Active Video Games and Appetite Control
Conditions
Keywords
Active video games, Food intake, Energy balance, Adolescents
Brief summary
STATEMENT OF THE PROBLEM: Video games have enormous mass appeal, are omnipresent in the daily schedule of most children and youth and have been linked to the obesity epidemic. The investigators research group recently reported that sedentary video game playing increases food intake in adolescents. Interestingly, the overconsumption of food associated with seated video game play was observed without increased sensations of hunger and appetite, as previously observed with television viewing. Active video games offer an appealing opportunity for increasing energy expenditure and promoting healthy body weight among children and youth who might otherwise be spending time in sedentary screen-based activities. However, significant increases in energy expenditure as a result of active video game play might be of little importance to energy balance if one compensates by increasing energy intake and/or decreasing physical activity. Studies to date have failed to measure energy intake so it is currently unknown the effects of active video games on daily energy balance. OBJECTIVE: The main aim of this study is to examine the acute effects of playing active video games on energy intake and expenditure. HYPOTHESIS: The investigators hypothesize that the increase in energy expenditure promoted by active video games will be offset by compensatory adjustments in food intake and spontaneous physical activity subsequent to the intervention. RESEARCH PLAN: With the use of a randomized crossover design, 30 normal-weight and 30 obese adolescents between 13 and 17 years of age will complete three 1-hour experimental conditions, namely (1) resting in a sitting position (control condition), (2) playing Xbox 360 (sedentary video game condition) and (3) playing Kinect (active video game condition), followed by an ad libitum lunch. The primary outcomes will be acute (24-h) and short-term (3-day) energy intake and expenditure. Food intake will be measured using an ad libitum test meal immediately following the intervention, a food menu for the remainder of the day and a dietary record for the subsequent 3-day period. Energy expenditure will be measured using indirect calorimetry during the intervention and an Actical accelerometer for the subsequent 3-day period. Secondary outcomes will include appetite sensations (visual analogue scales), stress markers (heart rate variability, blood pressure, and mental workload), and levels of appetite-related hormones and substrates (glucose, insulin, cortisol, leptin, and ghrelin). RELEVANCE: The present study is innovative and likely to result in a number of new and important findings that can inform future recommendations. If the investigators confirm our hypothesis, the clinical implication will be to rethink the strategy of promoting active video games as an intervention tool for the prevention of overweight and obesity in youth.
Interventions
Sponsors
Study design
Eligibility
Inclusion criteria
* Adolescent between the ages of 13 and 17
Exclusion criteria
* Current smoker * Unstable body weight (±4 kg) during the 6 months preceding testing * Excessive intake of alcohol (\>10 drinks/week) or substance abuse * Metabolic disease (e.g. thyroid disease, heart disease, diabetes, etc) * Celiac disease or vegetarian * Medication use that could interfere with the outcome variables * Highly restrained eating behavior * Irregular eating pattern (e.g. skipping breakfast) * Unfamiliar with the use of video games * Inability to comply with the protocol
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Energy Intake and Energy Expenditure (Over 24 Hours and Over 3 Days) | Acute (24 hours) and short-term (3 days) | Energy intake (kJ) was measured using an ad libitum test meal immediately following the 3 experimental conditions, a food menu for the remainder of the day, and a dietary record for the subsequent 3-day period. Energy expenditure was measured by indirect calorimetry during the 3 experimental conditions, and by using an Actical accelerometer for the subsequent 3-day period. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Appetite Sensation | 1 day | Visual analogue scale to assess appetite feelings. The scale is 100 mm in length and ranges from 0 mm (not hungry at all) to 100 mm (extremely hungry). |
| Stress Marker | 1 day | Mental effort assessed on a visual analogue scale (100 mm in length). It ranges from 0 mm (no mental effort at all) to 100 mm (extremely mentally challenging). |
| Levels of Appetite-related Hormones | 1 hour | Profiles of glucose, insulin, cortisol, leptin, and ghrelin assessed at every 10 minutes during each 1-hour experimental condition. |
Countries
Canada
Participant flow
Recruitment details
Randomized crossover study (1 group doing all 3 conditions). Wash-out period of 1 week between conditions.
