Enter a coffee shop and you'll see a group of teens sipping lattés. Drive by a high school sporting event and you'll see kids slamming energy drinks. Or cross through a park and you'll see a few children drinking soda pops. Kids and caffeinated beverages have become the norm. But is it okay?

According to a recent editorial in the Canadian Medical Association Journal, the answer is no. Excessive caffeine in kids can cause nervousness, irritability, sleeplessness, and occasionally rapid heart rate. And way too many caffeine-laden products are marketed to children through advertising and sponsorship of events like snowboarding and skateboarding competitions. Thus, the authors of the editorial urge their government officials to step in and mandate labeling, marketing, and even sales of all products with caffeine levels exceeding 100 mg. Furthermore, they urge Health Canada (similar to the U.S. Department of Health and Human Services) to provide the public with more information on the health consequences of caffeine in children.

Sounds like a good idea, doesn't it? Well, the research behind the ill effects of caffeine in children is not so clear. Several other groups (and not just the beverage industry!) say that while caffeine may not benefit children, it probably won't hurt them either. The International Food Information Council (IFIC) reminds consumers that the U.S. Food and Drug Administration as well as the American Medical Association and American Cancer Society state that moderate caffeine consumption produces no increased risk to health. And in reference to children, IFIC says research has found no evidence to suggest the use of caffeine at the levels in foods and beverages is harmful; that caffeine-containing foods and beverages do not cause children to become hyperactive; and that while someone may exhibit short-term symptoms if they stop consuming caffeine suddenly, it isn't addictive.

So what is "moderate consumption"? For adults, moderate consumption has been defined as 200-300 mg caffeine per day. The U.S. doesn't provide specific guidelines for children, but Health Canada recommends:
-no more than 45 mg/day for children ages 4-6
-no more than 62.5 mg/day for children ages 7-9
-no more than 85 mg/day for children ages 10-12
-no more than 2.5 mg per kilogram body weight per day for kids 13 and older

Can kids easily exceed these recommendations? I'd say so! One 8-oz cup of drip-brewed coffee has 65-120 mg caffeine; one 8-oz energy drink has 50-200 mg caffeine; and one 12-oz soft drink has 30-60 mg caffeine. A 2007 study of U.S. adolescents aged 12-18 found that 73% consumed 100 mg or more of caffeine per day, with most consumption in the evening, the time of the day most likely to negatively effect sleep.

What do you think? Should parents watch or restrict their children's caffeine intake? Might caffeinated beverages be replacing healthy beverages like milk and water in children's diets? Or, is caffeine consumption in children (coffee and energy drinks) just another harmless fad that will pass with time?

MacDonald, N. (2010). Caffeinating children and youth. Canadian Medical Association Journal, Retrieved from http://www.cmaj.ca doi: 10.1503/cmaj.100953.

Fact sheet: caffeine and health. (2007, August 1). Retrieved from http://www.foodinsight.org/Resources/Detail.aspx?topic=Fact_Sheet_Caffeine_and_Health.

Malinauskas B.M. (2007). A survey of energy drink consumption patterns among college students. Nutr J;6:35. 

Are all cardio machines created equally? Studies have shown that when individuals exercise on different pieces of cardio equipment at the same self-selected effort level, some pieces of equipment result in greater calorie burn. For example, at the same self-selected effort level, most individuals burn more calories exercising on the treadmill compared to the rowing machine, stair stepper, cycle ergometer or cross-country ski machine. However, until recently, newer forms of exercise equipment like the elliptical machine have not been investigated.

A study published in Journal of Strength and Conditioning Research¹ examined whether you burn more calories on the elliptical or the treadmill when you self-select your exercise intensity as moderate. In this study 18 untrained college-aged subjects performed 15 minutes of exercise on both the treadmill and elliptical machines. They exercised at the same effort level as determined by their Rating of Perceived Exertion (RPE). The scale is a numerical scale used to rate overall exercise effort level. The scale uses numbers ranging from 6 (no effort - rest) to 20 (maximal effort) as shown in the RPE chart below. Each subject exercised at the same moderate-intensity rating of 12-13 on both machines.

