Obesity

Exploring the potential of computer and video games for health and physical education: A literature review

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This study aims at critically reviewing recently published scientific literature on the use of computer and video games in Health Education (HE) and Physical Education (PE) with a view: (a) to identifying the potential contribution of the incorporation of electronic games as educational tools into HE and PE programs, (b) to present a synthesis of the available empirical evidence on the educational effectiveness of electronic games in HE and PE, and (c) to define future research perspectives concerning the educational use of electronic games in HE and PE. After systematically searching online bibliographic databases, 34 relevant articles were located and included in the study. Following the categorization scheme proposed by [Dempsey, J., Rasmussen, K., & Lucassen, B. (1996). The instructional gaming literature: Implications and 99 sources. University of South Alabama, College of Education, Technical Report No. 96-1], those articles were grouped into the following four categories: (a) research, (b) development, (c) discussion and (d) theory. The overviewed articles suggest that electronic games present many potential benefits as educational tools for HE and PE, and that those games may improve young people's knowledge, skills, attitudes and behaviours in relation to health and physical exercise. Furthermore, the newly emerged physically interactive electronic games can potentially enhance young people's physical fitness, motor skills and motivation for physical exercise. The empirical evidence to support the educational effectiveness of electronic games in HE and PE is still rather limited, but the findings present a positive picture overall. The outcomes of the literature review are discussed in terms of their implications for future research, and can provide useful guidance to educators, practitioners and researchers in the areas of HE and PE, and to electronic game designers.

Playing Active Video Games Increases Energy Expenditure in Children

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OBJECTIVE: To compare energy expenditure rates in children playing the physically active video games, Dance Dance Revolution ( DDR) and Nintendo's Wii Sports in relation to treadmill walking.METHODS: Energy expenditure, heart rate, step rate, and perceived exertion were measured in 14 boys and 9 girls ( ages 10-13 years; BMI at 3-98th percentile for age and gender) while watching television at rest, playing DDR at 2 skill levels, playing Wii bowling and boxing, and walking at 2.6, 4.2, and 5.7 km/h. Arterial elasticity was measured at rest and immediately after gaming.RESULTS: Compared with watching television, energy expenditure while gaming or walking increased 2- to 3-fold. Similarly, high rates of energy expenditure, heart rate, and perceived exertion were elicited from playing Wii boxing, DDR level 2, or walking at 5.7 km/h. This occurred despite variations in step rate among activities, reflecting greater use of upper body during Wii play ( lowest step rate) than during walking ( highest step rate) or DDR play. Wii bowling and beginner level DDR elicited a 2-fold increase in energy expenditure compared to television watching. Large-artery elasticity declined immediately after both DDR and Wii. The change was inversely related to the increment in energy expenditure above rest achieved during the activity.CONCLUSIONS: Energy expenditure during active video game play is comparable to moderate-intensity walking. Thus, for children who spend considerable time playing electronic screen games for entertainment, physically active games seem to be a safe, fun, and valuable means of promoting energy expenditure. Pediatrics 2009; 124: 534-540

Parents of Preschoolers: Expert Media Recommendations and Ratings Knowledge, Media-Effects Beliefs, and Monitoring Practices

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OBJECTIVE. Given the increase in screen media targeted at the very young, the purpose of this study was to examine preschooler parents' knowledge about expert recommendations for young children's screen media experience, their knowledge of specific screen media ratings, their beliefs about screen media effects, and actual monitoring practices.METHOD. Parents of 94 children < 5 years of age (mean age: 2.95 years) were surveyed. Questionnaires were distributed in day care centers and completed at the parents' convenience. The questionnaire included background questions about parental education, age and gender of child, and parents' perceptions of their child's favorite television show and favorite video or computer game. Eleven multiple-choice questions assessed the respondent's knowledge of expert recommendations for screen media for preschoolers and the meaning of television and video game content ratings. Fourteen questions addressed the typical amount of their preschooler's screen media exposure, parental rules regarding screen media use, and parents' beliefs about appropriate use of screen media for preschoolers.RESULTS. Preschoolers were exposed to an average of similar to 12 hours of screen media in a typical week. Parents believe that media do have either short- or long-term effects on preschoolers. Performance on factual questions was poor (mean score: 2.83 of 11). In particular, only 34% of the parents correctly identified the expert recommendation for children > 2 years of age.CONCLUSIONS. Parents should continue to be educated about the need for preschoolers to participate in activities that promote language development, socialization, imagination, and physical activity. Although professionals should work to improve the ratings, and ultimately to implement a universal ratings system for all screen media, parents need to be encouraged to improve their understanding of current recommendations for screen media exposure and television and video game ratings. Pediatrics 2009;123:981-988

Cardiovascular effects in adolescents while they are playing video games: A potential health risk factor?