Participants by arm
| Arm | Count |
|---|---|
| Video Game Condition Playing Kinect
Playing Xbox 360
Sitting on a chair (control) | 26 |
| Total | 26 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 | FG003 | FG004 | FG005 |
|---|---|---|---|---|---|---|---|
| Third Intervention (Hour 3) | Lost to Follow-up | 1 | 1 | 1 | 0 | 1 | 0 |
Baseline characteristics
| Characteristic | Video Game Condition | — |
|---|---|---|
| Age, Continuous | 14.5 years STANDARD_DEVIATION 1.4 | — |
| BMI (kg/m2) | 21.8 kg/m2 STANDARD_DEVIATION 5 | — |
| Cohen's Perceived Stress Scale score | 13.0 units on a scale STANDARD_DEVIATION 5.4 | — |
| Levels of appetite-related hormones | — | — mmol/L |
| Physical Activity Questionnaire score | 2.3 units on a scale STANDARD_DEVIATION 0.5 | — |
| Pittsburgh Sleep Quality Index score | 4.8 units on a scale STANDARD_DEVIATION 2.3 | — |
| Race and Ethnicity Not Collected | — | — Participants |
| Region of Enrollment Canada | 26 participants | — |
| Resting metabolic rate (kJ/day) | 7101 kJ/day STANDARD_DEVIATION 1224 | — |
| Sex: Female, Male Female | 0 Participants | — |
| Sex: Female, Male Male | 26 Participants | — |
| Tanner puberty stages (self-assessed by questionnaire) | 3.5 units on a scale STANDARD_DEVIATION 0.9 | — |
| Waist circumference (cm) | 74.1 cm STANDARD_DEVIATION 12.7 | — |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 26 | 0 / 26 | 0 / 26 |
| other Total, other adverse events | 0 / 26 | 0 / 26 | 0 / 26 |
| serious Total, serious adverse events | 0 / 26 | 0 / 26 | 0 / 26 |
Outcome results
Energy Intake and Energy Expenditure (Over 24 Hours and Over 3 Days)
Energy intake (kJ) was measured using an ad libitum test meal immediately following the 3 experimental conditions, a food menu for the remainder of the day, and a dietary record for the subsequent 3-day period. Energy expenditure was measured by indirect calorimetry during the 3 experimental conditions, and by using an Actical accelerometer for the subsequent 3-day period.
Time frame: Acute (24 hours) and short-term (3 days)
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| All Study Participants | Energy Intake and Energy Expenditure (Over 24 Hours and Over 3 Days) | Energy intake Kinect 24 hours | 17981 kJ | Standard Error 10104 |
| All Study Participants | Energy Intake and Energy Expenditure (Over 24 Hours and Over 3 Days) | Energy intake Xbox360 24 hours | 17014 kJ | Standard Error 10023 |
| All Study Participants | Energy Intake and Energy Expenditure (Over 24 Hours and Over 3 Days) | Energy intake control 24 hours | 17566 kJ | Standard Error 9984 |
| All Study Participants | Energy Intake and Energy Expenditure (Over 24 Hours and Over 3 Days) | Energy expenditure Kinect 24 hours | 10413 kJ | Standard Error 567 |
| All Study Participants | Energy Intake and Energy Expenditure (Over 24 Hours and Over 3 Days) | Energy expenditure Xbox360 24 hours | 9581 kJ | Standard Error 562 |
| All Study Participants | Energy Intake and Energy Expenditure (Over 24 Hours and Over 3 Days) | Energy expenditure control 24 hours | 9598 kJ | Standard Error 558 |
| All Study Participants | Energy Intake and Energy Expenditure (Over 24 Hours and Over 3 Days) | Energy intake Kinect 3 days | 31412 kJ | Standard Error 4123 |
| All Study Participants | Energy Intake and Energy Expenditure (Over 24 Hours and Over 3 Days) | Energy intake Xbox360 3 days | 35412 kJ | Standard Error 3967 |
| All Study Participants | Energy Intake and Energy Expenditure (Over 24 Hours and Over 3 Days) | Energy intake control 3 days | 3346 kJ | Standard Error 4043 |
| All Study Participants | Energy Intake and Energy Expenditure (Over 24 Hours and Over 3 Days) | Energy expenditure Kinect 3 days | 30997 kJ | Standard Error 1456 |
| All Study Participants | Energy Intake and Energy Expenditure (Over 24 Hours and Over 3 Days) | Energy expenditure Xbox360 3 days | 30498 kJ | Standard Error 1489 |
| All Study Participants | Energy Intake and Energy Expenditure (Over 24 Hours and Over 3 Days) | Energy expenditure control 3 days | 30141 kJ | Standard Error 1534 |
Appetite Sensation
Visual analogue scale to assess appetite feelings. The scale is 100 mm in length and ranges from 0 mm (not hungry at all) to 100 mm (extremely hungry).
Time frame: 1 day
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| All Study Participants | Appetite Sensation | Kinect | 51 mm | Standard Deviation 53 |
| All Study Participants | Appetite Sensation | Xbox360 | 56 mm | Standard Deviation 54 |
| All Study Participants | Appetite Sensation | Control | 58 mm | Standard Deviation 49 |
Levels of Appetite-related Hormones
Profiles of glucose, insulin, cortisol, leptin, and ghrelin assessed at every 10 minutes during each 1-hour experimental condition.
Time frame: 1 hour
Population: Not analyzed due to lack of funds (major budget cut)
Stress Marker
Mental effort assessed on a visual analogue scale (100 mm in length). It ranges from 0 mm (no mental effort at all) to 100 mm (extremely mentally challenging).
Time frame: 1 day
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| All Study Participants | Stress Marker | Kinect | 52 mm | Standard Deviation 45 |
| All Study Participants | Stress Marker | Xbox360 | 54 mm | Standard Deviation 56 |
| All Study Participants | Stress Marker | Control | 43 mm | Standard Deviation 42 |