This study found no difference in caloric expenditure between the treadmill and elliptical at the same RPE. Worth noting, although subjects burned the same number of calories, heart rate was higher when exercising on the elliptical compared to the treadmill. They found heart rates were an average of 16 – 18 beats/minute higher on the elliptical machine at the same RPE level. Reasons for this may include a lack of familiarity with the elliptical machine and/or the arms may contribute more work than the legs during elliptical exercise compared to the treadmill. Other studies which examined the heart rate response to combined arm and leg exercise showed that as the amount of work contributed by the arms increased that heart rate also increased² even though total workload did not change.

These results suggest that when individuals self-select exercise intensity based on rating of perceived exertion, they burn an equal number of calories on the elliptical and treadmill. The elliptical machine is a great cross training alternative to the treadmill as it reduces impact and provides more conditioning for the arms. However, expect higher heart rates on the elliptical machine compared to the treadmill for the same calorie burn. Which cardio machine do you prefer and why?

1. Brown, G.A., Cook, C.M., Krueger, R.D., & Heelan, K.A. (2010). Comparison of energy expenditure on a treadmill vs. an elliptical device at a self-selected exercise intensity. Journal of Strength and Conditioning Research, 24(6), 1643-49.

2. Mayo, J.J., Kravitz, L., & Wongsathikun, J. (2001). Detecting the onset of added cardiovascular strain during combined arm and leg exercise. Journal of Exercise Physiology, 4(3), Retrieved from http://www.asep.org/journals/JEPonline.

Year after year national guidelines urge Americans to do physical activity and eat a healthy plant-based diet. And year after year Americans become more sedentary and choose more highly-processed foods high in fat and calories. So what's the disconnect? Are our healthy messages too complex? Do Americans not see the benefits of a healthy lifestyle? Or, perhaps, are Americans trying to change, but just not using the right strategies?

This week the American Heart Association released a Scientific Statement titled, Interventions to Promote Physical Activity and Dietary Lifestyle Change for Cardiovascular Risk Factor Reduction in Adults. After reviewing dozens of physical activity and dietary behavior change interventions conducted from 1997 to 2007, the panel of authors determined the most efficacious and effective strategies for lasting lifestyle change. The key strategies (for individuals) are briefly described below. As you read through them, note whether you do or don't use each skill. 

• Set specific, attainable but challenging short-term physical activity and healthy eating goals
• Self-monitor, or keep track, of physical activity and foods (e.g., minutes of physical activity or calories consumed per day) to determine what changes are needed and monitor progress
• Frequent and long-term follow-up with healthcare providers or peers (in-person, oral, written, electronic) to assess goal attainment or progress toward goal(s) and provide support
• Problem solve barriers to physical activity and healthy eating (e.g., lack of access to affordable healthier foods, lack of resources for physical activity, or no time)
• Use incentives or rewards to induce or support behavior change
• Observe others performing healthy behaviors (e.g., engaging in physical activity or preparing healthy food)
• Recognize and plan for risky situations that may lead to lapses in healthy behaviors (e.g., vacations, injuries, or holidays)

Which of these do you do most often? Which might you start doing?

In addition to these individual behavior change skills, the report outlines policy changes like providing healthcare providers with the skills to assess and provide counseling around lifestyle change and calorie labeling on menus that should be implemented to assist Americans in adopting and maintaining a healthy lifestyle.

As a healthcare provider it's frustrating to tell people over and over that there's no magic bullet. Americans need to clearly understand that it's not about the latest diet or fitness fad. Changing one's lifestyle is about making healthy foods and physical activity part of their daily routine - that will be continued forever. And to do this, one must use strategies for change (as described above) to be successful. It's not necessarily easy and it's not quick. But if someone wants to reduce their risk for disease that's what they need to do.

How do you help people realize that achieving and maintaining a healthy lifestyle requires more than a meal plan and list of exercises to do?

