ExerGames: Not Just Another Health Craze!

ExerGames: Not Just Another Health Craze!

ExerGames: Not Just Another Health Craze!

Exergames (exercise + games) otherwise known as active video games are being touted as the ultimate cure for obesity. Refreshing, since everyone is still looking for that magic diet pill!

   

ExerGames: Not Just Another Health Craze!

image by: RODNAE Productions

Can exergames be used positively to treat childhood obesity and get kids moving more than just their thumbs? In contrast to traditional video games, exergames allow players to experience various activities (e.g., bowling, fishing, tennis, golf) in a virtual world or even take a walk or run. Hand controllers are eliminated and the body is used to power the game.

For obese children, “eating less and moving more” is the formula. In fact, research has revealed that children were six times more likely to take to exercise if it involved a video game. Experts think it is “a step forward in working towards reducing obesity among the young” as “electronic entertainment is not going away. So, if we want to promote physical activity in the context of contemporary society, we will have to fight fire with fire”.1-7

Obesity is not only a serious public health issue but it is also considered one of the global epidemics along side AIDS and malaria. In 2004 the Institute of Medicine of the National Academies announced that “approximately 9 million children in the U.S. are overweight".  This figure is at least double of that three decades ago. The trend observed for children is similar in adults and internationally, in both developed and developing countries.8,9

For instance, about 15% of adults in the EU countries are obese.  The 2010 Health Survey for England for the period from 1995 to 2010 reported that "the prevalence of obesity among boys aged 2-15 increased by 6 percentage points (from 11% to 17%), and the equivalent increase for girls was 3 percentage points (from 12% to 15%)".10

A combination of many factors are responsible for this, such as environmental setups and family pressures that either or both decrease access to sports and traditional physical activities and encourage the consumption of convenience foods which are usually high in calories.

Consider the following:

As early as 2003 statistics in the Health Survey for England showed that the percentage of adults meeting the recommendations for physical activity declined with age for both sexes. Since the early 1990s there has been a steady increase in the use of cars and a decrease in walking and cycling to school or to work in GB. Among children aged five to ten, the proportion who walked to school fell from 61 per cent in 1992–94 to 52 per cent in 2002–03, mirroring the equivalent 10 percentage point rise in the proportion of school journeys by car, from 30 per cent to 40 per cent.

Among adolescents aged 11 to 16, the proportion of journeys to school by car increased from 16 to 23 per cent over the same period, reflecting the combined decrease in journeys on foot or by bicycle. For adults aged 17 and over, the proportion of journeys to work where the main mode of travel was by car rose from 66 per cent in 1989–91 to 71 per cent in 2002–03. During the same interval journeys that were mainly on foot fell from 13 to 10 per cent".11

Nielsen Wire reports that “the average American watches approximately 153 hours of TV every month at home, a 1.2% increase from last year.  In addition, the 131 million Americans who watch video on the Internet watch on average about 3 hours of video online each month at home and work. The 13.4 million Americans who watch video on mobile phones watch on average about 3 ½ hours of mobile video each month."  Time spent on TV decreases what could have been spent on other leisure activities such as sports.12

Not only TV, but the presence of other media competes with traditional leisure activities.  “In the last decade, computer and video game sales have increased by $5.2 billion and more than 83 percent of U.S. children age 8 to 18 have video game players in their bedrooms." 

The Pew Internet & American Life Project revealed that 97% of American children play videogames and more than half of the adults (53%) play computer games.  Parents are gaming as well and introduce their children to video games. There is no difference among ethnic and income groups.13

The Media Use Statistics also informs that those who do not have computers at home have a game console, such as Sony Corp.'s PlayStation, Microsoft Corp.'s Xbox or Nintendo Co.'s Wii.   And the National Obesity Forum reports “among children, the amount of time spent on TV/Video game play is different among states but is strongly positively correlated to percentage of children classed as overweight per state”.14,15

In a recent study published in the Journal of Preventive Medicine it was found that male video game players (and heavy Internet users) usually have higher body max index (therefore, obese). Research has shown that obesity increases the risks for many diseases from cardiovascular disorders, to arthritis, to sleep disorders and cancer. In children this may be associated with lower life expectation and serious psychosocial problems.16

Moreover,“every day, one in three children (from age 4 to 19) eats fast food.”  Partly to blame here is the significant “increase of fast food chains and considerable marketing that focus on children".17

One of the first exergames was Konami's Dance Dance Revolution (DDR), which was released in 1998.

