Reading A New Scale Pediatric Association Pushes For Body Mass Index Testing In Children

To America’s largest pediatric organization, it’s a clear cause and effect.
As the percentage of obese children rises, they contend, so will the obesity rate in adults down the line. One response to combat the dual trend is more vigilant monitoring of children’s weight.

To that end, The American Academy of Pediatrics (AAP) recently proposed a series of strategies designed to foster early identification and prevention of obesity in children.

The primary diagnostic tool in the AAP’s arsenal is the body mass index (BMI), a scale that balances weight against height to identify whether someone is overweight or obese. It has primarily been used in adults, but the AAP wants to make the BMI a regular part of children’s health regimen.

“The BMI is widely used to define overweight and obesity, and significant changes in a child’s BMI should be recognized and addressed before the child becomes severely overweight,” the new policy states.

With statistics suggesting a strong link between childhood obesity and problems shedding the weight as adults, pediatricians say the increased monitoring is a step in the right direction.

Trusted Gauge

Developed by the federal government in 1998, body mass index basically assigns a number based on a formula that incorporates height and weight. Calculating it is simple math: multiply weight in pounds by 703, then divide by height in inches, and divide by height in inches again. In adults, a figure of 25 or more generally signifies an overweight condition, while 30 or more edges into obesity.

The numbers don’t always tell the full story; women have a higher percentage of body fat than men, and the scale doesn’t apply at all for very muscular athletes. For children, variations in translating the numbers can be sharp, so the AAP stresses that pediatricians should also consider family history, birth weight, and socioeconomic, ethnic, cultural, and environmental factors in considering who is most at risk.

But the organization does consider the BMI a largely accurate scale; hence, the recommendation to test children annually.

“Some parents may not recognize or accept the potential risk of their child being overweight,” the report states. “Anticipatory guidance or treatment intervention before obesity has become severe will likely be more successful.”

But the AAP didn’t stop with BMI testing, setting out some other general health and wellness guidelines.

The organization said doctors should encourage mothers to breastfeed, since some studies show it might help keep children from becoming overweight; urge parents and caregivers to promote healthy eating patterns; routinely promote physical activity, including unstructured play; and recommend limitation of television and video time to a maximum of two hours per day.

The AAP is also asking doctors to actively promote anti-obesity programs in their communities, including discouraging the sale of soda at school and encouraging physical education programs that focus on personal fitness, not just team sports.

Hefty Concerns

Doctors aren’t just throwing around buzzwords when they talk about unhealthy food and sedentary lifestyles. The statistics strongly back up connections between these factors and childhood obesity.

For instance, the AAP report states, “parental food choices influence child food preferences. … Absence of family meals is associated with lower fruit and vegetable consumption, as well as consumption of more fried food and carbonated beverages.”

Furthermore, “national survey data indicate that 20{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of U.S. children 8 to 16 years of age reported two or fewer bouts of vigorous physical activity per week, and more than 25{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} watched at least four hours of television per day,” the report continues. “Children who watched four or more hours of television per day had significantly greater BMI compared with those watching fewer than two hours per day.”

Furthermore, the AAP claims, having a television in the bedroom seems to be a strong predictor of being overweight, even in preschool-aged children.

Perhaps partly as a result of these trends, the number of overweight and obese children has risen sharply for several decades. Since the 1960s, the number of overweight children and adolescents in the U.S. has nearly doubled, with 10{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of 2- to 5-year-olds and 15{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of 6- to 19-year-olds registering as overweight, according to KidsHealth, an online medical information resource. Meanwhile, Pediatrics magazine, the print arm of the AAP, has reported that 77{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of overweight children remain overweight into adulthood.

The health risks of obesity are well-documented, including diabetes, high blood pressure, and high cholesterol, not to mention increased risk of eating disorders, depression, and substance abuse. Later in life, overweight people struggle to a greater degree with joint trouble, shortness of breath, sleep disorders, and liver problems.

With these health issues — not to mention heart disease, strokes, and certain cancers — often finding their roots in bad childhood habits, the AAP takes seriously the effort to make a dent in these habits for as many children as possible.

“Abundant opportunities exist for pediatricians to take a leadership role in this critical area of child health,” the report concludes — and BMI tracking can be an effective component.