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1.
OBJECTIVE: To measure change in fruit and vegetable (F&V) consumption among elementary-school children after the introduction of a salad bar programme as a lunch menu option in the US Department of Agriculture's (USDA) reimbursable lunch programme in Los Angeles Unified School District (LAUSD). DESIGN: A cross-sectional sample of children was interviewed before and after a salad bar intervention (1998 and 2000, respectively) utilising a 24-hour food recall questionnaire. Frequencies of F&V consumption were calculated. SETTING: The evaluation took place in three LAUSD elementary schools participating in the salad bar programme and the USDA reimbursable lunch programme. SUBJECTS: Three hundred and thirty-seven children in 2nd-5th grade (7-11 years old). RESULTS: After the salad bar was introduced, there was a significant increase in frequency (2.97 to 4.09, P < 0.001) of F&V consumed among the children studied. The increase in frequency of F&V consumed was almost all due to an increase during lunch (84%). Mean energy, cholesterol, saturated fat and total fat intakes were significantly lower in the children after the salad bar was introduced in the schools compared with the intakes in the children before the salad bar was introduced.Conclusion: A salad bar as a lunch menu option in the USDA reimbursable lunch programme can significantly increase the frequency of F&V consumption by elementary-school children living in low-income households. 相似文献
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Mamabolo RL Alberts M Steyn NP Delemarre-van de Waal HA Levitt NS 《Public health nutrition》2005,8(5):501-508
OBJECTIVES: To determine the prevalence of stunting, wasting and overweight and their determinants in 3-year-old children in the Central Region of Limpopo Province, South Africa. DESIGN: Prospective cohort study. SETTING: Rural villages in the Central Region of the Limpopo Province, South Africa. SUBJECTS: One hundred and sixty-two children who were followed from birth were included in the study. Anthropometric measurements and sociodemographic characteristics of the children were recorded. RESULTS: Height-for-age Z-scores were low, with a high prevalence of stunting (48%). The children also exhibited a high prevalence of overweight (22%) and obesity (24%). Thirty-one (19%) children were both stunted and overweight. Gaining more weight within the first year of life increased the risk of being overweight at 3 years by 2.39 times (95% confidence interval (CI) 1.96-4.18) while having a greater length at 1 year was protective against stunting (odds ratio (OR) 0.41; 95% CI 0.17-0.97). Having a mother as a student increased the risk for stunting at 3 years by 18.21 times (95% CI 9.46-34.74) while having a working mother increased the risk for overweight by 17.87 times (95% CI 8.24-38.78). All these factors also appeared as risks or as being protective in children who were both overweight and stunted, as did living in a household having nine or more persons (OR 5.72; 95% CI 2.7-12.10). CONCLUSION: The results of this study highlight the importance of evaluating anthropometric status in terms of both stunting and overweight. Furthermore, it is important to realise the importance of normal length and weight being attained at 1 year of age, since these in turn predict nutritional status at 3 years of age. 相似文献
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OBJECTIVE: To define the prevalence of overweight and obesity among school-aged children resident in mountain areas, rural areas and urban areas.Design, setting and subjectsThe sample (n = 12 832; 50.7% boys) included 9- and 11-year-old children of the Veneto Region of north-east Italy. Overweight and obesity status were determined using the International Obesity Task Force cut-off points for body mass index. The prevalence of overweight and obese subjects was calculated with a confidence interval of 95%. The Mantel-Haenszel method was used to compare the combined prevalence of overweight and obesity among children resident in mountain areas, rural areas and urban areas. RESULTS: Among boys the prevalence of overweight was 21.06%, while obesity prevalence was 5.92%; among girls overweight prevalence was 21.30%, while obesity prevalence was 5.15%. The prevalence was higher among 11-year-old boys (odds ratio (OR) = 1.19; 95% confidence interval (CI): 1.06-1.33) and 9-year-old girls (OR = 1.13; 95% CI: 1.01-1.26). Children resident in rural areas presented a higher risk of overweight and obesity compared with children resident in mountain areas (Mantel-Haenszel OR = 1.27; 95% CI: 1.13-1.42; chi2 = 17.55; P < 0.0001) and in urban areas (Mantel-Haenszel OR = 1.18; 95% CI: 1.07-1.31; chi2 = 10.39; P < 0.001). CONCLUSIONS: A relevant prevalence of overweight and obesity was found; the excess weight concerns one child in four. There are differences linked to different geographical areas that must be further investigated. 相似文献
