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Association between dietary diversity, nutritional status, and academic performance of school-age children in Southeast Ethiopia using structural equation modelling. 利用结构方程模型分析埃塞俄比亚东南部学龄儿童的饮食多样性、营养状况和学习成绩之间的关系。
IF 2.4 3区 医学 Q3 ENVIRONMENTAL SCIENCES Pub Date : 2024-11-18 DOI: 10.1186/s41043-024-00687-0
Girma Beressa, Abera Biratu, Bikila Lencha, Biniyam Sahiledengle, Demisu Zenbaba, Desalegn Bekele, Yohannes Tekalegn, Kenenisa Beressa

Background: Undernutrition, manifested as stunting and/or thinness, is a major public health concern in low-income countries, including Ethiopia. Factors such as sociodemographic, economic, and dietary status influence children's academic achievement. This study aimed to assess the association between dietary diversity, nutritional status, and academic performance of school-age children in pastoral communities in Southeast Ethiopia.

Methods: A school-based cross-sectional study was conducted among 395 randomly selected school-age children. A multistage sampling followed by systematic random sampling was used to collect the data. Students' academic performance (AP) was evaluated by computing two-semester average grade scores of the 2016/17 academic year in all disciplines using the school record. A pre-tested, interviewer-administered, structured questionnaire was used to collect the data. To assess nutritional status, the z scores of height for age (HAZ) and BMI for age (BAZ) were employed according to WHO's new reference values. The WHO Anthroplus software was used to generate nutritional indices. A structural equation model (SEM) was used to examine the direct, indirect, and total effects of the dietary diversity score (DDS), HAZ score, and BAZ score on AP. The beta coefficient (β) along with the confidence interval (CI) were used to estimate the strength of the association.

Results: The prevalence of stunting and thinness was 26.6% (95% CI: 21.8, 31.4%) and 28.9% (95% CI: 24.3, 33.2%), respectively. The proportion of dietary diversity (DD) among school-age children was 40% (95% CI: 35.7, 45.3%) low DD and 60% (95% CI: 54.7, 64.3%) adequate DD. The SEM revealed that a unit increment in the child's DDS (unstandardised β = 0.130, 95% CI: 0.049 to 0.211) did have direct and total effects on the HAZ score. However, HAZ score, BAZ score, and DDS did not have direct, indirect, or total effects on AP. Similarly, DDS did not have direct or total effects on the BAZ score.

Conclusion: The academic performance (AP) was low among these school-age children, and the prevalence of stunting and thinness was high. Thus, nutrition interventions on dietary diversity for school-age children would be crucial interventions for increasing academic achievement.

背景:营养不良表现为发育迟缓和/或消瘦,是包括埃塞俄比亚在内的低收入国家的主要公共卫生问题。社会人口、经济和饮食状况等因素会影响儿童的学习成绩。本研究旨在评估埃塞俄比亚东南部牧区学龄儿童的饮食多样性、营养状况和学习成绩之间的关系:方法:对随机抽取的 395 名学龄儿童进行了一项基于学校的横断面研究。采用多阶段抽样和系统随机抽样的方法收集数据。学生的学业成绩(AP)通过使用学校记录计算 2016/17 学年所有学科的两学期平均成绩来评估。收集数据时使用了一份预先测试、由访谈者主持的结构化问卷。为评估营养状况,根据世界卫生组织的新参考值,采用了年龄身高(HAZ)和年龄体重指数(BAZ)的z得分。世卫组织 Anthroplus 软件用于生成营养指数。采用结构方程模型(SEM)研究了膳食多样性评分(DDS)、HAZ 评分和 BAZ 评分对 AP 的直接、间接和总体影响。贝塔系数(β)和置信区间(CI)被用来估计关联的强度:结果:发育迟缓和消瘦的发生率分别为 26.6% (95% CI: 21.8, 31.4%) 和 28.9% (95% CI: 24.3, 33.2%)。学龄儿童的膳食多样性(DD)比例为低 DD 40% (95% CI: 35.7, 45.3%) 和充足 DD 60% (95% CI: 54.7, 64.3%)。SEM 显示,儿童 DDS 的单位增量(非标准化 β = 0.130,95% CI:0.049 至 0.211)对 HAZ 分数有直接和总体影响。然而,HAZ 评分、BAZ 评分和 DDS 对 AP 没有直接、间接或总体影响。同样,DDS 对 BAZ 分数也没有直接或总体影响:结论:这些学龄儿童的学习成绩(AP)较低,发育迟缓和瘦弱的发生率较高。因此,对学龄儿童进行膳食多样性营养干预将是提高学习成绩的关键措施。
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引用次数: 0
A cross-sectional descriptive analysis of technology addiction in adolescents: associations with food addiction, emotional eating, and body weight status. 青少年科技成瘾横断面描述性分析:与食物成瘾、情绪化饮食和体重状况的关联。
IF 2.4 3区 医学 Q3 ENVIRONMENTAL SCIENCES Pub Date : 2024-11-15 DOI: 10.1186/s41043-024-00675-4
Hilal Toklu Baloglu, Zeynep Caferoglu Akin

