Can a video game convince children to eat more fruits and vegetables?


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You already know that eating the daily recommended amounts of fruits and vegetables is essential not only to stay fit and trim but also — and arguably more importantly — to keep at bay certain chronic illnesses, including diabetes, cardiovascular disease and even some cancers. And yet U.S. children are still not eating enough fruits and vegetables.


Finding common ground

What's a surefire way to get a kid not to do something? You tell them they have to do it. It seems like an unfair generalization, but when it comes to food, even adults would be hard-pressed to choose apple slices over delicious French fries.

Rather than force the issue, a team of researchers decided to try to improve the fruit and vegetable intake of fourth and fifth graders with a video game.

The team — made up of researchers from the United States Department of Agriculture, Agricultural Research Service Children's Nutrition Research Center at Baylor College of Medicine and Texas Children's Hospital — used an online video game called "Squires Quest! II: Saving the Kingdom of Fivealot," which promotes fruit and vegetable intake.

For the study, 400 children played 10 episodes of Squires Quest! II. During the goal-setting process to eat fruit and vegetables at specific meals, the students had to create either an action or a coping implementation intention; create both an action and a coping implementation intention; or create no implementation intention.

The children were asked to record whether they had met their goals during the next episode of the game. Parents were sent emails with a newsletter and link to a parent website. These resources provided parents with information on their child's weekly goals, suggestions for supporting achievement of fruit and vegetable goals and ways of overcoming common barriers to helping their family make healthy food choices.

To track the effect of the video game on real-life fruit and vegetable consumption at baseline and six months later, researchers completed 24-hour dietary recalls with children over the phone three times, averaging breakfast, lunch, snack and dinner fruit and vegetable intakes. Six months after intervention, improvements in both fruit and vegetable intake were noted for participants.

"By using a serious video game, we saw increases in meal-specific vegetable intake at dinner for the children in the Action and Coping groups and fruit intake at breakfast, lunch and snacks for all intervention groups," said lead author Karen Cullen, DrPH, RD, USDA/ARS, Children's Nutrition Research Center, Baylor College of Medicine.

Of the 400 participants, 79% reported meeting all goals during game play. Researchers attributed this partly to the game content, as serious video games are designed to both entertain and promote behavior change. Likewise, getting parents involved with email and newsletters might also have played a role in the increase in fruit and vegetable intake among participants and certainly supports the notion that healthy eating does indeed start at home.

Increasing intake of fruits and vegetables among fourth and fifth grade students via serious video game play showed promising results, but the researchers insist more work must be done to ensure children meet their recommended intake.