Video Game Play, Child Diet, and Physical Activity Behavior Change: A Randomized Clinical Trial

BackgroundVideo games designed to promote behavior change are a promising venue to enable children to learn healthier behaviors.PurposeEvaluate outcome from playing “Escape from Diab” (Diab) and “Nanoswarm: Invasion from Inner Space” (Nano) video games on children's diet, physical activity, and adiposity.DesignTwo-group RCT; assessments occurred at baseline, immediately after Diab, immediately after Nano, and 2 months later. Data were collected in 2008–2009, and analyses were conducted in 2009–2010.Setting/participants133 children aged 10–12 years, initially between 50th percentile and 95th percentile BMI.InterventionTreatment group played Diab and Nano in sequence. Control Group played diet and physical activity knowledge-based games on popular websites.Main outcome measuresServings of fruit, vegetable, and water; minutes of moderate to vigorous physical activity. At each point of assessment: 3 nonconsecutive days of 24-hour dietary recalls; 5 consecutive days of physical activity using accelerometers; and assessment of height, weight, waist circumference, and triceps skinfold.ResultsA repeated measures ANCOVA was conducted (analyzed in 2009–2010). Children playing these video games increased fruit and vegetable consumption by about 0.67 servings per day (p<0.018) but not water and moderate-to-vigorous physical activity, or body composition.ConclusionsPlaying Diab and Nano resulted in an increase in fruit and vegetable intake. Research is needed on the optimal design of video game components to maximize change.