Artinian, N.T. (2010). Interventions to promote physical activity and dietary lifestyle change for cardiovascular risk reduction in adults. a scientific statement from the American Heart Association. Circulation. Retrieved from http://circ.ahajournal.org doi: 10.1161/CIR.0b013e3181e8edfl.

Each exercise workout and sport competition can result in various magnitudes of physiological and psychological changes such as increased soft tissue damage (causing muscle soreness), increased fatigue, increased core temperatures, and altered mood.  How rapidly one recovers is influenced by factors such as genetics, diet, fitness level, sleep, environment, and winning or losing.  The exercise demands and the recovery processes are specifically related to the stressors the athlete is exposed to.  Recovery is so important that historically legal and illegal restoration techniques have been used by athletes; anything to get an edge. Examples are the use of anabolic drugs, over-the-counter medications, electrical stimulation, dietary supplements, vibration, massage, and hypnosis therapy. Recently compression garments have been viewed as a potential “tool” in the wide array of restoration techniques.

Study Focus:
In this particular study conducted at The University of Connecticut, the objective was to evaluate the influence of a whole body compression suit on recovery from a typical heavy resistance training workout.¹ The subjects were 11 men and 9 women who were highly resistance trained for the past 2 years.  They were given an 8-10 repetition maximum load for each exercise.  Furthermore, subjects were trained with the protocols and loads for several workouts during the familiarization phase to reduce novelty and assure similar physiological responses each day.  Three sets of the following 8 exercises (in order) were performed: back squats, bench press, stationary lunge, bent over row, Romanian dead lift, biceps curl, sit-up, high pull from a hang. The Control Group would not wear a compression suit post exercise.

Pre-Study Details:
A registered dietitian screened each subject for dietary habits and instructed them on replicating diet profiles for the 2 days before the study and during the 24 hour recovery.  Proper water behaviors were address to ensure normal hydration status for all testing as hypohydration (low hydration) has been shown to impact physiological responses and performance.

A variety of testing was performed such as Ultrasound Analysis to discern swelling, Psychological Questionnaire and Corresponding Scales for (soreness/pain, sleep quality, fatigue, vitality, and mood), Blood Samples, Circumference Measurements, Movement Reaction Time, Countermovement Vertical Jump, Bench Throw and Squat Jump.
Each subject was fitted for a whole compression body suit. The compression suit was applied after a shower post exercise and keep on for a 24 hour period. The control group took a shower post exercise and put on non compression clothes like a t-shirt and running shorts.

Results:
In both the men and the women the 10 point generalized muscle soreness scale, ratings were significantly lower with the use of compression garments.
The amount of swelling was significantly lower as measured by ultrasound, and the test results demonstrated that fatigue was also significantly lower in the compression garments groups. Vitality ratings were significantly higher with compression use compared to control group. No differences were statistically significant in any of the mood states, nor were the sleep quality differences compared to the control.  There were also no significant differences in the countermovement vertical jump of peak power, average power, and maximum performance decrement. 

It is important to remember that these were trained subjects accustomed to hard training and the experiment protocol was used to elicit both mechanical and chemical stressors to the body’s recovery process.  Yet this was thought to be the populations most in the need of recovery enhancements (e.g. training athletes and active individuals).  The women’s compression suit was Women’s Recharge ™ Suit and the Men’s Recharge ™ Suit.

1 William J. Kraemer, Shawn D. Flannagan, Brett A.Comstock,Maren S. Fragala, Jacob E. Earp, Courtenay Dunn-Lewis, Jen-Yu Ho, Gwendolyn A. Thomas, Glenn Solomon-Hill, Zachary R. Penwell, Matthew D. Powell, Megan R. Wolf, Jeff S. Volek, Craig R. Denegar, and Carl M. Maresh. Effects of Whole Body Compression Garment on Markers of Recovery After A Heavy Resistance Workout in Men and Women. J. Strength Cond. Res 24: 3 804-814.

If you read last week's blog you learned that prepared baby and toddler foods are often high in sugar, particularly added sugar. And as previously mentioned, because infancy and toddlerhood is a critical time period for forming taste preferences and possibly preventing future disease, the need for caretakers to take steps to limit these products is high.

