{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T12:42:37Z","timestamp":1777898557169,"version":"3.51.4"},"reference-count":28,"publisher":"SAGE Publications","issue":"2_suppl","license":[{"start":{"date-parts":[[2017,11,1]],"date-time":"2017-11-01T00:00:00Z","timestamp":1509494400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Public Health Rep"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>The FitnessGram Healthy Fitness Zone continuum (HFZc) score reflects the relative difference of a person\u2019s body mass index (BMI) from the established FitnessGram standard. As such, it may provide added utility for public health programming and research on obesity among school-aged children and adolescents. We used the standard BMI Z (BMIz) score and the alternative HFZc score to describe changes in BMI of school-aged children and adolescents in Georgia over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We compiled 2012-2014 BMI data from the Georgia FitnessGram database. The sample included 162\u2009992 boys and 141\u2009711 girls enrolled in 239 schools from a large urban district in Georgia. We analyzed trends in BMIz and HFZc scores separately for normal-weight, overweight, and obese categories for school-aged children and adolescents using hierarchical linear models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>From 2012 to 2014, the BMIz score shifted favorably in up to 40.7% (2052\/5047) of normal-weight, 51.0% (758\/1485) of overweight, and 52.8% (5430\/10\u2009279) of obese students. We also found favorable shifts in HFZc score in up to 69.8% (105\u2009831\/151\u2009739) of normal-weight, 78.3% (3605\/4603) of overweight, and 80.8% (8305\/10\u2009279) of obese students.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Compared with the BMIz score, the HFZc score may be a better indicator of favorable changes in BMI over time among school-aged children and adolescents with different baseline BMI levels, making it potentially valuable for use in individualized assessments, school programs, obesity research, and public health curriculum and policy development.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0033354917719707","type":"journal-article","created":{"date-parts":[[2017,11,14]],"date-time":"2017-11-14T18:44:41Z","timestamp":1510685081000},"page":"57S-64S","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["The Healthy Fitness Zone Continuum Score as a Measure of Change in Body Mass Index of School-Aged Children and Adolescents, Georgia, 2012-2014"],"prefix":"10.1177","volume":"132","author":[{"given":"Pedro F.","family":"Saint-Maurice","sequence":"first","affiliation":[{"name":"School of Psychology, University of Minho, Braga, Portugal"},{"name":"Department of Kinesiology, Iowa State University, Ames, IA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory J.","family":"Welk","sequence":"additional","affiliation":[{"name":"Department of Kinesiology, Iowa State University, Ames, IA, 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