Background: This cross-sectional descriptive study aimed to determine the prevalence and risk factors of technology addiction (TA) in adolescents, as well as investigate the association of TA with food addiction and emotional eating by body weight status.

Methods: Adolescents (n = 1388) completed a questionnaire that featured socio-demographic characteristics, the Game Addiction Scale (GAS), the Social Media Disorder Scale (SMD), the dimensional Yale Food Addiction Scale for Children 2.0 (dYFAS-C 2.0), and the Emotional Eating Scale Adapted for Use in Children and Adolescents (EES-C). The body mass index (BMI) Z-score was classified according to the World Health Organization.

Results: TA was present in one-fifth of adolescents, and boys were four times more likely to develop a digital game addiction (p < 0.001). A 1-point increase in the GAS score is associated with a 1.08-point increase in the dYFAS-C-2.0 score and a 0.5-point increase in the total EES-C score (p < 0.001). A 1-point increase in the SMD score was also related to an increased of 1.21 and 1.26, respectively (p < 0.001). All of these positive associations were significant in adolescents with overweight (p < 0.001).

Conclusions: Given the rapidly increasing prevalence of TA among adolescents, its association with food addiction, emotional eating, and body weight status is worrisome, and our findings shed light on the relevance of developing strategies to reduce the prevalence of TA in this population.

研究背景这项横断面描述性研究旨在确定技术成瘾(TA)在青少年中的流行程度和风险因素,并根据体重状况调查TA与食物成瘾和情绪化饮食之间的关联:青少年(n = 1388)填写了一份调查问卷,其中包括社会人口学特征、游戏成瘾量表(GAS)、社交媒体障碍量表(SMD)、耶鲁儿童食物成瘾量表 2.0(dYFAS-C 2.0)以及儿童和青少年情绪化进食量表(EES-C)。体重指数(BMI)Z-分数根据世界卫生组织的标准进行分类:结果:五分之一的青少年存在数字游戏成瘾问题,而男孩患数字游戏成瘾的可能性是男孩的四倍(P 结论:数字游戏成瘾在青少年中的发病率正在迅速上升:鉴于TA在青少年中的流行率迅速上升,其与食物成瘾、情绪化进食和体重状况的关联令人担忧,我们的研究结果阐明了制定策略降低TA在这一人群中的流行率的相关性。
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引用次数: 0
Body composition-derived abdominal circumference, waist-to-hip ratio, and waist-to-height ratio cut-offs for Ethiopian adults in Northwest Ethiopia, 2023. 2023 年埃塞俄比亚西北部埃塞俄比亚成年人的身体成分衍生腹围、腰臀比和腰高比临界值。
IF 2.4 3区 医学 Q3 ENVIRONMENTAL SCIENCES Pub Date : 2024-11-13 DOI: 10.1186/s41043-024-00678-1
Mekonnen Assefa, Aster Tsegaye, Adamu Addissie, Alemayehu Worku

Background: Central and general obesity are commonly measured using tools like waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). However, the universally recognized cutoffs for these measures may be inadequate for individuals of Ethiopian descent. Due to the lack of universally applicable cutoffs, studies recommend tailoring the optimal screening thresholds to each population's specific characteristics. Therefore, this study aimed to determine body composition-based WC, WHR, and WHtR cutoffs for the healthy adult population of Ethiopia.

Method: A population based cross-sectional study was conducted in the Amhara region of Ethiopia from June to August 2023, collecting anthropometric and body composition data from 838 adult participants. Data were analyzed using Stata, and MedCalc software. The cut-off values were determined using ROC analysis, and performance was assessed using area under the curve (AUC), Youden index, sensitivity, and specificity.

