# Exercise as it relates to Disease/Video games leading to obesity among youths
## Background

With remarkable technological advancements each year, video gaming has become one of the most popular leisure time activities among youths and adolescents, especially within the western world. This worldwide popularity has gotten the attention of many sweet drink producers from around the world and has created sponsored events to help increase their business and target youths and adolescents into consuming their products. The study model (Linking video gaming, sleep quality, sweet drink consumption and obesity among children and youth(1)) conducted by O.Turel, A.Romashkin and K.M. Morrison was to research the links between higher abdominal obesity and lack of sleep among the age groups of nine and seventeen which whom takes part in video gaming while consuming sweet drinks prior to sleep. Video gaming and obesity is a highly researched topic with more articles focusing on most time played during the day, but this model instead was designed to consider average gameplay prior to bedtime and impacts it may have towards sleeping quality and behaviours.

## Where is this research from?

It was recorded that in Northern America, 72% of teenagers takes part in playing video games and 84% of this group are teenage boys. The participants for the research paper was gained from the paediatric lipid clinic and weight management hospitals located in Canada.

## What kind of research was this?

The aim of the paper for was to; Identify the pinpoint patterns or “attributes such as timing and duration(1)” of video games and physical activity in relation to sleep quality within youths and adolescents. It was also to identify any correlations between sweet drink consumption during video gameplay and how it may be affecting abdominal adiposity.

## What did the research Involve?

The research involved 125 patients from the paediatric lipid clinic and weight management hospitals and included youths and adolescent ranging from nine to seventeen years of age. All these subjects were regular video game players and did consume some type of sweet beverage during the day. With parent consent and the help from nurses, each subject went through an average of six-week self-reported questionaries on how long they spent playing video games prior to their bedtime and how many sweet drinks they consumed. Physical activity was also recorded using Fitbit devices for a one-week period. Sleep quality was recorded using the Pittsburgh sleep quality index which varies from 0-23 with lower scores being associated with increased sleep quality. After the average sex weeks has passed, each subject returned to the clinic to have their, height, weight and abdominal adiposity measured.

## What were the basic results?

Pre-screening was done on all subjects and the data showed (1) that the average age for the group was 13.06 years, average height was 161.1 cm and average waist circumference was 91.57 cm. The results showed the participants played video games for 4.76 days of the week and before bed, they played for an average time of 58.39 minutes with a standard deviation of 75.65minutes. Normally during the day, they would play for an average time of 91.12minutes with an S.D. of 84.52minutes. Each participant managed to have an average of 13.94 steps per minute and scored a 4.53 on the sleep quality index. After the data was analysed, it showed good sleepers only spent around 43.80minutes gaming before bed while poor sleeper spent around 91.80minutes. Good sleepers had an average sweet drink consumption of 0.73 while poor sleepers had a consumption of 1.91 drinks per day. The Abdominal adiposity (waist to height ratio) for good sleepers were 0.55 and for poor sleepers, it was 0.60.

## What conclusion can we take from these results?

The aim of the study was to identify if playing video games prior to bedtime and drinking sweet drinks had any links to sleep quality and abdominal adiposity. The results show that the majority of participants play video games for approximately 58.39minutes before bed but the standard deviation is set at 75.65minutes. The analysed data states good sleepers only played for an average of 43.80 minutes before bed. Considering most participants played above this timeframe, their gaming prior to sleep is likely linked to their poor sleep quality. There was also a 1.18 sweet drink consumption difference between the groups meaning there is evidence to prove it does affect sleep quality. However, there was only a 0.05 difference in abdominal adiposity meaning there is no evidence supporting sweet drink consumption with gaming does lead to an increase in abdominal adiposity. It's clear from the results, the research paper did achieve its aim in directly linking reduced sleep quality and video gaming but the method was flawed when trying to find out its link to abdominal adiposity. It failed in recognizing the importance of key factors such as fitness and nutrition.
For youth and adolescents, it’s clear there is a correlation between the quality of sleep and video gaming prior to bedtime while having consumed sweet beverages. However, there is an indirect link between video gaming, drinking sweet beverages and abdominal adiposity. It’s also clear there is an indirect link between abdominal adiposity and sleep quality but this paper does not contain the required research to reach a conclusion for this topic. From these findings, it's clear the paper proves the correlation between video gaming and poor sleep quality. However, this data is not taking into consideration physical activity and overall sedentary behaviours leaving questions unanswered on whether if video gaming is the only direct link to sleep quality or if there are other factors.

## Further Information/resources

Video gaming is linked to poor sleep quality and lower sedentary time meaning lower physical activity; however, this does not mean it should be considered a problem. Although it may not be researched in this particular paper, children between the age of nine and seventeen are at high risk of feeling left out due to low social skills, going through high-stress periods and being overweight ultimately leading to depression(2). A meta-analysis done on depression and diabetes (2) indicate that the two are tightly linked with one another and to escape these major issues, an individual requires motivation(3). Video games provide an outlet for these individuals to escape into and relieve stress, improve social skills and increase their moods and self-confidence to help them move out of their comfort zone. Although video game might create the problem of obesity due to high sedentary time, it can also be a solution.

## Practical Advice

It’s understood there is a correlation between video gaming prior to bedtime and poor sleep quality. The PSQI scored an average of 4.53 meaning the quality of sleep is okay but considering the participants are in the stages of puberty and are growing, being in the stages of 1-2 PSQI sleep index scores would be in their best interest. However, if youths and adolescents enjoy playing video games during night time, they should try and stay under the 45minute mark and drink only one sweet beverage a day to help increase sleep quality and possibly reduce abdominal adiposity. Following this guideline can also help reduce the risk of depression and can help motivate a young individual to be physically active making it very beneficial to their mental and physical wellbeing. For further clarification, the diagram to the right is a representation on how all these factors expressed above impact with one another.

## References

* Turel O, Romashkin A, Morrison K. A model linking video gaming, sleep quality, sweet drinks consumption and obesity among children and youth. Clinical Obesity. 2017;7(4):191-8.
* Mezuk B, Eaton WW, Albrecht S, Golden SH. Depression and type 2 diabetes over the lifespan: a meta-analysis. Diabetes care. 2008;31(12):2383-90.
* Verloigne M, De Bourdeaudhuij I, Tanghe A, D'Hondt E, Theuwis L, Vansteenkiste M, et al. Self-determined motivation towards physical activity in adolescents treated for obesity: an observational study. International Journal of Behavioral Nutrition and Physical Activity. 2011;8(1):97. Available at: