Shape Up America! Newsletter
Assessing Obesity in Children
by Barbara J. Moore, PhD
In December 2007, the American Academy of
Pediatrics (AAP) published a series of
reports on the assessment,1
prevention3 of childhood obesity.
reports were the result of extensive
research and deliberations by an expert
committee of scientists and clinicians from
15 professional organizations including the
AAP and the American Medical Association, in
collaboration with the Health Resources and
Service Administration and the Centers for
Disease Control and Prevention (CDC).
Shape Up America! offers the first in a
series of articles summarizing the expert
The assessment report1 was based
300 studies published since 1995 and reviews
the issues relevant to identifying overweight
and obesity in children and adolescents.
There has been considerable confusion about
assessing weight status and whether the terms
"obese" or "overweight" should be used to
describe excess fat in children. The expert
committee states that primary care providers
should universally assess children for
obesity risk to improve early identification
of elevated body mass index (BMI), medical
risks, and unhealthy eating and physical
The committee makes the following
recommendations when assessing the weight of
- Because it correlates well
fat, BMI should be calculated and plotted on
growth charts at least
annually. (To reduce errors, the
calculation of BMI and plotting can be done
automatically on the Shape
Up America! or CDC
- Each year, height and
weight should be
accurately measured in metric units and BMI
calculated as weight in kilograms divided by
the square of height in meters.
height is squared, any errors in height will
be magnified. The expert committee prefers
measuring height in centimeters
since it offers greater precision. For those
unable to use metric units, BMI may be
calculated in pounds and inches using the
equation: wt/ht2 x 703.
- Height should be measured
in bare or
stocking feet with a wall-mounted height
stadiometer (not a platform scale with a
moveable rule on top), except in infants and
children who are unable to stand erect. These
children and infants under 2 years old should
lie supine (face up) and fully extended for
measurement of recumbent length, and 1.0 cm
should be subtracted from this value
BMI is calculated.
- Weight should be measured
in kilograms) with a calibrated balance-beam
scale, with the child in light clothing and bare
or stocking feet.
Below are the new terminology and definitions
of "overweight" and "obesity" recommended by
the expert committee:
|Age of child
||Definition of Overweight
||Definition of Obese
Children and adolescents
2 to 18 years old
BMI ≥85th percentile but <95th
BMI<30 kg/m2 (whichever is smaller).
BMI ≥95th percentile for BMI by age and sex
or >30 kg/m2 (whichever is smaller).
"At risk for overweight" should be replaced
with the term "overweight" as defined here.
The former definition of "overweight" should
be replaced with the term "obese" as defined
Children 2 years old or younger
Weight-for-recumbent length percentiles
should be used to evaluate weight relative to
linear growth. (See CDC
Children whose age- and sex-specific
weight-for-length is ≥95th percentile are
The term "obese" should not be used in
children this young.
Recumbent length is measured in this age
group and considered relative to the child's
weight and age.
Table prepared by Shape Up America! based on
information from reference 1.
Consideration of Possible
The expert committee concluded there is no
direct evidence of harm resulting from
screening for childhood overweight and
obesity.1 Although many studies have
demonstrated an array of negative social and
psychological consequences of obesity, the
committee concluded that screening would not
trigger or amplify any of these. The
committee acknowledged that the US Preventive
Services Task Force reviewed this issue in
2005 and described the level of evidence
about possible harm as
People seeking details and protocols for the
accurate measurement of height (or stature),
weight and recumbent length should consult
Barbara J. Moore, PhD, is President and
CEO of Shape Up America!
Push-Ups: A Great Exercise for Busy People
by Shelly McClellan, DPT
As a physical therapist, I am often
confronted by people with questions on how to
tone certain parts of the body. Isolated
muscle strengthening is often required to
restore balance and function in the case of
injury. To accommodate busy people,
and make the most of their time and efforts,
I like to take a broader approach and
prescribe exercises with multiple benefits.
The push up is a great exercise to do if you
are healthy and want to strengthen your upper
body or tone and improve its appearance. It
requires no equipment, very little time and,
if done consistently, will yield excellent
There are many ways to complete a push-up.
Each way emphasizes a different part of the
body. We will start easy and finish with the
#1 Plank Position
Description: Prone (face down), arms
straight, with hands contacting the floor
directly beneath the shoulders, while toes or
knees touch the floor. Hold it for as long as
you can without losing your form. (Also see
Do's and Don'ts below.)
