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Using the Body Mass Index (BMI)-for-age Growth Charts: A Training for Health Care Provider Assistants. Adapted by the CHDP Bay Area Nutrition Subcommittee (BANS) from Centers for Disease Control and Prevention National Center for Chronic Disease Prevention and Health Promotion

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Using the Body Mass Index (BMI)-for-age Growth Charts:

A Training for Health Care Provider Assistants

Adapted by the CHDP Bay Area Nutrition Subcommittee (BANS) from

Centers for Disease Control and Prevention

National Center for Chronic Disease Prevention and Health Promotion

Division of Nutrition and Physical Activity

Maternal and Child Nutrition Branch

January 2006


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Training Objectives

  • Understand BMI and its importance for health care providers

  • Learn how to plot BMI on the BMI-for-age growth charts


Obesity trends among u s adults brfss 1985 l.jpg

No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1985

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)


Obesity trends among u s adults brfss 1986 l.jpg

No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1986

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)


Obesity trends among u s adults brfss 1987 l.jpg

No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1987

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)


Obesity trends among u s adults brfss 1988 l.jpg

No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1988

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)


Obesity trends among u s adults brfss 1989 l.jpg

No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1989

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)


Obesity trends among u s adults brfss 1990 l.jpg

No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1990

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)


Obesity trends among u s adults brfss 1991 l.jpg

No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1991

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)


Obesity trends among u s adults brfss 1992 l.jpg

No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1992

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)


Obesity trends among u s adults brfss 1993 l.jpg

No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1993

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)


Obesity trends among u s adults brfss 1994 l.jpg

No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1994

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)


Obesity trends among u s adults brfss 1995 l.jpg

No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1995

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)


Obesity trends among u s adults brfss 1996 l.jpg

No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 1996

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)


Obesity trends among u s adults brfss 1997 l.jpg

No Data <10% 10%–14% 15%–19% ≥20

Obesity Trends* Among U.S. AdultsBRFSS, 1997

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)


Obesity trends among u s adults brfss 1998 l.jpg

No Data <10% 10%–14% 15%–19% ≥20

Obesity Trends* Among U.S. AdultsBRFSS, 1998

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)


Obesity trends among u s adults brfss 1999 l.jpg

No Data <10% 10%–14% 15%–19% ≥20

Obesity Trends* Among U.S. AdultsBRFSS, 1999

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)


Obesity trends among u s adults brfss 2000 l.jpg

No Data <10% 10%–14% 15%–19% ≥20

Obesity Trends* Among U.S. AdultsBRFSS, 2000

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)


Obesity trends among u s adults brfss 2001 l.jpg
Obesity Trends* Among U.S. Adults ≥20BRFSS, 2001

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%


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Obesity Trends* Among U.S. Adults ≥20BRFSS, 2002

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

(*BMI 30, or ~ 30 lbs overweight for 5’4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%


Obesity trends among u s adults brfss 2003 l.jpg
Obesity* Trends Among U.S. Adults ≥20BRFSS, 2003

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%


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How many…? ≥20

Nine Million Kids are Overweight

2000

2005


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Pediatric Nutrition Surveillance System (PedNSS) Growth Statistics forCity and County of San Francisco 2004BMI for age > 95% for Children 2-4 Years

All Races 17.90%

not enough data


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Pediatric Nutrition Surveillance System (PedNSS) Growth Statistics forCity and County of San Francisco 2004BMI for age > 95% for Children 5-19 Years

All Races 19.20%

White 17.90%


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What is BMI? Statistics for

  • A number that compares a child’s weight to her height

  • Body Mass Index (BMI) =

    Weight (kg) / Height (m)²

  • BMI is an effective SCREENING test to check for possible overweight; but alone it is nota diagnostic tool



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BMI is Not the Same for Adults and Children Statistics for

  • Adult BMI is evaluated by use of cut-off numbers; for example BMI >30 is indicative of adult obesity

  • The BMI for children is useful only when it is plotted on the “BMI-for-age Growth Chart”


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For Children, BMI Changes with Age Statistics for

