Dietary behavior of video game players and esports players in Germany: a cross-sectional study

Key results

The aim of the eSports Study 2021 was to investigate the health and dietary behavior of video game players and esports players in Germany. Data from over 800 mostly male, young, and well-educated participants show that self-reported health is generally good. While the players have relatively high sitting times, the majority are also physically active. Nevertheless, adults are slightly overweight on average. Dietary behavior shows no major abnormalities compared to the general German population, except for the energy drinks. The high consumption poses a health risk due to the high sugar content, among other things. Overall, the participants are mostly satisfied with their body image.

Demography and health behavior

As shown in previous studies, gamers in Germany are predominantly male, young, and well-educated [21, 22]. The vast majority of participants are students or have full-time jobs. Besides, they pursue their hobby of gaming, which, due to its nature, is played mostly while they sit. In comparison to other studies, the participants in this study played nearly the same amount of video games, approximately 20 h per week [4]. The high playing times of the professionals (36 h per week) are probably related to the fact that they earn their living with the video games and therefore have to invest more time in them. Due to the overall high playing times, the players have high sitting times, which are, however, comparable to the German population [29, 30]. Nevertheless, even though there is currently no evidence to recommend exact sitting times, these should be reduced [31]. The body mass index of the adult participants can be classified as overweight, but it is also comparable to the German population, which has an BMI of 26.0 kg/m2 [32]. In this respect, studies have already shown that gaming is not related to an increased BMI [33]. As in previous studies, the majority of gamers (85.3%) exceed the WHO’s recommendations of 2.5 h a week of moderate to vigorous physical activity. In Germany an average of 42.6% of female and 48.0% of male people reach the WHO recommendations. [34]. Therefore, a larger proportion reaches the recommendations than the German population. However, the sample of the present study is younger than the normal population, and physical activity often decreases with age [35]. Moreover, these are only the minimum recommendations [36]. For additional health benefits, more than 300 min of moderate physical activity and two muscle-strengthening activities per week are necessary. The results cannot provide any information on this because the type of physical activity was not surveyed. According to the data, the stereotype of the sedentary and physically inactive gamer cannot be supported.

Esports players reported a quiet, positive general health status. But there are significant differences between the desired and actual body image. However, on average this only differs in a maximum of one point, so for the most part they seem to be satisfied with their body image. Being satisfied with the own body is very important for well-being and overall health [37]. Regarding the WHO-5, the majority also show good psychological well-being. On average, the scores of the participants were above 50, which is considered the cut-off score, for precarious well-being [38]. Compared to amateur and professional athletes in traditional sports, the esports players showed similar scores [39]. However, it is a serious matter that almost a quarter of the participants were below the cut-off score and thus further psychological diagnostic procedures should be performed with regard to depression. Compared to previous studies, the well-being of video game and esports players decreased [21, 22]. One reason for the decreasing well-being could be the COVID-19 pandemic that occurred at the time of data collection. As some studies have shown, there has been a general decline in mental health and well-being in the population [40, 41]. Accordingly, future research should look more closely at the well-being of video game players and esports players.

Drinking behavior

With 1.6 L per day, water is the main source of fluid for the participants. This is above the general recommendations of the German Nutrition Society (DGE), which recommends 1.5 L per day [42]. The majority (91.3%) achieves the recommendation of 1.5 L a day. This puts them on par with 11–17 year-olds living in Germany, who drink 1.4 L per day [43]. However, the individual water intake depends on factors such as physical composition and activity during the day. Accordingly, 1.5 L is the minimum recommendation. Depending on age, weight, and physical activity, more water should be drunk [44].

Although it is recommended that water should be used to meet the liquid requirement, other beverages can also be consumed. Very popular in this context are soft drinks. Compared to the 14–17 year olds, who drink an average of almost half a liter of soft drinks per day, the participants in this study drink clearly less [45]. If adding the juice consumption, which contain nearly as much sugar as the soft drinks, the participants consume only half as many soft drinks and juice as the German 11–17 year olds, who drink about 573 ml per day [43]. Older age groups also consume more of these beverages. For example, men aged 18–29 drink an average of 4.5 glasses of juice and soft drinks per day [46]. Nevertheless, the consumption of gamers at one serving per day is already too high and should be decreased. The high sugar content of these drinks can lead to an increased risk of diabetes, weight gain, and high blood pressure [19, 47].

Similar reasoning applies to energy drinks. On average, participants drink more than one can per week. Compared to the German population, in which only just under 10% drink a can at least once a week, the players in this study drink much more energy drinks [48]. In comparison to the other groups, esports players drink significantly more. This could be related to the prevalent sponsorships in esports. Energy drinks are also advertised in a way to provide health benefits [49], especially for increasing performance and concentration, which are particularly relevant in esports. However, besides the high amount of sugar, energy drinks have further health risks. According to this, insomnia, stress, depressive mood, and gastrointestinal upset could be observed with regular consumption [50]. Nevertheless, an overall reduction of sugary beverages is to be strived for, because these are associated with obesity and diseases such as diabetes [14, 15, 51]. The association between energy drinks and health status in this study strengthens the explanation.

