Adherence to Singapore 24-hour Integrated Activity Guidelines and Quality of Life among Singaporean Children and Adolescents in the COVID-19 Pandemic
Keywords:
lifestyle behaviours, quality of life, time-use, young people
Abstract
This study aimed to examine the prevalence of children and adolescents in meeting The Singapore Integrated 24-Hour Activity Guidelines for Children and Adolescents and whether the number of guidelines met was associated to Quality of Life (QoL). Parents of youths aged 7 to 18 years completed an online questionnaire consisting of the Singaporean Children Lifestyle Questionnaire and the Pediatric Quality of Life (PedsQL™) 4.0 Inventory. Parents reported on the physical activity (PA), sedentary behaviour (SB), recreational screen time (ST), sleep, dietary habits, as well as the QoL of their children. Their responses were benchmarked against the Singapore Integrated 24-Hour Activity Guidelines. Survey results of 181 youths showed that more than 38% of children and adolescents did not meet any of four guidelines relating to PA, recreational ST, sleep, and diet. Daily moderate-to-vigorous PA (31.1 vs. 17.1 min) and ST (3.5 vs. 2.5 h) of adolescents were significantly higher than that of children (p <.05) while adolescent sleep was significantly lower than that of children (7.3 vs 8.5 h, p < .05). QoL scores were higher when more guidelines were met but the association was not statistically significant (p = .11). Ameliorative programmes to help more youths cultivate positive lifestyle habits are recommended.
References
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PedsQLTM 4.0 Generic Core Scales - Parent Proxy-Report for Children (ages 8-12) and Teens (ages 13-18) Acute. Copyright © 1998 JW Varni, Ph.D. All rights reserved.
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Brownlee, I. A., Low, J., Duriraju, N., Chun, M., Ong, J. X. Y., Tay, M. E., Hendrie, G. A., & Santos-Merx, L. (2019). Evaluation of the Proximity of Singaporean Children’s Dietary Habits to Food-Based Dietary Guidelines. Nutrients, 11(11), 2615. https://doi.org/10.3390/nu11112615
Cain, N., & Gradisar, M. (2010). Electronic media use and sleep in school-aged children and adolescents: A review. Sleep Medicine, 11(8), 735–742. https://doi.org/10.1016/j.sleep.2010.02.006
Carson, V., Hunter, S., Kuzik, N., Gray, C. E., Poitras, V. J., Chaput, J. P., Saunders, T. J., Katzmarzyk, P. T., Okely, A. D., Connor Gorber, S., Kho, M. E., Sampson, M., Lee, H., & Tremblay, M. S. (2016). Systematic review of sedentary behaviour and health indicators in school-aged children and youth: an update. Applied Physiology, Nutrition, and Metabolism, 41(6 (Suppl. 3)), S240–S265. https://doi.org/10.1139/apnm-2015-0630
Chaput, J. P., Carson, V., Gray, C., & Tremblay, M. (2014). Importance of All Movement Behaviors in a 24 Hour Period for Overall Health. International Journal of Environmental Research and Public Health, 11(12), 12575–12581. https://doi.org/10.3390/ijerph111212575
Chia, M. (2008). Physical inactivity among children and adolescents in Singapore: A paradoxical issue. Acta Kinesiologica, 2(2), 7–15. http://hdl.handle.net/10497/14242
Chia, M., & Lee, M. B. C. (2015). Relationship between quality of life and resilience among sport-active Singaporean youth. Physical Education of Students, 19(2), 29–36. https://doi.org/10.15561/20755279.2015.0205
Chia, M. Y. H., Tay, L. Y., & Chua, T. B. K. (2019). Quality of Life and Meeting 24-h WHO Guidelines Among Preschool Children in Singapore. Early Childhood Education Journal, 48(3), 313–323. https://doi.org/10.1007/s10643-019-00987-9
