Group 5: Anjelika Evangelopoulos, Seyed-Arash Hosseini, Britney Luimes, Kathryn Parker

Project Contributors:
Arash Hosseini - Introduction and Conclusions

Anjelika Evangelopoulos - Brief History of Video Games

Kathryn Parker - The Problem

Britney Luimes - The Solution

The Issue:
According to Health Canada, the number of Canadians who are obese has increased substantially over the past 25 years. Obesity is considered to be a risk factor in a number of chronic diseases. Achieving and maintaining a healthy weight is important to reduce the risks of those diseases and improve overall health. (23)



The evolving game industry and the development of innovative and exciting games has led to kids spending ever increasing amounts of time in front of their TV set playing games. Games and television sets along with the gaming consoles are gradually replacing the outdoor events and natural sports in the daily activities of children, raising a lot of questions.

Are these new technological advancements beneficial to the development of the kids? Are they the root cause of obesity at a young age? Who is to blame and what steps can be taken to prevent obesity?

Moreover, physical inactivity, poor eating habits and their contribution to obesity are critical public health challenges. Statistics Canada reports that two out of every three adults in Canada are overweight.

The proportion of obese children has nearly tripled in the last 25 years. The increases were seen for both boys and girls and across all age groups except pre-schoolers. Also, more than half of Canadian children and youth are not active enough for optimal growth and development.(23)

Many factors have contributed to the increasing rates of overweight and obesity. Changes in society, work and leisure have affected activity and eating patterns, leading to a rise in obesity. There has been a shift towards less physically demanding work, as well as an increased use of automated transport and passive leisure activities, such as watching TV and playing video games. Many children and youth have fewer opportunities to be physically active at school as physical education classes and time spent being physically active at school has been reduced to compensate for the increasingly demanding academic side. There are also fewer children and youth walking to and from school. Statistics Canada found a direct correlation between the amount of time youth spent watching TV and playing video games, and their likelihood of being overweight or obese.

Definitions
Obesity is defined as a medical condition in people who have excess body fat compared to what is healthy for their height. Consumption of excess food energy compared to what the body requires for the day’s activities, including work, study and exercise is considered as one of the primary causes of obesity. Contributing factors to obesity are social, economics, biological, genetic make-up, environmental and more importantly activity levels.

Childhood obesity as well as increasing the risk of obesity in adulthood, is associated with Type II diabetes mellitus, increases the risk of coronary heart disease, is the leading cause of pediatric hypertension, increases stress on the weight-bearing joints, lowers self-esteem, and affects relationships with peers.

The body mass index (BMI) is a main tool used by health professionals to help assess the risks of developing health problems associated with being overweight and underweight. This tool is used with adults age 18 years and over, with the exception of pregnant and breastfeeding women. The BMI may underestimate or overestimate health risks in certain adults, such as:

- highly muscular adults;

- adults who have a very lean body build;

- young adults who have not reached full growth;

- adults over 65 years of age.

The BMI is a ratio of weight-to-height. It is not a direct measure of body fat but it is an indicator of health risk associated with being under- and overweight. Research conducted with large groups of people has shown that the BMI can be classified into ranges associated with health risk. There are four categories of BMI ranges in the Canadian weight classification system. These are:

Underweight	BMI less than 18.5

Normal weight	BMI between 18.5 and 24.9

Overweight	BMI between 25 and 29.9

Obese	       BMI of 30 and over

Obesity increases the risk of contracting coronary heart disease, hypertension or high blood pressure, stroke, type 2 diabetes, gallbladder disease, osteoarthritis, sleep apnea and other breathing problems, some cancers such as breast, colon and endometrial cancer, mental health problems, such as low self-esteem and depression and possibly vision problems. In addition, because of their youth, obese children have a long duration to develop these problems.

