Q&A with Tom Baranowski on video games and health

Most children (and adults, really) have a penchant for chicken nuggets and French fries—but why?

Tom Baranowski, professor of pediatrics and leader of the Behavioral Nutrition Group at the Baylor College of Medicine in Houston, has been trying to find out. He researches why children eat the foods and engage in the physical activities they do, and the role that families play in influencing young children's diet. Baranowski is a pioneer in designing and evaluating programs (including video games) that seek to help change children’s poor dietary and physical activity behaviors. ASBJ’s Margaret Suslick spoke with Baranowski to find out what is—and is not—working to prevent or lessen childhood obesity in the U.S.

What influences children’s choices?

What a child eats and how much physical activity a child does are likely the results of complex webs of genetic, physiological, physical environmental, behavioral, and psychosocial influences. At the most basic level, genes have been identified that are related to food preference and amount of physical activity. Epigenetics (influences usually from early life) turn these genes on or off. Certain hormones increase our appetite for foods, while others decrease it. There are likely brain chemicals that give some of us a good feeling after exercise, but not others. What foods we eat can predispose to better activity performance, and more activity influences what and how much we eat. Parents can be very influential on children’s intake, especially earlier in life.

The challenge is to understand how all these influences interact to result in a child’s diet and physical activity.

What is behavioral nutrition?

Nutrition is a large area of research involving many diverse scientific disciplines concerning foods, the components of foods, and how they influence growth or development and health. Some nutritionists also include a concern for physical activity. Behavioral nutrition includes research on why people eat what they do or why they are physically active and how to help people (including children) eat healthier and be more physically active.

Can video games designed to improve children’s diet and increase their physical activity help?

Children (and many adults) find video games engaging, and are more likely to seriously attend to messages in this engaging medium. If properly designed, video games offer the possibility of encouraging healthier diets and physical activity. Escape from Diab and Nanoswarm are two video games, designed to be played in sequence, that encourage healthy behaviors (eat more fruit and vegetables, drink more water, be more active, watch less TV). Our initial small randomized clinical trial revealed that 10- to 12-year-old children in the intervention group ate more fruit and vegetables after playing the games than the control group. The physical activity outcomes were less clear. We take this as encouraging news, and we are currently doing a larger trial. We hope that future efforts to prevent obesity and other chronic illnesses will use video games to increase their effectiveness.

How can school districts get families to promote nutrition and physical activity with their children?

Getting families involved in health programs is a challenge faced by all of us interested in child health promotion. Simply sending fliers, newsletters, or emails home has no effect. Parents have to be engaged face-to-face. We are working on a video game to help parents of preschoolers learn better “vegetable” parenting practices. We are excited about that game’s possibilities. To encourage parents to come to meetings at schools, we have offered simple meals (e.g., spaghetti, garlic bread, salad, and tea). Colleagues in Australia have involved fathers (the hardest group of parents to get involved) by offering more male fun-oriented ways to interact with their child around physical activity. We all have a lot to learn in this area.