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Body Mass Index
If you would like to calculate your body mass index divide your weight in pounds by your height in inches squared times 703. For adults, a BMI of less than 18.5 is underweight; 18.5 to 24.9 is normal; 25 to 29.9 is overweight; 30 to 39.9 is obese; and, greater than 40 is morbidly obese. Or go to www.cdc.gov/nccdphp/dnpa/bmi/calc-bmi.htm
The fight against childhood obesity, which has succeeded in getting soda and candy out of school vending machines, could eventually lead to letters going home to parents telling them their child is overweight and they should consult a physician.
Language to that effect – using the term Body Mass Index versus overweight – was taken out of legislation passed earlier this year. The parts of that bill that did go through will eventually lead to better regulation of the food sold in a la carte lines at school cafeterias.
“The only way the bill was going to get through with unanimous support at the committee level,” was to take out parental notification, said Karen O’Rourke of the Maine Center for Public Health – a non-profit research and educational foundation created by the Legislature in 1996.
“I’m an advocate for sending it home to parents if it’s done in the right way,” O’Rourke said. “It’s not saying your kid’s necessarily overweight. It’s saying you should go to your doctor.”
The Maine Center for Public Health is putting on a workshop next month to generate support for parental notification, using testimony from officials in two states – Pennsylvania and Arkansas – that now require it.
“I think the purpose of our conference in November is to make sure we have enough support,” when the bill comes up again, O’Rourke said. Principals, superintendents, school nurses and pediatricians will be invited to attend, along with a few legislators.
“It’s a very sensitive issue for families. It’s a tough issue,” she said, even for physicians. They don’t like to talk about it either. Doctors don’t like to make kids cry.”
Hard truth
Difficult or not, Dr. Dora Mills, the state’s public health director, said if people don’t confront the issue of overweight and obese children, they’re going to have to deal with an even tougher reality: “Because of this epidemic, our youth may be the first generation in America to not live as long as their parents’ generation.”
Mills points to statistics that show while the whole country is too fat – close to 60 percent of adults in the U.S. are overweight – the most alarming trend is among the youngest children.
About one-third of Maine’s youth are overweight or at risk of being overweight and 36 percent of kindergartners fall into that category.
And, an overweight kid is likely to become an obese adult, carrying with him the increased likelihood for heart disease, diabetes and premature death.
“We’re just seeing the start of this epidemic,” Mills said.
The causes are all around us and imbedded in our society, she said. People drive instead of walk and do less physical work, and they have access to cheap, high-calorie food.
Kids, in particular, have been affected by two staples in the American diet – soda pop full of sugar and hours of watching TV.
A study just released in the International Journal of Obesity showed the time spent in front of the television “is a significant predictor of body-mass index and being overweight” and could have more of a direct effect than diet.
Mills believes that government policy has a role in changing behavior because it will take more than telling people, “you’ve got to get off your duff and eat healthy.”
In a position paper she reviewed such things as using the gas tax to fund not just highways but bike paths, sidewalks and walking trails or using the sales tax to make healthy foods more affordable than junk food.
The reality is obesity is more prevalent among the poor, and Maine is a poor state, she said.
“If you’re poor and you’re hungry and you go into a fast-food restaurant,” she said, “are you going to buy one $4 salad or four $1 hamburgers?”
Reaching children
Schools provide the most direct link to changing young people’s behavior and there the effort has been to regulate what kids eat in the lunch line or out of vending machines.
On July 1, soda pop and candy were officially banned from school vending machines 24-hours-a-day, expanding a ban that had only applied during school hours.
Legislation also was passed earlier this year that empowers the Department of Education to develop rules around the labeling, nutritional value and portion size in the a la carte line in school cafeterias. Those regulations will be rolled out over the next two years.
“Schools will be required to post calories on pre-packaged a la carte items,” O’Rourke said, because “kids make better choices when they know more.”
Portion size also will be adjusted so “you don’t see any more of these humongous cookies,” she said.
And, the Maine Center for Public Health will continue to push for measurement of body mass and parental notification, with the goal of getting parents and pediatricians involved in treating obesity as a preventable illness.
Arkansas passed a law in 2003 requiring parental notification and the Pennsylvania Department of Health started requiring the measurements this school year for K-4, with the goal of measuring all kids by 2007-2008.
While the measurements have been controversial, O’Rourke said, officials in those states say they wouldn’t change the program.
“Many of us think that it’s important for two reasons,” O’Rourke said. “How do we know if we really have a handle on the problem and how can we prevent the problem…if we don’t do anything?”
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