BMI Measurement in Schools

BMI's in schools.  Huge issue.  Here are my thoughts.

I see both sides of the coin.  I have a unique stance due to my positions at one point in time being on both sides.

As a 22 year old dietetic intern at Vanderbilt, we have a very extensive final community nutrition project that needs to be executed before graduation.  My project was titled, "Address your Health. A Sample Systems Guide to Implementing Health Report Cards in your State."  Seriously, here is proof.

Back then, I was working in Tennessee, a state at the time that ranked 47th in childhood health.  I was in and out of the schools doing various nutrition presentations.  You can't help but physically see the obesity issue.  My project conclusion was a guide to help schools implement "Health Report Cards" that included height, weight, BMI, blood pressure, body fat percentage and waist circumference with suggestion of adding 24 hour diet recall.  It also included sending a letter out to parents in advance allowing them to opt their child out of the Address Your Health screening.  See below.

After I graduated from Vanderbilt, passed my RD Exam and jumped into the world of medical nutrition therapy, guess what my first job was?  Lead Registered Dietitian at a private intensive outpatient treatment center for eating disorders.  My world changed drastically and became a revolving door of anorexia, bulimia, binge eating and addiction.  Patients of all ages cried in my office every single day over how much they hated their bodies, how evil food was, and how they struggled to have a positive personal relationship with themselves.  My view of calories and numbers on a scale swung to the other extreme.  Maybe we should just get rid of all nutrition labels and all scales?

Currently, I treat various different people. I specialize in eating disorders but I also see kids, adults, issues of weight loss, chronic disease management, etc.  I have been in both camps and have felt both sides of the argument.  The bottom line is that health is a major problem with our youth.  The question is, what do we do about it, and who is primarily responsible to do something about it?

Here is my current stance.  It is the parent or guardian's responsibility to ensure that their children are as healthy as possible - in physical health and emotional health.  There are some great parents out there, there are some not-so-great parents out there.  There are also some great parents who struggle with certain aspects of life themselves; for example parents with their own eating issues.  The primary responsibility lies with the parents.

However, educators, administrators, health care providers, coaches and other adults also have a responsibility to demonstrate what a healthy life looks like.  I think it is absolutely ridiculous and hypocritical to be measuring children at school for health data and then offering soda and fried chicken nuggets to them for a meal at lunchtime.  French fries and ketchup are not vegetables.  Schools should be embarrassed if that is the case.  That sends a very confusing message to the child and the parents.

So here is my solution.  If you, your school, your district, your community, truly care and want to get involved in the youth health crisis on a personal or a school level, here is what you need to do.

• As a school, send a letter to the parents.  State the the concern regarding the current youth health crisis and encourage them to visit their doctor or a dietitian to learn their child's trending height, weight, BMI as related to age, and waist circumference.  Let them know in the letter that your school nurse and school psychologist are available for any advice or questions.  And lastly, find a local registered dietitian nutritionist in your area and ask if they wouldn't mind being a resource for your students and parents.  And get the junk food out of your school, period.

• As a school employee, lead by example.  Do not reward children in class with candy or any food.  Do not eat the unhealthy options in the lunch line.  Do not use the soda vending machines.  Let your students see you being healthy and making positive changes.

• As a parent, lead by example.  Stock healthy foods at home.  Do not reward or punish with food.  Do not eat and drink junk food at home.  If you have your own issues with food, let your children see you work towards getting help and changing things for the better.  Do not talk about your body in a negative way.  Do not talk about their bodies in a negative way.  Be open to questions from your kids about anything.  

• As a health care provider, ask the child what they eat in a typical day - yes, ask about nutrition always.  Monitor health data, but never react to it or comment about it in front of the child.  It is typically a comment from a health care provider, said hastily and without support, that will give children the idea that they are overweight, obese, unhealthy, or not good enough.  Please watch your words.

As a registered dietitian nutritionist I would be happy to talk about this topic anytime.  I'll even let you read my "Address Your Health" proposal from grad school.  I will connect you with a registered dietitian nutritionist in your area for a reference.  The road to cleaning up this mess is not easy, but we have to start by taking individual responsibility first, and then we can help others.  The old airplane oxygen mask rule right?

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Influence of the Media

I cannot tell you how often young men and women sit in my office and tell me how hard it is to accept the goals and direction that I am giving them towards health, when they have to see and hear completely opposite information on TV, in magazines, on the radio, everywhere.

The influence that the media has over our minds is incredible, and lately very dangerous. The average American watches about 4 hours of TV per day (about 28 hours per week or a nonstop 2 months per year) compared to the average 3.5 minutes parents spend in meaningful conversation with their child. Wait, what?! Let me repeat that:

The average time an American watches TV per DAY: 4 HOURS

The average time an American parent spends in
meaningful conversation with their child per WEEK: 3.5 MINUTES.

Wow. We have some work to do.

We are subjected to a lot of media including television, magazines, internet and radio. There are shows about people who are too skinny, too fat, addicted, wanna-be models, wanna-be body builders, etc. And when those shows cut to commercial we see ads for diet pills (you know how I feel about those), diet food, makeup, clothes, hair, exercise equipment, and on and on and on…

The funny thing is, that no matter how smart you think you are, how confident, how “above others influences”, there are things in the media that will actually make you think twice about something you already know. The way information is presented, with tiny bits of science blown so out of proportion it’s insane, can actually get your brain thinking it’s true. How many people have heard of “The Blood Type Diet” or “The Lemonade Cleanse” or “Acai Berry” juice, pills, etc. I have been asked about all of these and many more by people who are in the health and fitness field and by those who aren’t. My point is that its very hard to sift through all this information when we don’t know who or what is actually credible. More on that topic in another post.

What concerns me is the youth, whose minds are still very impressionable and quick to jump to conclusions about themselves and their own bodies, which in turn severely impacts self-esteem and confidence. Let me show you what I mean:

The Dove Campaign is absolutely fantastic and I applaud Dove for stepping up and taking on the responsibility of showing young girls positive role models. The statistics of dieting and eating disorders among young girls is horrific and it gives me goosebumps just thinking about how staggering the numbers are. As adults, we all have a responsibility to set an example for our children, friends, peers, acquaintances and yes, even strangers. Accepting and loving yourself just the way you are can sometimes seem hard to do, but think about why its hard. Is it because you don’t look like the lingerie model on the billboard? Well if you watched that video you should know that model doesn’t look like that either.

God created each and every one of us the way we are for a specific reason. We are all not meant to look the same! Now, if you’ve not treated your body well, and it has morphed into something you don’t recognize, then you can work to get back the body God intended for you (my friend Paula calls it her “inheritance weight”). Being happy and healthy is what matters, not your pant size or a number on the scale.

Take today to walk with your head held high, and a smile on your face. The way you carry yourself on a daily basis has more influence over someone’s impression of you than the way you look. No matter what you might think. Do this in your own life and it may rub off on a child or a teenager you didn’t know was watching.

Blessings,

Ashley

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