Improvements in Identifying Obesity in Our Kids

A study by the University of Michigan in Ann Arbor, MI found that a child's neck circumference is a good indicator of obesity. Neck circumference (NC) was found to reliably identify children with a high body mass index (BMI).

BMI numbers can be misleading since people who are more muscular than average will often have a BMI number that indicates that they are overweight or obese. BMI is calculated based on height and body weight alone. It doesn't factor in age, muscularity, activity level, or other important factors that affect the likelihood of heart disease, stroke, and other obesity related diseases.

Neck circumference measuring is accurate in adults; this study was trying to find the most accurate neck circumference cut-off point for identifying children with a high BMI.

According to the study report published by the American Academy of Pediatrics (AAP), the following cut-off numbers were found to be accurate for identifying high BMI in children, "Optimal NC cutoff indicative of high BMI in boys ranged from 28.5 to39.0 cm. Corresponding values in girls ranged from 27.0 to 34.6cm." The study also found that these numbers are more accurate in older children.

Another study that reported results to the AAP in June 2005 looked at BMI and waist circumference (WC). This study was focusing on Coronary Artery Disease (CAD) risk factors in children and adolescents. The study was conducted by doctors and researchers from Queen's University, Kingston, Ontario, Canada; Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana; Tarleton State University, Stephenville, Texas; and the Pennington Biomedical Research Center, Baton Rouge, Louisiana.

This study found that when both BMI and WC were looked at together, the ability to accurately identify children at increased risk of CAD improved. The report stated the study's conclusion found, "...when BMI and WC values were categorized with a clinical approach,WC provided information on CAD risk beyond that provided byBMI alone. This was particularly true when BMI and WC categorieswere used to predict individuals with elevated CAD risk factorvalues and the metabolic syndrome."

The study didn't identify "the appropriate clinical thresholds" which would make standardized BMI and WC guidelines for the use of these tools together accurately in clinical settings.

With increasing ways to identify the risks that being overweight or obese place on our children, we are better able to understand how important it is to make changes when our children are young. Some doctors don't emphasize healthy weight at routine visits unless the parent brings it up or there is already a more serious cause for concern. Some parents may feel protective or hurt when a healthcare professional or doctor tells them their child is obese.

With numbers that have been proven to be accurate at identifying risk of developing heart disease, diabetes, and other weight-related illnesses, it should be easier for parents and doctors to define when weight becomes a health issue. Weight problems can be emotional to address. Changing your children's and your own lifestyle can be difficult and stressful too. However, if you can focus on the long term impact of your choices today on your children's health, you can focus on how to change things in a manageable way.

Sources:

Combined Influence of Body Mass Index and Waist Circumference on Coronary Artery Disease Risk Factors Among Children and Adolescents, Pediatrics Vol. 115, No. 6, http://pediatrics.aappublications.org/cgi/content/full/115/6/1623?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=waist+circumference+obesity&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT

Neck Circumference as a Screening Measure for Identifying Children With High Body Mass Index, Pediatrics(doi:10.1542/peds.2010-0242), http://pediatrics.aappublications.org/cgi/content/abstract/peds.2010-0242v1