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OBJECTIVES: To assess the prevalence and identify the predictors of food insecurity among households in Los Angeles County with incomes below 300% of the federal poverty level. METHODS: The Six-Item Short Form of the US Department of Agriculture's Household Food Security Scale was used as part of a 1999 county-wide, population-based, telephone survey. RESULTS: The prevalence of food insecurity was 24.4% and was inversely associated with household income. Other independent predictors of food insecurity included the presence of children in the household (odds ratio (OR) 1.7, 95% confidence interval (CI) 1.2-2.3) and a history of homelessness in the past five years (OR 5.6, 95% CI 3.4-9.4). CONCLUSION: Food insecurity is a significant public health problem among low-income households in Los Angeles County. Food assistance programmes should focus efforts on households living in and near poverty, those with children, and those with a history of homelessness. 相似文献
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Type of kindergarten and other potential determinants of overweight in pre-school children 总被引：3，自引：0，他引：3
OBJECTIVE: The study aimed to assess the relationship of various types of kindergarten differing in length of care and food availability with the development of overweight in pre-school children. DESIGN, SETTING AND SUBJECTS: A cross-sectional study was carried out in 2002 in Stuttgart, Germany, as part of the school entrance examination. Height and weight of 2140 children (participation 70.2%) were measured and information on type of kindergarten and other potential determinants of overweight was collected by a parental questionnaire. Change in relative body mass index (BMI) position between the ages of 4 and 6 years was assessed using medical records. RESULTS: The prevalence of overweight or change in relative BMI position did not differ according to the type of kindergarten. For the prevalence of overweight in German children, adjusted odds ratios (OR) comparing institutions that open only in the morning with those opening in the morning and afternoon or for the full day were 0.86 (95% confidence interval (CI) 0.40, 1.83) and 0.63 (95% CI 0.25, 1.58), respectively. Parental BMI and duration of television watching were positively associated, and maternal educational status and duration of breast-feeding were negatively associated, with overweight and/or change in relative BMI position. The prevalence of overweight was substantially higher among non-German than among German children (adjusted OR 2.17 (95% CI 1.53, 3.07)). CONCLUSIONS: These data show no association between different types of kindergarten and the development of overweight in early childhood. Duration of television watching and breast-feeding, as well as the relatively high prevalence of overweight in ethnic minorities, deserve further attention. 相似文献
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OBJECTIVE: To determine the prevalence of overweight and obesity in British young people (4-18 years) in 1997. DESIGN: Cross-sectional analysis of the National Diet and Nutrition Survey of young people. SETTING: Great Britain. SUBJECTS: Nationally representative sample of 1836 young people (age 4-18 years). RESULTS: The prevalence of obesity based on body mass index (weight/height(2)) and the International Obesity Task Force cut-offs was 4.0%, with a further 15.4% identified as overweight. Asians were almost four times as likely to be obese as white subjects (13.6 vs. 3.5%, P<0.001). Among white subjects there was no significant difference in the prevalence of obesity between girls and boys, or with age. The risk of obesity was significantly higher in subjects from social classes IV and V than from social classes I-III (6.5 vs. 2.7%, P=0.003). Subjects living in Scotland and Wales were significantly more likely to be obese than those in England (7.6 and 6.5 vs. 2.9%, respectively, P<0.01). Multiple logistic regression showed that, among white subjects, those in social classes IV and V living in Wales and Scotland were three times more likely to be obese than the other children in the survey (odds ratio 3.3, 95% confidence interval 1.1-9.8). CONCLUSION: These data provide information on the national prevalence of overweight and obesity in Great Britain and baseline data from which to monitor future trends. This analysis provides important demographic information on those most at risk of obesity, which may be used to inform public health strategies to prevent obesity in young people. 相似文献
