The old-fashioned trick of hiding broccoli in the casserole to get kids to eat it has been given a high-tech update.  The new tactic?  Slipping healthy behavior lessons into children’s video games.

A study conducted at Baylor College of Medicine found that overweight children who play video games promoting good nutritional choices consumed more fruits and vegetables than their “Call of Duty”-playing counterparts.

Researchers noted that overweight children who played these health-focused video games over a 2-month period achieved a two-thirds increase in fruit and vegetable consumption. Dr. Tom Baranowski, head of the research team, explains that this improvement is significant for a demographic that does not eat nearly enough of the required servings of fruits and vegetables.
The video games were developed by a company called Archimage with a grant from the National Institute of Health (NIH).  “Escape from Diab” and ” Nanoswarm: Invasion from Inner Space” are designed to look like any other video game, with a plot and levels that must be achieved.

In “Escape from Diab,” a boy named DJ falls through a time warp and lands in a magical land where the king won’t allow his subjects to exercise or eat fruits and vegetables.  As a result, the subjects don’t have enough energy to defy him.  DJ is a soccer player, though, and knows the advantages of exercising and eating well.  His task is to empower the people of Diab by teaching them how to make healthy choices.

“These games aren’t just ‘Tetrus’ with fruit,” says Richard Buday, president of Archimage.  In other words, they are more than just your classic game but with more face time given to fruits and veggies.

“We want stuff that really works, that has a clinical underpinning,” Buday says.  And researchers at Baylor have provided just that underpinning.

“Just about everything we know about behavior change is incorporated into these games,” says Dr. Tom  Baranowski, professor of pediatrics and head of the research team.

Baranowski explains that a child must see how a behavioral change aligns with his or her own values in order to adopt it.  This is why both games begin by asking a child questions that assess his or her reason for wanting to make healthier choices.  The games then incorporate that motivator into the child’s experience with the game.

“Behavior is most likely to be changed and maintained if kids do the behavior for internal reasons,” Baranowski says.

Another key to behavioral change is making a habit out of the good behavior, so that the right choice becomes not a choice at all, but a reflex.  “Thinking is an enemy of behavior change,” says Baranowski.  The games eliminate the thinking step by repeating scenarios in which a child has to choose between the healthy choice and the unhealthy one, until they begin to instinctively select the healthy option.

One activity places a child in a marketplace, faced with foods containing real fruit (like strawberries) and artificial fruit (like cherry Kool-aid.)  Players must select 20 real fruits in 3 minutes, or they have to start over.

The fact that it took children an average of 7 tries to successfully complete the task shows that this is a lesson they need, says Baranowski.

It’s also a lesson they won’t get bored learning.  In the case of a test, Baranowski explains, a child would never go over their answers 7 times until they got them all correct.  “Within the context of a video game, though, kids say, ‘Wow, that was challenging. I love that!’ ” he says.

Now the challenge for Archimage will be getting consumers to love the product as much as the children who have played it.  Consumers are most likely to include schools, families and healthcare providers.

Archimage hopes that schools will make the games a part of their curriculum, and plans to develop workbooks and other educational materials to accompany them.

As for introducing these games to healthcare providers, the recent healthcare bill could make healthcare a viable market for the games.  “Childhood obesity behavioral interventions are now fully reimbursed by insurance companies, and I have the product for that,” Buday says.

Children in the U.S. spend an average of 1 hour per day playing video games, according to Baranowski.  In his opinion, replacing some of the traditional games with ones that inspire healthy behavior would be a productive step in the fight against childhood obesity.

The study will be published in an article titled, “Video Game Play, Child Diet, and Physical Activity Behavior Change – A Randomized Clinical Trial” in the January 2011 issue of the American Journal of Preventive Medicine.

Editor’s note: The original version of this post incorrectly referred to Dr. Baranowski, whos first name is Tom.