Schools poised to adopt new body mass index policy, to trim kids
By Janet Hefler
Published: March 11, 2010
Starting with the 2010-2011 school year, some Island parents will receive reports not only about their children's grades, but also about their weight.
Click on photo to enlarge.The draft of a new Body Mass Index (BMI) policy for Martha's Vineyard Public Schools (MVPS) will undergo a third reading at the All-Island School Committee's meeting tonight, March 11, possibly followed by a vote for final approval.
Once adopted for Island schools, the BMI policy would require MVPS nurses to measure the height and weight of students in grades 1, 4, 7, and 10. Then a BMI number is calculated from a child's height and weight, using a standardized formula.
The BMI number is then used to find a corresponding BMI percentile, which is a measure of how a child's weight compares to that of other children of the same age and sex.
Why BMI?
The Massachusetts Public Health Council voted last April to approve new statewide regulations, to be phased in over 18 months. The regulations require public schools to regularly perform BMI screenings on all students and to provide the information to parents.
The newly enacted regulations were part of Governor Deval Patrick's Mass in Motion anti-obesity initiative launched last year to promote healthier eating and exercise habits.
When superintendent of schools James Weiss informed the AISC about the state's requirement for a BMI policy at a meeting last November, initial reactions were not favorable.
"This is another prime example of the state mandating another regulation with no funding, and it's an enormous amount of work," said Susan Mercier of Edgartown, who is the high school committee's chairman.
"It's opening a terrible can of worms," warned Priscilla Sylvia, a former Oak Bluffs teacher who serves on the Oak Bluffs School and high school committees. "Is the policy absolutely required?"
Mr. Weiss said that although there were no specific consequences for noncompliance yet, it is the law in the Commonwealth.
"I'm not comfortable with it at all," Ms. Sylvia said. "I see it as an invasion of parental responsibility."
School nurses provide the right touch
In addition to meetings about planning H1N1 flu inoculation clinics last fall, school nurses worked on drafting a BMI policy from the state regulation.
Mr. Weiss invited school nurses to attend the AISC's January 11 meeting to discuss the policy with school committee members when it was presented for a first reading. AISC chairman Daniel Cabot remarked later that he was impressed by the nurses' positive message, in both what they said at the meeting and in the written materials they prepared for parents, which explain the many factors involved in interpreting the BMI numbers.
The policy's second reading took place in individual Island school committee meetings in February.
In talking with school health personnel, several said they view the new BMI policy basically as an extension of screenings they've already been doing for years.
"What's new is that the state is now requiring that the schools do it," MVPS school physician Dr. Michael Goldfein said this week. "You know, the nurses have been weighing and measuring the kids forever. They do that on an annual basis. So the BMI screen is just a new twist."
Dr. Goldfein, who also is a practicing pediatrician, pointed out that the BMI screen is useful not only in determining which children are overweight, but also those who are underweight.
"It's going to be helpful, and it will hopefully help focus some attention on the importance of eating properly and eating healthy foods, so I'd like to think it will be very positive," he added.
In discussions about implementing the new policy, Edgartown School nurse Donna Joyce said she and other school nurses adopted the attitude, "Okay, let's look at this, and let's be positive about it. What do we really feel is the bottom line? And the bottom line is our children being healthy."
To dispel any fears about children being upset by the screening, Ms. Joyce explained, "We already do heights and weights on every child every year in the school in grades K through eight. They are not going to know their BMI."
She added that school nurses would complete the BMI calculations on a computer after heights and weights are measured, out of the children's presence.
"We're very sensitive to our children and their privacy, and we never put them in situations where they would be embarrassed or call any attention to issues like weight," Ms. Joyce said. "Really and truly, the nurses only have our children's best health in mind."
Screening results will be mailed to parents, along with information to help them understand what the numbers mean.
"We'll direct parents to their child's primary care physician," MVRHS school nurse Linda Leonard said. "This is not a diagnosis; this is a screening. That's a very important distinction to make. We'll also give parents a list of resources."
Both Dr. Goldfein and Ms. Leonard said it is unlikely the BMI report will contain any surprises for parents, especially those whose children regularly see a physician for checkups.
"It's information that parents probably already know about their children, but it's giving them the incentive to talk to their physicians about it," Ms. Leonard said. "It heightens their awareness."
A child whose BMI falls below the 5th percentile may be underweight, for example, while one whose BMI in the 85th percentile or above may be overweight or obese. However, a BMI calculation does not distinguish between muscle and fat, which means that a very athletic child may have a high BMI because of muscle, not because of being overweight.
Ms. Leonard said she plans to notate how many high school students who are athletic have BMI numbers in the false positive spectrum for being overweight.
"It will be interesting in a couple of years to look at that data," Ms. Leonard said. "I'm very sensitive to that issue and am going to incorporate that information in my letters to parents, too."
To begin implementing the new BMI policy, letters about it will be sent home this spring to parents of students entering grades 1, 4, 7, and 10 next September. For students in ungraded classrooms, screenings will be done by their seventh, tenth, thirteenth, and sixteenth birthdays.
Parents and legal guardians have the option to request in writing that their child not be screened.
Letters also will be sent to Island physicians and school personnel. Ms. Joyce said that school nurses would attend parent-teacher organization meetings to talk about the policy and answer questions.
Wholly healthful
"It's really about having our children healthy, that's all it's about," Ms. Joyce said. "Whatever ways we can be more active, and make better food choices; all of us can learn to look at our eating habits and lifestyles to be healthier."
State legislators also are thinking along those lines. Today, a school nutrition bill is slated for action in the state senate. The bill would require schools to offer healthier lunch and snack options, and to eliminate candy, soda and sports drinks from their vending machines.
In regard to nutrition at Island schools, Mr. Weiss said the high school, West Tisbury School, and Chilmark School contract cafeteria service from the Chartwells Division of Compass Group USA, which has a regional dietician that helps plan menus. Cafeteria managers do the same at the Edgartown, Oak Bluffs and Tisbury schools.
"Each school has a wellness policy that talks about what's served in the cafeteria, what's available for snacks, nutrition instruction, physical education; it's comprehensive," Mr. Weiss said.
In addition, each school has a wellness committee that includes an administrator, school staff such as a physical education teacher and/or a health teacher, a cafeteria staff member, and parents.
For example, as a result of Edgartown School's wellness policy, Ms. Joyce said only water is offered in vending machines.
"Most of the schools offer fruit bowls, which are free to the students, so they have that available every day, whether it's with a meal or for a snack," Ms. Joyce said. "I think we're doing a good job of exposing the kids to more and more things, and they are choosing to take fruit, which is great."
Ms. Joyce said in addition to measuring height and weight, school nurses currently do hearing and vision screenings, blood pressures, and postural screenings for students in grades 5-8.
High school students are screened for scoliosis in grade 9, and vision, hearing, height, and weight in grades 9-12 annually.
When asked if the new policy means a lot of extra work for school nurses, Ms. Joyce said they were told the state might eliminate other screenings to compensate for that.
"But most of us feel that the other screenings are so important, we would continue to do them," she said. "We'd fit them in somehow."
BMI data, without identifying specific students, will be submitted from schools annually to the Department of Public Health (DPH) to track trends in the weight of school-age children in Massachusetts. According to the DPH, recent data shows that more than one third of all middle school and high school students in the state are considered either overweight or obese.
Efforts to fight childhood obesity recently got a boost from First Lady Michelle Obama, who announced a goal to solve that problem within a generation. Ms. Obama launched a nationwide campaign, "Let's Move," on February 9, which features initiatives to help children be more active, eat better, and get healthy.
