Improving children's diets using behaviour change video games shows promise

Obesity in youngsters has risen dramatically in recent decades. Fruit and vegetable (FV) consumption and increased water intake can lower the risk of obesity, as can increased physical activity, but it is not always easy to convince children to eat better and exercise more. In a new study published in the January 2011 issue of the American Journal of Preventive Medicine, researchers found that video games designed to encourage these behaviours were effective.

'Escape from Diab' (Diab) and 'Nanoswarm: Invasion from Inner Space' (Nanoswarm) are epic video games specifically designed to lower risks of type 2 diabetes and obesity by changing youth diet and physical activity behaviours. Designed by Archimage, Inc., and funded by a Small Business Initiative Research Grant from the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health, Diab and Nanoswarm are based on social cognitive, self-determination, and persuasion theories.

'Diab and Nanoswarm were designed as epic video game adventures, comparable to commercial quality video games. These games incorporated a broad diversity of behaviour change procedures woven in and around engrossing stories. The games motivated players to substantially improve diet behaviours,' according to lead investigator Tom Baranowski, PhD, Professor of Paediatrics, U.S. Department of Agriculture/Agricultural Research Service supported Children's Nutrition Research Centre, Baylor College of Medicine. 'Serious video games hold promise, but their effectiveness and mechanisms of change among youth need to be more thoroughly investigated.'

Children playing these video games increased FV consumption by about 2/3 serving per day, but did not increase water consumption or moderate to vigourous physical activity, or improve body composition. Despite the increase, FV and water consumption and physical activity remained below the minimum recommendations.

In this randomised clinical trial, 153 children ages 10 to 12 years, were divided into a treatment group (103 children) and a control group (50). Complete data were obtained on 133 subjects. The treatment group first played Diab and then Nanoswarm. The control group played diet and physical-activity knowledge-based games on popular websites. Each group was assessed at the start of the trial, immediately after Diab, immediately after Nanoswarm, and again two months later. Height, weight, waist size, and triceps skin-fold thickness were measured. Physical activity was monitored for at least 4 days by accelerometer-based data from each child at each assessment. Food consumption was measured using 24 hour dietary recalls conducted by registered dieticians.