Monday, April 18, 2016

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.

Source : http://crave-health.blogspot.com/2014/11/BMIinschools.html