Nanny State or sensible precautions - measuring children's BMI

[thumbwitch]

Thanks to another thread linking to the toxic rag, I found this article by some one who doesn't want to have her DD weighed and measured in the National Child Measurement Programme.

Whilst I sympathise with her feelings re. her own DDs, and heartily condemn the use of BMI (a far too loose measure of anything) for small children, I do think her attitude is a bit small-minded. For once I agree with some of the readers' comments.

Why do so many of the writers in this rag, and others, seem to feel that they are representative of the population as a whole? ANd that if they know all there is to know about health and future health predictions, that most other parents will too? It's almost as if they don't believe in other demographic groups!

ANyway - just throwing it into the arena..

I agree with the woman who wrote the article. If you look at the best rated comments, you see that the Mail readers also agree with her.

As she says it was introduced in the last five years by the socialists. We hadn't had the need for it before. She rightly says
"In a stroke of genius, they scrapped the teaching of proper cookery lessons and sold off hundreds of school playing fields - and then started telling us that our children were eating too much junk and not getting enough exercise."

She says "A few years ago, if someone had suggested such a thing might happen in a British primary school, I'd have laughed like a drain at such a ridiculous notion."
and only last week we had a medical body calling for children to be removed from their parents if they didn't receive enough exercise and were obese and the parents didn't change their diet.

She is also right that this goes against the government campaign to stop girls trying to emulate skinny models.

I think if people are comfortable with the idea of eye tests at school, they should have no problem with children being weighed and measured. We wouldn't be upset and offended if school suggested our children might not be able to see, read or hear properly but BMI seems to get people up in arms.

Judgement has to be exercised. Children that are only mildly over/underweight should not be a cause for concern. Hoever, if a child is clearly badly overweight or underweight then the parents should be offered a referral to a dietician. Similarly if they can't see properly, an optician's appointment is on the cards. If handled sensitively it will not stigmatise children.

I declined consent for my DD. What I objected to with this "screening" tool was that it was stated as a research project, yet you had to opt out of it, not in to it as is the case with all the other research projects I have come across as a health professional. I then became very angry when the phone number given on the information sheet was incorrect, so it took me 2 hours to find the right person to inform that I wanted to opt out for my children.....grrrr

i gave my permission for my son to be weighed,...........and the cow of the nurse pointed out that he was underweight.

something we knew of, and with his medical history and something he is aware of.

i was under the impression that they wouldnt mention the weight to the children in any way, but apparently that only seemed to register with them if a child was on the plump side.

last summer my daughter asked to be weighed, as she thought being excluded would make her feel 'fat' in front of her friends

i would like this to be completely stopped and scrapped.

its a crap system.

May well be a socialist thing- weighing and measuring has been the norm in Swedish schools since at least the 1940s (though they don't actually have a socialist government atm). Otoh they do also have some of the world's healthiest children. But then they also have cookery lessons and plenty of space to play.

Was it New Labour who brought in the national curriculum thingy which signalled the end of Home Ec? I thought it was the Tories - I'm sure I remember it going before 1997...

The loss of PE is ridiculous though, and as for selling off playing fields, that is disgusting.

As I said, I sympathised with a lot of what the writer said (especially loss of Home Ec, PE and playing fields) but took strong issue with her concept that 99% of parents "know best" - they clearly don't of up to 1/4 of children in schools are overweight!

However, having a podgy tummy at that age (puppy fat) isn't really being overweight, I don't believe - it's natural and I'd rather see that than see them pulling their tummies in or thinking that they are fat.

Measurements should be done, if they need to be done, without comment. Just recorded in silence and the child sent on its way. I don't agree that it should be left up to the GP as there is often no need to take a child to the GP - so many children would never be checked at all. Can't see a problem with DC being measured for statistical purposes, nor for every parent to be sent a booklet on general health care/nutrition education - but don't like the condemnatory letters being sent out.

Children of the 80s and 90s, who may not have had decent Home Ec or nutritional education at school (or home) are now becoming parents themselves - how are they supposed to know about this stuff if no one tells them?

Even if they reversed the teaching policies now and brought back Home Ec, more PE and lots of outdoor space, there are still going to be another 2 generations of parents potentially lacking knowledge.

