PURPOSE: Over 15% of children aged 6 to 11 yr are overweight, more than three times as high as a generation earlier. Overweight children are at higher risk for diabetes, high blood pressure, high cholesterol, and orthopedic problems, as well as psychological problems. Overweight children are also more likely to become overweight adults, with higher risks for heart disease, stroke, hypertension, diabetes, and some types of cancers. In response to this epidemic, Health Management Consultants of VA Inc, funded by the National Institute of Child Health and Human Development, developed MetaKenkoh, an internet-based, activity-contingent game for children 9 to 11 yr of age. The game promotes physical activity through the use of pedometers that are used to relate game performance of children's own daily activity. METHODS: We conducted a clinical trial in which children aged 9 to 11 were randomized to groups that either played the game (intervention group -- IG) or that monitored only (control group -- CG). RESULTS: Preliminary data indicate that underweight and normal weight children in the IG (n = 22) show an increase in activity at one week, as measured by pedometer, whereas there is a drop in steps reported by children in the CG (n = 24). In the overweight and at-risk groups, both the IG (n = 16) and the CG (n = 15) show a slight increase in activity levels. CONCLUSION: Activity-contingent games may have the potential to facilitate increased physical activity in children. However, more research is needed in order to evaluate the effectiveness of this approach.

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