Acute effects of violent video-game playing on blood pressure and appetite perception in normal-weight young men: a randomized controlled trial

Heartbeats and high scores: esports triggers cardiovascular and autonomic stress response

Introduction

Gaming is often labeled as sedentary behavior. However, competitive gaming, also known as esports, involves significant cognitive demands and may induce stress. This study aims to investigate whether the psychophysical demands during esports elicit a physiological stress response.

Methods

Fourteen FIFA 21 and thirteen League of Legends players (23.3 ± 2.8 years) were recruited for the study. Heart rate (HR), root mean square of successive differences between normal heartbeats (RMSSD), peripheral and central blood pressure (BP), pulse wave velocity (PWV), and energy expenditure (EE) were assessed during supine rest, seated rest, and competitive FIFA or League of Legends matches.

Results

No significant group × condition interactions were observed for any of the outcomes. However, there were significant increases in mean HR (p < 0.001, η p 2  = 0.383), RMSSD (p = 0.019, η p 2  = 0.226), peripheral systolic BP (p < 0.001, η p 2  = 0.588), peripheral diastolic BP (p = 0.005, η p 2  = 0.272), central systolic BP (p = 0.005; η p 2  = 0.369), central diastolic BP (p = 0.016, η p 2  = 0.313), PWV (p = 0.004, η p 2  = 0.333), and EE (p < 0.001, η p 2  = 0.721) during both games compared to the seated rest condition.

Conclusion

Despite the sedentary nature of esports, the psychophysical demands appear to elicit physiological responses. Interestingly, no significant differences were found between the different game genres.

The eSports Medicine: Pre-Participation Screening and Injuries Management-An Update

Recently, electronic sports (eSports) became one of the growing forms of new media due to the wide diffusion of games and online technologies. Even if there is still a debate about the definition and characterization of eSports, eAthletes train heavily, compete in tournaments, must abide by competition, association, and governing body rules, just like all other athletes. Furthermore, as in any other competitive discipline, there can be injuries. Aberrant sitting posture, repetitive movements, screen vision, prolonged playing hours, and a sedentary lifestyle can lead to several medical hazards in musculoskeletal, ophthalmology, neurological, and metabolic systems. Moreover, several cardiovascular changes occur in eAthletes. This paper aims to explore the different injuries that can occur in a professional eAthlete, suggesting how every high-level gamer could benefit from a pre-participation evaluation and a correct injury prevention strategy.

Arousal/Stress Effects of "Overwatch" eSports Game Competition in Collegiate Gamers

ABSTRACT

Kraemer, WJ, Caldwell, LK, Post, EM, Beeler, MK, Emerson, A, Volek, JS, Maresh, CM, Fogt, JS, Fogt, N, Häkkinen, K, Newton, RU, Lopez, P, Sanchez, BN, and Onate, JA. Arousal/stress effects of "Overwatch" eSports game competition in collegiate gamers. J Strength Cond Res XX(X): 000-000, 2022-To date, no physical response data are available for one of the most popular eSport games, Overwatch. The purpose of this investigation was to describe the stress signaling associated with competitive Overwatch play and to understand how acute hormonal responses may affect performance. Thirty-two male college-aged gamers (age: 21.3 ± 2.7 years; estimated time played per week: 18 ± 15 hours) completed the study. Subjects were randomly assigned to a 6-player team to compete in a tournament-style match. Salivary measures of cortisol and testosterone were collected immediately before (PRE) and after (POST) the first-round game, with the heart rate recorded continuously during the match. The mean characteristics were calculated for each variable and comparisons made by the skill level. Significance was defined as p ≤ 0.05. There were no differences in measures of salivary cortisol. A differential response pattern was observed by the skill level for testosterone. The low skill group displayed a significant increase in testosterone with game play (mean ± SD, testosterone PRE: 418.3 ± 89.5 pmol·L-1, POST: 527.6 ± 132.4 pmol·L-1, p < 0.001), whereas no change was observed in the high skill group. There were no differences in heart rate characteristics between skill groups. Overall, the average heart rate was 107.2 ± 17.8 bpm with an average max heart rate of 133.3 ± 19.1 bpm. This study provides unique physiological evidence that a sedentary Overwatch match modulates endocrine and cardiovascular responses, with the skill level emerging as a potential modulator.