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AIM: To investigate the determinants of overweight and obesity among 10- to 15-year-old schoolchildren in a population in the transitional phase in the North West Province of South Africa.METHODS: A cross-sectional survey was used to investigate weight status (anthropometric indicators) and determinants of overweight/obesity including dietary intake, physical activity and socio-economic status. A single, random sample (n=1257), stratified for gender, type of school and ethnic group, was used. Data were collected on demographics, family circumstances, habitual physical activity, dietary intake and anthropometry to evaluate weight status and body fat content. One-way analysis of variance, the generalised linear models procedure of SAS and the Tukey post hoc honest significant difference test were used to analyse the data.RESULTS: Few children were overweight or obese (7.8%) according to International Obesity Task Force (IOTF) standards (body mass index (BMI)-for-age). These standards were compared with other accepted standard values. Both Cole's IOTF/BMI-for-age standard and the sum of skinfold thicknesses standard classified normal-weight status similarly at a level of 92% (P<0.01) and were found to be useful in determining overweight/obesity. The prevalence rate was higher in females and white children, and was more apparent in urban areas, smaller households and children of parents with low- or high-income occupations. Boys and pre-menarcheal girls had mean body fat percentage in the normal/optimal range, whereas that of post-menarcheal girls was moderately high. Few variables showed a significant association with high body fat percentage: in boys, only the number of members in the household and physical activity levels over the weekend; in girls, only age. The overweight/obese boys mostly lived in smaller households, and the overweight/obese post-menarcheal girls were most inactive on both weekdays and weekends, and more overweight with increasing age.CONCLUSION: Smaller households, inactivity and increasing age for girls were found to be determinants that influence the development of overweight/obesity, while female gender and age post-menarche were identified as determinants of higher body fat content. For overweight/obesity prevention, the focus should be on pre-menarcheal girls, aged 10-13 years, using these determinants to identify overweight/obesity risk. Preventive programmes should aim to increase the physical activity of children to improve their current and future weight status. 相似文献
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OBJECTIVES: To compare the prevalence of overweight and obesity among adolescents using international and ethnic-specific cut-off points and to examine patterns of physical activity and dietary behaviours. DESIGN: Cross-sectional analytical study. SETTING: Schools on Tongatapu, Vava'u and Hapa'ai islands in the Kingdom of Tonga. SUBJECTS: A total of 443 school students aged 11-16 years underwent anthropometric measures of height and weight and provided self-reported measures of physical activity and dietary behaviours.Results Mean body mass index (BMI) was higher among girls than boys (23.7 kg m(-2) vs. 21.8 kg m(-2) and tended to increase with age. A total of 36.0% of boys and 53.8% of girls were overweight or obese using the international cut-off points, whereas 25.0% of boys and 37.6% of girls were classified in this way using Polynesian-specific cut-off points. Tinned mutton or beef was the food that most participants (56.9%) reported eating once or more per day. Over half of the young people did not eat taro, fruit or vegetables at least once per day. Regular physical activity outside of school hours was reported by 20.7% of respondents, and 58.2% watched 1 h or more of television per day. Physical activity participation was the only behaviour independently associated with a lower risk of overweight or obesity.Conclusions Using Polynesian-specific cut-off points for overweight and obesity the prevalence of these conditions was still among the highest found in adolescents. The prevalence of physical inactivity and poor dietary habits indicate that risk factors for chronic disease are well established during adolescence in Tonga. 相似文献
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OBJECTIVE: A number of individual risk factors for childhood obesity have been identified, but only some of these are amenable to prevention. To assess the amount of cases in a general population attributable to these risk factors, adjusted population-attributable fractions were estimated. DESIGN: Cross-sectional study. SETTING: Obligatory school entry examination in 2001/2002 in six Bavarian communities (Germany). SUBJECTS: 5472 children at age 5-6 years. MEASURES: Anthropometric measures were ascertained by public health nurses, and measures concerning sociodemographics, lifestyle and child behaviour such as child's daily meal frequency were obtained with self-administered parental questionnaires. Obesity was defined according to sex- and age-specific body mass index cut-off points proposed by the International Obesity Task Force. Adjusted population-attributable fractions were calculated based on logistic regression. RESULTS: A combination of the risk factors low meal frequency, decreased physical activity, watching television >1 h day- 1, formula feeding and smoking in pregnancy accounted for 48.2% of obese children. This combination yielded a maximal achievable prevalence reduction of 1.5% for obesity (3.2% observed prevalence). CONCLUSIONS: A modification of five known risk factors for childhood overweight and obesity could reasonably lower obesity prevalences at school entry. These risk factors should be particularly considered in decision making on preventive measures. 相似文献