Now, there are several successful exergames in the marketplace such as Xavix, X-Bike, X-Board Snowboard Simulator, Eye Toy Kinetic and WiiSport. Basically, there is a console which makes the players imitate bikers, boxers, golfers, tennis players etc. or do a particular sport such as in the case of NEXGYM. It is an “interactive sports arena” where one can attend sports training like aerobics, karate and yoga.

WiiFit was recently introduced and includes a “Wii Balance Board” which allows the body mass index (BMI) to be calculated. It was the No. 2 selling game in 2008 with 8.31 million sold. Gamercize, a British product that connects a device, usually a mini-bike or a step machine to any video game system and is kept running only as long as the user keeps moving on the device, may not be in the category of exergames but is also a popular product for a similar purpose.

So, does exergaming work?

Several published studies have evaluated exergaming, but only in age groups ranging from 6 to 17 years old. Calories burned and heart rates increase after engaging in exergames when compared with seated video games or watching TV. Not a surprise!

But after reviewing the published studies to date, researchers at the University of Birmingham in the UK concluded that there is no adequate evidence supporting the contention that exergaming positively influences children's health.18

This conclusion was based on the following:

The amount of energy spent doing exergames is just equivalent to doing moderate-intensity walking.  This was very clearly shown from the investigations of Dr. Graf’s team from the University of Oklahoma who compared energy use  in two popular exergames with treadmill walking.  Dr. Maddison and co-workers from the University of Auckland in New Zealand already in an earlier study concluded that exergaming is "similar in intensity to light to moderate traditional physical activities such as walking, skipping, and jogging".19,20

Although the energy spent in exergaming doubles that when doing seated video gaming, the former does not equal the energy used to doing the sport itself.  Dr. Graves and co-workers from the Research Institute for Sport and Exercise Sciences in Liverpool John Moores University published their results in the British Journal of Sports and Medicine stated that exergaming does not meet the daily requirements of exercise recommended for children.21

Little movement is better than no movement. Dr. Mellecker and Dr. McManus, who did a study involving primary school children in Hong Kong commented that low-intensity activity may still have positive health benefits like washing and cooking in adults which positively influences plasma-glucose levels. So if the choice is between moving and not moving at all, the alternative of exergaming is indeed preferable. Whether this improves health is still questionable.22

In fact, there are some downsides.

Gaming or watching TV encourages consumption of unhealthy food. The importance of diet should not be taken for granted. According to LiveScience, exercise alone cannot cure obesity. Physical activity has many proven benefits. It strengthens bones and muscles, improves mental health and mood, lowers blood pressure, improves cholesterol levels and reduces the risk of cardiovascular disease, diabetes, breast cancer and colon cancer…It may not be a cure-all for obesity, however. Though better nutrition coupled with exercise has long been the favored prescription for losing weight and avoiding obesity, a new study suggests diet actually plays the key role.  A longterm diet change must be associated with exergaming to achieve positive results.23

Exercise programs can cause injury.  Exergames are no exception, experts say. They also worry that people will substitute light game workouts (such as the three-minute hula-hoop sessions on Wii Fit) for more vigorous activities (such as brisk 30-minute, real-world walks). 

And there is also the risk of isolation in exergames.  An article in e!Science News reports a recent study  published in the American Journal of Preventive Medicine that there is now a strong correlation between video gaming and social isolation and therefore depressiveness in adults. “Playlike activities” presented in video games are different from original forms of play.24

This leads one to think: how “different” are exergames to traditional games and how do they influence our thinking process. Will exergames still encourage social interaction?  Are they as satisfying as doing sports itself?  A complaint of a WiiFit user is “…the virtual trainer who keeps trying to strike up a conversation with me, but it's all one sided as he never listens to me telling him to shut up and get on with the next exercise.”  

