Active Video Games and Appetite Control in Adolescents

Study Overview
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Brief Summary
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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.

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

Conditions
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Active Video Games and Appetite Control

Intervention / Treatment
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* Behavioral: Active video gaming
* Behavioral: Passive video gaming
* Behavioral: Resting


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 13 Years
Maximum Age: 17 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Active video gaming<br>Playing Kinect | Behavioral: Active video gaming<br> <br> Behavioral: Passive video gaming<br> <br> Behavioral: Resting<br> <br> |
| Experimental: Passive video gaming<br>Playing Xbox 360 | Behavioral: Active video gaming<br> <br> Behavioral: Passive video gaming<br> <br> Behavioral: Resting<br> <br> |
| Experimental: Resting<br>Stay seated on a comfortable chair | Behavioral: Active video gaming<br> <br> Behavioral: Passive video gaming<br> <br> Behavioral: Resting<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 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. | Acute (24 hours) and short-term (3 days) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 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). | 1 day | 
| 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). | 1 day | 
| Levels of Appetite-related Hormones | Profiles of glucose, insulin, cortisol, leptin, and ghrelin assessed at every 10 minutes during each 1-hour experimental condition. | 1 hour | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Active video games, Food intake, Energy balance, Adolescents