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OBJECTIVES: To determine whether weight problems in children (overweight, obesity and overweight or obesity) were related to deprivation indices when attributed only according to electoral ward of the school attended. To determine whether children with weight problems were more likely to be found in some wards rather than others, and to compare the distribution for boys and girls. DESIGN: Retrospective, cross-sectional, observational study. SETTING: One hundred and six primary schools from all parts of Liverpool city. SUBJECTS: Five cohorts of 9-10-year-old children between 1998 and 2003. Main outcome measures: Body mass index (BMI) for each child to estimate proportions overweight, obese and overweight or obese according to international criteria. RESULTS: Between January 1998 and March 2003, the heights and weights of 7902 boys and 7514 girls were measured and BMI calculated. The prevalence of boys and girls categorised as overweight or obese was very high (1620, 20.6% and 1909, 25.7%, respectively). Prevalence was not related to deprivation and varied between wards only for the girls; some wards had very different prevalence rates for boys and girls (Picton: 59 boys, 23.4%; 106 girls, 36.6%). The most deprived ward did not have a remarkable prevalence of overweight or obesity (Speke: 32 boys, 15.3%; 40 girls, 19.8%). CONCLUSIONS: Obesity is a major problem and requires urgent action but targeting intervention on the basis of administrative areas may be very wasteful. Different factors seem to lead to obesity in boys and girls, and attention should be paid to the role of the physical environment. 相似文献
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OBJECTIVE: This study assessed and compared heath-related behaviours and nutrient and food group intakes between US-born and Korea-born Korean American women. DESIGN AND SUBJECTS: Cross-sectional analyses were performed for ethnic Koreans who participated in the Multiethnic Cohort Study in Hawaii and Los Angeles in 1993-1996. The sample included 492 Korean American women aged 45-75 years who were born in the USA (n = 274) or Korea (n = 218). Participants were recruited using driver's license files as a primary sampling source and completed a self-administered questionnaire, including a quantitative food frequency section. RESULTS: The proportion overweight or obese was 31.4% in US-born and 9.4% in Korea-born women. US-born women had higher intakes of total fat and fat as a percentage of energy, and lower intakes of sodium, vitamin C, beta-carotene and carbohydrate as a percentage of energy, than Korea-born women. Comparing intakes of food group servings from the Food Guide Pyramid, US-born women reported more whole grains, red meat and nuts, and less soy products, than did Korea-born women. US-born women also consumed fewer vegetables and fruit than those born in Korea. Few women in either group reported intakes that met the recommendations for dairy foods. Intake of discretionary fat from the Pyramid tip was higher in US-born than in Korea-born women. CONCLUSIONS: These findings indicate that the acculturation of Korean immigrants affects dietary intakes in ways that may alter risks of several chronic diseases. Further studies will be necessary to examine the effects of dietary acculturation on disease patterns. 相似文献
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OBJECTIVE: To assess the nutritional status of the Andean population of Puna and Quebrada of Humahuaca, Jujuy, using anthropometric measurements. DESIGN AND SUBJECTS: A cross-sectional nutritional survey was carried out in a representative sample (n = 1236) of individuals from these regions. Children aged 2-9 years, adolescents (10-17 years) and adults (>or=18 years; pregnant and lactating women excluded) were considered. Height-for-age, weight-for-height and body mass index (BMI) were calculated in children and adolescents and compared with World Health Organization/National Center for Health Statistics/Centers for Disease Control and Prevention reference standards using Z-scores or percentiles, in order to assess the prevalence of stunting, wasting/thinness and excess weight. In adults, BMI, waist circumference (WC) and waist-to-hip (WHR) ratio were used to identify obesity and central adiposity. RESULTS: Stunting (height-for-age Z-score <-2 standard deviations) and obesity (BMI >or= 95th percentile) were found to be major nutritional problems in children and adolescents. Stunting was prevalent in 10.7% of children and 12.4% of adolescents; 8.2% of children and 3.5% of adolescents were obese. Adults were short (mean: 155.8 cm) and values of overweight (32.3%), obesity (18.3%) and central adiposity (mean WC: 86.5 cm) were high. Older adults and those with higher economic development showed higher prevalence of obesity and central adiposity. CONCLUSIONS: The present population may be at the early stages of nutritional transition as symptoms of undernutrition and overnutrition coexist at the population level. These results suggest that rates of growth retardation may be decreasing owing to improved nutritional conditions; however, this could be accompanied by a sharp increase in the prevalence of other diet-related chronic diseases. 相似文献
