In an unusual move to address increasing obesity in children, Arkansas has begun mailing health reports to families of all its 450,000 public school children, informing parents of their children's weights and offering lifestyle tips.
The state is the first in the country to require such annual reports. Its survey represents the largest body-weight assessment of American children and adolescents.
The first year's measurements, conducted for the 2003-04 school year, suggest that American children might be heavier than health experts believed, according to a report released Thursday at an obesity conference in Virginia convened by Time magazine and ABC News.
The Arkansas Center for Health Improvement, which is responsible for analyzing the weight data, found that 40% of Arkansas' children are either overweight or at risk of becoming so -- 10% more than the federal government had estimated for 2001 for this region.
"I think the alarm bell should be sounded that this epidemic may be advancing much more quickly than previously predicted," said Dr. Joe Thompson, a University of Arkansas pediatrician and director of the Arkansas Center for Health Improvement.
The schools measured the children's height and weight in private with their faces away from the scales, then calculated the students' body mass index, or BMI. BMI is a person's weight in pounds multiplied by 703, divided by the square of their height in inches.
So far, researchers have analyzed BMI measurements on 276,783 students, more than half of Arkansas' public school students.
Nearly 90% of the schools have reported their data and several thousand letters have been sent. The remainder of the 450,000 letters will be mailed during June and July.
The survey found that 22% of children were overweight, 18% were at risk of becoming overweight, 58% fell in the normal range and 2% were underweight.
Letters for children in the overweight or at-risk categories encourage parents to meet with a pediatrician, suggest healthier snacks such as fruits and vegetables, limiting sodas, restricting television and computer time, and increasing family exercise time.
But some experts worried that more detailed advice than this was needed if the letters were to be of use.
"It's just a bit general for my tastes," said Pat Crawford, co-director of the Center for Weight and Health at UC Berkeley. "I think parents need very explicit information on what to do and what not to do."
Crawford said she worried that some parents could hurt the situation by putting their children on stringent diets or seeking out dietary supplements.
The individualized health report is one of several anti-obesity moves that the Arkansas Legislature mandated in 2003.
The state has also banned vending machines from elementary schools, required reports on competitive food and beverage sales in schools, set up school nutrition and exercise committees and established a child health advisory committee.
Experts hope that in future years Arkansas could become a scientific testing ground for measures to prevent obesity in children. Among the items that should be tested is whether annual BMI report cards could foster a preoccupation with food and a greater risk of eating disorders, they said.
"I want to applaud Arkansas," said Dr. Carden Johnston, president of the American Academy of Pediatrics, in a news conference.
The academy recommends that doctors determine a child's BMI each year.
Reuters contributed to this report.
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A growing problem
Nearly one of every four public school students in Arkansas is overweight, according to a recent study of 276,783 students.
Weight classification of Arkansas students, kindergarten through grade 12: Normal 58% Overweight 22% At-risk 18% Underweight 2%
Source: State of Arkansas
Percentage overweight by grade K 16.1% 1 18.4 2 20.5 3 22.7 4 23.7 5 24.3 6 24.4 7 24.0 8 23.7 9 22.7 10 23.1 11 22.1 12 20.2
Associated Press / Los Angeles Times