Result: The optimal cut-off values for WC, HC, WHR, and WHtR to define obesity in men were 85.0 cm, 93.5 cm, 0.89, and 0.53 respectively. Correspondingly, these values in women were 81.1 cm, 97.2 cm, 0.84, and 0.5. These cutoff values showed the highest effectiveness in defining obesity especially for WC and WHtR. The new proposed cutoff values for waist circumference, hip circumference, and waist-to-height ratio had sensitivity ranging 76-93% and specificity of 83-94% in accurately identifying obesity. The current study also determined the cut-off values for underweight, normal weight, and overweight body weight categories. Accordingly, for men, the WC cut-offs were: ≤ 74.55 cm (underweight), 74.56-78.95 cm (normal), and 79.0-85.0 cm (overweight). For women, the cut-offs were: ≤ 68.25 cm (underweight), 68.26-79.59 cm (normal), and 79.60-81.10 cm (overweight). The WHtR thresholds were: ≤0.43 (underweight), 0.44-0.47 (normal), and 0.48-0.53 (overweight) in men; ≤0.43 (underweight), 0.44-0.50 (normal), and 0.50-0.51 (overweight) in women.

Conclusion: The findings indicate that the WC, WHR, and WHtR cutoff values for defining obesity in Ethiopian adults are lower than international standards. The newly proposed cutoff values showed improved sensitivity and specificity, suggesting their potential diagnostic relevance. Considering these country-specific cutoffs may be beneficial for clinical practice and obesity-related research in Ethiopia.

背景:中心性肥胖和全身性肥胖通常使用腰围(WC)、臀围(HC)、腰臀比(WHR)和腰高比(WHTR)等工具进行测量。然而,对于埃塞俄比亚后裔来说,这些普遍认可的测量值可能并不合适。由于缺乏普遍适用的临界值,研究建议根据每个人群的具体特征来定制最佳筛查临界值。因此,本研究旨在为埃塞俄比亚的健康成年人群确定基于身体成分的体重指数、体重减轻指数和体重增加指数的临界值:方法:2023 年 6 月至 8 月在埃塞俄比亚阿姆哈拉地区开展了一项基于人群的横断面研究,收集了 838 名成年参与者的人体测量和身体成分数据。数据使用 Stata 和 MedCalc 软件进行分析。使用 ROC 分析确定临界值,并使用曲线下面积(AUC)、Youden 指数、灵敏度和特异性评估其性能:结果:界定男性肥胖的最佳截断值(WC、HC、WHR 和 WHtR)分别为 85.0 厘米、93.5 厘米、0.89 和 0.53。相应地,女性的这些数值分别为 81.1 厘米、97.2 厘米、0.84 和 0.5。这些临界值在界定肥胖方面显示出最高的有效性,尤其是在腰围和 WHtR 方面。新提出的腰围、臀围和腰围-身高比的临界值在准确识别肥胖方面的灵敏度为 76%-93%,特异度为 83%-94%。本次研究还确定了体重不足、体重正常和体重超重类别的临界值。因此,男性的体重上限为:≤ 74.55 厘米(体重不足)、74.56-78.95 厘米(正常)和 79.0-85.0 厘米(超重)。女性的临界值为:≤ 68.25 厘米(体重不足)、68.26-79.59 厘米(正常)和 79.60-81.10 厘米(超重)。男性的 WHtR 临界值分别为:≤0.43(体重不足)、0.44-0.47(正常)和 0.48-0.53(超重);女性的 WHtR 临界值分别为:≤0.43(体重不足)、0.44-0.50(正常)和 0.50-0.51(超重):结论:研究结果表明,埃塞俄比亚成年人定义肥胖的 WC、WHR 和 WHtR 临界值低于国际标准。新提出的临界值显示出更高的灵敏度和特异性,表明它们具有潜在的诊断意义。在埃塞俄比亚,考虑这些特定国家的临界值可能对临床实践和肥胖相关研究有益。
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引用次数: 0
Relationship between Chlamydia Trachomatis infection, infertility, and serum 25-hydroxyvitamin D: a cross-sectional study from NHANES 2013-2016. 沙眼衣原体感染、不孕症与血清 25- 羟维生素 D 之间的关系:一项来自 2013-2016 年 NHANES 的横断面研究。
IF 2.4 3区 医学 Q3 ENVIRONMENTAL SCIENCES Pub Date : 2024-11-13 DOI: 10.1186/s41043-024-00681-6
Miran Na, Lin Zeng, Xiya Sun, Yinrou Huang, Mingmei Lin, Xu Zhi

Background: Chlamydia trachomatis is a common sexually transmitted disease that is associated with considerable morbidity and harmful sequelae, including pelvic inflammatory disease and infertility. Strategies for prevention and treatment of infertility in women with C. trachomatis infection require further investigation. There is evidence suggesting that vitamin D could be a potential treatment. This study aimed to investigate the relationship between serum 25-hydroxyvitamin D [25(OH)D] levels, chlamydia seropositivity, and the risk of infertility in women.