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OBJECTIVE: To examine the pattern of intake of key foods and beverages of children aged 4-12 years and the association with weight status. DESIGN AND SETTING: A computer-assisted telephone interview was used to determine the intake of fruit, vegetables, packaged snacks, fast foods and sweetened drinks 'yesterday' and 'usually' as reported by parents/guardians of a representative sample of 2184 children from the Barwon South-Western region of Victoria, Australia. RESULTS: Children who consumed >2-3, >3-4 and >4 servings of fruit juice/drinks 'yesterday' were, respectively, 1.7 (95% confidence interval (CI) 1.2-2.2), 1.7 (95% CI 1.2-2.5) and 2.1 (95% CI 1.5-2.9) times more likely to be overweight/obese compared with those who had no servings of fruit juice/drink 'yesterday', adjusted for age, gender and socio-economic status (SES). Further, children who had > or = 3 servings of soft drink 'yesterday' were 2.2 (95% CI 1.3-3.9) times more likely to be overweight/obese compared with those who had no servings of soft drink 'yesterday', adjusted for age, gender and SES. In addition, children who 'usually' drank fruit juice/drinks twice or more per day were 1.7 (95% CI 1.2-2.4) times more likely to be overweight/obese compared with those who drank these beverages once or less per week, adjusted for age, gender and SES. Although fast foods and packaged snacks were regularly eaten, there were no associations between weight status and consumption of these foods. CONCLUSIONS: Intake of sweetened beverages was associated with overweight and obesity in this population of Australian schoolchildren and should be a target for intervention programmes aimed at preventing unhealthy weight gain in children. 相似文献
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OBJECTIVE: To investigate the prevalence of obesity in affluent schoolchildren of Delhi. DESIGN: This was a cross-sectional study covering over 4000 students. Anthropometric measurements and birth weights of all the students were recorded. SETTING AND SUBJECTS: The study was carried out in a school catering to the affluent section of Indian society and included both boys and girls in the age range 4 to 17 years. RESULTS: The heights and weights of the children were almost similar to those of the National Center for Health Statistics standards, and were much above the values reported by the Indian National Nutrition Monitoring Bureau, which largely captures rural children belonging to lower socio-economic strata in India. Of the subjects studied, 22% were overweight and 6% were obese. Only 6% of these children had low birth weight. CONCLUSION: The prevalence of obesity is rising among children because of their change in lifestyle. Children born with a birth weight of > or = 3 kg tended to have higher body mass index in their adolescent years and maybe consequently in their adult years. Nutrition education can play an important part in reducing the incidence of overweight/obesity and its associated complications. 相似文献
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BACKGROUND: Positive secular trends in adolescent obesity and an increased prevalence of fear of fatness, particularly among girls, have been documented world-wide. There is a lack of consensus about assessment criteria for childhood obesity and no standard exists for assessing Irish children. In 1990, the Irish National Nutrition Survey used body mass index (BMI) > or =26 kg m(-2) to describe the prevalence of overweight among Irish adolescents. OBJECTIVES: (1) To examine the range in classification of Dublin schoolchildren as overweight according to four standard assessment methods; (2) to assess changes in weight status, prevalence of fear of fatness and accompanying slimming practices in a one-year follow-up; and (3) to compare the prevalence of overweight with that documented in 1990 among adolescents of similar age. DESIGN: A one-year follow-up study of 199 healthy schoolchildren (90 boys and 109 girls; mean age of 11 years at baseline) attending seven fee-paying (six single- and one mixed-sex) and eight non-fee-paying (four single- and four mixed-sex) primary schools in Dublin city centre. MEASUREMENTS: Weight, height, waist circumference and triceps skinfold were measured and used in five definitions of overweight, including published cut-off points of BMI-for-age (Centers for Disease Control and Prevention BMI-for-age charts for boys and girls; BMI reference curves for the UK 1990; International Obesity Task Force age- and sex-specific BMI cut-offs), actual relative weight and BM > or =26 kg m(-2). Assessment of body image perceptions and satisfaction (using figure line drawings) was reported in a questionnaire specifically designed for this study. RESULTS: The prevalence of overweight within the total group differed between the four standard definitions of weight status, by 9% at baseline and 8% at follow-up. Accordingly, increasing trends over the year ranged from zero to 3%. Using the criterion BMI > or =26 kg m(-2), 6% of Dublin schoolchildren were overweight, compared with 1.9% of schoolchildren in 1990. Significantly more girls than boys were affected by fear of fatness and were trying to lose weight. CONCLUSION: A standard method for assessment of weight status is urgently needed for the evaluation of obesity prevention initiatives among Irish schoolchildren. Such initiatives need to be sensitive to the pervasiveness of fear of fatness among adolescent girls. 相似文献
