The long term physical and behavioral effects of countless hours spent playing video games have been bemoaned by critics for years, but researchers at Baylor College of Medicine (BCM) have found that when properly structured, video games can yield positive implications, even influencing children to make healthier food choices.
 
“Obesity prevention interventions are not working with children (nor adults),” commented Tom Baranowski, PhD, professor of Pediatrics, Behavioral Nutrition, BCM. “We need to find new ways to engage children, and being fun seems more promising than not.”
 
Dr. Baranowski and his colleagues at Baylor recently concluded their fourth study on the effects of video games on children’s behavior regarding diet and physical activity. The study observed 133 children aged 10-12 with Body Mass Indices (BMIs) between the 50th and 95th percentile as they played two video games—“Escape from Diab” (Diab) and “Nanoswarm: Invasion from Inner Space” (Nano)—which were specially designed and based on social cognitive, self determination and persuasiontheories as they related to diet, physical activity and tendency toward obesity. A control group, on the other hand, was furnished with diet and activity information along with website video games. Both groups were questioned about attitudes and behaviors after playing the games.
 
“Diab and Nano were designed as epic video game adventures, comparable to commercial-quality video games [and] incorporated a broad diversity of behavior change procedures woven in and around engrossing stories,” the research team reported in the study titled “Video Game Play, Child Diet, and Physical Activity Behavior Change—A Randomized Clinical Trial,” which was published in the January issue of the American Journal of Preventative Medicine. “The games motivated players to substantially improve diet behaviors.”
 
At the close of the study, researchers found some positive attitude shifts related to increased fruit and vegetable consumption in comparison to the control group, however water consumption and activity levels remained virtually unchanged.
 
“More work is needed,” they wrote, and added that although “Serious video games hold promise, effectiveness and mechanisms of change among youth need to be investigated more thoroughly.”
 
Dr. Baranowski said that although the team had hoped for data to indicate a greater shift, the small sample size and unequal groups at baseline impaired any ability to detect true changes. “When we analyzed the data with a repeated measures statistic we found diet change of a full serving per day and 10 minutes of MV physical activity, but the statistical consultant to the editor insisted we use the analysis of covariance technique,” he said. “We were hoping to do better than one serving and 10 minutes too, but this would have been the first study to show that videogames could change diet and physical activity at the same time!”

In all, Dr. Baranowski was excited by the possibility that someday there could be video games that persuaded the pickiest eaters and most sedentary kids to, say, give broccoli a try or get out and enjoy some fresh air with friends, but there is still much work to be done in terms of fine tuning such an approach. “There are many things to learn about the design of videogames for obtaining behavior change,” he said. “For example, there were no mediating variable changes in our pilot study. That doesn’t make sense in our current understanding of how change programs work.”

In the meantime, Dr. Baranowski is working to secure funding for a larger study centering on Diab and Nano. “We have a current grant funded on active videogames promoting physical activity among inner city kids,” he said. “We have another grant funded on training parents in effective vegetable parent practices (using a game format to help parents get their child to eat vegetables, based on food parenting research being done at BCM).”
 
Funding for this video game study was provided by the National Institute of Diabetes and Digestive and Kidney Diseases, a part of the National Institutes of Health.