Dr. Holder and colleagues from the University of British Columbia published a report on the importance of active leisure undertaking to a child’s feeling and well-being compared to passive video games. After all exergaming is still passive entertainment.25

However, exergame fans still believe the benefits go beyond just physical activity.

The influence of exergaming in acquiring basic movement skills such as balance, agility and reaction, is still being unravelled and is the object of current research at Canada’s first Exergaming Research Centre.

Additionally, Linda Carson, a professor of physical education at West Virginia University, recently stated that exergaming may stimulate children to engage in outdoor sports for the first time. Another potential of active video games is in rehabilitating people after injuries or encouraging elderly to walk and thus “learn to maintain their balance, strength and reaction to physical events.”

The Bottom Line

Exercising or playing outside is still irreplaceable. A trainer and mother gave these words in an article in the Boston News, "If you're not doing anything at all, then DDR ( Dance Dance Revolution) is better than doing nothing...But kids have to be creative; you're not making friends when you're sitting inside playing Wii".

However, exergames may offer an alternative to moderate exercise for those leading sedentary lives and at high risk for obesity and diabetes. The actual benefits, however are not well-known as the current state of evidence is not really conclusive.

Published January 4, 2010, updated May 30, 2012


References:

  1. Video games promoted in Fight Against Childhood Obesity, Montreal Gazette, Canada.com, November 4, 2008
  2. Couch athlete: how to get fit from the comfort of your sofa, The Independent, July 17, 2007
  3. Gaming Gets in Shape, BBC, August 22, 2006
  4. Obesity and Exercise, KickstartFit
  5. Children's calorie expenditure, heart rate increase during active video games, eScience News, September 1, 2008
  6. Graves LE, The contribution of upper limb and total body movement to adolescents' energy expenditure whilst playing Nintendo Wii, Eur J Appl Physiol. 2008 Nov;104(4):617-23. Epub 2008 Jul 8
  7. Maddison R, 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, BMC Public Health 2009, 9:146
  8. Overweight and Obesity, Centers for Disease Control and Prevention, April 27, 2012
  9. Preventing Childhood Obesity: Health in the Balance, Institute of Medicine of the National Academies, September 2004
  10. Health Survey for England - 2010: Trend tables, NHS
  11. Statistics on Obesity, Physical Activity and Diet: England, NHS, February 2009
  12. Americans Watching More TV Than Ever; Web and Mobile Video Up too, Nielsen Wire, May 20, 2009
  13. Pew study shows 53% of US adults play computer games, Top News, December 2008
  14. The Evolving Video Landscape study, Media Use Statistics
  15. Waine C, TV/video games and child obesity, National Obesity Forum, September 2007
  16. Weaver JB 3rd, Health-risk correlates of video-game playing among adults, Am J Prev Med. 2009 Oct;37(4):299-305
  17. Fast Food Consumption Leads to Child Obesity, WeightLossWand.com
  18. Daley AJ, Can exergaming contribute to improving physical activity levels and health outcomes in children? Pediatrics. 2009 Aug;124(2):763-71. Epub 2009 Jul 13
  19. Graf DL, Playing active video games increases energy expenditure in children, Pediatrics. 2009 Aug;124(2):534-40. Epub 2009 Jul 13
  20. Maddison R, Energy expended playing video console games: an opportunity to increase children's physical activity? Pediatr Exerc Sci. 2007 Aug;19(3):334-43
  21. Graves L, Energy expenditure in adolescents playing new generation computer games, Br J Sports Med. 2008 Jul;42(7):592-4
  22. Mellecker RR, Energy expenditure and cardiovascular responses to seated and active gaming in children, Arch Pediatr Adolesc Med. 2008;162(9):886-891
  23. Exercise won’t cure obesity, Live Science, January 2009
  24. New study finds links between video-game playing and health risks in adults, e! Science news, August 2009
  25. Holder MD, The contribution of active and passive leisure to children's well-being, J Health Psychol. 2009 Apr;14(3):378-86

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Last Updated : Monday, November 28, 2022