Masker’s Mission: UNK graduate student challenges pediatric BMI assessments


UNK Communications

KEARNEY – When John Masker’s youngest brother, Jake, consistently found himself categorized as overweight during his youth due to his height and weight, it sparked a personal curiosity.

“Growing up, Jake was always taller and heavier than his classmates and categorized as obese,” Masker says of his brother. “Even though he was classified in that category, I never felt he was unhealthy or had health risks. I simply thought he was a bigger kid through his genetics.”

Motivated to explore whether other children faced similar misclassifications due to early maturation, Masker embarked on a research journey that would challenge conventional weight assessments for children.

Working under Kinesiology and Sport Sciences professor Kate Heelan, Masker’s research focused on pediatric obesity and the practice of screening and classifying weight status using age- and sex-specific body mass index (BMI) percentiles. His thesis studied adolescent growth spurts and showed that using BMI measurements for some children can be problematic due to their different rates of growth and maturation.

A one-size-fits-all approach doesn’t work, he discovered. Weight status assessments should be modified during the age range when maturational events occur.

“I was intrigued to see if there were more kids out there like Jake, who may have also been misclassified due to early maturation,” said Masker. “Kids who matured earlier than the average for their age and sex can be misclassified as overweight or obese according to our standard BMI calculations.”

Masker graduated from the University of Nebraska at Kearney in 2021 with a master’s degree in physical education after receiving his bachelor’s degree in exercise science in 2019. A Kearney native, he is the winner of the university’s 2022 Most Outstanding Thesis for Biology/Professional Science.

Since completing his thesis, Masker has ventured into a career in orthopedic sales and technology consulting, working for Arthrex in Omaha.

Specializing in products and implants for hand, wrist, foot and ankle injuries, including major long bone fractures, Masker credits his academic background in kinesiology and research at UNK for his early career success.

“Completing a thesis prepared me to be well versed in today’s orthopedic journals and better understand anatomy, physiology and pathology that relate to current surgical techniques.”

What are the qualities of a good student researcher?
You need to be a lifelong learner at your core. You always need to be open-minded and willing to adapt to your circumstances. There is not a cut-and-dry method for conducting any form of research. If something isn’t working well for you, be open to trying something else.

It is hard to define success as a researcher. I would say if you come to a conclusion that concretely answers your research question, whether it supports or denies it, that is a success.

What was your biggest strength as a researcher?
I was always willing to admit when I was at a roadblock. A huge part of conducting research is collaborating with your mentors and faculty. Multiple times, I needed guidance to move forward with my thesis.

At what stage of doing your research did you work the hardest?
The most difficult part was analyzing the longitudinal growth data Dr. Heelan acquired from 2006-20 through her BMI Report Card program. Specifically, utilizing Microsoft Excel and taking our growth data and converting that into growth velocities. We had height, weight and BMI values for hundreds of children. I had to figure out how much each kid had grown in height, weight and BMI from year to year (growth velocities). Once I had growth velocities figured out for each child, through a statistical analysis I had to estimate at what age each kid would be growing their fastest. This age at which each kid was growing the fastest then determined their maturation status, being early, average or late.

What stands out about your experience at UNK?
The biggest thing is the treatment of students. No matter your background or upbringing, you are treated equally and given the tools to succeed. The most enjoyable part about life as a graduate student at UNK is learning from some of the brightest minds in their field. I cannot stress how much I learned from all the Kinesiology and Sport Sciences faculty during my time as a graduate student.

How did you decide to enter your current profession?
My path in deciding on a career has not been the clearest. I always knew I wanted to help others. I was just not sure how. The more I learned about this industry and a technology consultant’s role, I felt this would be a great fit for me. As a technology consultant, I can provide insight into the latest surgical techniques and products developed by Arthrex, which will provide greater outcomes for patients.

What are your career goals?
A big goal of mine is to acquire a managerial position within our agency. I want to become a leader in the field and continue to fulfill Arthrex’s mission of “helping surgeons treat their patients better.”

Education: Bachelor of Science in exercise science, University of Nebraska at Kearney, 2019; Master of Arts in physical education, University of Nebraska at Kearney, 2021.
Current Employment: Orthopedic sales representative and technology consultant for Arthrex, Omaha.
Recognition: Winner of UNK’s 2022 Most Outstanding Thesis for Biology/Professional Science
Areas of Research/Specialization: Pediatric Obesity, Growth and Maturation
Thesis: “Growth, Maturation and Weight Status: Insights from a Longitudinal Cohort of Nebraska Youth.” Pediatric obesity continues to be a major public health concern in the United States, with well-known short-term and long-term consequences. In efforts to combat pediatric obesity and identify children at high risk for potential health problems, physicians and health professionals widely practice screening and classifying weight status using age-and-sex-specific body mass index (BMI) percentiles. However, some studies suggest the use of BMI for establishing weight status in relation to health risks in youth is problematic, especially during the period of the adolescent growth spurt. … Children grow and mature at different rates, and while the overall effects of maturational adjustment are relatively small, it should be considered when assessing adolescents. Weight status assessments should be modified during the age range when maturational events occur.