Methods: We conducted this cross-sectional study using 2013-2016 National Health and Nutrition Examination Survey data. Women aged 18-39 years with complete serum 25(OH)D and chlamydia Pgp3Ab multiplex bead/enzyme-linked immunosorbent assay data available were included. The correlation between 25(OH)D level, chlamydia seropositivity, and infertility was evaluated using the weighted chi-squared test and the t-test with multivariate logistic regression and moderation effect models.

Results: Among the 1424 women who met our eligibility criteria, the weighted chlamydia seropositivity rate was 36.8%. The 25(OH)D level was significantly lower in the seropositive group compared with seronegative control. (P = 0.009). After adjusting for ethnicity, the effect of 25(OH)D was no longer significant (P = 0.693). Further analysis in the chlamydia-seropositive subset revealed that the vitamin D level was lower in the infertile group (P = 0.024). In an interaction model, 25(OH)D was found to antagonizes the positive relationship between chlamydia and infertility (OR = 0.985, 95% CI: 0.971-0.999, P = 0.040).

Conclusion: The serum vitamin D level may be more related to the prognosis in terms of infertility than to the risk of chlamydia infection. This finding may reveal a possible treatment strategy for chlamydia infection.

背景:沙眼衣原体是一种常见的性传播疾病,与相当高的发病率和有害的后遗症(包括盆腔炎和不孕症)有关。预防和治疗沙眼衣原体感染妇女不孕症的策略需要进一步研究。有证据表明,维生素 D 可能是一种潜在的治疗方法。本研究旨在调查血清 25-羟基维生素 D [25(OH)D]水平、衣原体血清阳性与女性不孕风险之间的关系:我们利用 2013-2016 年全国健康与营养调查数据开展了这项横断面研究。研究纳入了有完整血清 25(OH)D 和衣原体 Pgp3Ab 多联珠/酶联免疫吸附试验数据的 18-39 岁女性。采用加权卡方检验和 t 检验以及多变量逻辑回归和调节效应模型评估了 25(OH)D 水平、衣原体血清阳性和不孕症之间的相关性:在符合资格标准的 1424 名妇女中,加权衣原体血清阳性率为 36.8%。与血清阴性对照组相比,血清阳性组的 25(OH)D 水平明显偏低。(P = 0.009).调整种族因素后,25(OH)D 的影响不再显著(P = 0.693)。对衣原体血清阳性亚组的进一步分析表明,不育组的维生素 D 水平较低(P = 0.024)。在交互模型中,25(OH)D 可拮抗衣原体与不育之间的正相关关系(OR = 0.985,95% CI:0.971-0.999,P = 0.040):结论:与衣原体感染风险相比,血清维生素 D 水平与不孕症预后的关系可能更大。这一发现可能揭示了衣原体感染的可能治疗策略。
{"title":"Relationship between Chlamydia Trachomatis infection, infertility, and serum 25-hydroxyvitamin D: a cross-sectional study from NHANES 2013-2016.","authors":"Miran Na, Lin Zeng, Xiya Sun, Yinrou Huang, Mingmei Lin, Xu Zhi","doi":"10.1186/s41043-024-00681-6","DOIUrl":"10.1186/s41043-024-00681-6","url":null,"abstract":"<p><strong>Background: </strong>Chlamydia trachomatis is a common sexually transmitted disease that is associated with considerable morbidity and harmful sequelae, including pelvic inflammatory disease and infertility. Strategies for prevention and treatment of infertility in women with C. trachomatis infection require further investigation. There is evidence suggesting that vitamin D could be a potential treatment. This study aimed to investigate the relationship between serum 25-hydroxyvitamin D [25(OH)D] levels, chlamydia seropositivity, and the risk of infertility in women.</p><p><strong>Methods: </strong>We conducted this cross-sectional study using 2013-2016 National Health and Nutrition Examination Survey data. Women aged 18-39 years with complete serum 25(OH)D and chlamydia Pgp3Ab multiplex bead/enzyme-linked immunosorbent assay data available were included. The correlation between 25(OH)D level, chlamydia seropositivity, and infertility was evaluated using the weighted chi-squared test and the t-test with multivariate logistic regression and moderation effect models.</p><p><strong>Results: </strong>Among the 1424 women who met our eligibility criteria, the weighted chlamydia seropositivity rate was 36.8%. The 25(OH)D level was significantly lower in the seropositive group compared with seronegative control. (P = 0.009). After adjusting for ethnicity, the effect of 25(OH)D was no longer significant (P = 0.693). Further analysis in the chlamydia-seropositive subset revealed that the vitamin D level was lower in the infertile group (P = 0.024). In an interaction model, 25(OH)D was found to antagonizes the positive relationship between chlamydia and infertility (OR = 0.985, 95% CI: 0.971-0.999, P = 0.040).</p><p><strong>Conclusion: </strong>The serum vitamin D level may be more related to the prognosis in terms of infertility than to the risk of chlamydia infection. This finding may reveal a possible treatment strategy for chlamydia infection.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":"43 1","pages":"186"},"PeriodicalIF":2.4,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association between the composite dietary antioxidant index and erectile dysfunction in US men: a cross-sectional study. 美国男性膳食抗氧化综合指数与勃起功能障碍之间的关系:一项横断面研究。
IF 2.4 3区 医学 Q3 ENVIRONMENTAL SCIENCES Pub Date : 2024-11-11 DOI: 10.1186/s41043-024-00653-w
Xuefeng Jin, Li Sun, Hangxu Li, Yan Liu