Brief History of Video Games


In 1958, the first video game was created by an American nuclear physicist, William Higinbotham who worked for a government science lab. Realizing that most science exhibits were boring and rigid, William decided to “liven things up” by developing a game called “Tennis for Two”. The electronic game was first played at the Brookhaven National Laboratory during the annual Visitor’s Day. It featured a small analog computer with an oscilloscope and two separate controllers. Hundreds of visitors to Higinbotham’s lab lined up to play his video game. Higinbotham could never imagine that his idea would trigger an entire industry, with sales well over 20 billion dollars in the U.S. alone and over 2 billion dollars in Canada annually. (5)Much later, Ralph H. Baer who became known as “the father of video games” was the brainchild behind the first home video game console by Magnavox.(2) Introduced in 1972, the Odyssey could play 12 different games, including the historic hit, “Ping Pong”. In 1975, Atari’s founder, Nolan Bushnell, sold his version of a video game console through the Sears catalogue. His hit video game was coincidently called “Pong”, which propelled the home video game systems into stardom. (1) It seemed that consumers were hooked onto the idea and the market was flooded with inferior manufacturers and products that had poor quality. In the next year the extremely controversial arcade game, “Death Race” was launched, enticing players to kill zombie pedestrians with cars. It is not the first game which used violence but the first to be protested when the video game was released again in 1990, thus stirring debate and dissention among parents, youth and society.(9) By 1978, Magnavox still lead the market with its computer inspired keyboard console named, Odyssey 2. Close by was Atari who had employed Activision, a band of four former Atari employees who began creating games for Atari’s 2600 game console. The most popular animated game of the early 80’s was introduced as Pac-Man instead of its original name, “Puck-Man”.(3) A milestone in the video game industry occurred with, Nintendo’s release of “Donkey Kong”. The creator of the game, Shigeru Miyamoto, introduced “Mario”, a character which will later be synonymous with God. It was Nintendo’s pride and joy, also the first game that had four play levels. By 1983 the video game market suffered a major crush, sending most of the smaller inexperienced companies into bankruptcy. This led Americans to believe that like all fads, the era of the video game had passed.(4)

Showing tenacity, perseverance and true grit and almost two years later, Nintendo made a huge comeback with its Nintendo Entertainment System. With a new console and front loading cartridge port, similar to a VCR, the video game market was once again rehabilitated. Equipped with color graphics, elaborate sound effects and quick game play it was the one to beat. Sales soared and Nintendo continued making history with its sequel video game, “Super Mario Brothers”. In the same year, Russian mathematician Alexey Pajitnov developed the quite addictive game, “Tetris” which became one of the most popular games in history when it was resurrected again in 1989, by Nintendo’s handheld Game Boy version. (3)In 1989, creator Will Wright singlehandedly published “Sim City”, a game that allowed users to create and run a city. Other popular “Sims” games followed and became the top selling PC game in history. It’s no wonder that the top video companies kicked themselves for not publishing them instead. (6)Almost simultaneously in 1991, both Nintendo and Sega revealed their 16-bit systems and games such as “Street Fighter II” and “Civilization” fighting for top sales.(3) Another controversy surrounding violence in video games occurred with the release of “Mortal Kombat” in 1992. The game used digital images of real actors and users were crazed by bloody moves such as ripping their opponent’s heart out. By the next year some states in America launched an investigation into video game violence. This prompted the Entertainment Software Association to form and establish a ratings code on video and computer games content. (3) In 1992, video game consoles were all the rage with the top contenders being Nintendo, Sony Playstation and Sega’s Saturn.By the mid 90’s Nintendo’s “Mario 64”and the “Legend of Zelda” and Microsoft’s “Age of Empires” dominated the charts.



