It is commonly assumed that excessive gaming can lead to various health problems, including poor emotional regulation, bad diets, erratic sleep patterns, and cause mood issues like anxiety, depression, and aggression. However, a new study has shown that contrary to this belief, gamers can actually be healthier than expected.
Engaged vs. addicted
As of this year, it is estimated that more than three billion people across the world play video games, around 55 percent of whom are male. On average, gamers spend around nine and a half hours a week playing games, primarily on smartphones or tablets.
But with the rapid expansion of this industry, concerns over the health of gamers have continued to grow. In recent years, Internet Gaming Disorder (IGD), or sometimes just Gaming Disorder, has become a formally recognized mental health disorder that appears in people who struggle to control how often they play video games.
People who have IGD can experience a range of behavioral and emotional issues, including difficulty maintaining social relationships, mood regulations, and sometimes, though rarely, outbreaks of violence. But despite the emergence of this new classification of psychological disorder, its diagnosis remains controversial.
One of the common criticisms made against IGD diagnosis is that it does not differentiate between unhealthy gaming habits expressed by excessive gamers, from those of “highly engaged gamers”. These individuals also spend considerable amounts of time per week playing video games, but without experiencing negative outcomes.
This is what led Dr Catarina N. Matias from Universidade Lusófona, Lisboa, Portugal, and colleagues to conduct their latest research.
“Exploring the habits and health of this specific population of nonpathological, highly engaged gamers can provide important information about the difference between intensive gaming and problematic gaming,” the authors explain.
It can also shed light on the protective and risk factors associated with IGD and how it develops in excessive gamers.
Measuring gamers' habits
To explore this, the team recruited 235 participants (85.1 percent were men) from Portugal in the period between September 2021 and May 2022. To be included in the study, participants had to be living in Portugal, aged between 18 and 60, and currently playing video games for at least seven hours per week (within the previous month).
Each participant was asked questions about their lifestyle and gaming habits. This included sociodemographic information related to their age, sex, area of residence, date of birth, level of education, and their marital status.
They were then asked questions about their gaming behavior and habits, including the types of games they played, the time they spent playing, and the time they spent looking at screens more generally. They were also asked about their nutrition – supplement consumption, coffee or energy drink intake, and snacking habits during gaming.
To assess the health and well-being of the participants more generally, the team also asked them to take the International Physical Activity Questionnaire, which is designed to measure a person’s physical activity levels. In this study, physical activity was calculated as the sum of days, hours, and minutes of vigorous- and moderate-intensity physical activity.
The researchers also examined the amount and quality of sleep the participants experienced. They did this through the Pittsburgh Sleep Quality Index, a 19-item, self-reported questionnaire designed to measure sleep quality.
The questionnaire includes a scoring key to calculate seven components of sleep, such as subjective sleep quality, sleep latency, sleep duration, and sleep disturbances, among others. In addition, participants took the Morningness-Eveningness Questionnaire to help identify their chronotype profile (their body’s natural sleep-wake cycle).
Finally, participants took a number of tests designed to assess their overall mental health and well-being. They were also assessed to see how they scored on the IGD scale, which included the nine diagnostic criteria for the disorder.
Highly engaged and healthy
The results found that, despite having poor sleep quality, highly engaged gamers appear to have healthy lifestyles which included regular physical activity, healthy diets during gaming, and largely unproblematic gaming behavior. The results also showed that engaged gamers were emotionally healthy and experienced a positive state of well-being.
“The results showed that most players spend between 0 and 4 [hours] per day playing video games,” the authors explain. “These results seem to be consistent with previous studies that reported that highly engaged gamers tend to play between 7 [hours] per week and 20 [hours] per week.”
However, more than five hours per day were spent using computers for other activities, which meant players spent more screen time on activities other than playing games or related to their work/studies. This result should be taken with caution, as the data was gathered during the final months of the COVID-19 pandemic restrictions in Portugal, which may have increased the amount of time people used digital devices.
Overall, the authors report, “highly engaged gamers who participated in this study presented a healthy pattern of gaming, with only three cases of IGD reported using this questionnaire, which are not significant when considering the total sample.”
“Additionally, most of our sample reported playing games (FIFA, Counter-Strike, League of Legends, and Call of Duty) on a console and on the computer more than on other platforms, such as mobile.”
The results also showed that most highly engaged gamers did not consume ultra-processed snacks (fast food, gummies, lollipops, chewing gum) while gaming. Most of the participants did not consume energy drinks either, which is in stark contrast to evidence in the existing literature on the subject.
“The healthier eating habits of our sample during gaming time may also be explained by the participation in physical activity reported by the participants.”
Sixty-five percent of players reported performing physical activity, with around 39 percent taking part in team sports (football, handball, volleyball, and so on), while 28 percent regularly performed resistance training and another 22 percent took part in individual sports (running, cycling, swimming). A further 6 percent reported taking part in combat sports.
Sleep is the problem
But sleep was the biggest issue. Although the participants maintained an overall healthy lifestyle, the results showed that most of the gamers had poor sleep quality. It is possible that this is because gamers prioritize playing over maintaining regular sleep habits and practicing good sleep hygiene. In addition, exposure to screen light in the evening can disturb the body’s circadian rhythm.
Nevertheless, the study challenges many of the existing ideas associated with highly engaged gamers and shows that more needs to be done to investigate how gaming can become a pathological issue.
“Future research is warranted to assess these findings after the global COVID-19 global pandemic and to further investigate possible correlations between nutrition, physical exercise, sleep patterns, and gaming.”
The study is published in Computers in Human Behavior.