1. Standard: FCS-FNW-1 Students will discuss basic nutrient requirements and their use in dietary planning. Element “C” Define a calorie, compare energy sources, compute Basal Metabolic Rate, Body Mass Index, and waist to hip ratio; apply outcomes to dietary planning and selection of nutrient dense foods. How to Use Growth Charts & Anthropometric Measures: Basal Metabolic Rate, Body Mass Index, Waist-to-Hip Ratio Presentation by Rhonda L. Barlow; source: CDC.gov

2. Training Objectives At the end of this presentation, you will be able to: 1. Discuss the history of the current CDC Growth Charts, 2. Select the appropriate CDC Growth Chart (Grid) needed based on the age and gender of the person, 3. Use the CDC Growth Charts to plot anthropometric measures, 4. Interpret the data plotted to assess physical growth.

3. History Released = May 2000 Developed by  National Center for Health Statistics (NCHS) Distributed by  Centers for Disease Control and Prevention (CDC) Used for all children 2 to 20 years of age Screening Tool  Assess physical growth/nutritional status  Assess risk of underweight/overweight

4. Why Revise 1977 NCHS Charts? Reference Population Racially/Ethnically Diverse Infants: Birth to 36 months Children and Adolescents: 2 to 20 years Breast- and formula-fed infants

5. Use and Interpretation of Charts Step 1 = Obtain accurate weight and measures. Step 2 = Select appropriate growth chart. Step 3 = Record anthropometric data. Step 4 = Calculate Body Mass Index (BMI). Step 5 = Plot measurements. Step 6 = Interpret plotted measurements. As listed in “Use & Interpretation of the CDC Growth Charts,”

6. Accurate Weight and Measures Calibrate height and weight equipment. Take off excess clothes and shoes CDC Recommended Protocol  Stature http://www.cdc.gov/nccdphp/dnpa/bmi/meas-height.htm  Weight http://www.cdc.gov/nccdphp/dnpa/bmi/meas-weight.htm

7. Measuring Stature Stand against stadiometer. Feet, bottom, shoulders and head against wall. Head straight. Bring measuring tool level with head. Read height. Head Feet Wall Top of stadiometer Floor stadiometer

8. Measuring Weight “Zero” out scale. Stand on scale. Hands and arms straight down by side. Waite for balance to record weight. Read weight.

9. Measuring Waist Use sturdy/un-stretched measuring tape. Minimal/thin clothing Measure around smallest area or near navel. Read measuring tape. Record data.

10. Measuring Hip Use sturdy/un-stretched measuring tape. Minimal/thin clothing Measure around largest area of bottom. Read measuring tape. Record data.

11. Select Appropriate Growth Chart CDC growth charts available on Internet www.cdc.gov/growthcharts Clinical vs. individual growth charts

12. Record Data Student’s name Record number = birth date Mother’s/Father’s Stature = optional Date = day measurements taken Age = years, months, days Weight = pounds Stature = inches BMI = manual calculation Comments = any notable occurrence/observation

13. BMI Calculation Formula Metric System BMI = weight (kg)/[stature (cm)] 2 x 10,000 {OR} English System BMI = weight (lb) ÷ [stature (in)] 2 x 703 Calculate as a continuous equation.

14. Calculation Practice Sam’s anthropometric measures weight = 37 pounds, 4 ounces height = 41½ inches Convert ounces and fractions to decimals. Answer 37.25lbs ÷ 41.5 ÷ 41.5 x 703 = 15.2

15. Calculation Practice FractionOuncesDecimal 1/82.125 1/44.25 3/86.375 1/28.5 5/810.625 3/412.75 7/814.875 Complete Your Growth Chart Fill in name, birth date in “Record #” Today’s date Age = pretend you are 18, 19, or 20 Record estimated weight and height Calculate your BMI based on above. Decimal Conversions Table

16. Plot Measurements Find your age on horizontal axis. Years = 3 months increments Find appropriate measurement on vertical axis. (Weight, length, stature, head circumference, BMI) Make a small dot where the two lines intersect.

17. Visual Example of Plot

18. Interpret Plotted Measurements 1. Determine the percentile rank. 2. Determine if the percentile rank suggests that the anthropometric index is indicative of nutritional risk based on the percentile cutoff value. 3. Compare today’s percentile rank with the rank from previous visits to identify any major shifts in the child’s growth pattern and the need for further assessment. 4. Anthropometric Index Percentile Cut-off Value Nutritional Status Indicator

19. Percentile Rank Indicated Nutrition- Related Health Concern Anthropometric IndexPercentile Cut-off Value Nutritional Status Indicator BMI-for-Age≥ 95 th Overweight Weight-for-Length> 95 th Overweight BMI-for-Age≥ 85 th and < 95 th At Risk of Overweight Weight-for-Length< 5 th Underweight Stature/Length-for-Age< 5 th Short Stature Head Circumference-for-Age 95 th Developmental Problems

20. Growth Charts and BMI Resources For this presentation, “Use and Interpretation of the CDC Growth Charts.” Online, http://www.cdc.gov/nccdphp/dnpa/growthcha rts/resources/growthchart.pdf. http://www.cdc.gov/nccdphp/dnpa/growthcha rts/resources/growthchart.pdf For additional training materials related to the growth charts, For tools related to the growth charts, To download the growth charts, visit http://www.cdc.gov/growthchartshttp://www.cdc.gov/growthcharts.

21. THE END Thank You for Your Interest