Abstract
Objective: To study the impact of active video games on Body Mass Index (BMI) in children and adolescents. Design and Methods: A systematic review and meta-analysis. Data were pooled in meta-analysis using the method of random effects or fixed effects, as appropriate, after examination of statistical heterogeneity. Data sources and eligibility criteria for selecting studies. A comprehensive literature research was conducted in Medline (PubMed), ISI web of Knowledge, and SCOPUS up to April 2018, in relation to clinical trials (both controlled and non-controlled) in children and adolescents, whose intervention was based on active video games. Results: The overall intragroup effect of the intervention based on active video games was in favor of the intervention, reaching statistical significance using the fixed effects model: (standardized mean difference (SMD) = −0.138; 95% CI (−0.237 to −0.038), p = 0.007 and was of borderline statistical significance in the random effects model: SMD= −0.191; 95% CI (−0.386 to 0.003), p = 0.053. The individual results of the determinations of the 15 included studies for this analysis showed a high heterogeneity among them (I2 = 82.91%). When the intervention was applied to children and adolescents with greater than or equal to 85 (overweight or obese) BMI percentile showed a greater effect in favor of the active video games: SMD= −0.483, p = 0.012. The overall intra-group effect in the control group was close to zero (SMD = 0.087). With respect to the non-standardized mean difference (MD) between groups, it was also in favor of active video games for both BMI (Kg/m2): DM = −0.317, 95% CI (−0.442 to −0.193), p = < 0.001 and BMI z-score: DM = −0.077, 95% CI (−0.139 to −0.016), p = 0.013. Conclusions: Our meta-analysis show a statistically significant effect in favor of using active video games on BMI in children and adolescents. The clinical relevance of this positive effect must be evaluated.
Highlights
Overweight and obesity are currently a serious public health problem
A comprehensive literature research was conducted in relation to clinical trials in children and adolescents, written in English or Spanish, whose intervention was based on active video games
When the intervention was applied to children and adolescents with a basal body mass index (BMI) percentile more than or equal to 85, a greater intra-group effect was showed in favor of the intervention with a standardized mean of difference (SMD)= −0.483, 95%CI (−0.862 to −0.105) p = 0.012 under the random effects model
Summary
Overweight and obesity are currently a serious public health problem. Its increasing prevalence affects children and adolescents, with diet and physical activity being the most important modifiable factors for its prevention [1,2]. Individual primary studies and subsequent meta-analyses have focused on the effects of active video games on the promotion of physical activity [3,4,5,6,7,8], energy expenditure [3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26], oxygen volume consumption [9,12,15,16,27,28,29], and heart rate [9,14,15,17,18,27,28,29,30,31,32]. A meta-analysis synthesizing the quantitative findings in relation to BMI, and incorporating a subgroup analysis based on the quality of the identified studies and other methodological characteristics would be very useful
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