Yesterday, I read Ragen Chastain’s amazing post on the new policies implemented by the Boy Scouts of America regarding participation in events and BMI.  In order for any Boy Scout to participate in a “high adventure” activity which includes a duration of over 72 hours and being over 30 minutes drive from emergency medical services, his parents and doctors must fill out a group of forms including Part C which has a whole lot of questions about BMI.  In fact questions about height and weight are the first things listed on the form before listing any pre-existing conditions or other information about disease or wellness.  Any scout with a BMI over 40 will be forbidden from participating in these high adventure activities (including the Jamboree).  And according to the site:

The Jamboree Medical Staff will review all applicants with a BMI of 32.0–39.9 and consider jamboree participation based on  1) health history, 2) submitted health data, and 3) recommendation of the applicant’s personal health care provider. For applicants with a BMI >31.9, a recommendation of “no contraindications for participation” by the applicant’s personal health care provider does not necessarily guarantee full jamboree participation. The jamboree medical staff will have final determination of full jamboree participation.

The Boy Scouts of America (BSOA) site, lists these reasons for the new restrictions:

“Anyone who is obese and has multiple risk factors for cardiovascular/cardiopulmonary disease would be at much greater risk of an acute cardiovascular/cardiopulmonary event imposed on them by the environmental stresses of the Summit. Our goal is to prevent any serious health-related event from occurring, and ensuring that all of our participants and staff are “physically strong.”

And frankly, all of this sent me scrambling for my manuals and training information about exercise in children.  One question I had right away was, “Are they using data for all-cause mortality in adults and extrapolating that information for children?”  Because, the data I’ve reviewed indicate that mortality among exercising children and teens comes from different sources that that of adults.

According to the Youth Sports Safety Alliance, the number one cause of death among exercising young athletes is Sudden Cardiac Arrest (SCA).  During my fitness certification training, I learned that the number one cause for SCA is a heart defect called hypertrophic cardiomyopathy, a thickening of the heart muscle.  Hypertrophic cardiomyopathy and other heart conditions likely to lead to SCA are often virtually undetectable from a standard physical exam.  This is why many schools are starting to recommend and a few are beginning to require a EKG for participation in strenuous school sports.  When SCA occurs, death often follows.  Being close to a hospital only helps so much as mortality risk increases by 10 percent for every minute it takes to get to medical care.  This is why there is a greater focus on CPR and Automatic External Defibrillators for helping to protect student athletes these days.

I am not aware of any research indicating that SCA is more frequent among overweight or obese young athletes.  I am also unaware of any efforts on the part of the BSOA to ask that participants in high adventure activities be screened for hypertrophic cardiomyopathy or be given an EKG as part of the Part C form.  Now, I understand that an EKG can be expensive to administer and read, but if the concern is really about the safety of the participants, it would seem that this is a more important test than BMI.

Another important risk for kids and strenuous exercise is heat stroke.  And there is some research that indicates that heat illness is more frequent among overweight and obese football players than “normal weight” players.  But many experts stress that exertional heat illness is 100 percent preventable.  Most experts strongly recommend an acclimation process to help get student athletes ready for physical exertion.  The super punishing, first day of practice workouts in full pads and gear is now frowned upon.  I wonder if the Jamboree and other “high adventure” scouting activities really do enough to help scouts of all sizes acclimate to higher temperatures and altitudes or if they simply assume that as long as the kids are skinny, they will be safe.

Which makes me wonder.  Where is the data?  Show me the data that BMI has a serious impact on safety for children and youth who wish to participate in strenuous physical activity.  Do not simply show me studies from adults and extrapolate down to kids.  And if the health and safety of your scouts is of primary importance, why are you not requiring adequate screening for the leading cause of death among young exercisers?  Are you building adequate acclimation days to make the camp safe for participants?  Or again, are  you assuming skinny = safe and healthy?  And why are you making your most important event so strenuous that you have to worry so much about health and safety in the first place?

To borrow from a famous phrase from the film Jerry Maguire, “Show me the data!”

Love,

TFC

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