Guess who would run the farthest in a 9-minute race, today's Hong Kong kids or a previous generation?

Boys from 1999, who could become fathers by now, are likely to come out ahead. This suggests that current boys may not match the physical fitness levels of their parents' generation.

Those from the past could run 1590 meters in nine minutes, whereas the physical fitness test results issued by the Education Bureau in 2015 indicate that boys nowadays would fall behind by more than 120 meters.

A similar situation was observed among girls, with a gap of about 22 meters.

The differences in lifestyle between digital natives and their parents' generation are the primary factors contributing to this trend.

From Playgrounds to Screen:

How Activity Levels Among Hong Kong Youth Are Changing

By Tse Man

The deteriorating running performance signals a decline in youth's physical fitness and health. For instance, the 9-minute run test is a crucial measure of cardiovascular capacity, reflecting peak oxygen uptake.

When assessing cardiovascular capacity, children and adolescents in Hong Kong ranked in the 31st percentile globally, meaning that they lagged behind 61% of their counterparts, as evidenced by the results of running tests.

This performance has led to a grade of D in 'Physical Fitness' on the 2022 Hong Kong Report Card on Physical Activity for Children and Adolescents (Report Card), a report card issued to over 60 countries by the Active Healthy Kids Global Alliance since 2014.

In other aspects, such as tests measuring skinfolds in triceps and calf, the subcutaneous fat thickness in high school boys increased by 7.7%, while in girls, it rose by 12%.

Sze Sze Hon, the Vice-Chairman of the Physical Fitness Association of Hong Kong and a lecturer of PE programmes at Hong Kong Baptist University.

“Insufficient physical activity and prolonged sedentary time among our kids may explain this situation”, said Sze Sze Hon, the Vice-Chairman of the Physical Fitness Association of Hong Kong.

While the World Health Organization (WHO) reports that over 80% adolescents worldwide lacked adequate physical activity in 2022, evidence suggests that this lack of engagement in physical activities has been a significant issue for Hong Kong's youth for over two decades.

A 2005-2006 survey by the Department of Health revealed that around 60% of Hong Kong children aged 5 to 14 were sedentary for more than two hours daily, spending time on screens such as TV and video games.

Corresponded with sedentary behaviour was a considerable shortfall in physical activity. Less than 15.3% of respondents met the WHO's recommendations on physical activity for Health, which is 60 minutes of moderate- to vigorous-intensity physical activity daily (ideal physical activity level).

The questions then arise: As smartphones have become the most accessible screens for the younger generation in the past decade, has this situation worsened?

1. Continued Falling Physical Activity Level

Data shows that Hong Kong young people's physical activity level lags behind the population's average.

According to the Report of Population Health Survey 2020-22, young people in Hong Kong aged from 15 to 24 engaged in vigorous physical activity for an average of 2.6 days per week, compared to the overall population average of 3.5 days. Even for moderate physical activity, the frequency for young people was 2.2 days, lower than the overall mean of 3.2 days.

For the duration of daily physical activity, the time young people spent exercising dropped from 103.7 minutes to 61.7 minutes in 2022, compared to the figure in 2015, a reduction of nearly 41%.

All age groups saw a significant drop in daily physical activity minutes from 2015 to 2022, with the 15-24 age group experiencing the largest decline.

When asked about the reasons for not doing exercise, almost half of young people responded that they were either too tired to do sports or too lazy to motivate their bodies. Another 33.6% of them said they had no time left for exercise.

Not in the mood for exercise, the reluctance to engage in physical activity is also evident among students, with only 26% meeting the WHO's ideal physical activity level in 2022, as indicated by a grade of D- in 'Overall Physical Activity' on the Report Card.

In Asia, Japan was the only country to achieve a grade of B- in overall physical activity in 2022, with up to 66% of children meeting the recommended amount of physical activity.

On a global scale, the overall score for physical activity among all 57 participant countries was D in 2022. As reported by WHO, Not being in the mood for exercise can be a global issue.

2. “I am not in The Mood for Exercise, so I Choose to Play My Phone”

Waking up at 7 a.m., the 18-year-old boy started another school day with only five hours of sleep.

Cyril Cheng, a Form 5 student at a local aided secondary school in Tin Shui Wai, did not sleep until 2 a.m. His phone data showed that he had been using his phone for the three hours preceding bedtime. This nocturnal pattern has become a regular occurrence for him.

Over the past week, Cheng's daily phone usage averaged 11.5 hours, with Instagram accounting for nearly 12 hours of his total screen time that week.

