83 FR 818 - CDC Sex-Specific Body Mass Index (BMI)-For-Age Growth Charts
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention Federal Register Volume 83, Issue 5 (January 8, 2018)
Centers for Disease Control and Prevention
Federal Register Volume 83, Issue 5 (January 8, 2018)
| Page Range | 818-818 | |
| FR Document | 2018-00060 |
[Federal Register Volume 83, Number 5 (Monday, January 8, 2018)] [Notices] [Page 818] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2018-00060] ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention [Docket No. CDC-2018-0001] CDC Sex-Specific Body Mass Index (BMI)-For-Age Growth Charts AGENCY: Centers for Disease Control and Prevention (CDC), Department of Health and Human Services (HHS). ACTION: Notice with comment period. ----------------------------------------------------------------------- SUMMARY: The National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention (CDC) in the Department of Health and Human Services (HHS) announces the opening of a docket to obtain public comment on the production of sex-specific body mass index (BMI)-for-age growth charts for children and adolescents aged 2-19 years specifically designed for tracking extremely high values of BMI. The 2000 CDC growth charts include sex-specific BMI-for-age percentile charts based on data representative of the United States (US) population from the National Health Examination Survey (NHES) and National Health and Nutrition Examination Survey (NHANES). In US children and adolescents, obesity is defined as at or above the sex-specific 95th percentile on the CDC BMI- for-age growth charts. Severe obesity is often defined as at or above 120% of the sex-specific 95th percentile on the CDC BMI-for-age growth charts. Currently, the highest percentile displayed is the 97th percentile. Therefore, it is difficult to assess changes in weight status in children with very high BMIs that exceed this level. The new charts will provide additional lines representing 120%, 130%, 140%, and 150% of the 95th percentile. The intent of these charts is to provide a mechanism for documenting BMI percentiles for children and adolescents with severe obesity in both clinical and research settings. DATES: Written comments must be received on or before March 9, 2018. ADDRESSES: You may submit comments, identified by Docket No. CDC-2018- 0001 by any of the following methods:Federal eRulemaking Portal: http://www.regulations.gov. Follow the instructions for submitting comments. Mail: Verita C. Buie, DrPH, Office of Planning, Budget, and Legislation, National Center for Health Statistics, Centers for Disease Control and Prevention, 3311 Toledo Road, MS-08, Hyattsville, MD 20782. Instructions: All submissions received must include the agency name and Docket Number. All relevant comments received will be posted without change to http://regulations.gov, including any personal information provided. For access to the docket to read background documents or comments received, go to http://www.regulations.gov. FOR FURTHER INFORMATION CONTACT: Cynthia Ogden, Ph.D., Division of Health and Nutrition Examination Survey, National Center for Health Statistics, 3311 Toledo Road, MS-P08, Hyattsville, MD 20782-2064, phone: (301) 458-4405. SUPPLEMENTARY INFORMATION: The National Center for Health Statistics (NCHS) is congressionally mandated by the National Health Survey Act of 1956 to monitor the health of the nation. The National Health and Nutrition Examination Survey (NHANES), part of NCHS, is a nationally representative health survey designed to assess the health and nutritional status of adults and children in the United States. The survey is unique in that it combines interviews with physical examinations and laboratory studies. NHANES data are used throughout Department of Health and Human Services (HHS) agencies in addition to public health researchers world-wide. NHANES data have been used to determine national obesity estimates, produce pediatric growth and BMI charts, and monitor prevalence of infectious diseases such as the human papillomavirus (HPV). Body mass index (BMI) is calculated as weight in kilograms divided by height in meters squared and is used in the diagnosis, clinical management, and estimation of population prevalence of obesity and severe obesity. Among adults, obesity is defined by an absolute BMI value (>=30). Among children, BMI varies with age as well as sex. Therefore, to classify obesity among children and adolescents aged 2-19 years, measurements are standardized by age and sex using BMI-for-age growth charts. The 2000 CDC growth charts include smoothed percentiles of BMI-for-age based on data representative of the US population. In the US, obesity is defined as at or above the sex-specific 