Helping parents understand kids’ body mass index can thwart obesity, but Kentucky doesn’t require BMI to be reported

By Melissa Patrick
Kentucky Health News

Parents are more likely to change their child’s lifestyle when schools provide educational materials along with the results of their child’s body mass index screening, according to a recent study. But Kentucky has declined to require student BMIs to be measured, or to engage with parents about what they mean.

BMI, a ratio of height to weight, is used as a screening tool to indicate whether a person is underweight, a healthy weight, overweight or obese. A minor with a BMI of 30 is considered obese.

The study, published in the journal Childhood Obesity, analyzed 1,500 parental surveys from 31 Pennsylvania elementary schools, some who had only received their child’s BMI results, while others got the results along with access to an online tool that helps parents evaluate their home environments and practices as they relate to nutrition and physical activity.

The tool appears to help parents better understand their child’s BMI number, and how that relates to lifestyle changes that could improve health, like increasing fruits and vegetables, decreasing screen time, increasing activity levels and ensuring adequate sleep, Greg Welk, a professor of kinesiology at Iowa State University and leader of the study, said in an ISU news release.

Welk said BMI numbers are of little use if not shared with parents. The American Academy of Pediatrics and the Institute of Medicine have endorsed BMI screening for use in school assessments, but it is important to follow recommended practices for assessment and notification, he added.

A bill was introduced in the 2010 Kentucky General Assembly to increase physical activity in the lower grades, with the stated goal of reducing obesity and improving the body mass index of Kentucky’s children, but it didn’t pass. The bill would have required schools to collect and track the aggregate BMI of students in these grades.

Since then, Kentucky has added an optional box for health-care providers to include a child’s BMI on the physical-examination reports that are required to enter children in kindergarten and sixth grade. Middle-school and high-school students are required to get a physical exam only if they participate in a sport.

Reporting of BMI varies widely among school districts, so the state has data for only 17.3 percent of its students.

If a BMI is provided, individual schools can enter it in a statewide database, which is reported collectively for use in developing school wellness programs, but the data entry is a suggested practice and is not required, said Jaimie Sparks, coordinated school health director at the Kentucky Department of Education, said in an interview.

“We wanted to collect the data from a public health perspective and let its usefulness be in guiding decisions, say around chronic disease and obesity. We also wanted to be very careful that discussions around the individual student stayed within the medical home,” Sparks said, adding that it was also important to avoid any situation where school personnel might be perceived as health experts.

As of 2012, 21 states were required to measure and collect BMI data, though one-third of the schools in these 21 states had policies that did not require parental notification, said the release.

The Iowa State researchers said their study shows there is potential to increase awareness and access to educational tools related to BMI reports, and if this information prompts parents to make changes, it could help reduce obesity rates. They cited research showing that very few parents identify their own children as having weight problems, though more than 17 percent of American youth are obese.

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