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We analyzed heart rate (HR), systolic and diastolic blood pressure (SBP, DBP), oxygen consumption, and carbon dioxide production in 17 male adolescents during a racing simulation video game (VG) and compared to resting state (RS) and exercise testing (ET) measures. We were able to demonstrate a significant (p<.005) increase from RS to VG concerning HR (+13.1 bpm), SBP (+20.8 mmHg), and DBP (+12.1 mmHg) with SBP and DBP elevations exceeding 2 SD in all children and 14/17 children, respectively. The energy consumption during VG (max 1.71 kcal/min) was unaltered compared to RS and significantly lower compared to ET even at the starting strain of 25 W (1.94 kcal/min). Hemodynamic parameters tested demonstrated lower HR, unchanged SBP, and higher DBP during the VG compared with ET. Comparing all measured parameters it can be said that the relation of blood pressure and energy consumption during VG might not be favorable. Copyright \copyright2007 Society for Psychophysiological Research.

Energy expenditure of sedentary screen time compared with active screen time for children

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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 games.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 traditional 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 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).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.

Television, computer use, physical activity, diet and fatness in Australian adolescents

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Purpose. To examine sedentary behaviours (including television viewing, playing computer games and computer use), diet, exercise and fitness in relation to overweight/obesity in Australian adolescents. Methods. Questionnaires elicited food frequency data, time spent in TV viewing, using computers, other sedentary occupations and physical activity recall. Weight, height and fitness (laps completed in the Leger test) were measured. Results. Among 281 boys and 321 girls, mean age 12 years (SD 0.9), 56 boys (20.0%) and 70 girls (23.3%) were overweight/obese. Greater fitness was associated with decreased risk of overweight/obesity in boys (Odds ratio [OR] 0.74; 95% CI 0.55, 0.99) and girls (OR 0.93; 95% CI 0.91, 0.99). TV-viewing predicted increased risk in boys (OR 1.04; 95'% CI 1.01, 1.06) and decreased risk in girls (OR 0.99; 95% CI 0.96, 0.99). Computer use, video games, and other sedentary behaviours were not significantly related to risk of overweight/obesity. Vegetable intake was associated with lower risk in boys (OR 0.98; 95% CI 0.97, 0.99); greater risk was associated with lower fat intake in boys and girls, lower consumption of energy-dense snacks in boys (OR 0.74; 95% CI 0.62, 0.88) and greater intake of vegetables in girls (OR 1.02; 95% CI 1.00, 1.03), suggesting dieting or knowledge of favourable dietary choices in overweight/obese children. Conclusions. Among these adolescents, fitness was negatively related to risk for overweight/obesity in boys and girls. TV-viewing was a positive predictor in boys and a negative predictor in girls but the effect size was small; other sedentary behaviours did not predict risk.

Trends in physical activity and sedentary behaviour in adolescence: ethnic and socioeconomic differences

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Objective: To assess developmental trends in physical activity and sedentary behaviour in British adolescents in relation to sex, ethnicity and socioeconomic status (SES).Design: A 5-year longitudinal study of a diverse cohort of students aged 11 - 12 years at baseline in 1999.Setting: 36 London schools sampled using a stratified random sampling procedure.Participants: A total of 5863 students categorised as white, black or Asian, and stratified for SES using the Townsend Index.Main outcome measures: Number of days per week of vigorous activity leading to sweating and breathing hard. Hours of sedentary behaviour, including watching television and playing video games. Data were analysed using multilevel, linear, mixed models.Results: Marked reductions in physical activity and increases in sedentary behaviour were noticed between ages 11 - 12 and 15 - 16 years. Boys were more active than girls, and the decline in physical activity was greater in girls (46% reduction) than in boys (23%). Asian students were less active than whites, and this was also true of black girls but not boys. Black students were more sedentary than white students. Levels of sedentary behaviour were greater in respondents from lower SES. Most differences between ethnic and SES groups were present at age 11 years, and did not evolve over the teenage years.Conclusions: Physical activity declines and sedentary behaviour becomes more common during adolescence. Ethnic and SES differences are observed in physical activity and sedentary behaviour in British youth that anticipate adult variations in adiposity and cardiovascular disease risk. These are largely established by age 11 - 12 years, so reversing these patterns requires earlier intervention.