This week, we're revealing the findings on SODIUM content of baby and toddler foods from the same research study (see last week's blog for information on what products were analyzed).¹

As we did with sugar, let's start with the sodium recommendations. The American Academy of Pediatrics and The American Heart Association recommend that children ages 1-3 consume no more than 1,500 mg of sodium per day; 4-8 consume no more than 1,900 mg of sodium per day; 9-13 consume no more than 2,200 mg of sodium per day; and 14-18 consume no more than 2,300 mg of sodium per day. The American Dietetic Association recommends even less at 1,200 mg/day or less for 4-8 year-olds and 1,500 mg/day or less for older children. Thus, toddlers should clearly be consuming less than 1,200 to 1,500 mg of sodium per day - about 3.8 grams of salt or 2/3 teaspoon of table salt.

So what did the researchers find? Over 12 percent of toddler products analyzed contain more than 130 mg of sodium per serving. Sixteen products contain more than 260 mg of sodium per serving. And 11 products contain over 400 mg of sodium per serving. Toddler entrees/dinners topped the 'high-sodium' list with some products exceeding 500 mg of sodium per serving - 1/2 to 1/3 of their daily limit.

And similar to what was found with sugar, sodium levels in baby/toddler products are not always nutritionally superior (less sodium) than adult products. One such case is yogurt where the amount of sodium was less in the comparable adult product.

Thus, while not quite as problematic as sugar, researchers found sodium levels in toddler products to be higher than expected. And therefore, the recommendation given at the end of the last week's blog on sugar also applies here:

Parents need to carefully select the foods they serve their babies and toddlers. Products marketed toward this age group are not necessarily healthy and oftentimes are quite the opposite. So what's the busy parent to do? Read food labels, in particular the Nutrition Facts panel of the food label where sodium is listed, and purchase as many whole foods like fruits, vegetables, whole grain breads, pastas, cereals, and lean meat, eggs, and beans. The more "whole" a product is, the less processed it is and less potential for additives like sodium and sugar. 

¹Elliott, C.D. (2010). Sweet and salty: nutritional content and analysis of baby and toddler foods. Journal of Public Health, Advance Access, doi: 10.1093, pp.1-8. 

I was running up and down the street in front of my house one day because I had to stay close to home. A neighbor down the street was out washing his cars so every time I passed him we would exchange some quick words about this and that. During one of my passes he made the comment that he should be out running. I didn’t have time to respond but I thought about this comment for the next few minutes. He had been out washing his cars (as well as the neighbor’s) as long as I had been running and I think he actually was out there before I was. And he just wasn’t washing his cars; he was WASHING his cars.  When I passed him again, I pointed out this observation to him. I started reflecting on the fact that many people do not realize how important lifestyle physical activity is on our health. One of our recent blogs, “Physically Active with a Sedentary Lifestyle: Are You at Risk?” explored the effects of inactivity on cardiovascular death rates¹. As a reminder death rates were highest in those who spent most of the day sitting even if they met their recommended physical activity requirements. So being active during the day provides protection different than structured exercise. And being more active during the day also yields higher calorie expenditure which helps with calorie balance. As I continued my run I thought about how many don’t realize that small activities throughout the day really do add up. Modern conveniences have taken much of the activity out of life and it is important for us to find ways to put it back like my neighbor washing his own car versus going to a automated drive-through service.  And unfortunately for many the perception about physical activity is that you have to be training for something. Yes, some structured exercise is important (and doesn’t have to entail training for something) but really the goal should be to decrease our sedentary behaviors and simply move more.