The late 90’s, Nintendo unleashed a virtual pet that you could take care of, named “Pocket Pikachu”, a character from its popular game, “Pokémon”. With all fears of the Y2K computer bust put to rest, Sony released the Playstation 2 on October of 2000, using DVD technology and 128-bit capability. (6)Just in time for another controversy, the game “Grand Theft Auto 3” crashed into stores with players having the option to pick-up prostitutes, steal cars and money as well as kill people. (6)In the wake of New York’s September 11th terrorist attacks, many of the video game giants either edited video games or abandoned some altogether because of the sensitivity issues surrounding the attacks.(3) In the hopes of enlisting more young men, the U.S. army developed and distributed free of charge, the game “America’s Army” which went on to become the country’s most played online game. Since its launch in 2002, the game has been hailed for it’s training and educational value. More controversy arises when Washington State becomes the first state to prohibit the sale of the game, “Cop-Killers” to under agers.(6)

Late in 2001, Microsoft releases XBOX and the first of the trilogy video game, Halo. Sales soar but are still far behind Sony’s Playstation which is also a DVD player. Nintendo finally introduces a no cartridge console named, GameCube and is the first to support online play. All 3 giants competed for their share in the multi billion dollar video game market and all three have developed top sellers. (10)With over 3 billion video games sold, Nintendo has been the forerunner in both the hand held game systems such as Game Boy and Nintendo DS and its most popular thus far, the Wii games. Game Boy and DS use full colour LCD screens and touch technology not to mention the ease and convenience of their pocket size. Nintendo has outsold the competition with such mammoth hits such as “Super Mario Brothers”, “Pokémon”, “Nintendogs”, “Wii Play”, “Tetris” and “Brain Age”. In 2008, Microsoft’s Solitaire game was named the most popular among computer players, after all it is included with every copy of Windows.(41) The most surprising success of video game history came in 2005, with the release of a music video game called “Guitar Hero”. With controllers shaped as guitars the players rocked and Playstation 2 reported a whopping 2 billion dollars in sales. Sequels to the original “Guitar Hero” soon followed and in 2007, Microsoft’s XBOX 360 console offered “Guitar Hero II” and “Guitar Hero III” video games. Playstation has continued to offer their version of “Guitar Hero” sequels as well and the video game can be played on a PC. Continuing in the tradition, the three video game super powers are Nintendo, Microsoft and Playstation. (11) Since its launch in 2006, Nintendo’s Wii has been the leader in the market in interactive video games, winning many awards. Its Wii fit exercise videos featuring yoga, strengthening and aerobics have been acclaimed world wide and hailed as beneficial and fun.(39)

Some 50 odd years later since William Higinbotham’s first video game, technology has grown in leaps and bounds and video games are as hot as Macbooks and iPhones. While Higinbotham’s original motive was to add some fun to science exhibits, he also expressed that scientific work was meaningful and it had aim, purpose and relevance for our society. Indeed no one can dispute society’s need for leisure, socializing and play. The relevance of video games is clear, humans play games for the challenge, curiosity and the mere fantasy. Surely, and if nothing else video games can help us escape the challenges and stress of everyday life.

The Risks of Obesity
Obesity increases the risk of developing Type II diabetes, serious asthma, heart disease, elevated blood pressure, cholesterol, and cancer in adolescence and adulthood. It also affects joints, breathing, sleeping, mood, and energy. Obese children also suffer damaging psychological effects due to the social stigma of being overweight. They frequently suffer from low-self esteem and tend to rate their quality of life as extremely low. Obese children are also at high risk for developing eating disorders and depression. (12) (13) (14) (15)



Addiction
Video games have addictive qualities. The excitement of gaming can release addictive chemicals in the players brains, including the highly addictive chemicals adrenaline and dopamine. Video games are often made with built-in reward systems; playing the game continously will result in more rewards. Receiving these rewards boosts self-esteem in children, especially in some obese children with low self-esteem who do not feel they are good at other activities. Kids may also need to keep playing the game for a certain length of time in order to reach a goal or a checkpoint at which they can save their progress, and if this point is not reached they feel they have wasted their effort playing the game. It is still under debate as to whether video game addiction qualifies as a mental illness, but it is known that many young people become obsessed with gaming. Many end up neglecting family, social relationships, school, and work in favour of gaming. There have even been cases of youth committing suicide after their parents try to break their video game addiction, or suicides otherwise related to video games. (16) (17)

Why Video Games
Because of the potential addictivity of video games and their link to some children’s self-esteem, kids may spend too much time playing video games. They also spend too much time playing because video games reward long stretches of game play. The time spent playing video games is time taken away from exercise, sometimes causing children's weight gain. Because after weight is gained, exercise becomes more difficult and less appealing to the child, so exercise is further rejected, and more weight is gained, resulting in a cycle of gaming, not exercising, and gaining weight.

