The Boy Scouts of America are at it again. Now, the organization has mandated that no child or adult, with a BMI of 40 or above, could be accepted in the annual Jamboree that took place July 15-24 in West Virginia. "This policy is not meant to keep anyone out at all, and it's just to make sure that they're safe," offers Deron Smith, director of public relations for the Boy Scouts of America. Really?
Although the Jamboree went on, low BMIs and all, many organizations such as ANAD, BEDA and the National Association to Advance Fat Acceptance, publicly issued statements demanding the Boy Scouts reconsider this discriminatory practice. Attempts were made to educate the group that the BMI threshold, set of 40, is not an accurate indicator of either good health or an ability to walk up a hill or take a hike.
Dr. Jennifer Shu, a pediatrician in Atlanta and CNN's Living Well expert, said she found the restrictions on children with a BMI of over 40 to be somewhat discriminatory.
"Any organization can make their own rules, but as a pediatrician I feel like we should be promoting physical activity for everybody, be as inclusive as possible, and only exclude from activity if there's a physical threat to their health," she said.
On the other hand, she noted that in some summer programs there are physical activities involving equipment that has a weight or size limit for safety reasons. That should be a restrictive factor for those particular activities, she said, because of the danger to a participant who doesn't meet the requirements.
The concept of BMI was initially formulated in 1830 by a Belgian mathematician, Lambert Adolphe Quetelet, who sought to conceptualize the "average man"…of 1830. Quetelet was not a physician and had no medical background. His calculations were never meant to be used as a baseline for what is and is not considered "normal" or "healthy" some 183 years later.
A research team from the University of Michigan and Saginaw Valley State University measured the BMI in 400 college students finding that in most cases, BMI did not accurately reflect his or her body fat. The study cited a previous study of NFL players which found that 60% were considered "obese".
Indeed, studies have shown that one out of six children who had BMIs in the normal range "had an unhealthy level of body fat," said Dr. Kenneth Ellis, a Baylor College of Medicine professor of pediatrics who studies growth and body composition at the USDA/ARS Children's Nutrition Research Center in Houston. "And one out of four with a BMI in the at-risk-to-obese range had a body-fat level that was normal."
Dr. Ellis also notes that certain assumptions made about BMI in children are fundamentally wrong. One assumption is that individuals who have a BMI within the normal range have an average amount of body fat. The other is that every ounce of body weight over the standard weight for height is fat.
These assumptions generate the most classification errors for children with BMI values in the gray area between normal weight and overweight. The study found that body fat in these children varied from 10 to 40 percent. Males with body-fat levels over 25 percent and females with levels over 30 percent are generally considered obese.
These studies show that there is the risk of mislabeling 25 percent of high-BMI children as at-risk or overweight, despite their normal body-fat percentage. "Children are very sensitive to labeling," Ellis said. High levels of physical activity, early maturation, genetics and ethnicity can all contribute to a child having a high BMI but a healthy amount of body fat. "We find amazing variations in body composition and percent body fat in different ethnic groups in this country and among citizens of different countries," Ellis said. For example, at any given BMI value, African-American children have more bone and muscle mass and less body fat than their European-American counterparts.
"If the concern is that excess body fat in childhood increases the risk of chronic illness later in life, health professionals must consider ethnicity, maturation, diet and physical activity, in addition to gender and age, when evaluating a child's BMI," Ellis said.
If the Boy Scouts truly wanted to further their mission of helping kids live a "sustainable, healthy lifestyle" and promote outdoor activity and camaraderie, a more reasonable and useful approach would have been to require medical clearance for all prospective Jamboree participants, regardless of BMI, to simply confirm a participant's actual and complete health picture and their true ability to take part in the event. Hopefully, the young men participating in the Jamboree understand how hurtful and irresponsible this policy is, and learn to not stigmatize their peers based on meaningless numbers and arbitrary policies.