Fright but not fight‐or‐flight: Violent video games elevated stress markers, but did not impact muscle function, memory recall or food intake, in a randomized trial in healthy young men

Objectives

Regular video game playing has been linked with obesity, but the underlying mechanisms remain unclear. Drawing on evolutionary life history theory, we hypothesized that playing violent video games, through activating the stress response, might increase the immediate demand for fuel by muscle and brain tissue, resulting in elevated appetite and food consumption.

Methods

We randomized 71 young adult men to play video games, involving either violent content or nonviolent puzzle‐solving, for 1 h. Over this period, we measured stress markers (blood pressure [BP], heart rate, visual‐analogue scale [VAS] self‐ratings), muscle function (handgrip strength) and cognitive function (memory recall test). Appetite was assessed by VAS, and by food intake using a test‐meal after the intervention. Linear mixed‐effects models were fitted to assess group effects and group:time effects.

Results

During the intervention, the violent video game group showed elevated systolic BP (∆ = 4.7 mm Hg, 95% CI 1.0, 8.4) and reported feeling more alert but less calm or happy. They showed no difference in grip strength or memory recall. They reported lower feelings of “fullness” but consumed similar food‐energy during the test‐meal.

Conclusions

Although playing a video game with violent content elevated physiological and perceived stress markers compared with a nonviolent game, this was not associated with markers of altered fuel distribution toward two tissues (muscle and brain) that contribute to the “fight‐or‐flight” response. Rather than more energy being allocated to the brain overall, energy may have been reallocated within the brain. This may explain why there was no compensatory increase in energy intake in the violent video game group.

Acute Effects of Esports on the Cardiovascular System and Energy Expenditure in Amateur Esports Players

Introduction

Esports is practiced by millions of people worldwide every day. On a professional level, esports has been proven to have a high stress potential and is sometimes considered equivalent to traditional sporting activities. While traditional sports have health-promoting effects through muscle activity and increased energy expenditure, amateur esports could represent a purely sedentary activity, which would carry potentially harmful effects when practiced regularly. Therefore, this study aims to investigate the acute effects of esports on the cardiovascular system and energy expenditure in amateur esports players to show whether esports can be considered as physical strain or mental stress or whether amateur esports has to be seen as purely sedentary behavior.

Methods

Thirty male subjects participated in a 30-min gaming session, playing the soccer simulation game FIFA 20 or the tactical, first-person multiplayer shooter Counter-Strike: Global Offensive. Respiratory and cardiovascular parameters, as well as energy expenditure, blood glucose, lactate, and cortisol, were determined pre-, during, and post-gaming.

Results

There were no significant changes in oxygen uptake, carbon dioxide output, energy expenditure, stroke volume, or lactate levels. Heart rate, blood glucose and cortisol decreased through the intervention until reaching their minimum levels 10 min post-gaming (Cortisolpre: 3.1 ± 2.9 ng/ml, Cortisolpost: 2.2 ± 2.3 ng/ml, p &lt; 0.01; HRmin0.5: 82 ± 11 bpm, HRpost: 74 ± 13 bpm, p &lt; 0.01).

Conclusion

A 30-min esports intervention does not positively affect energy expenditure or metabolism in amateur esports players. Therefore, it cannot provide the same health-promoting effects as traditional sports participation, but could in the long-term rather cause the same potentially health-damaging effects as purely sedentary behavior. However, it does not trigger a negative stress response in the players. Deliberate physical activity and exercise routines adapted to these demands should therefore be part of the daily life of amateur esports players.

Sedentary behavior is more related with cardiovascular parameters in normal weight than overweight adolescents

This study analyzed the relationship between sedentary behavior and cardiovascular parameters in normal weight and overweight adolescents. The sample included 449 boys and 555 girls with mean age of 13 years from public schools, which were divided into five geographical regions, with data collections performed in one selected school from each region. Sedentary behavior was assessed by screen time on TV, computer, videogame and cell phone/tablet, with good reliability in adolescents. Physical activity was assessed by Baecke's questionnaire, validated for adolescents. Measures of body weight, height and waist circumference were collected. Adolescents were classified as overweight or normal weight by cut-off points of body mass index for age and sex. Cardiovascular parameters were evaluated by oscillometric device and heart rate by specific monitor. Computer use was positively related to systolic blood pressure (SBP) (β = 0.35; 95%CI = 0.07-0.62) and diastolic blood pressure (DBP) (β = 0.25; 95%CI = 0.05-0.44) in normal weight but not in overweight adolescents. Similar results were observed for cell phone/tablet in SBP (β = 0.46; 95%CI = 0.20-0.72) and DBP (β = 0.36; 95%CI = 0.18-0.54), only for normal weight. The cluster of screen time was related to SBP in normal weight (β = 0.44; 95%CI = 0.03-0.84) and overweight (β = 0.60; 95%CI = 0.01-1.19). Screen time in computer and cell phone/tablet was more related to cardiovascular parameters in normal weight than overweight adolescents.

