Active Video Games and Appetite Control in Adolescents


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.

Full Title of Study: “Effects of Active Video Games on Energy Balance: a Randomized Crossover Study in Adolescents”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Crossover Assignment
    • Primary Purpose: Prevention
    • Masking: None (Open Label)
  • Study Primary Completion Date: September 2014


  • Behavioral: Active video gaming
  • Behavioral: Passive video gaming
  • Behavioral: Resting

Arms, Groups and Cohorts

  • Experimental: Active video gaming
    • Playing Kinect
  • Experimental: Passive video gaming
    • Playing Xbox 360
  • Experimental: Resting
    • Stay seated on a comfortable chair

Clinical Trial Outcome Measures

Primary Measures

  • Energy Intake and Energy Expenditure (Over 24 Hours and Over 3 Days)
    • Time Frame: 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 Measures

  • Appetite Sensation
    • Time Frame: 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
    • Time Frame: 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
    • Time Frame: 1 hour
    • Profiles of glucose, insulin, cortisol, leptin, and ghrelin assessed at every 10 minutes during each 1-hour experimental condition.

Participating in This Clinical Trial

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

Gender Eligibility: All

Minimum Age: 13 Years

Maximum Age: 17 Years

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • Children’s Hospital of Eastern Ontario
  • Collaborator
    • Canadian Institutes of Health Research (CIHR)
  • Provider of Information About this Clinical Study
    • Principal Investigator: Jean-Philippe Chaput, Junior Research Chair – Children’s Hospital of Eastern Ontario
  • Overall Official(s)
    • Jean-Philippe Chaput, PhD, Principal Investigator, Children’s Hospital of Eastern Ontario Research Institute


Chaput JP, Visby T, Nyby S, Klingenberg L, Gregersen NT, Tremblay A, Astrup A, Sjödin A. Video game playing increases food intake in adolescents: a randomized crossover study. Am J Clin Nutr. 2011 Jun;93(6):1196-203. doi: 10.3945/ajcn.110.008680. Epub 2011 Apr 13.

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