Saturday, 25 February 2017

NurtureSG: Improving kids' health; More exercise, better diet

Pre-schoolers to get more physical activity and healthy meals; panel to also study youth suicide
By Salma Khalik, Senior Health Correspondent, The Straits Times, 24 Feb 2017

The road to health in Singapore will start early. All pre-school children will have at least one hour of physical activity a day, including time spent in the sun.

They will also be served healthy meals that include fruit. Once a key law is passed, pre-schools will no longer be allowed to offer unhealthy eating options.

These recommendations from the NurtureSG committee to get children and youth to grow up healthy - both physically and mentally - have been accepted by the Health and Education Ministries. Some are already being rolled out.

With obesity rates among children going up and chronic diseases like diabetes and hypertension on the rise, the committee was tasked with finding ways to improve children's health. It was co-chaired by Minister of State for Health Lam Pin Min and Minister of State for Communications and Information, and Education Janil Puthucheary.

Among the issues that the committee addressed were mental health problems, eating habits, and the lack of sleep and exercise.

Obesity rates among children have risen from 10 per cent in 2010 to 12 per cent in 2015.

"So very often you can see young children on their handheld devices," said Dr Lam. "That has also resulted in children not exercising enough and leading a more sedentary lifestyle."

The committee decided to get the fitness ball rolling with pre-schoolers, who will have at least one hour of physical activity every day.

Mr Eugene Leong, chief executive officer of the Early Childhood Development Agency (ECDA), said that once the Early Childhood Development Centres Act is in force - in a year or so - all pre-schools must provide healthy meals and a minimum duration of physical activities as part of their licensing requirement.

Schools from primary to junior college levels will be encouraged to lend out sporting equipment, like footballs, so children can have "unstructured play" during recess, after lessons, and even on weekends.

Dr Lam added that more time outdoors for the young might also reduce the high rate of myopia. By the time they finish their studies, seven in 10 children here are myopic.

He also touched on a relatively less-discussed issue. Children here do not sleep enough. Half the teens don't get the recommended eight to 10 hours of sleep while one in three sleeps less than 5-1/2 hours each night, said Dr Lam.

This affects their mental abilities, and increases their risk of obesity. Students will be offered tips on the importance of having enough sleep.

The mental health of children is also a growing concern. In particular, the committee looked at self-harming behaviour and suicide among youth.

Child psychiatrist Daniel Fung, who is in the NurtureSG committee, will chair a committee to look into factors that lead to youth suicides, which come at the tail-end of other issues. For 15 to 24-year-olds, suicides had increased from two to three per 100,000 previously to 5.9 in 2015.

Dr Fung said that Singapore's youth suicide rate was actually low, compared to places such as Hong Kong and South Korea.

Said Dr Puthucheary: "It's not about the numbers because I think every single one of them (the suicides) represents a tragedy."

Since students who are stressed do not always approach their parents and teachers for help, their peers will be roped in to look out for signs of distress and offer support.


Students will spend more time on physical activities
By Linette Lai, The Straits Times, 24 Feb 2017

Children of all ages will be given the chance to be more involved in physical activities at school, starting in pre-school.

Under new rules to be introduced by the Early Childhood Development Agency (ECDA), full-day pre-school programmes must devote at least an hour to physical activity every day.

And at least half of this time must be spent outdoors, said Mr Eugene Leong, ECDA's chief executive.

NurtureSG, a task force set up to help young people adopt healthier habits, also recommended that older children be given more opportunities to get active outside formal curriculum time. For instance, they should be allowed to borrow sports equipment for games after school hours or during recess time.

Schools will also work with parents and alumni groups to organise physical activities on weekends.

In addition, the Health Promotion Board is planning a pilot programme to train students at institutes of higher learning to lead activities such as workouts for their peers.

Explaining the rationale for these changes, Minister of State for Health Lam Pin Min, who co-chairs the NurtureSG task force, said: "So often you can see young children on their handheld devices... and that has resulted in children not exercising enough and leading a more sedentary lifestyle."