Physiological and Cognitive Functions Following a Discrete Session of Competitive Esports Gaming

Competitive organized electronic video gaming, termed “esports,” has become an international industry. The physiological and cognitive health results of prolonged esport practice and competition have not been adequately studied. The current study examined physiological and cognitive changes after a session of esport gameplay for two types of games, first-person shooter and multiplayer online battle arena games. Increases in systolic blood pressure, increases in speed, and decreases in accuracy and inhibitory processes were found for esport gamers overall. For peak heart rate change, first-person shooter games elicited a larger change than did multiplayer online battle arena games. These results have implications for the management of esport player cognitive and physical health as well as for the optimization of performance in competitive esport tournaments.

The physiological and biochemical effects of gaming: A review

BACKGROUND

Recreational, seated video gaming (gaming) has become a favorite pastime of children, adolescents, and adults (gamers) in developed countries. Some engage in gaming behavior for more than 6 h daily, which can subsequently lead to less time spent being physically active. Gaming can potentially have a serious impact on the physiology and biochemistry of gamers and can influence both short-term and long-term health. The aim of this review was to provide an overview of what is known about how gaming affects physiological and biochemical parameters in the human body and how studies have previously been designed and to discuss how studies can be designed moving forward.

METHODS

The literature search included material from three scientific databases (PubMed, EMBASE, and Web of Science) using a two-block search strategy. To be included in this review, studies had to investigate a biochemical or physiological aspect of sedentary, video game-related activities. Studies that investigated neurological, psychologic or musculoskeletal outcomes along with physiological or biochemical outcomes in gaming were eligible for inclusion. Studies regarding psychiatric conditions were excluded as this subject was outside the scope of this review. Additionally, non-English language articles were excluded.

RESULTS

A total of 5417 articles were screened, 138 studies from the literature search and 4 studies from reference lists were selected for further evaluation. The studies were evaluated based on their abstracts or full texts, and 51 studies were eventually included in the review. Thirty-seven studies included physiological results, seven studies included biochemical results, and seven studies included both. Several outcomes such as heart rate, blood pressure, blood glucose levels, and cortisol levels, were the subjects of a large number of investigations.

CONCLUSION

This field is heterogenic and does not lend itself to firm conclusions. Tentatively, it seems reasonable to conclude that heart rate variability studies show that gaming increases activity in the sympathetic nervous system. More high-quality studies are required, and the lack of studies using uniform, standardized designs and realistic gaming sessions (i.e., longer than 30 min) limits our current knowledge.

Movie violence acutely affects food choices in young adults

BACKGROUND

Extensive research has been conducted to investigate the effects of media violence on attitudes, behaviors, and cardiovascular health; however, only few studies have examined its effect on appetite, eating behavior and food preferences. Little attention has been given to understand how movie genre manipulates the physiology and the eating behavior of individuals. The present study aimed at investigating the acute effect of violence content in movies on appetite perception, heart rate and blood pressure, along with food preferences and intake in young individuals.

METHODS

Participants (n = 84) were randomly assigned to either watch a violent movie or a non-violent narrative movie. Measurements including anthropometry, heart rate, blood pressure and grip strength were taken and appetite as well as stress perception were assessed. Subjects were then provided with an individual snack tray containing various items to be consumed ad libitum.

RESULTS

Post intervention, the experimental group (EG) had a higher consumption of fatty (t (82) = 2.28, p = 0.025, d = 1.52) and salty (t (82) = 2.61, p = 0.01, d = 0.71) food items compared to the control group (CG). Out of the 42 participants in the EG 62% consumed >2 fatty items and 71.4% consumed >2 salty food items. No significant difference in the consumption of sugary items was observed between the two groups.

CONCLUSION

Movie violence affects eating behavior and may promote weight gain.

Externalizing behavior is prospectively associated with intake of added sugar and sodium among low socioeconomic status preschoolers in a sex-specific manner

BACKGROUND

High intake of added sugar and sodium is a public health concern for preschool-aged children living in the US. Externalizing behavior may predict higher consumption of added sugar and/or sodium; however, previous studies have mostly been cross-sectional. The aim was to evaluate whether externalizing behavior is prospectively related to added sugar and intake in a sex-specific manner among preschoolers.