So how much do you know about the caloric expenditure of various activities? Let’s test your activity calorie knowledge.
*all questions are assuming the person weighs 150 pounds (68.2 kg)

1. How many calories would a 150 pound person burn putting boxes away in the attic for 10 minutes?
      a.     40 calories
      b.     85  calories

2. Which burns more calories?
      a.    washing dishes for 30 minutes
      b.    walking the dog for 15 minutes

3. Which of the following activities would burn 270 calories if done for an hour by a 150 pound person?
      a.    gardening
      b.    washing a car
 
4. Which burns more calories?
      a.    vacuuming for 20 minutes
      b.    carrying an infant for 20 minutes

5. Taking the stairs burns how many more calories than standing in an elevator?
      a.    about 3 times more
      b.    about 6 times more

How did you do?
Here are the answers. Question number one: 150 pound person would burn 85 calories putting boxes away in the attic for 10 minutes. The vertical challenge of climbing up a ladder with a weighted box is quite an intense activity. Question number two: washing dishes for 30 minutes (85 calories) will burn more calories than walking the dog for 15 (50 calories). Question number three: Gardening burns 270 calories in an hour while washing a car burns about 205 calories. And for many gardening brings enjoyment, although the same could be said about washing a car especially in my neighbor’s case! We should all strive to find activities that are fun for us. Question number four: Vacuuming and carrying an infant for 20 minutes both burn 80 calories. Question number five: Taking the stairs burns about 6 times more calories than riding in an elevator.

My challenge to you is to find ways to put activity back in your life. Oh and if you are curious as to how many calories those different activities will burn, check out this calorie calculator. It is based on the Compendium of Physical Activities which was developed to assess the intensity and energy expenditure of 605 physical activities². The site will calculate caloric expenditure for 222 of the activities. For a complete listing, check out the Compendium of Physical Activities itself. Report back to us what you come up with. You may just be providing a great idea to another reader.


1 Katzmarzyk, P.T., Church, T.S., Craig, C.L., & Bouchard, C. (2009). Sitting time and Mortality from All Causes, Cardiovascular Disease, and Cancer. MSSE, 41(5),998-1005.

2 Ainsworth, B.E., Haskell, W.L., Whitt, M.C. et al. (2000). Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc. 32 (9 Suppl): S498-504.

If you read our recent blog on the 2010 Dietary Guidelines you know that added sugar and sodium are two dietary components that Americans are eating WAY too much of. While there are differing opinions as to why we're eating too much, it's clear that this is a problem in not only adults, but also children. This is concerning because research shows that dietary habits are formed early in life and persist over time. Furthermore, studies show that the composition of early childhood diet may directly impact metabolic pathways and health during adulthood. Thus, it's imperative that we feed our children the healthiest foods possible.

In this two-part series (see our blog on 7/16 for part two) we'll reveal the results of a study recently published in the Journal of Public Health which collected nutritional information on 186 baby and toddler foods and compared these foods against their adult counterparts for sugar and sodium.¹ Are baby and toddler foods nutritionally superior to adult foods or do they contain levels of sugar and salt that are just as high and may be promoting a taste for 'sweet' and/or 'salty' in young people?

While this study was conducted in Canada, it included brands frequently purchased by American parents like Gerber Graduates, Beech-Nut's Let's Grow, and Walmart's Parent's Choice. Excluded from the study were simple purees of 100% vegetables and fruits. While these foods have naturally occurring sugars, they differ from prepared dinners or desserts that have sugar and/or salt added to them. Thus, the 186 products analyzed included: pureed dinners and desserts, toddler entrees and dinners, snacks (including biscuits, cookies, fruit snacks, snack bars, and yogurts), and some cereals.

So how did the SUGAR content of these baby/toddler foods compare to what's recommended for a "healthy diet" and amounts found in similar adult products?

Let's start with the recommendations. The Institute of Medicine recommends that 25 percent or less of total calories come from added sugars. The World Health Organization recommends that less than 10 percent of total calories come from added sugars. And the American Heart Association recommends that added sugars are no more than half of daily discretionary calories. As an example, a 3-year-old girl who does 30-60 minutes of physical activity a day needs about 1200 calories and is allowed 171 discretionary calories. Thus, it would be recommended that she consume no more than 300, 120, or 85 calories from added sugar.

Determining how much added sugar a food product has is difficult, however. The Nutrition Facts panel on the food label does not distinguish added sugars from naturally occurring sugars. Thus, total sugar was considered for the products in this study, and a product that had more than 20 percent of it's calories from sugar was considered high.

