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When Arkansas schools began measuring every child's body-mass index and sending the information home to parents, it seemed that Generation XXL was getting a raw deal.
Many of America's public schools have eliminated physical education but still offer high-calorie junk food in vending machines and fatty, greasy meals in cafeterias. More than 15 percent of our children are obese, but kids aren't learning how to read food labels, plan meals, control portions or choose nutritious fare.
What could be more hypocritical than having the schools assess children's bodies, when the school environment adds to the problem?
But since Arkansas launched the controversial program in 2003, California, Florida and Missouri also have adopted the body-mass index measure, a height-to-weight ratio that measures fatness. This year, elementary-school parents across Pennsylvania will receive letters explaining whether their children's BMI is above, below or within the normal range for the child's age and sex. At least 12 states considered student body-mass measurement legislation for 2005.
And in Illinois, the only state to still require daily gym (hurrah!), a new law requires children entering kindergarten, 5th and 9th grades to have a school physical exam. The BMI will be recorded during the doctor's visit.
Why the focus on BMI? It's a simple, non-invasive, low-cost tool that can spot whether someone is at risk for becoming underweight or overweight or whether they already are. In youngsters, the BMI is gender- and age-specific, because children's body fatness changes as they grow. It's also given as a percentile, rather than a specific number. The Institute of Medicine and the American Academy of Pediatrics recommend BMI as a screening tool.
Although the BMI is a good way to assess large populations and collect data that can drive changes (such as incorporating nutrition or physical education classes into a curriculum), it's just one indication of health risk. It doesn't distinguish between muscle mass and body fat, so it can give well-muscled people confusing or distorted results, especially athletes with more lean muscle tissue.
When used in school settings, nurses and gym teachers must record the BMI with extreme sensitivity, because the results could cruelly label still-developing children as obese, trigger eating disorders or prompt parents to restrict food. And although it's a first step, it's not the only one. Vending machines should be scrapped, and comprehensive health and fitness programs for students-and their parents-should be introduced if a school is going to use BMI testing.
The BMI is not a silver bullet. No single intervention is going to help with the childhood obesity crisis, because food is used for reasons beyond nourishment, including reward, comfort and punishment. But anything that sounds an alarm for parents-or wakes them out of a stupor-is worth trying.
Schools, which screen children for vision, hearing and scoliosis, have been taking height and weight information for 50 years. The BMI simply allows people to take this information and calculate obesity risk. Why not provide the information to parents, who can choose to follow up with a pediatrician and dietitian for a more comprehensive exam, or ignore it?
It's easy to criticize schools, because they can do so much more to provide a healthy environment. They could enhance physical education or rename it "wellness" and offer yoga, so children can learn about body image and the importance of breathing. They could teach children how food moves from the farm fields to the kitchen table, so they have a connection with the earth. And they could emphasize the critical difference between being healthy and being "thin" or "fat."
But ultimately, if we are going to save a generation of overweight children, parents have to be on board. Eight-year-olds are not driving themselves to fast-food joints. As now-thin Arkansas Gov. Mike Huckabee put it, good health is not so much "taught but caught."
Your child's healthy habits mirror yours. Studies by the AAP have shown that children with overweight parents are at greater risk of becoming obese in adulthood. So let's not just have schools test the BMI of our children. If we really want to wake people up, let's have the parents tested too.
To calculate BMI, take your weight in pounds and divide it by your height in inches squared. Multiply the total by 703. Or, if you were a journalism major, go to www.cdc.gov and type BMI in the search field. A BMI calculator will do the work for you.
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(E-mail Julie Deardorff at jdeardorff(AT)tribune.com)
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(c) 2005, Chicago Tribune. Distributed by Knight Ridder/Tribune News Service.
