818 Federal Register / Vol. 83, No. 5 / Monday, January 8, 2018 / Notices 

ESTIMATED ANNUALIZED BURDEN HOURS—Continued 

Type of respondents Form name Number of 

respondents 

Number of 

responses per 

respondent 

Average 

burden per 

response 

(in hours) 

Field Test Respondents (Adults >18 Years) .. Field Test Survey ........................................... 500 1 45/60 

Leroy A. Richardson, 

Chief, Information Collection Review Office, 

Office of Scientific Integrity, Office of the 

Associate Director for Science, Office of the 

Director, Centers for Disease Control and 

Prevention. 

[FR Doc. 2018–00142 Filed 1–5–18; 8:45 am] 

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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 sexspecific 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 BMIfor-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 sexspecific 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] 

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