Swiss studies have linked video game play independently with childhood obesity, particularly in non-Swiss children who also did not engage in much physical activity. It should also be noted that some obese children may turn to video games for recreation as opposed to sports and other activities, causing the correlation. (18)



Compared to Other Sedentary Activities
While one study concludes that video games are more closely related to childhood obesity than television watching is, most studies do not find a significant difference in weight between children who indulge in the two activities. One study in particular found that for every hour of tv watched, the incidence of obesity increased by 2% (Dietz, 1985). (19) (20)

As opposed to other sedentary activities, video games provide some benefits to the player. For example, they help sharpen the player's eyesight, correct ‘lazy eye’, improve ability to notice subtle differences in shades and pick specific objects out of a messy room. Video games also improve hand-eye coordination. In recent years, video games have been used as training programs for surgeons, because surgeons must use many of the same skills that advanced video game players use. (27) (29)

Studies Regarding Increasing Activity in Video Games
Can children really be made healthier if video games require more activity? Research says yes! In one study conducted by the Mayo Clinic on 15 normal children and 10 mildly obese children they found that virtual video games that place the child in the game and require some activity such as catching balls or other games caused energy expenditure to triple from that of sitting still. One of the most encouraging results was that when playing a dancing game the obese group burned six times the amount of energy it requires to sit still, even more than walking on a treadmill while watching TV which came in at five times. (32)

Similar studies at the Institute for Human Performance at University of Hong Kong in Pokfulam have found that players can burn up to four times as many calories when playing an active video game versus a regular seated game. The researchers of this study now say that, "the next step is to test whether active gaming interventions can provide sustainable increases in childhood physical activity." (34)

Due to these successes of the active generation of video games school districts have begun introducing these games into schools as a form of physical activity for school children. (31)

Dance Dance Revolution
This gaming system, also known as DDR, was originally released in the late 90s as an arcade game but soon versions were released for home gaming systems such as XBox and PlayStation. Players stand on a game pad and jump or stomp on the arrows on the pad as they correspond to the arrows that come across the screen.

As a means of exercise it has been reported that playing DDR has allowed users to lose up to 150lbs and break habits of inactivity. As a video game this can be an attractive form of exercise for entertainment hungry teens. (35) The gaming system has even been introduced into schools in West Virginia, USA and districts in the UK to increase the physical activity levels of students.(38)



Nintendo Wii
Released in 2006 the Nintendo Wii has been marketed toward more casual gamers and works by using infra-red detectors to track three dimensional motion as players imitate the motions required to bowl, swing a golf club or tennis racket, or even play a virtual instrument. Though the increased activity may help in the battle against sedentary lifestyles the motions required to play Wii have been known to cause injury to the player or damage to objects. (33)

The Wii Fit game is specifically designed to target the health benefits of interactive gaming systems. This game software can even measure fitness statistics such as BMI while the player stands on a specialized balance board.(39)

Should video games replace actual activity?
Technology should not replace real physical activity but as North American culture gets fatter and fatter "any strategy for increasing or promoting physical activity is worth exploring. " (40)Interactive video games might be especially worth trying for children with low skills in sports.

