In an article published three days ago in the New York Times, one of our favorite reporters, Jodi Kantor, writes about some recent goings-on in a small school district in Pennsylvania. Why is this interesting? As her story unfolds, Ms. Kantor brings to light some complicated issues arising from the proactive educational policies regarding childhood obesity in many school districts around the nation. Specifically, a number of elementary schools and junior highs have begun listing children's body mass index (BMI) on grade report cards.
Kantor points out that this obesity-awareness policy is brought to question for several reasons. First, many schools still serve fattening and unhealthy cafeteria food (unfortunately, still the status quo). Second, educational prevention plans cost money, and there is great disparity among what different school districts can afford. The Miami-Dade County Public Schools, for example, offer Pilates and kayaking to children who scored high on the BMI, a luxury very few other counties could even consider. Third, cultural differences within the US collide with the 'official' standards of healthy body mass. Finally, the doubts regarding the validity of the BMI are well-documented, even though no one can argue that it's not cost-effective. A problem arises, however, when parents and children are not sure what the BMI means and what it doesn't mean.
The players all await the federal Center of Disease Control and Prevention's forthcoming policy statement, which is expected to provide guidelines and information about the advantages and risks of the BMI. Also awaited is some kind of national or standardized guidelines as to how schools should respond to childhood obesity.
Still, as Dr. Ludwig of Children's Hospital Boston reasons, childhood obesity is major national problem, with long-lasting health implications. From our standpoint, we do support the inclusion of the BMI in report cards, and we think that the BMI report must come with background information and actionable suggestions, such as: 1) goals for appropriate BMI; 2) risks accompanying high BMI; and 3) steps to take to lower BMI. We hope that a leaflet of information about the BMI handed to each child along with the report card should not entail high costs to schools - surely something standardized on this front could be prepared. Some information is much more valuable than no information at all, as we know from the blood glucose monitoring education - if don't know what to do with the score, the information is far less valuable, if valuable at all - but if they do, they can greatly improve their health and quality of life.