College of Paediatrics & Child Health. (2021, January). The Singapore Integrated 24-Hour Activity Guidelines. Academy of Medicine Singapore. https://www.ams.edu.sg/view- pdf.aspx?file=media%5c6200_fi_777.pdf&ofile=CPCHS+- +Singapore+Integrated+24+Hr+Activity+Guidelines+2020+(Final)+20210706.pdf
Deng, X., He, M., He, D., Zhu, Y., Zhang, Z., & Niu, W. (2021). Sleep duration and obesity in children and adolescents: evidence from an updated and dose–response meta-analysis. Sleep Medicine, 78, 169–181. https://doi.org/10.1016/j.sleep.2020.12.027
Ekelund, U. (2012). Moderate to Vigorous Physical Activity and Sedentary Time and Cardiometabolic Risk Factors in Children and Adolescents. JAMA, 307(7), 704. https://doi.org/10.1001/jama.2012.156
Fuller, C., Lehman, E., Hicks, S., & Novick, M. B. (2017). Bedtime Use of Technology and Associated Sleep Problems in Children. Global Pediatric Health, 4, 2333794X1773697. https://doi.org/10.1177/2333794x17736972
Goh, D. Y. T., & Jacob, A. (2011). Children’s consumption of beverages in Singapore: Knowledge, attitudes and practice. Journal of Paediatrics and Child Health, 47(7), 465–472. https://doi.org/10.1111/j.1440-1754.2010.01999.x
Grgic, J., Dumuid, D., Bengoechea, E. G., Shrestha, N., Bauman, A., Olds, T., & Pedisic, Z. (2018). Health outcomes associated with reallocations of time between sleep, sedentary behaviour, and physical activity: a systematic scoping review of isotemporal substitution studies. International Journal of Behavioral Nutrition and Physical Activity, 15(1). https://doi.org/10.1186/s12966-018-0691-3
Guo, Y. F., Liao, M. Q., Cai, W. L., Yu, X. X., Li, S. N., Ke, X. Y., Tan, S. X., Luo, Z. Y., Cui, Y. F., Wang, Q., Gao, X. P., Liu, J., Liu, Y. H., Zhu, S., & Zeng, F. F. (2021). Physical activity, screen exposure and sleep among students during the pandemic of COVID-19. Scientific Reports, 11(1). https://doi.org/10.1038/s41598-021-88071-4
Hays, R. D., & Reeve, B. B. (2010). Measurement and Modeling of Health-Related Quality of Life. In J. Killewo, K. Heggenhougen, & S. Quah (Eds.), Epidemiology and Demography in Public Health (1st ed., pp. 195–205). Academic Press.
Higuchi, S., Motohashi, Y., Lui, Y., & Maeda, A. (2005). Effects of playing a computer game using a bright display on presleep physiological variables, sleep latency, slow wave sleep and REM sleep. Journal of Sleep Research, 14(3), 267–273. https://doi.org/10.1111/j.1365-2869.2005.00463.x
Jeon, M., Dimitriou, D., & Halstead, E. J. (2021). A Systematic Review on Cross-Cultural Comparative Studies of Sleep in Young Populations: The Roles of Cultural Factors. International Journal of Environmental Research and Public Health, 18(4), 2005. https://doi.org/10.3390/ijerph18042005
KK Women’s and Children’s Hospital. (2021, January 8). Launch of The Singapore Integrated 24-Hour Activity Guidelines [Press release]. https://www.kkh.com.sg/news/Announcements/launch-of-the-singapore-integrated-24-hour-activity-guidelines
Liao, J., Cao, C., Hur, J., Cohen, J., Chen, W., Zong, X., Colditz, G., Yang, L., Stamatakis, E., & Cao, Y. (2021). Association of sedentary patterns with body fat distribution among US children and adolescents: a population-based study. International Journal of Obesity, 45(9), 2048–2057. https://doi.org/10.1038/s41366-021-00874-7