So what did the researchers find? Over half (52 percent) of the products had more than 20 percent of their calories from sugar. Pureed baby food desserts averaged 48 percent of calories from sugar and snacks (biscuits, cookies, corn snacks, rice cakes/crackers, fruit snacks, yogurt) averaged 30 percent of calories from sugar. Forty percent of the products listed sugar or some variant of sugar (e.g., corn syrup, fructose) in the first four ingredients on the label and 36 products listed sugar or some variant of sugar as either the first or second ingredient! Therefore, it can be reasonably assumed that a child who consumes just two of the previously mentioned baby/toddler snacks will exceed his/her recommended daily limit of added sugar.

But these products are nutritionally superior to their adult equivalents, right? Not always! Researchers found that toddler cereal bars had more calories from sugar (on average) than adult cereal bars and teething biscuits had almost the same amount of calories from sugar as adult-targeted biscuits.

In conclusion, parents need to carefully select the foods they serve their babies and toddlers. Products marketed toward this age group are not necessarily healthy and oftentimes are quite the opposite. So what's the busy parent to do? Read food labels, in particular the ingredient list where sugar is listed, and purchase as many whole foods like fruits, vegetables, whole grain breads, pastas, cereals, and lean meat, eggs, and beans. The more "whole" a product is, the less processed it is and less potential for additives like sugar.

Did the results of this study surprise you? Stay tuned for the results of the SODIUM test in next week's blog.

¹Elliott, C.D. (2010). Sweet and salty: nutritional content and analysis of baby and toddler foods. Journal of Public Health, Advance Access, doi: 10.1093, pp.1-8. 

It’s time to make physical activity as routine as brushing our teeth! Did you know that research is starting to show that oral hygiene along with exercise may help reduce cardiovascular (CV) disease?

A recent blog, “Physically Active with a Sedentary Lifestyle: Are you at risk?,”explored the effects of prolonged sitting on all-cause and CV death rates in individuals who exercised and those who did not¹.  Researchers reported the highest death rates in persons who spent most of the day sitting and those who spent more time sitting.  And this was true even if they met their recommended PA requirements.  In fact, death rates were similar for exercisers and non-exercisers who sat during the day.

So moving throughout the day is seen as a way to lessen the risk of CV deaths, but it’s time to add more teeth brushing too. de Oliveira and associated (2010)² investigated whether the number of times individuals brush their teeth is correlated with the risk of developing heart disease.

In the 8+ year study, just over 11,000 individuals were tracked through to hospital admissions and deaths. During the study, 555 cardiovascular events occurred. Those that brushed less had an increased risk for CV disease than those that brushed twice per day.

The stats from the study compared to twice per day brushers:
• Once per day  - 1.3 increased risk for CV events
• Less than once per day - 1.7 increased risk for CV events

So keep those pearly whites nice and clean (at least twice a day) for a longer and healthier life!  And don’t forget to walk to the water cooler for an extra swish.

¹Katzmarzyk, P.T., Church, T.S., Craig, C.L., & Bouchard, C. (2009). Sitting time and Mortality from All Causes, Cardiovascular Disease, and Cancer. MSSE, 41(5),998-1005.
²de Oliveira, C, Watt, R, & Hamer, M. (2010). Toothbrushing, inflammation, and risk of cardiovascular disease: results from Scottish health survey. British Medical Journal, 340(c2451), Retrieved from http://www.bmj.com

A recent report shows that adult obesity rates rose in 28 states during the past year and now exceed 25 percent in more than two-thirds of the states! Furthermore, while 4 states last year had obesity rates over 30 percent (Mississippi, Alabama, Tennessee, West Virginia), 8 states now have that distinction (4 previously mentioned states plus Louisiana, Kentucky, Oklahoma, and Arkansas).

This report, F is in Fat 2010: How the Obesity Crisis Threatens America's Future published by Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) this week, shows that while steps have been taken to address the obesity crisis in recent years the effort is not nearly enough to address the problem. The report recommends ensuring that the disease-prevention measures in the new health reform law are implemented strategically to help prevent and reduce obesity, expanding the commitment to community-based prevention programs, and sustaining investments in research and evaluation around obesity.

