Ran Goldman, MD (biography and disclosures)
What I did before
Children are less physically active than in previous generations. With advances in computer based gaming, safety concerns and sedentary life style of today’s families, children have been significantly less active. This resulted in higher rates of children fulfilling the criteria for ‘overweight’ and ‘obese’.
Children 8- 18 years old spend close to 25% of their awake time watching TV, resulting in increased rate of obesity [1]. With the use of more screen-based gaming and communication devices, the portion may be even higher.
Several studies in the past, both in a laboratory based investigation as well in real-life circumstances research, reported that children playing active video games have a moderate or vigorous levels of physical activity [2-4].
I used to recommend to families to engage their children in active video games if they decide to purchase a gaming system, in hopes that these games will enhance physical activity by moving and dancing in front of the screen.
What changed my practice
A recent study [5] by a group from the Baylor College of Medicine in Houston, Texas, suggests that active video games have no effect on the amount of physical activity in children, compared to non-active games. Eighty four children were recruited, and along with their parents completed surveys. They were randomized to receive two computer games that were either very active games or inactive games. The children wore accelerometers for 7 days in order to measure their physical activity levels.
There was no difference in level of physical activity between the groups. The authors suggested that children with the active games either did not do more activity or compensated for the increased intensity by being less active at other times in the day.
What I do now
There is no alternative to healthy outdoor physical activity. I now recommend to all parents (with overweight/obese children or not) to significantly limit use of video games and other screen-based devices for their children, and to remove them from the child’s room, if possible. While no clear recommendations exist, I suggest to parents to limit screen time to an hour a day during weekdays. Parents should support their child’s healthy living by following the Canadian Paediatric Society’s recommendation [6] to have 60-180 minutes a day (!) of physical activity in different intensities for all children.
References / Additional reading (Note: Article requests might require a login ID with CPSBC or UBC)
1. Robinson TN. Television viewing and childhood obesity. Pediatr Clin North Am. 2001;48(4):1017-25 (View article with CPSBC or UBC)
2 Bailey BW, McInnis K. Energy cost of exergaming: a comparison of the energy cost of 6 forms of exergaming. Arch Pediatr Adolesc Med. 2011;165(7):597–602 (View article with CPSBC or UBC)
3. Barnett A, Cerin E, Baranowski T. Active video games for youth: a systematic review. J Phys Act Health. 2011;8(5):724-737 (View article with UBC)
4 Madsen KA, Yen S, Wlasiuk L, Newman TB, Lustig R. Feasibility of a dance videogame to promote weight loss among overweight children and adolescents. Arch Pediatr Adolesc Med. 2007;161(1):105–107 (View article with CPSBC or UBC)
5. Baranowski T, Abdelsamad D, Baranowski J, O’Connor TM, Thompson D, Barnett A, Cerin E, Chen TA. Impact of an active video game on healthy children’s physical activity. Pediatrics. 2012;129(3):e636-642 (View)
6. Lipnowski S, LeBlanc CMA, Canadian Paediatric Society, Healthy Active Living and Sports Medicine Committee. Healthy active living: Physical activity guidelines for children and adolescents. Paediatr Child Health 2012;17(2):209-10 (View)
7. http://www.physicalactivityline.com/
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thank you
No surprise here! How many docs set a realistic example for their kids as far as physical activity is concerned? – relatively few would be my bet.
A good point to look at how was individual inactivity before this study.
It was clear, if not always easy, for parents to limit screen time, that is television, in the past. Today children use screen time for homework, social interaction and entertainment. Much more ubiquitous and much harder to control. Parents are also afraid to allow children to “play outside” without supervision as in the past. Kids watching TV, playing on the computer, or texting a friend are “safe”. We’re left with safe, over-protected, inactive, unfit kids.
For us, the best way to get away from all the screens, both fixed and portable, is to get the family and friends, onto the bikes. Unfortunately we must drive to safe bike paths in our community which makes it somewhat of a hassle.
no surprises. Need to move more and limit sedantary life style
Having an obesity epidemic contributed to ,by physical inactivity, the recommendation to encourage activity is helpful.
I totally concur with the recommendations outlined. I have, myself, started an exercise program, so this will make it easier for me to advise parents and children.
I totally agree. we need to encourage more activity even for young adults as they continue to paly videogames as they were in their teens yrs.
Nowadays, the physician uses only the thumb and index fingers in navigating their tablet, phone, EMR, computers. People no longer write or talk, everything is through a click or a touch! Kids “talk” to each other on their “texting” even if they are sitting next to each other.
The modern technological advances are seriously reducing our physical activities. We do have to put a brake or restratint on these and need to assign time specifically for physical activities.
Interesting as usual
Surprised and enlightened