Trim and Fit - The Program

The Program

The TAF program was introduced into schools in 1992 as part of the National Healthy Lifestyle Campaign. It was a result of a 1991 review of the nation's health plan by a national committee. Students aged 9 to pre-tertiary education were required to undergo annual BMI measurements and National Physical Fitness Award test (a precursor fitness test similar to Individual Physical Proficiency Test for National Servicemen). The country's population at that time was showing an increase in obesity that became associated with health problems and loss of manpower for male conscripts in National Service, which caused many conscripts to be deemed unfit for deployment into combat service.

The program was deemed by observers as an interventionist measure, requiring students who were deemed overweight to be subject to additional intense exercises or physical activities for at least one and a half hours per week. These activities were organised during recess or at times set aside before or after lessons at schools' discretion. They were also issued with "calorie cash" - food ration coupons from which no more than a certain number of calories may be purchased and consumed in a recess break. The amount of calorie cash was inversely proportional to the child's obesity rate. Children which exceeded the 160% of the ideal BMI were referred to the Health Promotion Board for follow-up action.

A direct impact of the TAF program was a reduction of the obesity rate of schoolchildren from 14% to 9.8% by 2002. Worldwide public health experts have evaluated the TAF model for possible replication around the world.

A carrot-and-stick approach was adopted in putting pressure on schools to meet the targets of fitness and obesity set by the ministry. Cash incentives were awarded by the ministry to schools that exceeded fitness targets and created new strategies to maintain students' obesity levels. Schools that failed had to face "consultation" sessions with ministry officials. Schools were also ranked annually based on how well targets were met at national level. Schools were given a wide discretion in determining how TAF was to be implemented, which resulted in some schools going so far as to implement apartheid-like segregation - for instance, where children were grouped to sit at normal and overweight tables during recess.

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