A picture is worth a thousand words.
Before I post representative BMI growth charts which illustrate how well a Low Carb diet works with our children and teens, let’s look at what we are seeing on a daily basis. Most physicians are able to plot weight and height on growth charts. They have been doing so for decades. Although not perfect, Body Mass Index (BMI) has been used by the World Health Organization (WHO) as the standard for recording obesity statistics since the early 1980’s.
BMI = [ Weight in lbs / ((Height in inches) x (Height in inches)) ] x 703
BMI = [ Weight in kg / ((Height in meters) x (Height in meters)) ] x 703
As you can probably guess, prior to the advent of Electronic Medical Records, calculating and plotting the BMI for a child at every check-up visit had the potential to be time consuming for either the nurse, dietician or physician. One of the advantages of the widespread use of EMR’s in medical offices is the quick and easy BMI calculation.
Which BMI Growth Chart should we use? Most offices use the CDC Growth Chart from 2000 (either in print or digital form). In 2006, WHO released a new version of its own growth chart as well. In 2010, with the support of the American Academy of Pediatrics, the CDC now recommends that the WHO growth chart be used to measure height, weight and head circumference between ages 0 and 2. After age 2, it recommends using the CDC growth chart to measure height, weight and BMI.
Let’s look at some sample BMI growth charts. You might agree with me that in this age of childhood obesity the difference between the CDC and the WHO growth charts is probably minimal. Using and plotting BMI at every checkup visit, regardless of the growth chart used, is the most important step in tracking growth development.
First, here is a sample BMI growth chart for a 15 year old girl. Note the dots which represent the BMI measurement at each yearly checkup. Age is plotted along the x-axis and BMI is plotted on the y-axis. You can also see the lines which represent the 95th%, the 50th% (average), and the 5th% (as determined by the CDC in 2000). In other words, the BMI for this sample 15 year old girl has been tracking below “average” and above the 5th%. Most physicians would consider this completely normal:
Here is a corresponding “normal” growth chart for a sample 15 year old boy. He has been tracking slightly above “average”, but well below the 95th%:
Now let’s look at a sample BMI growth chart for a 13 year old girl who is overweight. Her BMI is above 34 – well above normal. Follow the dots and notice the increasing rate of BMI gain. The measurement tracks well above the 95th% and has been doing so since early elementary school. UNFORTUNATELY, THIS IS NOT AN UNCOMMON SCENARIO. Most pediatricians and family physicians are seeing this particular pattern on a regular basis:
Finally, let’s examine a sample “abnormal” growth chart for a 10 year old boy. Again, I see this pattern almost on a daily basis. Follow the dots. The rate of increase (the increasing slope of the line that would connect the dots) is very alarming!
Again, the above sample charts show BMI trajectory without any attempt on the part of the healthcare professional to institute a specific dietary plan of action.