But my biggest issue with her piece is her assumption that everyone is the same as her. Annoys the tits off me, that does.

The selling off of school playing fields, and loss of practical cookery lessons was long before the labour government.

Sorry.

JulesJules, you're right, I wondered if anyone would notice

Apparently there are doubts about the accuracy of BMI as a measure of obesity
www.guardian.co.uk/lifeandstyle/2006/nov/28/healthandwellbeing.health1

The Daily Mail has an article showing the impact on young children whose parents received letters home as a result of the programme which was introduced in 2005

www.dailymail.co.uk/news/article-1295925/Parents-fury-healthy-classmates-branded-overweight-NHS-heal th-police.html

another example of strict guidelines, rules and regulations being applied without any flexibility or common sense

www.dailymail.co.uk/news/article-1292111/Grovelling-apology-NHS-bosses-11-year-old-food.html

I sometimes wonder why it's OK to weigh and measure children but not OK to check their hair for nits.

BOTH happened when I was at school (60s) [old gimmer]

True - but my point is that the nurse isn't allowed to check for nits. Personal contact, stigmatising the child blah de blah. I'm not seeing much difference in either practice.

Both are fine by me as long as the child isn't held up in front of it's peers as fat and or nit ridden.

Children being weighed is not necessarily the problem. It is the use of BMI that is.

BMI is a notoriously flawed measurement as it divides weight by the square of height. Now, I don't know about you, but I don't know many healthy humans who are two dimensional.

Also, when a measurement classifies a 6'3" heavily muscled military type as obese, surely that says more about the measurement than the man?

www.theregister.co.uk/2009/03/17/bmi_rubbish/

Oh that old 'the BMI is flawed' chestnut.... There's a range of normal, healthy BMI which reflects the vast majority of the population and which accounts for different frames. (Heavily muscled athletes account for less than 0.1% of the population). And being outside the normal range does not mean imminent death and disability. Like any test, it simply serves as a cue for the doctor to make further checks.

This is why children should not be sent home with 'it's too fat/thin and it's going to die of diabetes/malnutrition' letters if their BMI is outside the normal range. A more sensible next step would be to refer such children to their GP who could then use their professional judgement as to whether the child had a problem or not.

BMI is a very loose indicator. It does not measure fatness. The Waist:Hip ratio is a far better measure of healthy weight distribution in adults but wouldn't be much use in children.

BMI is used as a screening test because it is very simple and very cheap, which are key characteristics of screening tools. Not sure how it scores on the specificity tests (how many false positives and false negatives).

Playing fields and home economics were policies of previous governments (a long time ago) and checking height and weight as part of general health screening in schools has been around for many many years. The change is that an increasing number of children are now overweight. Now you could say who cares that is their look out, but given that we have a publicly funded health system it is a wider concern. There are a whole range of health issues involved with obesity, which lead to direct health costs, and also indirect costs for the wider economy (one of the reasons why the health service came into being was the very poor health of volunteers for the wars).

So childhood obesity is a very real concern, it is a very good indicator of adult obesity (to do with the habits formed in childhood) and much easier to resolve at an early age. But many people do not recognise that their children are overweight, many do not regularly visit their GPs, but most do go to school, so schools are usually chosen for population interventions (again because it is cheap and efficient, which as we are all paying for the health service is in our interests).

I titally agree with the woman who wrote the article.

I agreed for Dd1 one to have her BMI checked in school this years (y6, 11yo) because so many people ask me if "she is OK" as she is very very slim and it started playing on my mind that she might be underweight. It turns out she is (according to the BMI for children I did on internet with the weight nand measure Dd gave me)but at no time the people who actually did the BMI in school came back to me saying there was anything to do about it. To me it means that they are only concerned about overweight children rather than genuine concern about the health of a child IYSWIM. My 3 other DCS will not be taking part in the BMI check when it is their turn as I have absolutely no concern about their weight.

Being advised to have BMI done at your GP if you have got any concern about your child's weight yes. Routinely doing it in school whith no other purpose than pointing a finger at the "fat" ones absolutely NO!