95th percentile for BMI-for-age. However, categorizing severe obesity (defined in adults as BMI>=40) is problematic given specific measures are not available in standard CDC growth charts for values beyond the 97th percentile. Researchers have proposed using percent of the 95th percentile as a flexible, stable measure for extreme BMI values. Consequently, severe obesity in children is often defined as a BMI at or above 120% of the sex-specific 95th percentile of BMI-for-age. Prevalence of severe obesity has increased among children and adolescents and very high BMI has been shown to increase risk for obesity in adulthood in addition to adverse health outcomes such as diabetes, abnormal cholesterol levels, and high blood pressure and behavioral health and social victimization impacts. Recent research has focused on effective management and treatment of children and adolescents with severe obesity, but researchers and clinicians lack a tool to determine BMI percentiles for these individuals. Specialized growth charts with lines reflecting 120%, 130%, 140% and 150% will provide an improved tool for documenting BMI in the clinical and research settings. Please see the draft example chart for boys (Attachment 1) and girls (Attachment 2). Date: January 2, 2018. Lauren Hoffmann, Acting Executive Secretary, Centers for Disease Control and Prevention. [FR Doc. 2018-00060 Filed 1-5-18; 8:45 am] BILLING CODE 4163-18-P
![818 Federal Register / Vol. 83, No. 5 / Monday, January 8, 2018 / Notices
ESTIMATED ANNUALIZED BURDEN HOURS—Continued
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Number of
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Type of respondents Form name responses per
respondents response
respondent (in hours)
Field Test Respondents (Adults >18 Years) .. Field Test Survey ........................................... 500 1 45/60
Leroy A. Richardson, children and adolescents with severe height in meters squared and is used in
Chief, Information Collection Review Office, obesity in both clinical and research the diagnosis, clinical management, and
Office of Scientific Integrity, Office of the settings. estimation of population prevalence of
Associate Director for Science, Office of the obesity and severe obesity. Among
Director, Centers for Disease Control and DATES: Written comments must be
Prevention. received on or before March 9, 2018. adults, obesity is defined by an absolute
[FR Doc. 2018–00142 Filed 1–5–18; 8:45 am] ADDRESSES: You may submit comments, BMI value (≥30). Among children, BMI
identified by Docket No. CDC–2018– varies with age as well as sex. Therefore,
BILLING CODE 4163–18–P
0001 by any of the following methods: to classify obesity among children and
• Federal eRulemaking Portal: http:// adolescents aged 2–19 years,
DEPARTMENT OF HEALTH AND www.regulations.gov. Follow the measurements are standardized by age
HUMAN SERVICES instructions for submitting comments. and sex using BMI-for-age growth
• Mail: Verita C. Buie, DrPH, Office of charts. The 2000 CDC growth charts
Centers for Disease Control and Planning, Budget, and Legislation, include smoothed percentiles of BMI-
Prevention National Center for Health Statistics, for-age based on data representative of
[Docket No. CDC–2018–0001] Centers for Disease Control and the US population. In the US, obesity is
Prevention, 3311 Toledo Road, MS–08, defined as at or above the sex-specific
CDC Sex-Specific Body Mass Index Hyattsville, MD 20782. 95th percentile for BMI-for-age.
(BMI)-For-Age Growth Charts Instructions: All submissions received However, categorizing severe obesity
must include the agency name and (defined in adults as BMI≥40) is
AGENCY: Centers for Disease Control and Docket Number. All relevant comments
Prevention (CDC), Department of Health problematic given specific measures are
received will be posted without change not available in standard CDC growth
and Human Services (HHS). to http://regulations.gov, including any charts for values beyond the 97th
ACTION: Notice with comment period. personal information provided. For percentile. Researchers have proposed
SUMMARY: The National Center for access to the docket to read background using percent of the 95th percentile as
Health Statistics (NCHS), Centers for documents or comments received, go to a flexible, stable measure for extreme
Disease Control and Prevention (CDC) in http://www.regulations.gov. BMI values. Consequently, severe
the Department of Health and Human FOR FURTHER INFORMATION CONTACT: obesity in children is often defined as a
Services (HHS) announces the opening Cynthia Ogden, Ph.D., Division of BMI at or above 120% of the sex-
of a docket to obtain public comment on Health and Nutrition Examination specific 95th percentile of BMI-for-age.