One school that already encourages its pupils to get active is Xinmin Primary, where pupils can borrow sports equipment such as footballs, skipping ropes and hula hoops before school or during recess time.

Said Mr Mohamad Azreen Mohamad Kusnin, who is the school's subject head for physical education: "We feel that this sort of unstructured play builds their fundamental skills.

"It also gives them extra motivation to lead a healthy lifestyle."


Say goodbye to sugary drinks and deep-fried food
By Linette Lai, The Straits Times, 24 Feb 2017

A big push to get healthier food served in schools is under way, and it will affect all students - from pre-schoolers to university undergraduates.

The intention is to get them to cultivate better eating habits from a young age, in the hope that these will stick as they grow up.

The push is part of the NurtureSG task force's series of recommendations to get young people to adopt healthy lifestyles.

With the changes, all pre-schools will no longer be allowed to serve unhealthy options such as sugary drinks or deep-fried and preserved food. Instead, they must provide balanced meals, including fruit.

More schools will also come on board the Healthy Meals in Schools Programme, which is currently being adopted by 319 out of 359 schools from the primary level to junior college.

Under this scheme, canteen stall operators must serve healthier food - such as white rice mixed with brown rice, or wholemeal bread for sandwiches.

Meanwhile, the Health Promotion Board is working with institutes of higher learning - such as universities and polytechnics - to provide healthier food op- tions under the Healthier Dining Programme.

"At that age, you want to ensure that these young adults take personal responsibility (for their meals)," said Minister of State for Education Janil Puthucheary, who co-chaired the NurtureSG task force.

Madam Lim Siew Fern, who has two children - one in Primary 6 and the other in Secondary 3 - said that the implementation will be challenging.

The 43-year-old, who works as a purchaser, said that meals in her younger son's school always come with a piece of fruit but not all pupils eat it, leading to wastage.


Children to be taught good sleep habits
The best way to build a healthy society is to inculcate good health habits in the young. The NurtureSG committee has identified four areas to focus on.
By Salma Khalik, Senior Health Correspondent, The Straits Times, 24 Feb 2017

At least half of the teenagers here do not get the eight to 10 hours of sleep they need, with one in three getting less than 5-1/2 hours a night.

A committee tasked with inculcating healthy habits in the young said a child who does not get enough sleep could have deficits in memory and thinking skills, and be prone to obesity and mental health problems such as irritability, moodiness, depression and anxiety.

The Education Ministry will have the job of imparting to schoolchildren, as part of the physical education curriculum, the importance of sleep and how to get enough of it.

Asked if the early start time for school is why children do not get enough sleep, Minister of State for Health Lam Pin Min said starting school later might just mean that they go to sleep later.

Instead, young people need to know the importance of sleep and develop good sleep habits.

The Minister of State for Education, Dr Janil Puthucheary, said it is important that children do not use their electronic devices just before bedtime. "The idea is that we should look at gaming, social media and so forth, and do them at appropriate times of the day in appropriate amounts of time," he said.

Dr Lam said there are no figures on sleep for younger children here, "so moving forward, we are... trying to track the sleep duration of our younger cohorts".

Pre-school children should ideally get 10 to 13 hours, and six-year- olds to 13-year-olds, nine to 11 hours of sleep a night.

Health Promotion Board chief executive Zee Yoong Kang said the HPB will raise awareness so parents can help their children learn good sleep habits such as having a regular and relaxing bedtime routine.

Mental health

Peer support structures to be strengthened
By Toh Wen Li, The Straits Times, 24 Feb 2017

The NurtureSG task force stressed the importance of strengthening support networks and building resilience in young people.

Since students who are stressed do not always approach their parents or teachers for help, the Ministry of Education and Health Promotion Board will strengthen peer support structures in mainstream schools and institutes of higher learning by providing resources and training.

This way, students can spot signs of mental stress and look out for their peers.

A slew of initiatives have been introduced or are being considered to help support the mental well-being of young people. They include exploring the feasibility of mental health assessment for at-risk youth benefiting from the Government's Enhanced Step-Up programme.

