Improving Children’s Diets Using Behavior Change Video Games Shows Promise

Randomized Clinical Trial Reported in the American Journal of Preventive Medicine

San Diego, CA, 7 December 2010 – 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 behaviors 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 behaviors. 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 behavior change procedures woven in and around engrossing stories. The games motivated players to substantially improve diet behaviors,” according to lead investigator Tom Baranowski, PhD, Professor of Pediatrics, U.S. Department of Agriculture/Agricultural Research Service supported Children’s Nutrition Research Center, 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 vigorous physical activity, or improve body composition. Despite the increase, FV and water consumption and physical activity remained below the minimum recommendations.

In this randomized 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 dietitians.

The article is “Video Game Play, Child Diet, and Physical Activity Behavior Change - A Randomized Clinical Trial” by Tom Baranowski, PhD, Janice Baranowski, MPH, RD, Debbe Thompson, PhD, Richard Buday, FAIA, Russ Jago, PhD, Melissa Juliano Griffith, MPH, Noemi Islam, MPH, Nga Nguyen, MS, and Kathleen B. Watson, PhD. It appears in the American Journal of Preventive Medicine, Volume 40, Issue 1 (January 2011) published by Elsevier. doi: 10.1016/j.amepre.2010.09.029

# # #

Notes For Editors
Full text of the article is available to journalists upon request; contact eAJPM@ucsd.edu. To schedule an interview with the authors please contact Dipali Pathak, Communications Specialist, Baylor College of Medicine, 713-798-6826, pathak@bcm.edu.

About The Authors
Tom Baranowski, PhD
U.S. Department of Agriculture/Agricultural Research Service, Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX

Janice Baranowski, MPH, RD
U.S. Department of Agriculture/Agricultural Research Service, Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX

Debbe Thompson, PhD
U.S. Department of Agriculture/Agricultural Research Service, Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX

Richard Buday, FAIA
Archimage, Inc, Houston, TX

Russell Jago, PhD
Department of Exercise, Nutrition and Health Sciences, University of Bristol (Jago), Bristol, United Kingdom

Melissa Juliano Griffith, MPH
U.S. Department of Agriculture/Agricultural Research Service, Children’s Nutrition Research Center, Baylor College of Medicine

Noemi Islam, MPH
U.S. Department of Agriculture/Agricultural Research Service, Children’s Nutrition Research Center, Baylor College of Medicine

Nga Nguyen, MS
U.S. Department of Agriculture/Agricultural Research Service, Children’s Nutrition Research Center, Baylor College of Medicine

Kathleen B. Watson, PhD
U.S. Department of Agriculture/Agricultural Research Service, Children’s Nutrition Research Center, Baylor College of Medicine

Trailer for “Escape from Diab” may be viewed at www.escapefromdiab.com.
Trailer for “Nanoswarm: Invasion from Inner Space” may be viewed at www.nanoswarmthegame.com.

About The American Journal Of Preventive Medicine
The American Journal of Preventive Medicine is the official journal of The American College of Preventive Medicine (www.acpm.org) and the Association for Prevention Teaching and Research (www.atpm.org). It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health. The journal features papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women's health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and alcohol and drug abuse. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. The journal also publishes official policy statements from the two co-sponsoring organizations, health services research pertinent to prevention and public health, review articles, media reviews, and editorials.

The American Journal of Preventive Medicine, with an Impact Factor of 4.235, is ranked 11th out of 122 Public, Environmental & Occupational Health titles and 16th out of 132 General and Internal Medicine titles according to the 2010 Journal Citation Reports© published by Thomson Reuters.

About Elsevier

Elsevier is a world-leading provider of information solutions that enhance the performance of science, health, and technology professionals, empowering them to make better decisions, deliver better care, and sometimes make groundbreaking discoveries that advance the boundaries of knowledge and human progress. Elsevier provides web-based, digital solutions — among them ScienceDirect, Scopus, Elsevier Research Intelligence,and ClinicalKey—and publishes over 2,200 journals, including The Lancet and Cell, and over 25,000 book titles, including a number of iconic reference works.

The company is part of Reed Elsevier Group PLC, a world leading provider of professional information solutions in the Science, Medical, Legal and Risk and Business sectors, which is jointly owned by Reed Elsevier PLC and Reed Elsevier NV. The ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).

Media Contact
AJPM Editorial Office
Tel: 858-534-9340
eAJPM@ucsd.edu