Lin, Y., Tremblay, M. S., Katzmarzyk, P. T., Fogelholm, M., Hu, G., Lambert, E. V., Maher, C., Maia, J., Olds, T., Sarmiento, O. L., Standage, M., Tudor-Locke, C., & Chaput, J. P. (2018). Temporal and bi-directional associations between sleep duration and physical activity/sedentary time in children: An international comparison. Preventive Medicine, 111, 436–441. https://doi.org/10.1016/j.ypmed.2017.12.006
Loo, B. K. G., Okely, A. D., Pulungan, A., Jalaludin, M. Y., & Asia-Pacific 24-Hour Activity Guidelines for Children and Adolescents Committee (2022a). Asia-Pacific Consensus Statement on integrated 24-hour activity guidelines for children and adolescents. British journal of sports medicine, 56(10), 539–545. https://doi.org/10.1136/bjsports-2021-104527
Loo, B. K. G., Tan, B., Chia, M. Y. H., Chan, P. C., Sirisena, D., Zainuddin, M. A., Oh, J. Y., Teoh, O. H., Tan, T. S. Z., Lim, M. C. M., Lim, E. J. K., Müller-Riemenschneider, F., Tan, N. C., Siriamornsarp, R., Teo, T. C. C., Quah, P. L., Rajadurai, V. S., Tan, K. H., & Ng, K. C. (2022b). Consensus statement on Singapore integrated 24-hour activity guide for children and adolescents. Annals of the Academy of Medicine, Singapore, 51(5), 292–299. https://doi.org/10.47102/annals-acadmedsg.202141
Ministry of Health Singapore. (2021, December 21). Healthy Food for Kids and Teens. HealthHub. https://www.healthhub.sg/live-healthy/578/A%20Healthy%20Food%20Foundation%20-%20for%20Kids%20and%20Teens
Minitab. (n.d.). Data considerations for Kruskal-Wallis Test - Minitab Express. Minitab Express Support. https://support.minitab.com/en-us/minitab-express/1/help-and-how-to/modeling-statistics/anova/how-to/kruskal-wallis-test/before-you-start/data-considerations/
Müller, A. M., Khoo, S., & Lambert, R. (2013). Review of Physical Activity Prevalence of Asian School-Age Children and Adolescents. Asia Pacific Journal of Public Health, 25(3), 227–238. https://doi.org/10.1177/1010539513481494
NIH: National Institute of Diabetes and Digestive and Kidney Diseases. (2021, September 23). Child Nutrition. MedlinePlus. https://medlineplus.gov/childnutrition.html
Office of Disease Prevention and Health Promotion. (n.d.). Physical Activity | Healthy People 2020. Healthy People. https://www.healthypeople.gov/2020/topics-objectives/topic/physical-activity?topicid=33
PedsQLTM 4.0 Generic Core Scales - Parent Proxy-Report for Children (ages 8-12) and Teens (ages 13-18) Acute. Copyright © 1998 JW Varni, Ph.D. All rights reserved.
Peiris, C. L., O’Donoghue, G., Rippon, L., Meyers, D., Hahne, A., de Noronha, M., Lynch, J., & Hanson, L. C. (2021). Classroom Movement Breaks Reduce Sedentary Behavior and Increase Concentration, Alertness and Enjoyment during University Classes: A Mixed-Methods Feasibility Study. International Journal of Environmental Research and Public Health, 18(11), 5589. https://doi.org/10.3390/ijerph18115589
Quah, P. L., Kleijweg, J., Chang, Y. Y., Toh, J. Y., Lim, H. X., Sugianto, R., Aris, I. M., Yuan, W. L., Tint, M. T., Bernard, J. Y., Natarajan, P., Müller-Riemenschneider, F., Godfrey, K. M., Gluckman, P. D., Chong, Y. S., Shek, L. P., Tan, K. H., Eriksson, J. G., Yap, F., . . . Chong, M. F. F. (2019). Association of sugar-sweetened beverage intake at 18 months and 5 years of age with adiposity outcomes at 6 years of age: the Singapore GUSTO mother–offspring cohort. British Journal of Nutrition, 122(11), 1303–1312. https://doi.org/10.1017/s0007114519002253
Roberts, K. C., Yao, X., Carson, V., Chaput, J. P., Janssen, I., & Tremblay, M. S. (2017). Meeting the Canadian 24-Hour Movement Guidelines for Children and Youth. Health reports, 28(10), 3–7.
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2022-12-15
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