BACKGROUND: School-based body mass index (BMI) measurement has attracted

BACKGROUND AND OBJECTIVE: School-based BMI measurement has attracted attention across the nation as a potential approach to address obesity among youth. However, little is known about its impact or effectiveness in changing obesity rates or related physical activity and dietary behaviors that influence obesity. This article describes current BMI-measurement programs and practices, research, and expert recommendations and provides guidance on implementing such an approach. METHODS:An extensive search for scientific articles, position statements, and current state legislation related to BMI-measurement programs was conducted. A literature and policy review was written and presented to a panel of experts. This panel, comprising experts in public health, education, school counseling, school medical care, and parenting, reviewed and provided expertise on this article. RESULTS:School-based BMI-measurement programs are conducted for surveillance or screening purposes. Thirteen states are implementing school-based BMI-measurement programs as required by legislation. Few studies exist that assess the utility of these programs in preventing increases in obesity or the effects these programs may have on weight-related knowledge, attitudes, and behaviors of youth and their families. Typically, expert organizations support schoolbased BMI surveillance; however, controversy exists over screening. BMI screening does not currently meet all of the American Academy of Pediatrics' criteria for determining whether screening for specific health conditions should be implemented in schools.CONCLUSION: Schools initiating BMI-measurement programs should adhere to safeguards to minimize potential harms and maximize benefits, establish a safe and supportive environment for students of all body sizes, and implement science-based strategies to promote physical activity and healthy eating. Pediatrics 2009;124:S89-S97

Study results add to the limited body of knowledge about stakeholder perceptions during early implementation of Canadian SNPs. Dietitians can foster communication, engagement, and education of stakeholders, which will increase the likelihood that students and their families will accept SNPs.

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Concerns regarding the quality of children's diets and rising rates of childhood obesity have received considerable attention in recent years. [1][2][3][4] As of 2004, about 1.1 million (18%) Canadian boys and girls aged 2 to 17 years old were overweight, and another half million (8%) were obese. 5 School-age children in Prince Edward Island (PEI) have the second highest rate of overweight (22%) in the country. 5 These trends signify an important public health issue, given that recent reports indicate that obesity in childhood and adolescence persists or tracks into adulthood 6,7 and is associated with chronic diseases and increased mortality. 8,9 Canadian studies indicate that children's diets are not meeting current dietary recommendations, with low intakes of Vegetables and Fruit, Milk and Alternatives and Grain Products. [10][11][12] Dietary surveys suggest that children in PEI have lower intakes of vegetables and fruit and higher intakes of low nutrient density foods (low nutrients relative to energy content, such as soft drinks or candy) 13 compared to Ontario children. 14 Since poor diet quality and inadequate physical activity have been identified as key determinants of the observed increase in childhood overweight and obesity, there is an urgent need to implement preventive policies and programs designed to improve diet and physical activity in Canadian children. 15,16 The school food environment is increasingly recognized as having a significant influence over children's eating behaviours because of the amount of time spent at school and the large percentage of food intake consumed while at school. 4,15 Some studies have demonstrated the effectiveness of policies in improving students' dietary intake by modifying the school food environment. [16][17][18][19][20][21][22] One Canadian study provided persuasive evidence, for the first time, that comprehensive health promotion and wellness programs can have benefits for students. 18,23 Students attending health-promoting schools in Nova Scotia were less likely to be obese, had healthier diets and were more physically active. The majority of Canadian provinces have indicated that they have adopted new nutrition