BackgroundActive video games may contribute to reducing time spent in sedentary activities, increasing physical activity and preventing excessive weight gain in adolescents. Active video gaming can, however, only be beneficial for weight management when it replaces sedentary activities and not other physical activity, and when it is not associated with a higher energy intake. The current study therefore examines the association between active video gaming and other energy-balance-related behaviours (EBRBs).FindingsAdolescents (12–16 years) with access to an active video game and who reported to spend at least one hour per week in active video gaming were invited to participate in the study. They were asked to complete electronic 24-hour recall diaries on five randomly assigned weekdays and two randomly assigned weekend-days in a one-month period, reporting on time spent playing active and non-active video games and on other EBRBs. Findings indicated that adolescents who reported playing active video games on assessed days also reported spending more time playing non-active video games (Median = 23.6, IQR = 56.8 minutes per week) compared to adolescents who did not report playing active video games on assessed days (Median = 10.0, IQR = 51.3 minutes per week, P < 0.001 (Mann Whitney test)). No differences between these groups were found in other EBRBs. Among those who played active video games on assessed days, active video game time was positively yet weakly associated with TV/DVD time and snack consumption. Active video game time was not significantly associated with other activities and sugar-sweetened beverages intake.ConclusionsThe results suggest that it is unlikely that time spent by adolescents in playing active video games replaces time spent in other physically active behaviours or sedentary activities. Spending more time playing active video games does seem to be associated with a small, but significant increase in intake of snacks. This suggests that interventions aimed at increasing time spent on active video gaming, may have unexpected side effects, thus warranting caution.