Professor Satoshi Kusuda, President of the Federation of Asia and Oceania Perinatal Societies
Professor Lee Yung Seng, President of the College of Paediatrics and Child Health, Singapore
Professor Alex Sia, CEO of KK Women’s and Children’s Hospital (KKH)
Associate Professor Ng Kee Chong, Chairman Medical Board of KKH
Professor Tan Kok Hian, Organising Chairman of the Asia Pacific Maternal and Child Health Conference and IPRAMHO International Meeting 2022
Ladies and Gentlemen
1. It is my pleasure to join you today at the fifth International Meeting for Asia Pacific Maternal and Child Health Conference and Integrated Platform for Research in Advancing Metabolic Health Outcomes of Women and Children (IPRAMHO). As a surgeon and medical researcher myself, I am heartened to join my fellow healthcare colleagues at today’s conference to discuss important topics on supporting women’s and children’s health.
2. Despite the safe management measures due to the COVID-19 pandemic, this year’s event continues to draw a strong pool of experts, both locally and across the Asia Pacific region to share their insights. I would like to congratulate the organising team for the good effort.
3. For today’s keynote, I would like to focus on two key points. First, the importance of being physically active to keep healthy; and second, to go further upstream to encourage young children to be active to enhance their development and health.
Keeping healthy through physical activity
4. The World Health Organization (WHO) estimated that globally, up to five million deaths per year could be averted if people were more physically active. That is quite a large number, estimated at about 7% to 8% of global deaths annually, which could be potentially avoidable if we encourage individuals to stay active and avert or delay the onset of chronic diseases.
5. In addition, globally, one in four adults do not meet the WHO guidelines of having a minimum of 150 minutes of moderate-to- vigorous-intensity of physical activity per week.1 It is even more worrying that four in five adolescents, whom we expect to be more physically active, are not meeting the WHO guidelines.
6. Locally, the National Population Health Survey Report (NPHS) 2020, showed a rising prevalence of hypertension and hyperlipidaemia, higher body mass index and overall lower physical activity amongst Singaporeans aged 18 to 74 years. These risk factors, if left unchecked, can result in cardiovascular diseases such as stroke and heart attack, and lead to poor health outcomes. The survey findings underscore the need for us to do more to remind and encourage Singaporeans to keep a healthy and active lifestyle, even amidst the ongoing COVID-19 pandemic.
Moving upstream on active lifestyle for early childhood
7. This leads to my second point on the need to go further upstream to encourage young children to be active. Studies have shown that a child’s health in early childhood has a lasting impact on his health and well-being later in life.2 For example, obesity in childhood not only puts the child at risk of obesity-related childhood conditions, it also has the long term effect of predisposing them to adult obesity and chronic conditions such as diabetes, high blood pressure and high blood cholesterol levels in adulthood.
8. It is thus essential for parents and communities to prioritise keeping our children active and healthy. Adopting healthy lifestyle habits should start from young, and it is the best prevention against the development of lifestyle diseases and ill health in our children, which will in turn support them in realising their maximum potential to achieve good health, and social and educational outcomes.
KKH-led survey: Lifestyle habits of young children in Singapore
9. However, a recent survey that KKH conducted on 340 parents of children from infancy to seven years of age, revealed that more needs to be done to improve the lifestyle habits of our young. The study found that two in five infants, toddlers and preschoolers do not engage in sufficient physical activity. In addition, two in five infants have an average of one hour, and four in five toddlers have an average of 30 minutes of screen time daily. For these two age groups, screen time is not recommended, and should be kept to the minimum. Locally, findings from the GUSTO study have shown that early screen and TV viewing could impact the cognitive development of the child.
10. The same KKH study also revealed low awareness among parents on the impact of physical activity and screen time on the health of their children. In addition, half of the parents who claimed to be aware of existing guidelines, were unable to articulate the guidelines correctly. These findings reveal the need to do more to raise awareness and equip parents with the skills and knowledge to keep our children healthy. In doing so, we could empower more families, caregivers and community healthcare providers, to forge healthy habits in our young in their formative years that could last them a lifetime.
2022: The Singapore Integrated 24-Hour Activity Guidelines for Early Childhood
11. With this need in mind, IPRAMHO, led by KKH together with SingHealth Polyclinics and National Healthcare Group Polyclinics, facilitated a guideline development workgroup, to put together a set of guidelines in four main areas: physical activity, screen time, sleep, diet and eating habits, for infants, toddlers and preschoolers up to seven years old.
12. This set of guidelines, called ‘The Singapore Integrated 24-Hour Activity Guidelines for Early Childhood’, aims to help families adopt a structured and comprehensive approach to organising a child’s 24-hour day. It incorporated latest research findings on the effectiveness of adopting physical activities, sleep, reduction of screen time and eating habits of young children, going beyond the National Guidelines on Physical and Sedentary Behaviour for Children below seven years old which was launched in 2013 by Health Promotion Board (HPB). The intent is to cultivate good habits from young which could optimise the child’s health outcome in the long run, and nurture a population that takes charge of its health, contributing to our overall objective of building a healthier next generation.
13. In addition, this set of guidelines for early childhood is part of a series facilitated by IPRAMHO and the SingHealth Duke-NUS Maternal and Child Health Research Institute (MCHRI) together with College of Paediatrics and Child Health Singapore and other societies or colleges, to improve metabolic health in women and children, and transform national health. It builds on earlier guidelines that had been introduced for children and adolescents from seven to 18 years old, and those on the management of gestational diabetes, exercise and physical activity for pregnant women, as well as for perinatal nutrition.
14. I am heartened to see the strong collaborative efforts of various institutions, professionals and experts coming together to jointly develop the set of guidelines to provide guidance to parents and caregivers. I would also like to thank KKH and MCHRI for taking the lead to make this possible.
15. The set of guidelines for infants, toddlers and preschoolers that we are launching today will be distributed to all paediatricians and family physicians in Singapore. This will help them to better support parents and caregivers to improve the health outcomes of our young children. We are looking at other channels to share the guidelines with parents to support them in keeping their infants and young children healthy.
16. These efforts are part of series of recommendations of the Inter-agency Taskforce on Child and Maternal Health & Well-being, which was formed last year to look at ways we could better support families and parents in fostering good health and wellbeing for their children, starting as early as the preconception phase. Over the next few months, the Ministry of Health will be sharing more on the initiatives and programmes that would be put in place under the Child and Maternal Health and Well-being Strategy.
17. In closing, I would like to thank KKH and all participating institutions for your continued efforts to drive healthy living in Singapore and the region.
18. I wish you all a successful conference, and that you will benefit from the exchanging of views and new insights.