Other interesting findings from the report include:

• In 1991, no state had an obesity rate above 20 percent.
• Only the District of Columbia experienced a decline in adult obesity rates during the past year.
• Adult obesity rates for Blacks and Latinos are higher than those for Whites in at least 40 states and the District of Columbia.
• Eight states, plus the District of Columbia, have childhood obesity rates greater than 20 percent: Arkansas, Georgia, Illinois, Kentucky, Louisiana, Mississippi, Tennessee and Texas.
• Every state has some form of physical education requirement for schools, but these requirements are often limited, not enforced or do not meet adequate quality standards.

How does your state rate (see interactive map)? If you print the report's Executive Summary you can see detailed information on your state including 2010 obesity-related standards in schools (e.g., whether your state has nutritional standards for school lunches, breakfasts and snacks that are stricter than U.S. Department of Agriculture requirements or collects Body Mass Index or other health information from students).

More than half of U.S. adults play video games with one in five playing daily or almost every day.¹  Video games are gaining popularity, especially those that use arm gestures and motions or force plates to control the system.  Sedentary individuals who like video games may find these more active types of video games attractive.  But is the intensity of these video games high enough to provide health benefits?

Japanese² researchers investigated the energy cost of theWii Fit Plus videos for yoga, resistance, balance and aerobic exercise and Wii Sports including golf, bowling, baseball, tennis and boxing.  They measured caloric expenditure in a special airtight room called a metabolic chamber while subjects performed each activity for eight minutes. 

Researchers measured the intensity of each video activity in units called metabolic equivalents (METs).  Resting energy expenditure is defined as 1 MET; if you are exercising at 3 METs then the intensity of the activity is three times resting.  According to the American College of Sports Medicine, an activity must reach a level of moderate intensity to provide health benefits.  Moderate intensity exercise is defined as an intensity of 3-6 METs.  Vigorous activities have an intensity >6 METs.

Results of the study showed that Wii balance exercises and yoga were below the minimum intensity of 3 METs.  These exercises produced only light activity levels which were not adequate to provide health benefits.  Many but not all the resistance training and aerobic exercises met the minimum 3 MET criteria and would be considered adequate to provide health benefits.  Of the Wii Sports activities, boxing had the highest energy expenditure averaging just over 4 METs.  Tennis and baseball averaged 3 METs with golf and bowling <3 METs.  None of the sports or fitness activities were considered vigorous activity. 

The activity guidelines for health benefits are 30 minutes of moderate intensity (3-6 METs) activity performed 5 days/week. Some of the Wii sports games and fitness activities are sufficient to meet these minimum guidelines and could be used to meet part of the recommended 150 minutes of activity per week.  However, many of the games (about 2/3 of those tested) provide only light activity (<3 METs) and do not meet the criteria.  For this reason it is important to choose games requiring the greatest energy expenditure.  It is also important to note that 150 minutes of moderate intensity activity is the amount recommended for health benefits like improving cholesterol, blood pressure, and blood sugar levels.  If an individual’s goal is weight loss, the recommendation for activity is 300 minutes of moderate intensity exercise per week. 

Worth noting, the Wii Sports games and Wii Fit Plus aerobic exercise videos expend fewer calories than performance of the actual sport or exercise itself.  There is not much horizontal movement involved in playing Wii games; the added movement increases energy expenditure when playing the real sport or aerobic exercise.  So if you get the opportunity select the actual activity or sport to get the most fitness improvements and the greatest caloric expenditure.

1.  Lenhart, A. Jones, S., and Macgill, A. (2008). Adults and video games. In: Pew  Internet and American Lift Project. 2008 [cited July 1, 2009]. Available from http://www.pewinternet.org/Reports/2008/Adults-and-Video-Games.aspx

2.  Miyachi, M, Yomamoto, K, Ohkawara, K, Tanaka, S. (2010). METs in Adults While Playing Active Video Games: A Metabolic Chamber Study. Med Sci Sports Exerc. 42(6), 1149-1153.