Body mass index (BMI) standards can be misleading for athletic students whose bodies are in excellent condition, but higher in muscle mass. One 11-year-old Naples, Florida girl learned this when her school sent home a letter warning her parents that she was in danger of becoming overweight; Lilly Grasso is a star volleyball player and has a healthy lifestyle. More on the letter, and her parents' reaction, from Today.com:
The letter claimed that Lilly's body mass index, or BMI, was 22 and she was at risk for being overweight. The 11-year-old star volleyball player carries 124 pounds on an athletic frame of 5'3" and eats healthy foods.
"It says that and tells you to go to their website and the at risk turns to Lilly is overweight," Grasso said on TODAY.
She believes her daughter is a healthy weight and the Florida Department of Public Health in Collier County made a mistake by sending what's known by some as a "fat letter" home with her daughter. She thinks that children might feel bad by being labeled as overweight or fat, even if they are healthy.
But, Deb Millsap, public information officer of the Collier County Health Department, and Joan Colfer, MD, MPH, director of the Florida Department of Public Health, Collier County told TODAY that while the letters are sent home with the students, they are in sealed envelopes addressed to the parents. Students can open the letters, but that means they are reading their parents mail.
The letter included BMI—which uses height and weight to determine if someone is within a healthy range—and information on how students' vision and hearing are and if they are at risk for scoliosis. The data comes from a regular screening process that occurs when students in are kindergarten, first, third, and sixth grades. Florida is one of 21 states that have laws requiring BMI screenings. Millsap said the health department is currently in the middle of screenings for this school year, but last year the department tested 13,454 children. About 25 percent had possible vision issues, less than 1 percent had possible hearing problems, 2 percent had scoliosis, and 43 percent had BMI issues, either above or below normal numbers. Parents can opt out of the screening for their children, but Millsap and Colfer said not many parents do.
"We do not want kids to have self-esteem issues," said Millsap. "Right on [the] letter it says sports may impact the results."
Athletic children and adults might have a higher BMI because they have more muscle mass. BMI provides a rubric for doctors to work with, but does not provide an entire picture of a person's health.
"Because of the obesity crisis, we have to have some tool. The CDC will say [BMI] is not perfect," Colfer told TODAY. "These are simply screen tests, it is not a diagnosis."
Image: Girls playing volleyball, via Shutterstock