Nearly 25 percent of children ages 2 through 5 are classified as obese or overweight. Is your childcare center taking measures to prevent overweight and obesity or is it adding to the problem? In fact, The Institute of Medicine has published Early Childhood Obesity Prevention Policies that are really important to read.
As a childcare provider, one of your responsibilities is to be aware of the issues that affect young children, including obesity. We interviewed two experts to learn more about overweight and obesity in children:
Dr. Joseph Risser, M.D., director of clinical research for Lindora Medical Clinics
Dr. Robert Ziltzer, M.D., weight management experts at the Scottsdale Weight Loss Center
OwnADaycare What is the difference between overweight and obese?
Dr. Risser: CDC and the American Academy of Pediatrics (AAP) recommend the use of Body Mass Index (BMI) to screen for overweight in children and teens aged 2 through 19 years. A BMI above 95 percentile is considered overweight. There is not a separate definition of obesity for children and teens nor is there a very specific definition.
Dr. Zilter: A child’s weight and height determines the body mass index. This number varies by age. If a child’s body mass index (BMI) is between the 85th and 95 percentile (%) for age, they are considered at risk for overweight. If her/his BMI is greater than the 95th percentile, he/she is considered obese. This greatly increases the chances of having diabetes, high blood pressure, high cholesterol, joint disorders, sleep apnea, and a host of other medical problems. We are now seeing adult diseases affecting children.
OwnADaycare: How can I tell if my child is overweight or obese?
Dr. Risser: Doctors use BMI based on age-matched norms. This excerpt is from the CDCs website (http://www.cdc.gov/nccdphp/dnpa/obesity/childhood/defining.htm )
“For children and adolescents (aged 2–19 years), the result is plotted on the CDC growth charts to determine the corresponding BMI-for-age percentile. Overweight is defined as a BMI at or above the 95th percentile for children of the same age and sex. This definition is based on the 2000 CDC Growth Charts for the United States.7 A child’s weight status is determined based on an age- and sex-specific percentile for BMI rather than by the BMI categories used for adults. Classifications of overweight for children and adolescents are age- and sex-specific because children’s body composition varies as they age and varies between boys and girls.”
Dr. Zilter: It is often difficult to tell by looking, and is best assessed by your pediatrician at regular checkups. Most children who appear “stocky” are either obese or at risk for overweight.
OwnADaycare: What is BMI?
Dr. Risser: BMI is a calculation used to determine whether one is overweight. It is based on height and weight but is the same for men and women. It does not take into account body fat. For these reasons, BMI is not always considered the best way to assess weight.
Dr. Zilter: BMI is the best measure of the health of an individual’s weight. It does not, however adjust for muscle mass. Body Mass Index is your weight divided by height, in metric units.
OwnADaycare: What is BMI percentile?
Dr. Risser: BMI percentile is based on the proportion (or percent) of children at a given age within the same range of BMI. A child at the 95th percentile means that only 5% of children of that age have a higher BMI than that child.
Dr. Zilter: BMI percentile adjusts your child’s BMI for age. A four year old, for example would be normal with a BMI of 17. An adult at this BMI would be underweight. That four year old would be obese at a BMI of 20, a normal weight for an 15 year old or adult.
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