HOW TO ASSESS BODY MASS INDEX (BMI) FOR CHILDREN AND TEENS AGES 2 TO 20

A series of accurate weights and measurements of stature correctly plotted offer important information about a childs growth pattern. The Centers for Disease Control and Prevention (CDC) Growth Charts enable family physicians to compare growth in children and teens with a nationally representative reference based on children of all ages and racial or ethnic groups. This, in turn, enables growth to be monitored and potential health- or nutrition-related problems to be identified. CDC Growth Chart Training Modules are available at www.cdc.gov/nccdphp/dnpa/growthcharts/training/modules/modules.htm

To use the CDC growth charts, follow these 6 steps:

STEP 1. Obtain accurate weights and measurements. STEP 2. Use the appropriate growth charts based on the childs gender and age. STEP 3. Record data (parents stature as reported, patients DOB, todays date, childs age, and weight and stature immediately after measuring them). STEP 4. Calculate BMI using weight and stature measurements.

With a calculator, determine BMI using one of these calculations: BMI = Weight (kg) Stature (cm) Stature (cm) x 10,000 OR BMI = Weight (lb) Stature (in) Stature (in) x 703

Use the table below to convert the weight and stature measurements to the appropriate decimal value. Examples: 37 lbs. 4 oz. = 37.25 lbs. or 41 1/2 inches = 41.5 in. Decimal conversions to calculate BMI
Fraction 1/8 1/4 3/8 1/2 5/8 3/4 7/8 Ounces 2 4 6 8 10 12 14 Decimal .125 .25 .375 .5 .625 .75 .875

Enter BMI to one place after the decimal point (example, 15.204 = 15.2).
Adapted from Use and Interpretation of the CDC Growth Charts developed by the Centers for Disease Control and Prevention.

STEP 5. Plot the measurements recorded for the current visit on the appropriate growth chart.

Find the childs age on the horizontal axis. Use a straight edge or right-angle ruler to draw a vertical line up from that point. Find the appropriate measurement (weight, stature, or BMI) on the vertical axis. Use a ruler to draw a horizontal line across from that point until it intersects the vertical line. Make a small dot where the two lines intersect.

STEP 6. Interpret the plotted measurements. The curved lines on the growth chart show selected percentiles that indicate the rank of the childs measurement. For example, when the dot is plotted on the 95th percentile line for BMI-for-age, it means that only 5% of children of the same gender and age in the reference population have a higher BMI-for-age. Interpret the plotted measurements based on the percentile ranking and the percentile cutoff corresponding to the nutrition indicator shown in the table below.

Determine the percentile rank. Determine if the percentile rank suggests that the anthropometric index is indicative of nutritional risk based on the percentile cutoff value. Compare todays percentile rank with ranks from previous visits to identify any major shifts in the childs growth pattern. If the percentile rank indicates a nutrition-related health concern, additional monitoring and assessment are recommended. BMI-for-Age Percentile Cutoff Value <5th 5th to <85th > 85th to < 95th > 95th Nutritional Status Indicator Underweight Normal At risk of overweight Overweight

Visit the CDC website for more information at www.cdc.gov/nccdphp/dnpa/bmi/bmi-for-age.htm

Supported by a grant from McNeil Nutritionals, LLC, a Johnson & Johnson company, maker of SPLENDA Brand Products. 2005 American Academy of Family Physicians