Because the number of studies that investigated the consumption of energy drinks in traditional sports is limited, it is difficult to draw a comparison with them. Nonetheless, one study [52] looked at energy drink consumption in young athletes as young as 14 years old. Seventeen percent of them drank energy drinks daily or one to two times a week. While the authors could not show a correlation with time spent exercising, another study showed that people who exercise more in their leisure time also consume more energy drinks [53]. However, the values are also hardly comparable with the present study.

In contrast, the consumption of alcoholic beverages among video game players and esports players is low. About a quarter of the participants do not drink alcohol at all. Compared to the per capita consumption per year of the German population, gamers drink less. Beer alone is already drunk by the German population about 0.2 l per day [54]. In context, according to the German Nutrition Society, the tolerable amount of alcohol for healthy men is 20 g per day [42]. This corresponds to about half a liter of beer or 250 ml of wine. The average consumption of both the total sample and the groups of video game players and esports players are below this limit.

Dietary behavior

In terms of diet, gamers are very similar to the German population, with one-tenth following a vegetarian or vegan diet [55]. In contrast, the participants, with more than six servings a week, eat relatively much meat. In addition, they eat a slice of sausage on average every day. The German Nutrition Society recommends only 300–600 g of meat per week, which is equivalent to two to four servings [42]. Eating too much meat and sausage is associated with a higher risk of colorectal cancer [42, 56]. Fish should be eaten once a week because of its omega-3-fatty acids [57]. With just under one meal per week, the participants achieve this recommendation.

Dairy products are necessary to ensure adequate calcium intake. Gamers, on the other hand, consume less than the recommended amount of 200–250 g milk and two slices of cheese. Overall, the diet is largely carbohydrate-heavy. Several slices of bread, rice, pasta and potatoes are consumed almost daily. Due to the positive effects on the gut, it is recommended to consume whole grain products made from it [58]. In addition, whole grain products are associated with a lower incidence of cardiovascular disease [18], cancer [59], and type 2 diabetes [60]. However, this study did not ask about the quality of carbohydrates. Accordingly, no statement can be made about the type of consumed carbohydrates. For a balanced diet, vegetables and fruits are also necessary. They are an important source of vitamins, minerals, trace elements, and fiber [61]. The German Nutrition Society recommends “five a day,” which means that at least three servings of vegetables and two servings of fruits should be eaten every day [42, 62]. One serving of nuts or one glass of juice can replace one serving of fruit [62]. According to the results, only a small percentage of 16% achieves these recommendations. The video game players reach them significantly more often than the esports players do. Compared to the German population gamers perform minimally better. In Germany, only 15% of women and 7% of men reach recommendations for fruits and vegetables [61]. Nevertheless, there is an overall lack of vegetable and fruit consumption. Especially with regard to the prevention of chronic diseases such as stroke, heart disease, and hypertension, attention should be paid to increasing vegetable and fruit consumption [63, 64].

Even if the consumption of sweets and chips is quite low, the participants like to resort to quick meals such as fast food. Almost two meals per week consist of it. Due to the negative association with subjective health in this study, fast food consumption should be limited. Even though it is best to consume less, the amount compared to 12–17 year old Germans is similar. They consume about 400–600 g of fast food per week [65]. These results are also reflected in the cooking frequency of the participants. Nearly half of the participants cook for themselves five times a week. This is close to the 14–29 year old German population, in which half cook almost every day [55]. However, considering that participants were forced to cook for themselves during the COVID-19 pandemic due to lockdowns, this is only a small proportion of those who actually cook regularly.

Limitations

This study also has some limitations. First, because the current study is based solely on self-reported data, the results may be influenced by social desirability or subjective over- and underestimation of certain behaviors such as sedentary times, physical activity, or food and drink consumption [66] Especially when specifying the amount of nutrition, it might be difficult to remember exactly or to estimate the servings correctly. To minimize these effects, the data were checked for paradoxical entries or extreme values. However, the effects of social desirability and inaccurate reporting cannot be ruled out in general.

Secondly, the COVID-19 pandemic and the accompanying security measures had a significant impact on the population and therefore possibly also on dietary behavior. On the one hand, restaurants were closed during the lockdown, which meant that people were increasingly forced to cook for themselves. In addition, sports in clubs or studios were limited, which affected the sports opportunities and therefore possibly the physical activity. On the other hand, digital media got a boost, which increased screen time and, in particular, video game playing time.

Thirdly, questions about the characteristics of video gamers (like playing time, sitting time, physical activity, etc.) have been largely self-generated. Either there are no validated questionnaires on this yet or the processing time should be kept as short as possible to reduce the dropout rate. This could have led to inaccurate data. For example, the question on physical activity is based on a simple indication in minutes and hours. For more valid results in future, questionnaires like the IPAQ short form or EHIS-PAQ should be used. Overestimation, misreporting, or the effect of social desirability cannot be ruled out. Accordingly, the high proportion of physical activity compared to other population groups is questionable. Insofar as length and processing time allow, validated questionnaires should be used. The food frequency questionnaire was also slightly adapted, and some foods were combined into one. While portion sizes were included with all foods, everyone could subjectively perceive them differently. However, the results still provide a good overview of the approximate dietary behavior of video game players and esports players.

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