METHODS

This was a secondary analysis of 524 preschool children (48% male) from Michigan who participated in an obesity prevention trial that occurred during one school year from 2011 to 2015. Teacher-assessed externalizing behaviors and three 24-h dietary recalls were completed at baseline and follow-up. We used linear mixed effects regression to evaluate the association between externalizing behavior at baseline and added sugar (% of total Calories) and sodium intake (mg/1000 Calories) at follow-up. In adjusted analysis, we included baseline income-to-needs ratio, child race/ethnicity, and baseline overweight status. All models were adjusted for total energy intake and accounted for clustering by classroom.

RESULTS

Baseline externalizing behavior was positively associated with added sugar intake at follow-up among boys; after adjustment for confounders, every 5 points lower externalizing T-score (corresponding to higher externalizing behavior) was associated with a 0.6 higher percentage of added sugar per total Calories (95% CI 0.2 to 1.1; P value = 0.004). In contrast, girls with higher levels of externalizing behavior had lower consumption of added sugars; after confounder adjustment, every 5 points lower externalizing T-score was related to 0.6 lower percentage intake (95% CI -1.0 to -0.1; P value = 0.01). Baseline externalizing behavior was inversely associated with sodium intake at follow-up among boys. After potential confounder adjustment, for every 5 points lower externalizing behavior T-score, there was a 22 mg/1000 Cal lower sodium intake (95% CI -45 to 1; P value = 0.06). In contrast, after adjustment for confounders, every 5 points lower externalizing T-score among girls was related to 24 mg/1000 Cal higher sodium intake (95% CI 1 to 46; P value = 0.04).

CONCLUSIONS

Externalizing behavior among preschool-aged children was prospectively related to added sugar and sodium intake in a sex-dependent manner.

TRIAL REGISTRATION

NCT01398358 Registered 19 July 2011.

Acute effects of video-game playing versus television viewing on stress markers and food intake in overweight and obese young men: A randomised controlled trial

BACKGROUND

Sedentary or near-sedentary activities are associated with overweight/obesity in epidemiological studies. This has traditionally been attributed to physical activity displacement. A little-explored area is whether behavioural stresses alter sensations of appetite and eating behaviour. We examined whether behaviours conducted seated (television viewing, video gaming) induce different eating patterns, associated with differential levels of stress response.

METHODS AND FINDINGS

We conducted a randomized controlled trial in 72 overweight/obese adult males, assigned to three groups (24 per group): (i) non-violent television (control group); (ii) non-violent game (FIFA); (iii) violent game (Call of Duty). Following a standardized breakfast, the 1-h intervention was followed by 25-min rest, with sweet and savoury snacks and drinks available ad libitum. Stress markers (heart rate, blood pressure, visual analogue scale (VAS)) were measured throughout. Heart rate, systolic blood pressure, and stress by VAS were significantly higher (p < 0.05) playing video games than watching non-violent television, though the two game groups did not differ. Considered separately, only the violent video game group consumed more energy (Δ = 208.3 kcal, 95%CI 16, 400), sweet foods (Δ = 25.9 g, 95%CI 9.9, 41.9) and saturated fat (Δ = 4.36 g, 95%CI 0.76, 7.96) than controls.

CONCLUSION

Playing video games in overweight/obese adult males is associated with an acute stress response relative to watching non-violent television, associated with greater subsequent food intake. These findings highlight the need to focus on the metabolic effects, as well as the energy costs, of activities involving sitting in relation to obesity risk.

Windows of opportunity for physical activity in the prevention of obesity

Tackling increasing rates of obesity is likely to be a defining feature of health care over the next several decades. Adult obesity is a persistent and treatment-resistant problem. Consequently, an emerging theme in the literature is to commence prevention efforts earlier in the developmental time course. This view is based primarily on epidemiological data demonstrating a link between traits manifesting early during development and increased obesity risk in adulthood. Physical activity is a perennial factor in discussions of obesity prevention. However, the optimal timing and type of physical activity interventions to commence remains unclear. Critical developmental windows of plasticity may afford time-limited opportunities to shape body composition across the life course; however, physical activity has not been explicitly considered in these discussions. Although animal models suggest that physical activity commenced earlier in development has differential effects on obesity onset compared to physical activity commenced in adulthood, human research is lacking. In this conceptual review, we consider physical activity during critical developmental periods as a way to mitigate obesity risk later in life.