Perhaps instead of bemoaning our children's sedentary, media-obsessed, tendency to gain weight, we should think inside the box, the Xbox that is. Maybe kids can have their video games and exercise, too. A recent study suggests that exergames, video games that rely on physical activity by the player, may offer children and teens a way to avoid couch potato syndrome (not a medical term).

The epidemic of over-weight and under-fit school-aged children is well documented, and the health effects of this trend are already being seen. Children are at risk for early onset of chronic illnesses previously seen primarily in adults, including type II diabetes, elevated blood pressure, and metabolic syndrome.

It is not simply that children have lost interest in being active. Recess has been cut.

It's not all about a poor diet. A lack of daily exercise plays a major role in the current health crisis. Numerous studies have documented the decline in the exercise habits of children and teens.

One study found that more than 90 percent of the children aged nine to 11 met the recommended level of 60 minutes or more of moderate to vigorous physical activity each day. But after age 11, physical activity declined by about 40 minutes per day each year until, by age 15, only 31 percent met the recommended level on weekdays, and 17 percent met the recommended level on weekends.

Amid Diminishing Opportunities, A New Option

It is not simply that children have lost interest in being active. Slashing of school sports programs, elimination of recess, lack of access to recreational spaces, and increased reliance on sedentary and screen-based activities are among the factors conspiring against a more physically active younger generation. So there is a real need to find a way to reintroduce vigorous exercise into children’s recreational activities. Exergames may help to do this.

Exergames are video games that are motion-controlled. rely on physical activity by the player. The games range from dancing, to virtual sports simulators. They require a screen and a console to play. (Xbox Kinect, Wii, and PS3's PlayStation Move are the main motion-controlled platforms). The games appeal to children and adolescents who are attracted by the technology of video games for their entertainment and enjoy watching their own movements tracked on screen.

The Study
A group of Canadian researchers looked at a sample of over 1200 teenagers in 29 Montreal schools to determine who plays exergames, how often they play them, and whether they might be helpful in combating the epidemic of teenage overweight and under fit.

The researchers used self-report questionnaires mailed to 1241 students in grades 10 and 11.

After age 11, physical activity declined by about 40 minutes per day each year until, by age 15, only 31 percent met the recommended level on weekdays, and 17 percent met the recommended level on weekends.

They collected data about demographic characteristics, smoking and substance use, exergame and video game use, physical activity level, and mental health issues such as depression, anxiety, and stress. About 25% of the study population exergamed, playing an average of two days per week for 50 minutes a time.

Seventy-three percent (73%) of the exergamers reported their activity level during play was moderate or vigorous in intensity. Most exergamers were female; most played non-active video games as well and reported watching two or more hours of TV per day. Additionally, exergamers tended to report feeling concerned about their weight.

What Exergames Offer: Motivation, Privacy and Accessibility

In addition to exergaming's technological appeal, the games offer the novelty and fun of playing. Teens tend to like exergaming's easy accessibility, the investigators report. They can play at home, a plus in unsafe neighborhoods. They also enjoy the opportunities for social interaction with fellow players, and the immediate encouragement offered from the screen about their achievement.

The Centers for Disease Control recommends 60 minutes of moderate or vigorous physical activity most days per week for children ages 6-17.

Girls who are concerned about their weight and appearance may prefer exercising at home or with a few friends rather than at school or in a recreational program, thus increasing their ability to exercise effectively on their own. The games' ongoing feedback may especially benefit these girls because it motivates them to continue their efforts, the study suggests.

The Bottom Line

Even though the level of play reported in the study, two days per week, was not enough to meet fitness standards, the researchers recommend that this video game trend be explored for its potential to reintroduce exercise into an under-active population, and that the use of exergaming in school and community center settings may provide other opportunities for to get kids moving more and more vigorously.

The Centers for Disease Control recommends 60 minutes of moderate or vigorous physical activity most days per week for children ages 6-17. This should include aerobic, muscle strengthening, and bone strengthening activities.

Exergaming has been used as part of an exercise program in senior centers and nursing homes as well as schools.

In 2010 a White House Task Force on Childhood Obesity gave the games a preliminary nod, "Small, initial studies of these types of “exergaming” technologies suggest that these activities can help engage students who would not otherwise engage in activity and may burn more calories than being sedentary, but there are no studies yet showing a long-term effect on changing physical activity behaviors or on the overall impact on weight loss or children’s health. Additionally, these technologies can be prohibitively expensive for school districts to buy and maintain." Since schools are having trouble keeping recess as part of the school day, it does seem like exergaming is unlikely to become a regular program any time soon. The Canadian study does offer some data in support of exergames' potential to get sedentary people moving. In fact, exergaming has become part of some exercise programs in senior centers and nursing homes as well as in schools.

Parents may want to fine-tune their rules regarding video games. Games remain a factor in kids' increasingly sedentary screen time. But this study found that because motion-controlled games can be enjoyed by adults as well as children, they are a way for families who are used to congregating around the television to share in a healthful recreational activity together.