Diabetes Forecast

Work Up a Sweat With These Video Games

Who says video games are just for couch potatoes?

By Benjamin Page , ,

PixelChoice/Getty Images (man and sun); Tetiana Lazunova/Getty Images (background)

Safety Note: Check with your health care provider before starting or changing your exercise plan.

You may not automatically associate playing video games with fitness. After all, isn’t that how kids waste time when they should be outside getting fresh air and exercise? Not necessarily. Over the past decade or so, a number of developers have created video games designed to get players of all ages on their feet.

Being active every day is a key part of managing blood glucose and reducing the risk for cardiovascular disease. But finding the time and staying motivated can be tricky. Like exercise videos, fitness video games all but excuse-proof exercise by letting you work out in the comfort of your own home. Unlike regular exercise videos, however, video games have sneaky ways to keep you coming back. “The value is that there’s an interactivity with the game,” says Tom Baranowski, PhD, distinguished emeritus professor of pediatrics at Baylor College of Medicine in Houston and editor in chief of Games for Health Journal. “You can win or lose. There’s often competition, either with yourself or a participant. There’s a leaderboard [and other] reward mechanisms.”

Exercise video games, or “exergames,” are highly customized to individual users, thanks to sensors that track a player’s movements. If you complete certain actions, you win points or fun rewards. Don’t like the shirt your onscreen character (or avatar) is wearing? Do a few more leg lifts and you’ll have enough points to choose a new one. 
Arguably the best part: Many exergames don’t feel like exercise. “They design these games first and foremost to be fun,” says Gary Scheiner, MS, CDCES, owner and director of Integrated Diabetes Services in Wynnewood, Pennsylvania. “Getting the workout is a side effect of playing the game.” 

Level Up

Exergames are an ideal way to break sedentary habits, especially for older adults with diabetes. “For people who are inactive, [video games] help them burn a lot more energy than they normally do and help establish a baseline fitness level,” Scheiner says.

And they can be the ticket to satisfying physical activity guidelines. In its 2020 Standards of Medical Care in Diabetes, the American Diabetes Association (ADA) recommends that adults break prolonged sitting streaks every 30 minutes and log at least 150 minutes of moderate-intensity aerobic (for example, your breathing gets harder, but you’re not out of breath) activity per week.

Researchers use MET, or metabolic equivalent of task, to measure the intensity of a given exercise. Any activity measuring between 3 and 6 METs is considered moderate intensity. Multiple studies have shown that exergames generally clock in at 3 METs, and while this may be the lowest level of moderate activity, a study published in 2019 in BioMed Research International suggests that exergames can help adults meet their physical activity targets.

Kids who are overweight and at risk for prediabetes or type 2 diabetes can also benefit. In a study published in 2018 in Pediatric Obesity, overweight and obese children who played exergames regularly for 24 weeks lost weight and improved their blood pressure and cholesterol levels. Plus, the kids reported having fun while doing it, which may be why so many of them stuck with the program.

No Cheat Codes

It may all sound like fun and games, but you want to take the same precautions when playing exergames that you would during any other physical activity. That includes accounting for exercise’s ability to lower blood glucose.

“Somebody who’s taking insulin will need to cut back or have more carbs when they engage in these games,” Scheiner says. “Consider it physical activity like any other where you have to make some adjustments to keep your blood glucose in a healthy range.”

Reduce your risk for injury by reading the game’s instructions before you hit start. Most exergames are designed to be played while standing, but Scheiner recommends playing from a seated position if you have balance issues or if you have cardiac autonomic neuropathy, a heart-related complication of diabetes that can cause dizziness from too much sudden movement. That’s especially true for virtual reality exergames, which obscure your vision with a headset.

Game On

Before you can begin, you’ll need a gaming console. They range in price from $300 to $500. Nintendo consoles have always led the way in exergames, but virtual reality systems such as those from Oculus and PlayStation are making headway. Sound confusing? Electronics stores often have video game demonstrations set up for customers to try. Or you could ask your kids or grandkids, who may already have one of these consoles, to help with setup.

