Comment on FR Doc # 2012-28361

Please include the following text as an example related to health-contingent wellness plans. This will ensure a health-contingent wellness program is reasonably designed to improve health, without being discriminatory. “If a body fat percentage test administered by a fitness professional is less than or equal to the benchmark body-fat percentage for a person’s age, results will supercede a BMI measurement, since a measure of body fat percentage is a more accurate gauge of health than BMI. “ Background: Body fat percentage measures the actual composition of an individual’s muscle and fat, and is a more predictive metric of health than BMI. Regular exercise is encouraged to promote health by building muscle and reducing body fat. Muscle by volume, weighs more than fat. BMI is only a ratio of height to weight. BMI results are misleading as they are not mutually exclusive. Outliers along a bell curve of BMI results representing extremely healthy, fit people with BMI metrics above the benchmark. These outliers include fitness professionals and personal trainers employed to improve employee wellness. Reliance on BMI carries an unintended risk of mislabeling healthy individuals who have a greater portion of muscle. Their BMI is higher due to 1) greater muscle mass, and 2) muscle of the same mass weighing more than fat. As many individuals in this outlier group include certified fitness professionals, it is prudent to design a health-based incentive program so it does not punish some of the healthiest people at an expense of ease or insufficient foresight. This will encourage better health practices and outcomes by advocating body fat percentage as a health based metric in examples and references in place of BMI. For a guide to body-fat percentage recommendations, please refer to the ACSM Guidelines for Exercise Testing and Prescription.