II. Literature Review
2.1 Physical Activity Levels: Globally and Taiwan
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II. Literature Review
2.1 Physical Activity Levels: Globally and Taiwan
Due to our increased sedentary lifestyle, lack of physical activity and exercise have progressively become leading causes of declining health and premature death across the globe, especially in the developed world. According to the World Health Organisation “insufficient physical activity is one of the leading risk factors for death worldwide and is a key risk factor for noncommunicable diseases such as cardiovascular diseases, cancer and diabetes.” Being insufficiently physically active increases the risk of death by up to 30% compared to being sufficiently physically active. Roughly 25% of the world’s adults are not active enough and over 80% of adolescents are insufficiently physically active. As a nation’s economy becomes more developed, levels of physical activity tend to decrease. 26% of men and 35% of women are insufficiently physically active in high-income countries compared to 12% of men and 24%
of women in low-income countries (WHO, 2018). Lower physical activity is often attributed to less physically demanding work combined with inaction during leisure times. It is recommended by WHO that adults aged 18–64 should, weekly, do either 2 hours and 30 minutes of moderate-intensity aerobic physical activity or 1 hour and 15 minutes of vigorous-intensity aerobic physical activity or a similar combination of moderate and vigorous-vigorous-intensity activity (WHO, 2015).
Taiwan has followed the trend of much of the rest of the developed world in declining physically activity and increasing obesity rates, especially among young people, as its GDP has increased. In fact, physical activity among young people in Taiwan is comparatively worse than many other developed countries. James et al. (2005) reported that Australian adolescent students were more physically active and enjoyed physical activity much more than Taiwanese students. 86% of Australian students reported that they had exercised for an average of 30
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minutes or more at any one time, in comparison to 62% for Taiwanese students. Taiwanese girl’s levels of physical activity were especially poor in the study with only 47% reporting that they had exercised for an average of 30 minutes at any one time compared to 85% for Australian girls. 41% of the Taiwanese girls in the study reported that they were entirely dependent on school-based activities for sport and exercise compared to only 26% for Australian girls. Levels of enjoyment were similarly low for the Taiwanese students with less than half of boys saying they “really enjoyed” physical activity compared to 64% of Australian boys. Only 22.5% of the Taiwanese girls surveyed reported to really enjoy physical activity.
Tsai, Chen and Wong (1998) (noted in James et al., 2005) reported that studies of physically activity among Taiwanese in the 1990’s was similarly low when compared to other countries.
The Chinese Taipei (Taiwan) 2018 Report Card on physical activity for children and youth (Wu & Chang, 2019) provides the most thorough indication of poor levels of physical activity among young people in Taiwan. The Report Card contains findings from recent government reports and studies in Taiwan regarding the state of physical activity and health among young people in Taiwan. According to their findings, physical fitness levels have been steadily declining among young people in Taiwan over the past two decades with more than 30% of children and adolescents in Taiwan being categorised as overweight or obese.
Participation in sports teams is low with only 27.6% of all students from elementary to high school participating in some form of sports club or team in school. On average, only 12.1% of 15 to 18-year olds are achieving the WHO standard of doing at least 60 minutes of moderate to vigorous physical activity per day with just 5.4% of 13 to 15-year olds meeting the same WHO standard.
Not only are elementary students and adolescents lacking physical activity, Lin et al, (2007) reported that 89.8% of Taiwanese preschool children participating in their study did not meet the national recommendations for time spent being physically active. The authors
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highlighted the importance that physical activity plays on the acquisition and development of gross motor skills. 48.9% of the children tested had motor difficulty while 13.3% were at risk for motor difficulty and only 37.9% of the children had typically developing motor skills.
Children as young as 5 or 6 years old being so inactive, consequentially, with such poor motor skills, will lead to worse problems related to a lack of exercise such as obesity and chronic diseases later in life.
Numerous studies have found that physical activity decreases among young people as they get older. Chen et al. (2007) found that high-school students were 60% more likely to engage in physical activity than college or university students. Therefore, it is vital for children to be encouraged to play and be as physically active as possible in their youth so they can maintain healthy exercise habits as they get older.
Internet usage and screen time, which is often attributed to declines in physical activity, is steadily increasing amongst children and adolescents throughout the world but appears particularly serious in Taiwan. The Survey of Internet Usage of Students (noted in Wu and Chang, 2019) found that elementary school students spent 57.8 min per day on the Internet for non-study purposes, while junior and senior high school students spent 115.8 and 147.2 minutes, respectively.
As well as time spent looking at screens it is also noted by several researchers that time spent trying to achieve success academically has traditionally been more valued than time spent on exercise and physical activity. Chen et al. (2007) found that 76.7% of Taiwanese adolescents spent over 7 hours per day sitting down while 30% of adolescents sat for over 12 hours per day.
The peaks of ‘sedentary over 12 hours’ occurred at age 14 and 17, coinciding with the years Taiwanese junior and senior high school students prepare for national examinations for secondary schools and university entrance. Even when studying preschool children, Lin et al.
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(2007) note that “Taiwanese parents usually emphasise academics and cognitive abilities as crucial for their children’s development, and might be inclined to overlook motor development and physical fitness.” James et al. (2005) partially attributed high rates of obesity amongst boys in Taiwan (compared to girls), to parents “who were more tolerant of boys' excesses: they see academic achievement as much more important for a boy than their looks or their athletic prowess”.