KKH-led survey reveals unhealthy lifestyle habits in children and adolescents
Singapore, 8 January 2021 – To promote healthy lifestyle habits during their formative years, a structured and comprehensive approach is needed. This approach has been outlined in The Singapore Integrated 24-Hour Activity Guidelines for Children and Adolescents (“Guidelines”), and was launched today.
A first for Singapore, the Guidelines are based on locally and globally established studies and best practices, and have been developed with our local population in mind. It aims to standardise advice on physical activities, screen time, eating habits and sleep for children and adolescents aged seven to 18 years of age within a 24-hour period, to improve health and promote adoption of healthy lifestyle habits. These guidelines are aligned with the national goals of the Health Promotion Board to promote healthier lifestyles.
Dr Janil Puthucheary, Senior Minister of State, Ministry of Health and Ministry of Communications and Information, was the Guest of Honour at the Asia Pacific Maternal and Child Metabolic Health Conference (APMCMHC) and Integrated Platform for Research in Advancing Metabolic Health Outcomes of Women and Children (IPRAMHO*) International Meeting 2021 held at KK Women’s and Children’s Hospital (KKH) earlier today. The Guidelines were launched at the event.
According to Statistics from the Ministry of Education, the incidence of overweight children has increased from 11 per cent in 2013 to 13 per cent in 2017. Studies also showed that children and adolescents in Singapore could only meet up to 40 per cent of the recommended physical activity level and above 70 per cent of adolescents exceeded more than two hours of electronic screen time daily1-3. A recently-concluded KKH-led survey involving 100 parents of children aged five to 14 years of age gave further insights to their children’s lifestyle habits:
- 43 per cent do not engage in any vigorous physical activity while 32 per cent do not engage in any moderate physical activity - 25 per cent spend more than 10 waking hours per day in sedentary behaviour - 20 per cent spend more than four hours on screen viewing daily, exceeding the recommendation of two hours per day - 20 per cent are not meeting the recommended sleep requirement on weekdays
Parents surveyed also showed inadequate awareness of the recommended amount of physical activities, screen time and sleep for children, with:
Taking a longer-term, holistic approach
These developments have prompted healthcare professionals to develop a set of guidelines to provide structured and comprehensive health advice to children and adolescents, and their caregivers living in Singapore.
The Workgroup that has developed the Guidelines is formed by KKH-led IPRAMHO, and College of Paediatrics and Child Health in Academy of Medicine Singapore, in partnership with Exercise is Medicine Singapore, Sports Medicine Association, Singapore, Perinatal Society of Singapore, Singapore Paediatric Society and College of Family Physicians Singapore, and Singapore Medical Association.
Professor Tan Kok Hian, Head and Senior Consultant, Perinatal Audit and Epidemiology Unit, KKH, and Lead Principal Investigator of IPRAMHO, said, "Globally and locally, there is increasing evidence to show that children and adolescents reap more health benefits when they adopt healthy lifestyle habits such as exercising regularly, having adequate sleep and reducing screen time.4-8 In Singapore, our children and adolescents are not moving and sleeping enough, made worse by having more screen time than recommended. With interests in preventing and reducing risks for metabolic diseases in women and children, it is timely for KKH and IPRAMHO to support in making the new guidelines relevant and reflect the current lifestyle patterns of our youths."
The set of Guidelines complements the 2013 national guidelines on physical and sedentary behaviour for children and adolescents. The 2013 guidelines focus largely on moderate and vigorous intensity physical activities, sedentary behaviours and safety in sports. The new Guidelines includes the most recent researches on the effectiveness of adopting light physical activities, sleep and eating habits for children and adolescents in a 24-Hour period.
The Guidelines elaborates on the following 10 summary statements:
For more details on the guidelines, please visit
Coupled with being the only paediatric sports medicine facility, KKH as the only children’s hospital in Singapore is taking the lead to counsel parents and caregivers of patients to adopt these guidelines. KKH will also work hand-in-hand with other paediatricians, family medicine physicians to equip them in reinforcing the Guidelines.
Dr Benny Loo, Consultant, General Paediatrics Service and Sports Medicine Service, KKH, who is also the Chairperson of the Workgroup for the Guidelines said, "Research shows that adopting healthy lifestyle habits at a young age sets the stage for becoming healthy adults, reducing risks for metabolic diseases.9, 10 Singapore’s children and adolescents today are time-poor as they lead very hectic lives. This set of guidelines helps to promote a structured and comprehensive approach in organising a child’s 24-hour day of physical activities, sedentary time, and sleep, to optimise his/her health outcomes in the long run."
The Guidelines is part of a series of guidelines to improve metabolic health in women and children. It was launched at the fourth APMCMHC and IPRAMHO International Meeting 2021, focusing on Asia-Pacific perspectives in the management of metabolic diseases such as diabetes and obesity in pregnant women and children. In previous years, other guidelines released were for the management of gestational diabetes, perinatal nutrition, as well as physical activity and exercise in pregnancy.
The annual event, held during 8 and 9 January this year, was attended by key opinion leaders such as Senior Professor Anthony Okely, University of Wollongong, Australia, and Professor Satoshi Kusuda, President of the Federation of Asia and Oceania and Perinatal Societies. Experts from Australia, China, Hong Kong, India, Indonesia, Japan, Malaysia, Myanmar, Philippines, Singapore, Sri Lanka, Vietnam and Thailand also attended the event.
*IPRAMHO is a research platform that seeks to develop a seamless integrated model of care through optimal implementation of effective population prevention strategies and diabetes and weight reduction programmes for women and children. IPRAMHO is led by KKH in partnership with SingHealth Polyclinics and National Healthcare Group Polyclinics; and is a collaborative centre grant funded by the National Medical Research Council.
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