the production of sex-specific body Survey, National Center for Health
Statistics, 3311 Toledo Road, MS–P08, Prevalence of severe obesity has
mass index (BMI)-for-age growth charts
Hyattsville, MD 20782–2064, phone: increased among children and
for children and adolescents aged 2–19
(301) 458–4405. adolescents and very high BMI has been
years specifically designed for tracking
shown to increase risk for obesity in
extremely high values of BMI. The 2000 SUPPLEMENTARY INFORMATION: The
CDC growth charts include sex-specific adulthood in addition to adverse health
National Center for Health Statistics
BMI-for-age percentile charts based on (NCHS) is congressionally mandated by outcomes such as diabetes, abnormal
data representative of the United States the National Health Survey Act of 1956 cholesterol levels, and high blood
(US) population from the National to monitor the health of the nation. The pressure and behavioral health and
Health Examination Survey (NHES) and National Health and Nutrition social victimization impacts. Recent
National Health and Nutrition Examination Survey (NHANES), part of research has focused on effective
Examination Survey (NHANES). In US NCHS, is a nationally representative management and treatment of children
children and adolescents, obesity is health survey designed to assess the and adolescents with severe obesity, but
defined as at or above the sex-specific health and nutritional status of adults researchers and clinicians lack a tool to
95th percentile on the CDC BMI-for-age and children in the United States. The determine BMI percentiles for these
growth charts. Severe obesity is often survey is unique in that it combines individuals. Specialized growth charts
defined as at or above 120% of the sex- interviews with physical examinations with lines reflecting 120%, 130%, 140%
specific 95th percentile on the CDC and laboratory studies. NHANES data and 150% will provide an improved
BMI–for-age growth charts. Currently, are used throughout Department of tool for documenting BMI in the clinical
the highest percentile displayed is the Health and Human Services (HHS) and research settings. Please see the
97th percentile. Therefore, it is difficult agencies in addition to public health draft example chart for boys
to assess changes in weight status in researchers world-wide. NHANES data
sradovich on DSK3GMQ082PROD with NOTICES
(Attachment 1) and girls (Attachment 2).
children with very high BMIs that have been used to determine national Date: January 2, 2018.
exceed this level. The new charts will obesity estimates, produce pediatric
provide additional lines representing Lauren Hoffmann,
growth and BMI charts, and monitor
120%, 130%, 140%, and 150% of the prevalence of infectious diseases such Acting Executive Secretary, Centers for
95th percentile. The intent of these as the human papillomavirus (HPV). Disease Control and Prevention.
charts is to provide a mechanism for Body mass index (BMI) is calculated [FR Doc. 2018–00060 Filed 1–5–18; 8:45 am]
documenting BMI percentiles for as weight in kilograms divided by BILLING CODE 4163–18–P
VerDate Sep<11>2014 16:29 Jan 05, 2018 Jkt 244001 PO 00000 Frm 00036 Fmt 4703 Sfmt 9990 E:\FR\FM\08JAN1.SGM 08JAN1](https://thefederalregister.org/doc/83_FR_823/page/1.svg)
Document Created: 2018-01-06 02:32:17
Document Modified: 2018-01-06 02:32:17
| Category | Regulatory Information | |
| Collection | Federal Register | |
| sudoc Class | AE 2.7: GS 4.107: AE 2.106: | |
| Publisher | Office of the Federal Register, National Archives and Records Administration | |
| Section | Notices | |
| Action | Notice with comment period. | |
| Dates | Written comments must be received on or before March 9, 2018. | |
| Contact | Cynthia Ogden, Ph.D., Division of Health and Nutrition Examination Survey, National Center for Health Statistics, 3311 Toledo Road, MS-P08, Hyattsville, MD 20782-2064, phone: (301) 458-4405. | |
| FR Citation | 83 FR 818 |
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