Cheng's screen time data showed that he had been using his phone for the three hours preceding bedtime.

Social media accounted for around 30% of Cheng's total weekly screen time.

"I'm too tired to engage in physical activities," he confessed. Instead of mooving his body, Cheng opted for scrolling through social media platforms to stay connected with friends, which consumes little energy.

He attributed this fatigue to the demands of school and his involvement in a STEM project, leaving little room for exercise in his daily routine. By weekends, he often compensates for lost sleep until late afternoon, with minimal physical exertion.

Similarly, Tsz Ying Choi, a Form 2 student, prefers to spend her leisure time at her desk watching YouTube or tackling homework on her tablet. Acknowledging the influence of digital devices on her physical activity level, Choi maintained an average daily screen time of 5 hours in the last week.

Eelyn Wong, who is in Form 5 and takes the Physical Education elective subject, observed that some of her peers have become addicted to phones or video games, leading them to gradually quit exercising. “Choosing screens over sports, this trend has become prevalent among my peers.”

Tsz Ying Choi siad a once-a-month ice skating session is enough for her.

Eelyn Wong is a sports lover who actively participates in diversified sports at school, such as volleyball.

When leisure activities gradually converge to static, screen-based options, the choice of "get moving" is often pushed further and further back.

“Digital device is the main challenge for getting young people moving. Things only got worse after smartphones came out. As children increasingly tether themselves to their smartphones, it is more and more challenging to engage them in physical activities,” said Hon.

Hon is also a lecturer teaching the Physical Education and Recreation Management program at Hong Kong Baptist University. She noticed that whether during active practising sessions or static lectures, students are constantly clutching their phones. How to capture their attention and engage them without having to compete with their digital devices is a problem for her.

She believed that the reliance on digital devices among young people originates from their early childhood. “For many parents nowadays, their parenting is to give children an "electronic pacifier," such as tablets, TVs, and other electronic devices.”

Although this approach frees up parents' time to focus on other tasks, this early exposure to digital devices fosters a strong dependency on children, leading to a lifestyle in which sitting in front of a screen becomes normal.

As digital natives, only around 1/3 of Hong Kong's primary and secondary students have followed the screen time guidelines, which is no more than 2 hours of recreational screen time per day, according to a score of D in 'Sedentary Behaviour' on the 2022 Report Card. It deteriorated from a C in 2016.

The overall score in this aspect for all participating countries improved slightly from D in 2016 to D+ in 2022.

This lifestyle has been exposing the younger generation to an increased risk of non-communicable diseases such as cardiovascular diseases and diabetes, according to the WHO.

Then, the COVID-19 pandemic made this risk higher.

Students' physical fitness data, such as a 9-minute run, was not collected completely during the COVID-19 pandemic. Hon estimated that the outcomes might have deteriorated further than those in 2015, due to restrictions on outdoor physical movement and prolonged daily online lessons.

According to a study conducted by various universities in Hong Kong, before the pandemic, secondary school students were sedentary for an average of 10.79 hours per day. This figure increased by about an hour to 11.61 hours during school closures.

The overall daily screen time also saw a significant increase, from 8.09 hours to 10.64 hours. Concurrently, the time spent on exercises per day dropped by almost half, from 0.32 hours to 0.17 hours.

The Education Bureau's Data then showed that in 2021, just one year after the start of the COVID pandemic, the overweight rate among Hong Kong middle school students reached 26.8%.

The Active Healthy Kids Global Alliance highlighted that new habits have been formed by children and teenagers around the globe in response to the screen-centric indoor living new normal after the pandemic.

Hon remarked, "Once these habits were formed, it's uncertain whether they can be easily changed.”

3. Do Schools Contribute to Increased Physical Activity, or is the Reality More Complex?

Despite efforts by schools, the government and society to promote physical activity, the reality paints a different picture: Hong Kong students have experienced a continued decline in physical fitness over the past decade.

Schools have organized periodic sports activities and provided ample sports resources. For example, Hong Kong got a B- in “Organized Sport and Physical Activity” in 2022 and progressed a successive two times from a C- in 2016, meaning that 60.1% of local secondary school students engaged in organised sport for at least one day per week. In this area, Hong Kong is catching up with Japan.

In addition, 67% to 73% of students in Hong Kong have benefited from adequate sports facilities and resources for physical education (PE) provided by schools, as indicated by a score of 'B' in the 'School' aspect.

Not only have schools made an effort, but in the past decades, the government has also carried out various sports promotion programs at the school level, such as the School Sports Programme since 2001.

