Download presentation

Presentation is loading. Please wait.

Published byMalcolm Page Modified over 4 years ago

1
Assessing Child Growth Using the Body Mass Index (BMI)-for-age Growth Charts: A Training for Health Care Providers 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 March 2006

2
BMI-for-age Growth Chart is: considered standard practice by the American Academy of Pediatrics. now required as part of the well-child exam for children ages 2 through 19 by the Child Health and Disability Prevention (CHDP) Program.

3
Training Objectives Understand BMI and how it is useful to screen for normal growth Understand BMI and how it is useful to screen for normal growth Learn how to plot BMI on the BMI-for-age growth charts Learn how to plot BMI on the BMI-for-age growth charts Learn how to assess a child’s growth using BMI-for-age growth charts for early identification of childhood overweight Learn how to assess a child’s growth using BMI-for-age growth charts for early identification of childhood overweight

4
Source: Behavioral Risk Factor Surveillance System, CDC. Obesity Trends* Among U.S. Adults BRFSS, 1985 No Data <10% 10%–14% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

5
Source: Behavioral Risk Factor Surveillance System, CDC. Obesity Trends* Among U.S. Adults BRFSS, 1986 No Data <10% 10%–14% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

6
Source: Behavioral Risk Factor Surveillance System, CDC. Obesity Trends* Among U.S. Adults BRFSS, 1987 No Data <10% 10%–14% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

7
Source: Behavioral Risk Factor Surveillance System, CDC. Obesity Trends* Among U.S. Adults BRFSS, 1988 No Data <10% 10%–14% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

8
Source: Behavioral Risk Factor Surveillance System, CDC. Obesity Trends* Among U.S. Adults BRFSS, 1989 No Data <10% 10%–14% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

9
Source: Behavioral Risk Factor Surveillance System, CDC. Obesity Trends* Among U.S. Adults BRFSS, 1990 No Data <10% 10%–14% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

10
Source: Behavioral Risk Factor Surveillance System, CDC. Obesity Trends* Among U.S. Adults BRFSS, 1991 No Data <10% 10%–14% 15%–19% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

11
Source: Behavioral Risk Factor Surveillance System, CDC. Obesity Trends* Among U.S. Adults BRFSS, 1992 No Data <10% 10%–14% 15%–19% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

12
Source: Behavioral Risk Factor Surveillance System, CDC. Obesity Trends* Among U.S. Adults BRFSS, 1993 No Data <10% 10%–14% 15%–19% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

13
Source: Behavioral Risk Factor Surveillance System, CDC. Obesity Trends* Among U.S. Adults BRFSS, 1994 No Data <10% 10%–14% 15%–19% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

14
Source: Behavioral Risk Factor Surveillance System, CDC. Obesity Trends* Among U.S. Adults BRFSS, 1995 No Data <10% 10%–14% 15%–19% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

15
Source: Behavioral Risk Factor Surveillance System, CDC. Obesity Trends* Among U.S. Adults BRFSS, 1996 No Data <10% 10%–14% 15%–19% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

16
Source: Behavioral Risk Factor Surveillance System, CDC. Obesity Trends* Among U.S. Adults BRFSS, 1997 No Data <10% 10%–14% 15%–19% ≥20 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

17
Source: Behavioral Risk Factor Surveillance System, CDC. Obesity Trends* Among U.S. Adults BRFSS, 1998 No Data <10% 10%–14% 15%–19% ≥20 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

18
Source: Behavioral Risk Factor Surveillance System, CDC. Obesity Trends* Among U.S. Adults BRFSS, 1999 No Data <10% 10%–14% 15%–19% ≥20 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

19
Source: Behavioral Risk Factor Surveillance System, CDC. Obesity Trends* Among U.S. Adults BRFSS, 2000 No Data <10% 10%–14% 15%–19% ≥20 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

20
Source: Behavioral Risk Factor Surveillance System, CDC. Obesity Trends* Among U.S. Adults BRFSS, 2001 No Data <10% 10%–14% 15%–19% 20%–24% ≥25% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

21
Source: Behavioral Risk Factor Surveillance System, CDC. (*BMI 30, or ~ 30 lbs overweight for 5’4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) Obesity Trends* Among U.S. Adults BRFSS, 2002

22
Source: Behavioral Risk Factor Surveillance System, CDC. Obesity* Trends Among U.S. Adults BRFSS, 2003 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

23
All Races 17.90% not enough data Pediatric Nutrition Surveillance System (PedNSS) Growth Statistics for City and County of San Francisco 2004 BMI for age > 95% for Children 2-4 Years

24
All Races 19.20% White 17.90% Pediatric Nutrition Surveillance System (PedNSS) Growth Statistics for City and County of San Francisco 2004 BMI for age > 95% for Children 5-19 Years

25
A number that compares a child’s weight to her height A number that compares a child’s weight to her height Body Mass Index (BMI) = Body Mass Index (BMI) = Weight (kg) / Height (m)² BMI is an effective tool; alone it is not a diagnostic tool BMI is an effective SCREENING tool; alone it is not a diagnostic tool What is BMI?

