Body mass index charts: Useful yet underused - 24/08/11

Doi : 10.1016/j.jpeds.2004.01.047

Eliana Miller Perrin, MD, MPH ^⁎ , Kori B. Flower, MD, MS, MPH, Alice S. Ammerman, DrPH, RD
From the Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, the Robert Wood Johnson Clinical Scholars Program, and the Department of Nutrition and Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill Schools of Medicine and Public Health, Chapel Hill, North CarolinaUSA

Reprint requests: Eliana M. Perrin, MD, MPH, Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, CB #7220, 200 Mason Farm Rd, 5th Floor, Chapel Hill, NC 27599-7220.

See related article, p 461

Abstract

Objectives

To determine how frequently pediatricians use body mass index (BMI) and whether pediatricians are more likely to regard a child as “too fat” and manifest greater concern about health sequelae when presented with BMI versus height and weight charting.

Study design

North Carolina Pediatrics Society members completed a self-administered, quasi-experimental mail survey, using two different case vignette versions. They were given a clinical vignette but systematically received either the same hypothetical overweight child's height and weight data, percentile, and charts (Ht and Wt Group) or her BMI, percentile, and chart (BMI Group). They rated levels of fatness and concern by using Likert scales and the frequency of use of methods to determine overweight.

Results

Adjusted response rate was 71% (N=356). The BMI Group rated the hypothetical child with a higher mean on a scale of fatness (P<.0001) and reported higher levels of concern about all consequences (all P values ≤.01) than those in the Ht and Wt Group. Only 11% of respondents reported “always,” and 31% reported “never,” using BMI.

Conclusions

BMI charting prompted greater recognition of a weight problem than height and weight charting, yet BMI is inconsistently used. Interventions to help pediatricians adopt this tool may be warranted.

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Abbreviations : AAP, BMI, BMI Group, CASRO, CDC, Ht and Wt Group, NCHS, NCPS, NHANES

Plan

Supplementary data associated with this article can be found at doi:10.1016/j.jpeds.2004.01.047.
Supported in part by the Robert Wood Johnson Foundation and in part by the Institute of Nutrition and Centers for Disease Control Grant H75/CCH420060-01, entitled “Nutrition and Physical Fitness Program,” and by a National Institutes of Health–funded K12 “UNC BIRCWH Career Development Program” that supports Dr Perrin's research (HD01441).
Eliana Miller Perrin and Kori B. Flower were both fellows in the Robert Wood Johnson Clinical Scholars Program during part of the completion of this project (Eliana Perrin is now an Assistant Professor in the Division of General Pediatrics and Adolescent Medicine).