By launching different sports training and education projects and organising inter-school competitions, this programme aims to nurture students' interest in sports, boost their physical activity levels, improve their sports performance and identify potential student athletes, as outlined on its website.

The community, including initiatives like the Jockey Club's SportExplore Project, is paying attention to advocating for sports promotion at both the society and school levels.

After the collaborative efforts across various levels, the question remains: Why has students' physical fitness continued to decline?

Hon believed that with students lacking motivation for sports, having physical education classes only once a week is insufficient for both increasing their activity levels and nurturing their interest in sports.

A study conducted in 2019 across 10 local secondary schools reported that the PE teaching time varied from 80 to 100 minutes in a week or cycle. While this exceeded the minimum threshold, it still fell behind the recommended PE duration observed in other regions.

The latest Physical Education Curriculum and Assessment Guide updated in 2023 recommends that general PE constitute at least 5% of total lesson time in both primary and secondary education curriculums.

Given that total lesson time amounts to approximately 2,500 hours across three years of senior secondary education, the expected PE teaching time should be around 125 hours.

This figure in Japan stands at 262.5 hours, more than double that of Hong Kong. Its allocation of PE lessons is on par with that for Society according to the Ministry of Education, Culture, Sport, Science and Technology of Japan.

If the limited time allotted for physical education does not indicate the problem, the quality of PE can be another important index for assessing school PE effectiveness.

Not many schools in Hong Kong have recorded active policies, including daily PE, recess, and outdoor time, as highlighted by a study. It also mentioned that among 26 local schools, only 18.5% of PE class time was spent on activities that require students to engage in exercises.

Regarding this situation, Cheng felt that the teachers are primarily focused on getting students to participate, without placing much emphasis on the quality of PE classes.

Cheng has one 75-minute PE class in his weekly timetable. His Apple Watch recorded his health and activity metrics-everything from the distance he walks and runs to his active energy expenditure and exercise minutes.

His data of a typical school day with PE class revealed that his active energy expenditure during the PE class was under 120 kilocalories, whereas that figure during the lunch break was 106 kilocalories.

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“Teachers focus more on techniques teaching and our participation than physical exertion,” said Cheng. “They would not push us too hard to pursue higher learning outcomes because they do not want to hinder our interest and motivation.”

Another indicator of PE intensity is the "exercise minute", every full minute of movement at or above the intensity of a brisk walk recorded by an Apple Watch. Cyril's exercise minutes did not reach the ideal level, even on days with PE class.

The patterns of exercise minutes were in line with the energy expenditure's.
His moderate-intensity exercise minutes were fewer than 6 minutes, however, the figure during lunchtime was 17 minutes.

Relatively low-intensity PE classes were also observed by two girls.

Wong noticed that the intensity of PE classes is only moderate, as the teacher often interrupts the exercises to provide explanations, leading to frequent breaks in physical activity.

Though PE classes may not help students achieve the ideal physical activity level, Cheng, Wong, and Choi all highlighted the diversity in PE teaching content, mentioning that the curriculum often includes outdoor runs, dancing, jump rope, and ball games.

Besides the quality of PE classes, their quantity can be inadequate.

Wong with an established exercise routine, thought that a single PE class per week is unlikely to inspire those without regular exercise habits to develop an interest in physical activity.

“Because they even showed unwillingness to exercise in PE class, it is unrealistic to expect them to do sports during their free time,” said Wong. “On the other hand, for those who enjoy sports, PE classes offer a great opportunity to explore various forms of exercise.”

“I think at least two classes are needed to encourage students to be more active, build exercise habits, and avoid prolonged sitting.”

Both Cheng and Choi, however, worried that increasing the number of PE lessons on the schedule would disrupt other subjects' teaching plans.

Data suggests that even if the intensity of PE classes is insufficient, it can still mitigate students' sedentary behaviour. Having multiple PE classes per week can be beneficial.

Hon highlighted that this sit-oriented study mode promotes habitual sedentary behaviour. Some Western countries have adopted a 'sit and move' mode using sit-stand desks to reduce sedentary time and increase physical activity levels.

A 2022 study investigated the benefits of this intervention for Hong Kong's primary school children, showing improvements in physical activity levels, physical literacy, sleep quality, and executive functioning.

Creating an active environment for students is beneficial, but changing learning modes may not be feasible within Hong Kong's cultural context, according to Hon.

Some private international schools in Hong Kong have implemented better active policies. Yet these schools tend to have higher tuition fees and stricter admission requirements compared to ordinary schools.

