adults, using the most recent national data of height and weight measurements. As part of the National Health and Nutrition Examination Survey (NHANES), a complex multistage probability sample of the US noninstitutionalized civilian population, both height and weight measurements were obtained from 4115 adults and 4018 children in 1999-2000 and from 4390 adults and 4258 children in 2001-2002. Prevalence of overweight (body mass index [BMI] > or =95th percentile of the sex-specific BMI-for-age growth chart) among children and prevalence of overweight (BMI, 25.0-29.9), obesity (BMI > or =30.0), and extreme obesity (BMI > or =40.0) among adults by sex, age, and racial/ethnic group. Between 1999-2000 and 2001-2002, there were no significant changes among adults in the prevalence of overweight or obesity (64.5% vs 65.7%), obesity (30.5% vs 30.6%), or extreme obesity (4.7% vs 5.1%), or among children aged 6 through 19 years in the prevalence of at risk for overweight or overweight (29.9% vs 31.5%) or overweight (15.0% vs 16.5%). Overall, among adults aged at least 20 years in 1999-2002, 65.1% were overweight or obese, 30.4% were obese, and 4.9% were extremely obese. Among children aged 6 through 19 years in 1999-2002, 31.0% were at risk for overweight or overweight and 16.0% were overweight. The NHANES results indicate continuing disparities by sex and between racial/ethnic groups in the prevalence of overweight and obesity. There is no indication that the prevalence of obesity among adults and overweight among children is decreasing. The high levels of overweight among children and obesity among adults remain a major public health concern.
We develop an observation system that quantifies the duration, intensity, and frequency of children's physical activities. We use this system to assess the level and tempo of energy expenditure under free-ranging, natural conditions experienced by 15 children aged 6-10 yr in southern California. Observations were recorded every 3 s during 4-h time blocks from 8:00 a.m.-8:00 p.m. Agreement among observers using the coding system was 91%. Using indirect calorimetry, calibration studies in the laboratory determined VO2 (ml.min-1.min-1) during each coded activity, and activities were categorized by intensity (low, medium, or high). Subjects were found to engage in activities of low intensity 77.1% of time and activities of high intensity 3.1% of time. The median duration of low and medium intensity activities was 6 s, of high intensity activities only 3 s with 95% lasting less than 15 s. Children engaged in very short bursts of intense physical activity interspersed with varying intervals of low and moderate intensity. These findings may be important for discovering how children's activity patterns under natural conditions influence physiological processes leading to growth and development. This study demonstrates the advantages of using an observational system that captures more than the intensity and frequency of children's activities to include duration and the length of intervals between activities of varying intensity.
Research on the promotion of physical activity has been based on a variety of conceptual models. These models generally target one level of analysis, such as the individual, community, or the environment, and differ in their relative contact with basic or applied science. There have been limited attempts to develop approaches that target multiple levels of analysis and can stimulate basic and applied research. Theoretical integration in a multidiscliplinary field such as promotion of physical activity should take into account that social, behavioral, and biomedical colleagues may use different explanatory models, and use different approaches to the development of scientific knowledge. This essay argues for the development of integration of theory across multiple domains that can incorporate methods and findings of basic and applied scientists, and that uses language and methods common to social, behavioral, and biomedical scientists. Behavioral choice theory is presented as an example of one theoretical approach that bridges different approaches to physical activity intervention, and that can stimulate both basic and applied research on physical activity. Behavioral research on choice was discussed in relationship to basic research, human laboratory research, and community and clinical research. Implications of behavioral choice theory for community and environmental change was discussed. The essay ends with ideas for future directions in integration of theory for physical activity research.
Epidemiological studies have shown television watching to be a risk factor for the development of obesity in children. The effect of reducing television watching and other sedentary behaviors as a component of a comprehensive obesity treatment program has not been thoroughly tested. To compare the influence of targeting decreases in sedentary behavior vs. increases in physical activity in the comprehensive treatment of obesity in 8- to 12-year-old children. Randomized, controlled outcome study. Childhood obesity research clinic. Ninety families with obese 8- to 12-year-old children were randomly assigned to groups that were provided a comprehensive family-based behavioral weight control program that included dietary, and behavior change information but differed in whether sedentary or physically active behaviors were targeted and the degree of behavior change required. Results during 2 years showed that targeting either decreased sedentary behaviors or increased physical activity was associated with significant decreases in percent overweight and body fat and improved aerobic fitness. Self-reported activity minutes increased and targeted sedentary time decreased during treatment. Children substituted nontargeted sedentary behaviors for some of their targeted sedentary behaviors. These results support reducing sedentary behaviors as an adjunct in the treatment of pediatric obesity.
Interventions for prevention and treatment of childhood obesity typically target increases in physical activity and, more recently, reductions in physical inactivity (sedentary behaviour such as television viewing). However, the evidence base for such strategies is extremely limited. The main aim of the present review was to update the systematic review and critical appraisal of evidence in the light of the recent rapid expansion of research in this area. Randomised controlled trials (RCT) that targeted activity or inactivity, that followed up children or adolescents for at least 1 year and that included an objective weight-related outcome measure were included. Trials were appraised using previously published criteria (Harbour & Miller, 2001), and literature search strategies described previously (Reilly et al. 2002) were updated to May 2002. A total of four new RCT, two new systematic reviews and one meta-analysis were identified. The evidence base has increased markedly since the completion of earlier reviews, although high-quality evidence is still lacking. The evidence on childhood obesity prevention is not encouraging, although promising targets for prevention are now clear, notably reduction in sedentary behaviour. There is stronger evidence that targeting activity and/or inactivity might be effective in paediatric obesity treatment, but doubts as to the generalisability of existing interventions, and the clinical relevance of the interventions is unclear. Further research in settings outside the USA is urgently needed, and two ongoing RCT in Scotland are summarised.