Recommended Terminology Change for Adolescent BMI Percentiles

Posted on Tuesday, June 17th, 2008

In an article entitled, “Expert Committee Recommendations Regarding the Prevention, Assessment, and Treatment of Child and Adolescent Overweight and Obesity: Summary Report,” published in Pediatrics, the official journal of the American Academy of Pediatrics, recommendations are made by an expert committee regarding the prevention, assessment, and treatment of overweight and obesity in adolescent children. One of the recommendations made by the expert committee is to change the language used to describe BMI’s for children 2-18 years of age in the 85^th to 94^th percentiles and the ≥ 95th percentile. Below are the old terminologies as well as the recommended new terminologies:

Old terminology

• 85^th to 94^th percentile classified as at risk of overweight
• ≥ 95^th percentile classified as overweight

New terminology

• 85^th to 94^th percentile classified as overweight
• ≥ 95^th percentile classified as obese

The reason for the recommended change in terminology, as stated in the article, is because “the term obesity denotes excess body fat more accurately and reflects the associated serious health risks more clearly than the term overweight, which is not recognized as a clinical term for high adiposity. Overweight denotes high weight from high lean body mass as well as from high body fat levels and so is appropriate for the 85^th to 94^th percentile category, which includes children with excess body fat as well as children with high lean body mass and minimal health risks.”

Read the full article.

Also, with in the article, the expert committee recommends families follow these evidenced-based health habits:

• Limit consumption of sugar-sweetened beverages
• Encourage consumption of diets with recommended quantities of fruits and vegetables; the current recommendations from the US Department of Agriculture (USDA) are for 9 servings per day, with serving sizes varying with age
• Limit television and other screen time by allowing a maximum of 2 hours of screen time per day and removing televisions and other screens from children’s primary sleeping area (although a relationship between obesity and screen time other than television viewing, such as computer games, has not been established, limitation of all screen time may promote more calorie expenditure) (the American Academy of Pediatrics recommends no television viewing before 2 years of age and thereafter no more than 2 hours of television viewing per day)
• Eat breakfast daily
• Limit eating out at restaurants, particularly fast food restaurants (frequent patronage of fast food restaurants may be a risk factor for obesity in children, and families should also limit meals at other kinds of restaurants that serve large portions of energy-dense foods)
• Encourage family meals in which parents and children eat together (family meals are associated with a higher-quality diet and with lower obesity prevalence, as well as with other psychosocial benefits)
• Limit portion size (the USDA provides recommendations about portions, which may differ from serving sizes on nutrition labels, and a product package may contain >1 serving size).

Reference:

Barlow S.E. Expert Committee Recommendations Regarding the Prevention, Assessment, and Treatment of Child and Adolescent Overweight and Obesity: Summary Report. Pediatrics. 2007;120;s 164-s 192