Published on 25 March 2024

    A recent study found that unhealthy habits established in toddlers often persist into childhood, increasing the risk of developing health issues in their later years.

    Have you ever given in to your child's demands for unhealthy food, or allowed them to play with your phone for longer than usual?

    While it might be convenient to yield to their desires and avoid potential tantrums, these actions could be doing them more harm than good in the long run.

    According to a recent study of 546 children in Singapore, the lifestyle patterns toddlers develop from a young age can have a lasting impact on their health outcomes as they grow older.

    The children studied were part of the Growing Up in Singapore Towards Healthy Outcomes (GUSTO) cohort study, which began in 2008.

    The Gusto study – a collaboration between A*STAR’s Singapore Institute for Clinical Sciences (SICS), KK Women’s and Children’s Hospital, National University Health System and National University of Singapore (NUS) – aims to investigate the effects of pregnancy and early childhood conditions on the health and development of both mothers and their children.

    In the new study, researchers tracked the children across three time points – at ages two, five, and eight – with caregivers reporting on their child’s lifestyle behaviours including screen time, physical activity, and dietary intake, among others.

    The findings revealed that 11 per cent of the children regularly adhered to healthy lifestyle patterns, while 18 per cent consistently exhibited unhealthy behaviours. The majority, comprising 71 per cent, demonstrated a mixed pattern of both healthy and unhealthy behaviours.

    Children in the unhealthy group were found to be less active, had higher screen time, and had poorer diets characterised by low intake of fruits and vegetables, and high intake of less nutritious foods like unhealthy snacks and sugary drinks.

    These children also tended to be breastfed for shorter periods, had parents with lower educational attainment, and came from a lower income household. In addition, their mothers were more likely to exhibit sub-optimal behaviours during pregnancy, such as maintaining an unhealthy diet, being physically inactive, and experiencing poorer sleep quality.

    At eight years old, this group of children exhibited nearly three times the risk of pre-hypertension and higher levels of diastolic blood pressure, as well as increased levels of sugar and fats in their blood, compared to those in the mixed pattern group. This was despite having similar body mass index (BMI) as the rest of the children.

    Lead Principal Investigator of the GUSTO study, Prof Chong Yap Seng, Senior Consultant, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynaecology, National University Hospital (NUH), elaborated, “Children with unhealthy lifestyles may not always gain weight and be obese.

    “This study underscores the importance of measuring various cardiometabolic risk markers – predictive of future cardiovascular diseases – alongside BMI, to detect early signs of poor health in children.”

    In contrast, children in the healthy group were found to continue exhibiting healthy behaviours even as they grew older.

    The co-lead of the new study, Dr Chia Airu, Senior Research Fellow at Saw Swee Hock School of Public Health (SSHSPH), NUS, said, “These children exhibited healthy habits at the age of two, and continued to adhere to these healthy patterns as they grew older, emphasising the importance of promoting and reinforcing healthy behaviours from a young age to mitigate future health risks.”

    Prof Chong added that the study highlighted the importance of cultivating healthy lifestyle habits from as early as pregnancy.

    “Targeting positive behaviour change during pregnancy, which often continues after childbirth and integrated into family routines, may be effective in promoting healthier lifestyles for children,” explained Prof Chong, who is also the Dean of NUS Yong Loo Lin School of Medicine.

    The study’s other co-lead, SSHPH’s A/Prof Mary Chong, highlighted that having a large majority of children in the mixed pattern group suggests that “while many follow at least one healthy behaviour, this does not necessarily result in them adhering to an overall healthy lifestyle pattern”.

    She added, “This finding highlights that greater health promotion efforts need to be done to encourage more children and their parents to cultivate various healthy behaviours from young.”

    In consultation with Prof Chong Yap Seng, Senior Consultant, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynaecology, NUH, Dr Chia Airu, Senior Research Fellow, SSHPH, A/Prof Mary Chong, SSHPH.

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