#2 Partial Push-Up
Description: In plank position, with knees
and hands on the ground, slowly move your
whole body toward the floor and slowly return
to the original position. Hold it 2 seconds
at the bottom of the motion. (Also see Do's
and Don'ts below.)
#3 Full Push-Up
Description: In the full plank
toes and hands on the ground, slowly move
your whole body toward the floor and then
slowly return to the original position. Hold
it 2 seconds at the bottom of the motion.
(Also see Do's and Don'ts below.)
For all push-ups:
Do keep your ears parallel to your
Keep your abdominal muscles tight and your
Don't let your back sag.
Don't let your head hang forward.
These variations work your abdominal muscles
and the muscles of your shoulder girdle and
arms effectively and efficiently. To increase
the work load on your triceps (the muscle in
your upper arm that we focused on in the
issues of the
newsletter), you can vary the
position of your hands. Moving your hands
further apart makes the exercise harder. Be
sure to maintain good form at all times.
Shelley McClellan, DPT, is a physical
therapist with Great Northern Physical
Therapy in Bozeman, MT.
healthfinder.gov Wants Your Help
healthfinder.gov has a new look and new
features and the creators of the Web site
would like to know what you think.
healthfinder.gov, a consumer health
information Web site sponsored by the Office
of Disease Prevention and Health Promotion of
the US Department of Health and Human
Services, now gives consumers even more news,
tips and tools to stay healthy.
The new and easy-to-use features include:
Guide to Healthy Living— Discover
the top 5 things you can do to stay healthy,
learn why it's important and how to get
out which important
screening tests you need this year, plus get
other health recommendations based on your
age and sex.
Health Tools— Get menu and
activity planners, health calculators and
online check-ups, and take a quiz to learn
about your health and lifestyle.
Give your feedback on the new Web
by clicking on the feedback icon.
Menus for Weight Loss and Healthy Eating
Shape Up America! offers these simple,
calorie and 2000
calorie menus to help
you eat healthfully while controlling your
calories. If you have any suggestions or
comments, feel free to e-mail us at
The first step in losing weight is to
be ready and willing to do what it takes to
lose weight safely and healthfully. Makaila
realizes that despite the challenges and
hurtful "fat" talk that she endures, she is
ready to do something about it. We wish her
continued success in her weight loss efforts.
I'm 17 years old and I weigh about 220
pounds. Two weeks ago I was about 10 pounds
heavier. I do not look like I weigh that much
but I really do and at times I'm very
uncomfortable with myself. All my friends are
really skinny and they always talk about
their weight and how "fat" they are, which
really just makes me feel even worse about
myself because I outweigh some of them by
almost 100 lbs. But I hold my head high and
keep going because even though almost
everyone in my family is overweight and I
really love food, I am going to lose weight!!!
Shape Up America! wants to hear about
you would like to share your personal
success story and be an inspiration to others
who desire to lose weight, simply use our story
submission system on the SUA Web site.
Recipe of the Month
Beans give this tasty and filling recipe a high fiber boost.
Three Bean Chili
Makes 8 servings
1 Tbsp. olive oil
1 cup onion, peeled and finely chopped
1 cup carrot, peeled and chopped
1 cup red pepper, stems and seeds
1 cup green pepper, stems and seeds
3 cloves garlic, finely chopped
1 Tbsp. chili powder
1 tsp. ground cumin
3 cups chopped fresh tomato, or 1 (28
oz.) can plum tomatoes with juice
1 (16 oz.) can white beans (such as
cannellini), rinsed and drained
1 (16 oz.) can black beans, rinsed and
1 (16 oz.) can red kidney beans, rinsed
Salt and freshly ground pepper to taste
1 cup shredded lettuce
1 cup nonfat yogurt
- Heat oil in large heavy saucepan or
Dutch oven over medium heat. Add onion, and
sauté for 3-4 minutes. Add carrots, peppers
and garlic and sauté until very soft and
almost golden, about 10 minutes.
- Add chili powder and cumin, and stir
while cooking for 2 minutes to release the
aromas from the spices.
- Add tomato and beans. Season with salt
and pepper. Bring to a boil and cook,
uncovered, over low heat about 45 minutes,
- Ladle into bowls and garnish with
shredded lettuce and yogurt.
Nutritional analysis per serving: 188
calories, 3 gram total fat, 0 grams saturated
fat, 0 grams trans fat, 35 grams
carbohydrate, 10 grams protein, 11 grams
dietary fiber, 585 milligrams sodium
Source: Shape Up