Score a bonus with these video gaming tips: Extra life in the real world

In video games, all players usually need to do to stay healthy is to drink the occasional healing potion or perhaps grab a floating heart. Avoiding zombies and killer aliens helps, too.

In real life, deadly monsters may be less common, but maintaining health is trickier. Luckily, it doesn't take a secret hack to stay well while playing, experts say – and some of their advice might even help you level up your game.

Gaming has its benefits

Some aspects of gaming can be good for you, said Dr. Joanne Donoghue, director of clinical research at the New York Institute of Technology College of Osteopathic Medicine in Old Westbury.

"There's definitely a plus side," said Donoghue, who has led several studies on professional gamers' health. Some action video games have been shown to improve reaction time and may help with multitasking, she said. And unlike gamers from earlier eras, modern players sitting with their headphones and microphones are "live and interacting with a lot of people at one time. So there is a social component."

Dr. Jason Nagata, an associate professor of pediatrics at the University of California, San Francisco, has studied the effects of screen time, including video games, on children and adolescents. He said digital media is "not inherently good or bad. There are some risks but also some benefits."

Understanding the problems

The risks from gaming are both broad and specific.

For starters, there are only 24 hours in a day, and "if you're sitting on a couch playing your video game for however many hours, that's basically time that you're not outside, walking, being physically active," or doing anything else that's good for your physical or mental health, Nagata said.

Excessive video game time also can be associated with lack of sleep and poor nutrition, he said. That can affect heart health.

Donoghue's research published in 2019 in BMJ Open Sport and Exercise Medicine showed that competitive gamers, also called esports athletes, frequently report problems such as eye fatigue and neck, back, hand and wrist pain.

Donoghue led another study, published in April in the International Journal of Environmental Research and Public Health, that showed men who were competitive gamers had significantly higher body fat levels and significantly less muscle mass than noncompetitive gamers with the same body mass index, or BMI. "When you're sedentary, and you're not putting in the hours of exercise or strength training, essentially your muscles are atrophying," she said.

Meanwhile, players' heart rates can soar in an unhealthy stress response. Combining stress with immobility may raise the risk of a type of dangerous blood clot called deep vein thrombosis, which typically forms in the legs, arms or pelvis. "Gamer's thrombosis" has been documented in players as young as 12 years old. In 2004, a 24-year-old South Korean who played a game for 80 hours straight died after a blood clot traveled to his lungs.

Prolonged sitting at a computer at least 10 hours in a 24-hour period and at least two hours at a time without getting up has been associated with nearly triple the risk of developing dangerous blood clots, and the risk can rise for each hour seated without getting up.

Video games are linked to mental health as well. Nagata led a review of data collected by the Adolescent Brain Cognitive Study that looked at the effects of screen time and social media use, including video games, on more than 11,000 adolescents. The analysis by Nagata and his colleagues was published in the journal Current Opinion in Pediatrics in April. The ABCD study showed that greater screen time is associated with depression, anxiety and other problems, he said.

The social nature of gaming can also expose teens to problems such as cyberbullying. And while video game addiction is not an official diagnosis, Nagata said, psychologists acknowledge that some gamers can show signs of addiction, including withdrawal symptoms when not playing, loss of interest in other activities and "a general loss of control related to video gaming."

Luckily, six simple steps can help prevent many gaming-related problems, Nagata and Donoghue said.

1. Move something besides your thumbs

A little exercise can make a difference, Donoghue said.

Donoghue and her colleagues have measured the effects of taking an hourly 6-minute walking break on a small group of competitive gamers. In one study, published in 2024 in the American Journal of Physiology-Heart and Circulatory Physiology, gamers who took such a break saw significant improvement in their blood flow volume and velocity. Wearing sock-like compression sleeves also provided a small benefit.

In that study, about two-thirds of the participants believed that the break had helped their gaming performance. In a separate study Donoghue led, published in 2021 in BMJ Open Sport and Exercise Medicine, competitive players who took a walk break improved cognitive performance, with shorter planning and solution times on problem-solving tasks. Other researchers, who published in Medicine and Science in Sports and Exercise in 2020, found that a short bout of intense exercise improved video game performance.

Which all underpins Donoghue's advice to gamers: Set a timer, take breaks and stay active. "You've got to get the exercise in. You've got to move your body. The body is meant for motion, and muscles atrophy, no matter what age you're at."

Federal physical activity guidelines call for at least 150 minutes a week of moderate-intensity aerobic exercise or 75 minutes a week of vigorous aerobic activity, or a combination of both. The guidelines also discourage people from being sedentary and suggest they participate in moderate- to high-intensity activities to strengthen muscles at least two days per week.

2. Fuel up carefully

In research on young adolescents, more time gaming has been associated with a less nutritious diet and a higher BMI, Nagata said.

"Some of the potential reasons for that are that if you are eating while you're distracted, you're more likely to eat junk foods," he said. "You're also less likely to pay attention to your hunger or fullness cues, so you might eat more than you otherwise would if you were not distracted in front of screens."

So avoid mixing eating and gaming, he said.

High-caffeine energy drinks have become part of gaming culture, Donoghue said, but such drinks have been linked to a risk of a variety of health problems, including heart rhythm issues and cardiac arrest.

A consortium of health groups, including the American Heart Association and American Academy of Pediatrics, issued recommendations in January that say caffeinated beverages are not recommended for children younger than 18.

3. Try active games

Some games do encourage motion, Nagata said. These "exergames" can help players avoid being sedentary. "And some of those associations that we see related to weight gain and poor eating are probably not the case when you're exergaming or moving around a little bit more," he said.

4. Turn off screens before bed

"When people play video games at night right before bedtime, that can take away from the time they have to sleep," Nagata said.

In a 2024 survey by the Pew Research Center, 41% of teens said video games had hurt their sleep. A study published in March in Frontiers in Psychiatry found that among Norwegian college students, an hour of screen time before bed was associated with a loss of 24 minutes of sleep.

The AAP recommends turning off screens an hour before bedtime and keeping video games in common areas to help parents keep an eye on use.

5. Monitor and get buy-in

Parents need to be aware that some games just aren't suitable for kids, Donoghue said. "I don't think they realize how interactive they are and how toxic they can become." Parents should pay attention to ratings, which can help keep inappropriate games away from children, she said.

Nagata said it's important to get buy-in from children on restrictions, though.

"You have to pick your battles," he said. For him, the most important health-related limits would be limiting games at meals and bedtime.

The AAP recommends having a family media plan, which Nagata described as "a set of guidelines that is individualized to your household and that can take into account your kids' ages, what devices you have" and other factors. It should involve regular conversations and check-ins with the whole family.

Parents can start by modeling good behavior, he said. Parents' own media use is a big predictor of video game time in kids. "If you are going to make rules about household screen use, it's important that you follow them and act as a good example for your kids."

6. Have fun, but check yourself

Video games are about entertainment, leisure and recreation, Nagata said. "If they are fun for you, and it's not displacing other things, then it's fine to play them in moderation."

But every so often, he said, ask yourself how you're feeling. If your reply is, "Oh, wow, the last hour has passed – I don't know what happened, and I kind of feel tired and cranky," then it might be time to also ask, "What else could I be doing? Maybe go outside. Maybe take a walk or meet up with some friends in person."

Games "are supposed to bring you joy," Nagata said. If your answers indicate otherwise, "then those are reasons to think, 'OK, maybe I should stop this or do something differently tomorrow.'"