The Tote Board has separately set aside up to $10 million in grant funding to tap ground-up ideas to help young people.

Recognising that suicidal and self-harming behaviours are often complex matters, an inter-agency research work group will also be set up to study such behaviours in children and those up to 35 years of age.

At Bukit View Secondary School, trained student leaders offer their peers emotional support. Secondary 1 student Zara Azimah Zwiers, 12, who found the transition from primary to secondary school stressful, said peer support leaders gave her helpful advice and encouragement.

"They have been through what I have been through, so it is easier to talk to them," she said.

Peer support leader Prisca Sim, 14, who helped set up a "cheer up box" with motivational quotes for her classmates, believes that her role is a simple but important one.

"You don't have to do much. Just being there to listen will help."

* Schools helping students get active during free time by offering fitness equipment, facilities
They will offer equipment and facilities for them to play during recess and after school
By Calvin Yang, The Straits Times, 31 Jul 2017

Concerned about how sedentary their students are becoming, schools are unlocking their athletic equipment cupboards and facilities during recess and after school, to encourage young people to pick up a ball or a racquet and play for fun.

The Ministry of Education (MOE) told The Straits Times the move is to inculcate the good habits of an active lifestyle, which has many benefits such as reducing obesity.

It comes from a recommendation made by NurtureSG, a task force set up to encourage young people to adopt healthier habits, to give students greater opportunities for play.

MOE said: "Facilities in most primary and secondary schools are available to students to encourage unstructured play with their peers during recess and after- school hours."

Schools such as Fernvale Primary and Greendale Secondary are already letting students use equipment and facilities, previously available only during physical education (PE) classes or co- curricular activities (CCAs).

Students welcomed the go-ahead to take a break and de-stress after hours sitting in the classroom. A few quipped that they would also get to lose weight.

At Paya Lebar Methodist Girls' School (Primary), pupils can borrow equipment such as frisbees, badminton racquets, skipping ropes and roller racers - a scooter that is propelled forward by swinging the handlebars from side to side. Parent helpers and school staff are on hand to supervise and ensure the children are using the equipment safely.

Primary 3 pupil Nicole Soh, nine, who likes going around on the roller racers with her friends, said: "Instead of sitting in the canteen and doing nothing, I can go outdoors to play, bond with my friends and try out different sports."

Mrs Emily Han, the teacher in charge of the school's recess free play, said it gives pupils the space to run around and unwind between lessons, adding: "We want them to have fun and experience the sheer joy of playing."

At Fernvale Primary, pupils can use equipment such as basketballs as well as badminton nets, racquets and shuttlecocks.

Mr Willy Ong, head of the school's PE, CCA and aesthetics department, said unstructured play creates opportunities for pupils to make friends and pick up social skills. They also learn to be responsible, handling the equipment with care and returning it after use.

Primary 5 pupil Lance Liu, 11, spends no more than five minutes of his precious 30-minute recess time to eat, so he has the rest of it for a game of badminton with his friends.

"It helps us de-stress and we can focus better in class," he said.

Getting children to be more active has benefits, as obesity rates among schoolchildren have risen in recent years, from 10 per cent in 2000 to 12 per cent in 2014.

A recent Health Promotion Board study found that if a child is overweight at age seven, he has a 70 per cent chance of growing up into an overweight or obese adult.

All mainstream schools also now offer healthier food under the Healthy Meals in Schools Programme, launched in 2011 to foster better eating habits in the young.

Jalan Besar GRC MP Denise Phua, who heads the Government Parliamentary Committee for Education, said children are more likely to make exercise a lifelong habit if they can be active regularly, and not only during PE classes.

National University of Singapore lecturer Kelvin Seah said parents need not be concerned that their children are exerting themselves instead of resting during recess.

He said: "Since regular physical activity provides both physiological and mental health benefits, it will have a positive impact on the children's development."

Healthy Bodies, Healthy Minds: Recommendations by the NurtureSG Taskforce

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