Sleep timing and quantity in ecological and family context: A nationally representative time-diary study

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Associations between demographic characteristics, school schedules, activity choices, family functioning, and sleep behaviors were estimated using, nationally representative time-diary data from 2,454 children (ages 5.5 to 11.9 years) and adolescents (ages 12.0 to 19.1 years). For weekdays, African American adolescents, Asian children, and those with earlier school start times and longer travel times to school reported fewer sleep hours. More time spent watching television (for children), doing homework (for adolescents), and engaging in religious activities predicted fewer hours, whereas a longer time spent on meals predicted greater hours of weekday sleep. For younger children, greater parental warmth predicted more hours of weekday sleep, whereas for adolescents, stricter household rules were protective. On weekends, African American adolescents and Hispanic children slept less, and there were strong effects of activity choices including time spent on television, computer and video-games, sports, religious activities, socializing, and employment. In accounting for age-related decreases in sleep hours from childhood to adolescence, earlier school start times, greater hours of homework, greater paid employment, less time spent on meals, and fewer household rules were all significant mediators.

A descriptive epidemiology of screen-based media use in youth: A review and critique

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The purpose of this systematic review was to (i) estimate the prevalence and dose of television (TV) viewing, video game playing and computer use, and (ii) assess age-related and (iii) secular trends in TV viewing among youth (<= 18 yr). Ninety studies published in English language journals between 1949 and 2004 were included, presenting data from 539 independent samples (the unit of analysis). Results suggest contemporary youth watch on average 1.8-2.8 h of TV per day, depending on age and gender. Most (66%) are 'low users' (< 2 h day(-1)) of TV but 28% watch more than 4 h day(-1). Boys and girls with access to video games spend approximately 60 and 23 min day(-1), respectively, using this technology. Computer use accounts for an additional 30 min day(-1). Age-specific data suggest TV viewing decreases during adolescence, but those considered 'high users' at young ages are likely to remain high users when older. For children with access to a television set, the number of hours spent viewing does not appear to have increased over the past 50 years.

Changes in sedentary behavior among adolescent girls: A 2.5-year prospective cohort study

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Purpose: To describe longitudinal changes in leisure-time sedentary behavior among girls, during early to mid-adolescence. Methods: A 2.5-year prospective cohort study, comprising 5 data collections, 6 months apart, between 2000 and 2002. Girls aged 12-15 years (n = 200) from 8 high schools located in Sydney, Australia, self-reported the usual time spent each week in a comprehensive range of sedentary behaviors. Results: Retention rate for the study was 82%. Girls aged 12.8 years spent approximately 45% of their discretionary time in sedentary behavior, which increased to 63% at age 14.9 years. Watching TV, videos, and playing video games (small screen recreation; SSR) was the most popular sedentary pastime, accounting for 33% of time spent in sedentariness, followed by homework and reading (25%). Sedentary behavior increased 1.4 and 3.3 hours on week and weekend days, respectively. On weekdays, increased time was spent on hobbies (27 min/day) and on weekend days, increased time was spent sitting around talking with friends (60 min/day), computer use (37 min/day), and television viewing (34 min/day). Conclusions: Among girls, the transition between early and mid-adolescence was accompanied by a significant increase in leisure-time sedentary behavior. Interventions to reduce sedentariness among adolescent girls are best to focus on weekend behaviors. Studies seeking to examine the association between inactivity and the development of chronic health problems need to examine a diverse range of activities that comprehensively measure sedentariness. This information will provide a better understanding of inactivity patterns among adolescent girls.

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