APPLICATION OF BODY MASS INDEX PRINCIPLES

15 Dec
2009

APPLICATION OF BODY MASS INDEX PRINCIPLES

INTRODUCTION

Obesity is an ever-increasing problem in the United States. Recent reports describe a 30.5% age-adjusted prevalence rate of obesity for adults. Comparable figures for children and adolescents are 10.4% for ages 2-5 years, 15.3% for ages 6-11 years, and 15.5% for ages 12-19 years.

In a 2003 policy statement of the American Academy of Pediatrics, the Committee on Nutrition discussed the prevention of overweight and obesity in children and adolescents. This policy statement emphasized using body mass index (BMI) to assess risk. BMI among children and adolescents is best portrayed using the Centers for Disease Control (CDC) 2000 Growth Charts. These charts relate BMI to percentiles according to sex and age. An extension of these growth charts is the Nutstat module of Epi Info available on the Internet through the CDC. Childhood growth is affected by nutrition, health, and the environment. Historically, clinicians have used height (stature), weight, and head circumference measurements to follow pediatric growth and development. The weight-for-stature charts developed in 1977 (CDC 1978 Growth Charts) are not as useful as the CDC Growth Charts released in 2000 that now include BMI-for-age charts up to the 97th percentile according to sex. 

The 1977 weight-for-stature charts were based on limited national survey data for young children. Infant data were derived largely from white middle-class infants from southwestern Ohio. Nearly all infants were formula-fed. Current CDC Growth Charts derive from large national surveys conducted between 1963 and 1994 (mostly between 1963 and 1974) and from supplemental data sources. BMI percentiles, thus, derive from studies completed before the current epidemic of obesity among children and adolescents.

The City of Richmond’s first model elementary school provided a favorable setting to test and then implement the Nutstat module of Epi Info as a tool for assessing, following, and intervening in the public health problem of overweight and obesity among children in the United States. The City of Richmond Department of Public Health and the City of Richmond Public School System participated in this study. canadian discount drugs

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