Children who adopted and continued unhealthy lifestyle had higher risk of diseases like prehypertension: Study

SINGAPORE: Children who had unhealthy lifestyle patterns from a young age had a higher risk of diseases like prehypertension, a Singapore study has found.

Of the 546 children assessed at ages two, five and eight, 18 per cent were found to have consistently unhealthy lifestyles based on answers from their caregivers, according to the study led by National University of Singapore (NUS) Saw Swee Hock School of Public Health.

Such lifestyles include being less active, having higher screen time, and poorer diets, which include low intake of fruits and vegetables and high intake of ultra-processed foods, snacks and sugary drinks.

At eight years old, these children with consistently unhealthy lifestyles had close to three times higher risk of prehypertension and higher levels of diastolic blood pressure, fasting insulin and triglycerides than the group who adopted both healthy and unhealthy lifestyle habits, researchers found.

This was despite having a similar body mass index (BMI) as the rest of the children.

The children who fell under this category tended to be breastfed for shorter periods, had parents with lower educational attainment and lower household income, and had mothers who had lifestyles such as poor diet, poor sleep quality and higher tobacco exposure.

FIRST SUCH STUDY ON YOUNG AGE GROUP

The children studied were those enrolled since birth in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort study. The study is a collaboration between the Agency for Science, Technology and Research’s (A*STAR) Singapore Institute for Clinical Sciences (SICS), KK Women’s and Children’s Hospital, National University Health System (NUHS) and NUS.

The study, led by Associate Professor Mary Chong and Dr Chia Airu from the NUS Saw Swee Hock School of Public Health, was published in the International Journal of Behavioural Nutrition and Physical Activity in January this year.

“This is the first study that is conducted in children at such a young age, so 18 per cent is a very substantial proportion,” Dr Chia, a senior research fellow, told CNA’s Singapore Tonight on Wednesday (Mar 20).

“We feel that having this consistently unhealthy pattern predisposes them to higher risk of heart disease, diabetes, and also the development of chronic disease later in life,” added Dr Chia.

The researchers identified two other groups - 11 per cent of the children had a consistently healthy pattern, while the majority, 71 per cent, had both healthy and unhealthy behaviours.

SMALL PROPORTION ADOPTED HEALTHY PATTERNS

“Those that belong to the all-healthy segment - really small (proportion). It means that … there's a lot more work we can do to try to up that number,” said Assoc Prof Chong, who also joined the show.

This group adopted and continued lifestyle habits such as a balanced diet, regular physical activity and having sufficient sleep.

“Often enough when we look at behaviours, we tend to just look at it in silo, so we just look at diet, (or) physical activity and the outcome. So what's really special about this study is that we look at combinations,” said Assoc Prof Chong.

Dr Cai Shirong, principal investigator at SICS, noted that the data was gathered from early and middle childhood, which is a critical developmental period.

“As the lifestyle factors are modifiable, we can potentially target them in early childhood, especially in the groups that we have identified to be more likely to have unhealthy lifestyle habits,” said Dr Cai, who is also an adjunct assistant professor at NUS Yong Loo Lin School of Medicine’s Human Potential Translational Research Program.

When asked how caregivers can improve children’s lifestyles, Assoc Prof Chong said: “We have to lead by example, so role modeling healthy lifestyles, because our children may not always listen to us, but they're watching us and so they will emulate our behaviours.”