Can video games get kids eating right and moving?

I'm very old fashioned when it comes to video, computer and all other electronic games. OK, I'll admit it: I don't even fully understand why playing them is fun, or as my kids say, I just don't get it. My imaginary migraine-inducing chamber-of-torture is a video arcade - but that's just my personal inclination, and I'm in the minority. According to the Kaiser Family Foundation's recent survey kids spend an average 7 hours 38 minutes a day in front of a screen. A typical kid spends 65 minutes a day playing video games, and the majority of kids have a game console in their bedroom. So I guess video games are entertaining.

But spending hours in front of a screen is one of the least desirable uses of a kids' time, and there's plenty of evidence to back this assertion. The American Academy of Pediatrics recommends limiting screen time to less than two hours a day, and keeping screens out of the bedroom. That's because screen time's usually sedentary, and is linked with obesity and metabolic risk factors. Prolonged screen time is also associated with inferior academic performance.

Hours of inactivity are only one harmful outcome of sitting in front of a screen. Here's another reason why screen time can make kids fat: Advertisers look for eyeballs wherever they can find them, and screen time, whether it's TV, video, hand-held or computer, is soaked with ads. Guess who's willing to pay top dollar to get your kid as a loyal customer for life? Fast-food and junk-food makers top the chart of kid oriented ads in electronic media.

There's another really sad outcome of electronic games: Kids aren't playing the way they used to. Kids' play is the unstructured, messy, imaginative way in which kids create an inner world, interact with the real world, interrelate with friends, negotiate, solve problems, and work as a team. An old bed sheet becomes a toga, which turns into a sultan's turban, which doubles as a magic carpet that can transport the princess to the castle (the castle's roof made of the same cloth). A vivid example of child play is depicted in Toy Story 3 (one of the best movies I've seen this year). Kids' play is a healthy way for kids to learn so much of the skills they'll need, while having serious fun, and often while breaking a sweat.

Video games to the rescue?

Active video games debuted a few years ago, and my kids were excited to inform me that the Wii gets you moving and that "everyone has them" (to which I said: That's great! you'll be able to play them at your friends' house).

Exergames indeed get you moving. Somewhat moving. A recent review in the Archives of Pediatric and Adolescent Medicine looked at these games and concluded that they enable light to moderate physical activity. To put it in other words, the Wii is better than sitting on the couch, but won't improve aerobic fitness - to improve fitness kids need intense exercise and real sports, the kind that gets them sweating and their heart racing. Perhaps the groups that can benefit most from these exergames are patients undergoing physical rehabilitation and the elderly.

I asked my kids recently if the Wii's still popular among their friends, and their conclusion was that the Wii gets rather boring after a while - and once a kid has a gaming console he'll find something more exciting to play.

Here's another attempt to make gaming healthy. A new study published in this months' issue of the American Journal of Preventive Medicine examined the effect two epic video games, "Escape from Diab" and "Nanoswarm: Invasion from Inner Space". These games incorporate behavior change procedures woven into the gripping stories, and were designed to improve diet and increase physical activity and were especially planned to lower risks of type 2 diabetes and obesity.

The 103 Kids playing these video games did increase their fruit and veggies intake when compared to kids playing diet and physical-activity knowledge-based games on popular websites, but only by about half a serving a day. They did not drink more water or engage in more physical activity (as measured by an accelerometer), nor did they improve body composition.

There are hidden messages in any programming. If the hero in a film smokes it may glorify smoking , yet if he eats vegetables it might make veggies cool. That's what's so good about Popeye. So by all means, I'm all for trying to get the right subliminal messages in. Every little bit helps.

The good, the bad and the violent

Video games are just a medium. Any medium can be used for good or bad. A better video game is possible - there are educational and active games, just like there are excellent TV programs - but they are the exception that proves the rule.

I hope you're not feeling too sorry for my kids. They don't have a gaming console - they've stopped asking for it - and we strictly limit screen time. But, could these kids play! They have an amazing capacity to play with each other and with friends, and whether it's in the sun outside or on a cold day inside, they never fail to make up something wonderful to do.

Dr. Ayala

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