BMI

BMI

Example:

95th percentile tracking

Age BMI

2 yrs 19.3

4 yrs 17.8

9 yrs 21.0

13 yrs 25.1

Boys: 2 to 20 years

BMI

BMI


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Importance of Using BMI-for-age Statistics for

  • Associated with clinical risk factors for chronic disease including hyperlipidemia, elevated insulin, and high blood pressure


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CDC Statistics forStandardized Growth Chart

Formula to calculate BMI

Percentiles (5th,10th,25th, 50th, 75th,85th,90th,95th)

Published May 30, 2000


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What is a Percentile? Statistics for

50th Percentile

85th

5th

95th


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Using BMI-for-age Percentiles to Assess Risk Statistics for

> 95th percentile Overweight

85th to < 95thRisk of percentile overweight

< 5th percentile Underweight


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Steps to Plot BMI-for-age Statistics for

  • Obtain accurate weight and height measurements

  • Select the appropriate growth chart

  • Record the data

  • Calculate BMI

  • Plot measurements


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BMI Statistics for

BMI

Boys: 2 to 20 years

BMI

BMI

  • Obtain Accurate Weight and Height Measurements

  • Accurate Measurements are Critical

5 year old boy

Weight: 43.5 lb

Height: 43 in

BMI= 16.5

BMI-for-age = 75-84th %tile

Inaccurate height measurement: 42.5 in

BMI=17

BMI-for-age = 85-94th %tile


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2. Select the Appropriate Growth Chart Statistics for

  • For ages birth to 36 months old:

    • “Length-for-age,” and “Weight-for-age”

    • “Weight-for-length,” and “Head Circumference-for-age”

  • For ages 2 to 20 years:

    • “Weight-for-age,” and “Stature-for-age”

    • Body Mass Index “BMI-for-age”


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3. Record Data Statistics for


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4. Calculate BMI Statistics for

English:

Wt (lbs.) ÷Ht (in.) ÷ Ht (in.) x 703

Metric:

Wt (kg.) ÷Ht (cm.) ÷ Ht (cm.) x 10,000


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4. Calculate BMI Statistics for

  • Use a Pediatric BMI Wheel


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5. Plot Measurements Statistics for

95th

85th

75th

50th

BMI

5th

Age


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Practice using Statistics for“BMI-for-age” Growth Chart

Pete (3 y)

Gabriella (4 y)

Liz (4 y)

Photos from UC Berkeley Longitudinal Study, 1973


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Please Plot Pete Perfectly Statistics for

Measurements for Pete:

Age= 3 y 3 wks

Weight= 41 lbs (18.6 kg)

Height= 39.7 in (100.8 cm)

Find BMI and plot.

BMI= Wt ( lbs) ÷ Ht (in) ÷ Ht (in) x 703

Photo from UC Berkeley Longitudinal Study, 1973


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BMI Statistics for

BMI

Boys: 2 to 20 years

BMI

BMI

Answers: Pete’s “BMI-for-age”

BMI=18.3


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Let’s Look at Liz Statistics for

Liz


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Liz’s - BMI Statistics for

17.7

Liz


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2-3-02 Statistics for



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Gabriella’s BMI Statistics for


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Please visit: Statistics for

www.cdc.gov/growthcharts/

  • For additional training materials related to the growth charts

  • For tools related to the growth charts

  • To download the growth charts


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References Statistics for

  • Guidelines for Overweight in Adolescent Preventive Services (Am J Clin Nutr 1994;59:307-316)

  • Obesity Evaluation and Treatment: Expert Committee Recommendations (Pediatrics 1998 Sept;(102)3:e 29)

  • Assessment of Childhood and Adolescent Obesity: International Obesity Task Force (Am J Clin Nutr 1999, 70,suppl)

  • Centers for Disease Control and Prevention Website (www.cdc.gov/growthcharts)

  • American Academy of Pediatrics Policy Statement: Prevention of Pediatric Overweight and Obesity (Pediatrics 2003 Aug (112)2; 424-430)


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