26
BMI is Not the Same for Adults and Children Adult BMI is evaluated by use of cut-off numbers; for example BMI >30 is indicative of adult obesity Adult BMI is evaluated by use of cut-off numbers; for example BMI >30 is indicative of adult obesity There are no BMI cut-off numbers for children. The BMI number must be plotted on the BMI-for-age growth chart There are no BMI cut-off numbers for children. The BMI number must be plotted on the BMI-for-age growth chart The BMI for children is useful only when it is plotted on the “BMI-for-age Growth Chart” The BMI for children is useful only when it is plotted on the “BMI-for-age Growth Chart”

27
Example: 95th percentile tracking Age BMI 2 yrs 19.3 4 yrs 17.8 9 yrs 21.0 13 yrs 25.1 For Children, BMI Changes with Age Boys: 2 to 20 years BMI

28
Tracking tool for body size starting at age 2 years through adulthood Tracking tool for body size starting at age 2 years through adulthood Only indicator that examines weight, stature AND age for a child on a single growth chart Only indicator that examines weight, stature AND age for a child on a single growth chart Correlates with clinical risk factors for chronic disease including hyperlipidemia, elevated insulin, and high blood pressure Correlates with clinical risk factors for chronic disease including hyperlipidemia, elevated insulin, and high blood pressure Importance of Using BMI-for-age

29
BMI is Only an Indirect Measure of Body Fat

30
> 95 th percentileOverweight 85 th to < 95 th Risk of percentileoverweight < 5 th percentileUnderweight Using BMI-for-age Percentiles to Assess Risk

31
What is a Percentile? 95 th 5 th 50 th Percentile 85 th

32
CDC Standardized Growth Chart Formula to calculate BMI Published May 30, 2000 Percentiles (5 th,10 th,25 th, 50 th, 75 th,85 th,90 th,95 th )

33
> 95 th percentileOverweight? 85 th to < 95 th Risk of percentile overweight? < 5 th percentileUnderweight? Growth acceleration or deceleration across 2 percentile lines Using BMI-for-age Percentiles to Assess Risk

34
What is “Adiposity” Rebound (AR)? BMI A rebound or increase in BMI that occurs after it reaches its lowest point, usually between ages 4 to 6. Normal pattern of growth An early "adiposity" rebound, occurring before ages 4 to 6, is associated with obesity in adulthood.

35
Normal “Adiposity” Rebound BMI Early “Adiposity” Rebound

36
Steps to Plot BMI-for-age 1. Obtain accurate weight and height measurements 2. Select the appropriate growth chart 3. Record the data 4. Calculate BMI 5. Plot measurements 6. Interpret plotted measurements

37
5 year old boy Weight: 43.5 lb Height: 43 in BMI= 16.5 BMI-for-age = 75-84 th %tile Inaccurate height measurement: 42.5 in BMI=17 BMI-for-age = 85-94 th %tile 1. Obtain Accurate Weight and Height Measurements Accurate Measurements are Critical Boys: 2 to 20 years BMI

38
2. Select the Appropriate Growth Chart For ages birth to 36 months old: For ages birth to 36 months old: “Length-for-age,” and “Weight-for-age” “Length-for-age,” and “Weight-for-age” “Weight-for-length,” and “Head Circumference-for-age” “Weight-for-length,” and “Head Circumference-for-age” For ages 2 to 20 years: For ages 2 to 20 years: “Weight-for-age,” and “Stature-for-age” “Weight-for-age,” and “Stature-for-age” Body Mass Index “BMI-for-age” Body Mass Index “BMI-for-age”

39
3. Record Data

40
4. Calculate BMI English: Wt (lbs.) ÷Ht (in.) ÷ Ht (in.) x 703 Metric: Wt (kg.) ÷Ht (cm.) ÷ Ht (cm.) x 10,000

41
4. Calculate BMI Use a Pediatric BMI Wheel Use a Pediatric BMI Wheel

42
5. Plot Measurements Age BMI 50 th 75 th 85 th 5 th 95 th

43
6. Interpret the BMI-for-age Chart Need a series of BMI plots to determine the growth trend Need a series of BMI plots to determine the growth trend If growth deviates from expected growth pattern, further assessment may be needed If growth deviates from expected growth pattern, further assessment may be needed

44
Practice using “BMI-for-age” Growth Chart Liz (4 y)Pete (3 y)Gabriella (4 y) Photos from UC Berkeley Longitudinal Study, 1973

45
Please Plot Pete Perfectly Photo from UC Berkeley Longitudinal Study, 1973 Measurements for Pete: Age= 3 y 3 wks Weight= 41 lbs (18.6 kg) Height= 39.7 in (100.8 cm) Find BMI, plot, & interpret growth trend BMI= Wt ( lbs) ÷ Ht (in) ÷ Ht (in) x 703

46
BMI=18.3 Boys: 2 to 20 years BMI Interpretation: BMI-for-age = >95 th percentile Overweight Of 100 boys the same age, more than 95 have a lower BMI-for-age Answers: Pete’s “BMI-for-age”

47
Let’s Look at Liz Liz

48
Liz’s - BMI Liz 17.7

49
2-3-02

50
Graph Gabriella’s Growth

51
Gabriella’s BMI

53
Please Identify Overweight Children on PM160 Put comments here ex: overweight, > 95 th % BMI

54
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)www.cdc.gov/growthcharts American Academy of Pediatrics Policy Statement: Prevention of Pediatric Overweight and Obesity (Pediatrics 2003 Aug (112)2; 424-430) References

55
For additional training materials related to the growth charts For tools related to the growth charts To download the growth charts Please visit: www.cdc.gov/growthcharts/

Similar presentations

© 2020 SlidePlayer.com Inc.

All rights reserved.

To make this website work, we log user data and share it with processors. To use this website, you must agree to our Privacy Policy, including cookie policy.

Ads by Google