Only standing height and weight should be measured in school and other educational settings to calculate BMI given such concerns as measurement errors and privacy.

Two approaches to interpreting the results of the above three measures are recommended to determine whether individuals or populations are at risk of poor health outcomes. For BMI, the cut-points (cutoff scores) based on the 2000 Centers for Disease Control and Prevention (CDC) growth charts and percentiles should be applied for underweight, overweight, and obesity evaluations. Interim cut-points for waist circumference and skinfold measures should be set at levels analogous to those currently being applied by the CDC for BMI. This approach should be used until evidence becomes available to support establishing waist circumference and skinfold cut-points by associating those measures with cardiometabolic risk factors.

Body weight (mass) and body fat distribution are elements of body composition that have implications for health and fitness. No element on its own adequately and comprehensively describes an individual’s body composition, and each element has been linked with various health markers and outcomes in youth.

Measures of body composition have been used in the past as a component of fitness test batteries (see Table 2-6 in Chapter 2). The background paper for the Second International Consensus Symposium on Physical Activity, Fitness and Health in 1992 offered an outline of “components and factors of health-related fitness” (Bouchard and Shephard, 1994; Bouchard et al., 2007) in which body composition was included as a morphological component of health-related fitness. In a review of existing fitness tests, 10 of 15 physical fitness test batteries for children and adolescents included body composition as a component of health-related fitness (Artero et al., 2011; Castro-Piñero et al., 2010), but the supporting evidence for their inclusion was quite variable.

Body composition differs from the other fitness components reviewed in this report at various levels. First, there are different perspectives on whether body composition should be considered a component of fitness. The committee considered body composition to be a physiologic characteristic that affects an individual’s ability to carry out daily tasks with vigor and to be influenced by physical activity behavior. Second, body composition influences performance on many fitness tests and itself is also an indicator of health. The committee thus defined body composition operationally as a component of fitness, a marker of health, and a modifier of fitness,

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