Conclusions
Research has proven a direct correlation between obesity and video gaming however traditional video games are merely a contributing factor to children’s inactivity and are not the only cause of obesity. The movement by the gaming industry in order to address the obesity issue has provided a new generation of more ‘active’ games and is a step in a positive direction. Nevertheless, there is still a relatively large market for ‘no-movement’ video games, in which children are only moving their fingers. Moreover, the new generation of more active games can never replace natural sports and outdoor events. New life style changes along with appropriate diets must be implemented into children’s lives in order to address the issue of obesity. Parental control in creating a balance between sports, outdoor activities, video gaming and TV as well as providing a balanced diet for their children is of most importance in shaping the child’s development and would have a great impact for their future.

References:
Brief History of Video Games

1. http://inventors.about.com/library/inventors/blcomputer_videogames.htm

2. http://users.tkk.fi/eye/videogames/console.html

3. http://www.gamespot.com/gamespot/features/video/hov/

4. http://en.wikipedia.org/wiki/History_of_video_games

5. http://www.bnl.gov/bnlweb/history/higinbotham.asp

6. http://www.pbs.org/kcts/videogamerevolution/history/timeline_flash.html

7. http://arstechnica.com/old/content/2005/10/gaming-evolution.ars/2 8. http://www.thegameconsole.com/ 9. http://www.designboom.com/eng/education/pong.html 10.http://www.thocp.net/software/games/modern_age.htm

11.http://en.wikipedia.org/wiki/Guitar_hero

41.http://en.wikipedia.org/wiki/History_of_video_games#Seventh_generation_.282004.E2.80.93Present.29

The Problem - Video Games and Childhood Obesity

12.http://ezinearticles.com/?Long-Term-Effects-Of-Childhood-Obesity&id=459419

13.http://info.cancerresearchuk.org/healthyliving/obesityandweight/howdoweknow/

14.http://ezinearticles.com/?Child-Obesity-and-Depression&id=357327

15.http://kidshealth.org/teen/food_fitness/dieting/obesity.html

16.http://www.theparentreport.com/resources/ages/preteen/kids_culture/130.html

17.http://www.msnbc.msn.com/id/19354827/

18.http://www.healthcentral.com/drdean/408/60891_2.html

19.http://www.mediafamily.org/facts/facts_tvandobchild.shtml

20.http://www.innovations-report.de/html/berichte/gesellschaftswissenschaften/bericht-27081.html

21.http://www.mcvuk.com/news/29268/McDonalds-boss-Games-to-blame-for-childhood-obesity

22.http://www.sciencedirect.com : Elizabeth A. et al, "Linking obesity and activity level with children’s television and video game use"

23.http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/life-vie/obes-eng.php#he

24.http://aspe.hhs.gov/health/reports/child_obesity/

25.http://www.healthcentral.com/drdean/408/60891.html

26.http://children.webmd.com/news/20040702/video-games-tv-double-childhood-obesity-risk

27.http://www.channel4.com/news/articles/science_technology/violent+video+games+help+eyesight/3054662

28.http://www.cfah.org/hbns/news/video03-17-04.cfm

29.http://www.canada.com/Health/Action+video+games+sharpen+eyesight+study/1444200/story.html

30.http://en.wikipedia.org/wiki/Childhood_obesity

The Solution - Adding Activity to Video Games

31.http://www.dailymail.co.uk/news/article-510681/Teachers-bring-Wii-school-bid-fight-child-obesity.html

32.http://www.sciencedaily.com/releases/2007/01/070104144703.htm

33.http://www.nationalreviewofmedicine.com/issue/2007/03_15/4_advances_medicine_5.html

34.http://www.reuters.com/article/healthNews/idUSCOL86370920080908?feedType=RSS&feedName=healthNews

35.http://docnews.diabetesjournals.org/cgi/content/full/1/2/17

36.http://www.rgxlife.com/gaming/articles/active_gaming.html

37.http://www.futurelooks.com/the-blurring-line-between-video-games-and-exercise/

38.http://en.wikipedia.org/wiki/Dance_Dance_Revolution

39.http://en.wikipedia.org/wiki/Nintendo_wii

40.http://goliath.ecnext.com/coms2/gi_0199-6688538/Interactive-video-games-in-physical.html