Once you have a gaming console, pick the individual games. These generally cost between $25 and $80. Some are specific to one device, while others work across multiple consoles. You may already be familiar with some games, such as Nintendo’s Wii Fit, which offers users a range of activities, including aerobics, strength training, balance training, and sports. Here are five more options to get you started.

Perfect For: Working up a sweat
Game: Ring Fit Adventure
Players: 1
Gaming Console: Nintendo Switch

One of the newest exergames also comes closest to providing a full-body workout. Lead your character on a quest to defeat a bodybuilding dragon. You’ll do various leg, arm, and ab exercises to jump over obstacles, navigate rivers, and defeat enemies. The game includes a leg strap that monitors your motion as you run in place, as well as a ring that acts as a resistance band. Earn points to customize your in-game character with new outfits and skills, and then share your results through the online leaderboards. Exercise intensity can be adjusted based on your needs.

Perfect For: Puzzle solvers
Game: Superhot VR
Players: 1
Gaming Console: A virtual reality headset such as Oculus Rift or PlayStation VR

This game may sound traditional at first: Players face off against virtual bad guys who attack with guns, knives, or fists as each level increases in difficulty. But the twist with Superhot VR is that in-game time stays frozen until the player moves. Say, for instance, an opponent is coming toward you with a knife. Freeze to stop time and plan your own counterattack. A bad guy fires a gun? Slow your movements to simultaneously slow the bullet in midair. It sounds tricky, but the gameplay turns each level into a puzzle that requires you to analyze the situation and come up with the best strategy for attacking enemies and dodging bullets.

Perfect for: Music lovers
Game: Just Dance 2020
Players: 1 to 6
Gaming Console: Xbox One, PlayStation 4, Nintendo Switch, or Nintendo Wii

The latest in a long-running series, Just Dance 2020 lets players twist and sway to 40 popular songs. Earn points by following along as animated characters perform a variety of dance moves. Just Dance games have always favored fun over competition—there are no winners or losers; you simply earn points to unlock new songs—while still providing a full-body workout. There’s also a kids mode with simpler choreography.

Perfect For: Would-be percussionists
Game: Beat Saber
Players: 1
Gaming Console: A virtual reality headset such as Oculus Rift or PlayStation VR

This virtual reality game takes players to a neon-soaked virtual space where rhythm is king. With a controller in each hand to detect movement, users choose from a list of songs and slash away at multicolor blocks that approach in time to the music. Swipe too early or too late and you lose points. The concept will be familiar to those who have played Guitar Hero or Rock Band, but Beat Saber encourages more physical movement. You won’t be able to see your literal surroundings while wearing the headset, so make sure the floor is open and clear, and try not to knock over any lamps.

Perfect For: Gamers who need to stay seated
Game: Arms
Players: 1 or 2
Gaming Console: Nintendo Switch

For those who like the idea of boxing but have no interest in being punched, there’s Arms. The game takes the traditional concept of head-to-head matchups and gives it a zany twist. The cartoonish boxing characters of Arms use spring-loaded arms and super-powered gloves to fight opponents from a distance. With a controller in each hand, you use arm movements to duck and weave and attack your virtual opponent. Choose different characters, each with their own unique abilities, and earn points to make upgrades. Arms isn’t as intense a workout as some other options, but it’s a fun way to work up a light sweat.

Work Those Apps

Not ready to invest in an expensive gaming console? Your smartphone has options, too.

Pokemon Go
You can fight fictional creatures, but first you’ve got to find them by wandering around your own neighborhood using your phone’s camera. The more exploring you do on foot, the more creatures you’ll find. Free on Apple or Android devices.

Zombies, Run!
Turn your normal jog into a survival adventure. Each chapter tells the ongoing story of a zombie epidemic, complete with occasional prompts to pick up your speed because you’re being chased by an undead horde. Free on Apple or Android devices.

Ingress Prime
Aliens are creating energy-emitting portals across your city. Is this good or bad? Pick a side and race against other local players to “hack” the various portals, which you can do only by physically walking there. Free on Apple or Android device



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