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M A Luke H T Masumoto T Cairns H K Hundley 《Journal of the Association of Official Analytical Chemists》1988,71(2):415-433
During a 5 year period from 1982 to 1986, the FDA Los Angeles District Laboratory analyzed 19,851 samples of domestic and imported food and feed commodities for pesticide residues. A single, rapid, multiresidue method was used. The resultant data have been compiled showing the commodities sampled and the identity and range of levels of pesticide residues detected, including an indication of those residue findings that did not comply with U.S. federal tolerance levels. The residue data presented should not be viewed as being representative of the U.S. food supply; rather, the results are indicative of a surveillance- and compliance-oriented sampling of various food shipments collected by the Los Angeles District. 相似文献
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Maddah M 《Public health nutrition》2007,10(5):450-453
OBJECTIVE: This study aimed to investigate the frequency of overweight and obesity among Iranian adolescent girls aged 14-17 years and its possible association with maternal education in Rasht city in 2005. DESIGN: A cross-sectional survey on 1054 schoolgirls. SETTING: High schools in Rasht city, Iran. METHODS: A multistage sampling method was used and 1054 randomly selected schoolgirls were studied. Data on age and mother's years of schooling were collected by questionnaire and body weight and height were measured. Overweight and obesity were defined using age- and sex-specific body mass index (BMI) cut-off points proposed by the International Obesity Task Force (IOTF), and compared with 85th and 95th BMI percentile curves of the IOTF reference population, respectively. Data analyses included two groups based on mother's years of schooling: less educated ( < 12 years) and more educated ( > or = 12 years). RESULTS: The overall prevalence of overweight and obesity in this population was 21.9 and 5.3%, respectively. Results of logistic regression analysis showed that the risk of overweight was higher for lower age group (odds ratio = 2.0, 95% confidence interval 0.18-3.09). Overweight was more common in girls with less educated mothers than in girls with more educated mothers (26.0 vs. 19.8%, P = 0.03). CONCLUSION: These data indicate that overweight is highly prevalent among adolescent girls, especially in lower social groups in Rasht, and the rate is exceeding those reported in other parts of the country. Preventive strategies need to be adopted to combat the epidemic of overweight and obesity in this population. 相似文献
20.
OBJECTIVE: Childhood obesity is a growing public health problem. We have examined the association between sociodemographic profile and eating and physical activity patterns with overweight among primary-school students in Athens, Greece. DESIGN: Cross-sectional study. SETTING: Eleven primary schools in the greater Athens area, Greece. SUBJECTS: A total of 633 children aged 10-12 years (50 % boys, 50 % girls) were interviewed in person during spring 2003. Multivariate logistic regression was used to investigate the association between eating and physical activity patterns and overweight (> or =85th sex- and age-specific BMI centile). Results are presented as odds ratios and 95 % confidence intervals. RESULTS: Overweight was more common among girls than among boys (OR=1.73; 95% CI 1.11, 2.69) and substantially less common among children born outside Greece (OR=0.46; CI 0.22, 0.95). Reported physical activity (per 1.5 h per day) was unrelated to overweight (OR=0.97; CI 0.85, 1.12) but patent physical inactivity, operationalised as time spent watching television or working/playing with the computer (per 1.5 h per day) was a highly significant predictor of overweight (OR=1.20; CI 1.05, 1.36). Composition of diet was unrelated to overweight but the daily number of eating occasions, controlling for total energy intake, was significantly inversely associated with overweight (OR=0.61; CI 0.48, 0.76). CONCLUSIONS: The principal factor underlying overweight among children in Athens appears to be the extended inactivity imposed by modern childhood lifestyles. An intriguing finding is that spreading a given energy intake over several eating occasions was inversely associated with the likelihood of childhood obesity. 相似文献