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You might assume that portraying video games as bad for your health would be as easy as shooting ducks on an old Nintendo.

Even a professional gamer like Noah "Nifty" Francis, 22, admits players aren't known for having great habits. Francis, who plays Counter-Strike: Global Offensive for the Dallas-based Team Envy, knows people who play 14 hours at a time, so focused on the game that they forget to eat. "A lot are, like, so skinny – even frail-looking – because maybe they eat one meal a day."

While nobody is suggesting you trade in your gym membership for a game subscription, it turns out there probably are worse things you could be doing with your leisure time, experts say. Keeping things balanced is key to avoiding pitfalls.

Unless you're actually playing Pitfall!, the biggest threat a video game poses to your health is probably not quicksand or mutant scorpions. It's sedentary behavior – low-energy activity, such as watching TV or being a passenger in a car.

Simply put, sedentary behavior is bad for you, said Tracie Barnett, an associate professor in the department of family medicine at McGill University in Montreal. It "is really quite well-established that it increases risk of death from all causes," said Barnett, who was chair of the committee that wrote an American Heart Association scientific statement on sedentary behavior in youth in 2018.

That report said screen time seems to contribute to children becoming overweight. But, Barnett said, many studies on screen time lump games, computer time and television-watching into one category. "And I'd say, not all screen time is equal."

A 2012 study in the American Journal of Clinical Nutrition assigned people to either watch TV, play a video game with a controller or play a video game controlled by motion. An assortment of snacks was set nearby. Every group consumed more calories than they expended – but the net intake was highest in the TV group and lowest in the motion-controlled video game group.

A 2015 review of studies in the Journal of Physical Activity and Health also found video games were a step up from sedentary screen time.

Overall, games that inspire motion – "exergaming" – beat doing nothing, said Barnett. Federal guidelines recommend adults get at least 150 minutes a week of moderate-intensity aerobic activity or 75 minutes per week of vigorous aerobic activity. And there's "a huge amount of benefit" in getting someone to go from no activity to even as little as 15 minutes a day, Barnett said.

That could affect a lot of people. About 214 million people in the U.S. are video game players – 64% of adults and 70% of children, according to the Entertainment Software Association, an industry trade group.

Research shows video games also can boost emotions and thinking skills. And the power of games to motivate can inspire healthy behavior, said Daehyoung Lee, an assistant professor in the department of applied human sciences at the University of Minnesota Duluth.

But Lee, who helped develop an app that encourages people with autism to be more active, said there are limits to how much good games can do. "Active video games and gamified fitness apps are a creative way to reduce prolonged sedentary time especially in physically inactive individuals, but they are limited to supplementary roles," he said. "We have to pursue real exercise and regular physical activity to meet the recommended physical activity guidelines and gain health benefits."

Gaming before bed also can disrupt sleep patterns, Lee said. And some people have trouble stopping. The American Psychiatric Association recognizes "internet gaming disorder" as a potential diagnosis for children and adolescents when gaming leads to "impairment or distress."

Parents looking for safe limits on screens overall can turn to the American Academy of Pediatrics, which recommends bedrooms, mealtimes, and parent-child playtimes should be screen-free and that screens should be turned off an hour before bedtime.

For adults, Barnett said it's a good idea to take a break from gaming for five to 10 minutes every half hour, or 15 to 20 minutes every hour. And keep a healthy balance with the rest of your life. "Spend some time outdoors, make sure you have face-to-face interactions as well."

Balance is what Francis, who has played professionally since he was 14, aims for these days. He persuaded his team to hire a personal trainer and learned how to cook healthy meals at home. He also started hitting the gym five to six days a week. (Research shows exercise can actually help video game performance.)

Francis said he's felt the difference his lifestyle changes have made. He feels more creative, less groggy. That's vital to someone who's playing in tournaments where tens of thousands of dollars are on the line. "If it makes you 5% better, even 1% better, you take that."

Roberto CarasasFigueroa plays for lower stakes. The 30-year-old, who lives in Carrollton, Texas, has spent a lot of nights in front of the screen. When he was younger, he sometimes played until 5 or 6 a.m. – often fueling himself with little more than a frozen burrito.

These days, while he's between jobs because of the coronavirus, he plays about eight hours a day.

In recent years, he realized he was the model of an unhealthy stereotype. So, he started eating healthier food and exercising more. By doing so, he cut his weight from 250 pounds to around 160.

He intends to keep gaming, he said. But it was time for better habits.

"I have frozen burritos in the freezer right now," he acknowledged. "But you know, they've been there for a while."

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