Jill Xu, a young mother, chose an international school in Lam Tin for her 9-year-old son because it offers a sports session every day after lunch and a mandatory swimming class once a week. She believes this emphasis on PE will instil confidence, health, and better interpersonal communication skills in her son.

"Compared to the costs of his extracurricular sports classes each year, the nearly HK$200,000 for annual tuition fees seem minor."

Xu enrols her son in squash and basketball classes taught by private facilities once a week.

Hon holded that the gap in physical activity degrees between children who are from different levels of socioeconomic status will extend. “Economic resources can offer children more opportunities in advanced PE. Besides money, the awareness and perception of PE differ across families with varying socioeconomic status.”

Jaden, the one on the right, is Xv's son. Xv spent around HK$20,000 to have him attend private institutions for sports trainings.

A routine basketball training session held by a private training institution. Xv believes that such team sports can develop children's social skills.

4. The Underlying Reason of Physical Inactivity Traces Back to Early Childhood PE

In addition to digital devices, Hon believed that the underlying issue of physical inactivity among youth lies in the inadequacy of early childhood PE in Hong Kong.

For parenting, beyond the use of electronic babysitting, today's parents may not be that physically fit themselves, limiting their ability to set a positive example for their children regarding physical activity.

Data shows that besides the younger generation, physical activity among people aged between 25 and 54 has also seen a sharp decline over the past decade.

In addition to education at home, kindergarten environments may not be conducive to fostering children's physical activity.

Hon explained that kindergartens in Hong Kong are often small, providing limited space for free play, which is crucial for developing big muscle groups in children. These muscles are essential for gross motor skills, which coordinate activities such as walking, running and throwing.

"Gross motor skills serve as the foundation for children's future sports performance, encompassing coordination, reaction time, balance, and strength. Failure to cultivate these skills during early childhood can pose challenges for catching up later on."

As a result, some children exhibit poor performance in sports, leading to a lack of interest and confidence in physical activity. Hon posited that "proficiency in something tends to breed interest, whereas repeated failures can suppress enthusiasm."

In accordance with the 2023 Operation Manual for Pre-Primary Institutions issued by the Education Bureau, the minimum indoor activity area for institutions catering to children aged 2 to 6 is set at 1.8 square meters, with outdoor play areas not being mandatory for every kindergarten.

In cases where outdoor facilities are unavailable, indoor play areas should occupy at least 50% of the total classroom space.

A 2015 Legislative Council document titled "Consultancy Study on Accommodation Requirements for Kindergartens (LC Paper No. CB(4)1266/14-15(03))" once recommended that the ideal indoor activity area for kindergartens should be between 2.16 and 2.52 square meters per child, noting that the majority of kindergarten staff believed the space available for physical movement among students, whether indoors or outdoors, was inadequate.

This figure is not specified in Japan, but in Singapore, it is defined in the Early Childhood Development Agency's guidelines. The requirement for outdoor space for gross motor development activities should be 1/6 of the centre's capacity at 4m² per child or 40m², whichever is greater. The indoor space required is 3m², almost 1.7 times Hong Kong's counterpart.

Aside from limited space, Hon also believed that Hong Kong parents tend to be conservative, potentially leading to misconceptions about free play, which may be perceived as lacking in structure. Such conservative attitudes, akin to those observed in the "sit and move" classroom approach, may hinder feasibility.

When asked for suggestions to improve the activity levels of the younger generation in Hong Kong, Hon emphasized the importance of improving childhood PE. "Fostering children's interest in sports from a young age and minimizing their exposure to digital devices is crucial," she said.

Since 2014, Hon has served as a convener and project advisor respectively for two major children fitness promotion projects, Jockey Club Keep-Fit Formula for Children and Jockey Club Home-School Physical Fitness Academy for Kindergarteners.

These programs aim to create a supportive environment for physical fitness development at both home and school by strengthening collaboration between families and schools, improving the professional skills of educators in physical fitness, and raising parents' awareness of the importance of physical fitness.

Between 2015 and 2018, a total of 288 physical fitness lesson plans for kindergartens and primary schools and 55 parent-children games were designed by Jocky Club Keep-Fit Formula for Children programme to help foster children's physical activity and build a healthy lifestyle.

According to the findings of the Jockey Club Home-School Physical Fitness Academy for Kindergarteners' research in 2022, the participation of 3,055 preschoolers in the program led to improvements in performance across five physical fitness tests, compared to similar research in 2016.

Hon said, “The root cause lies in the lifestyle changes brought by screen time, with sedentary behaviour becoming the norm both at home and in schools. Various sectors of society are making efforts to address the issue of physical inactivity among our younger generation.”

End