Background: Erectile dysfunction (ED) is a common issue among adult males. The Composite Dietary Antioxidant Index (CDAI) reflects anti-inflammatory levels and has been linked to various diseases, but its relationship with ED is unclear.

Materials and methods: This cross-sectional study utilised comprehensive data on clinical factors from the 2001-2004 National Health and Nutrition Examination Survey (NHANES). To investigate the link between variables and ED, we used multivariate regression analysis, univariate analysis, and subgroup analysis. The linear relationship between CDAI and ED was investigated by dose-response curve analysis. For sensitivity analysis, propensity score matching (PSM) was utilised to exclude the influence of potential confounders. Finally, we investigated the association between CDAI and ED using threshold effects analysis.

Results: We included in our research a total of 2896 persons with data on CDAI from NHANES 2001-2004. Among these, 2,098 participants were thought to be free of ED, whereas 798 participants had ED. We found that compared to the ED group, men in the non-ED group had higher levels of CDAI (p < 0.0001 before PSM and p = 0.0145 after PSM). Additionally, after adjusting for covariates, it was found that an elevated CDAI was associated with a reduced incidence of ED [OR = 0.65(p = 0.001) before PSM and OR = 0.62(p = 0.002) after PSM]. Subgroup analysis indicated stronger associations in high-risk groups, and dose-response curves confirmed a linear negative correlation between CDAI and ED.

Conclusions: This study revealed a negative linear relationship between CDAI and the incidence of ED. The CDAI can be used as an indicator for assessing ED risk and for ED prevention.

背景:勃起功能障碍(ED)是成年男性的常见问题。膳食抗氧化物综合指数(CDAI)反映了抗炎水平,并与多种疾病相关,但其与勃起功能障碍的关系尚不清楚:这项横断面研究利用了 2001-2004 年美国国家健康与营养调查(NHANES)中有关临床因素的综合数据。为了研究变量与 ED 之间的联系,我们采用了多元回归分析、单变量分析和亚组分析。通过剂量反应曲线分析研究了 CDAI 与 ED 之间的线性关系。在敏感性分析中,我们采用了倾向得分匹配(PSM)来排除潜在混杂因素的影响。最后,我们使用阈值效应分析法研究了CDAI与ED之间的关系:我们的研究共纳入了 2896 名来自 2001-2004 年国家健康调查(NHANES)的 CDAI 数据。在这些人中,有 2098 人被认为没有 ED,而 798 人有 ED。我们发现,与 ED 组相比,非 ED 组男性的 CDAI 水平更高(p 结论:CDAI 与 ED 之间存在负线性关系:本研究揭示了 CDAI 与 ED 发生率之间的负线性关系。CDAI 可用作评估 ED 风险和预防 ED 的指标。
{"title":"Association between the composite dietary antioxidant index and erectile dysfunction in US men: a cross-sectional study.","authors":"Xuefeng Jin, Li Sun, Hangxu Li, Yan Liu","doi":"10.1186/s41043-024-00653-w","DOIUrl":"10.1186/s41043-024-00653-w","url":null,"abstract":"<p><strong>Background: </strong>Erectile dysfunction (ED) is a common issue among adult males. The Composite Dietary Antioxidant Index (CDAI) reflects anti-inflammatory levels and has been linked to various diseases, but its relationship with ED is unclear.</p><p><strong>Materials and methods: </strong>This cross-sectional study utilised comprehensive data on clinical factors from the 2001-2004 National Health and Nutrition Examination Survey (NHANES). To investigate the link between variables and ED, we used multivariate regression analysis, univariate analysis, and subgroup analysis. The linear relationship between CDAI and ED was investigated by dose-response curve analysis. For sensitivity analysis, propensity score matching (PSM) was utilised to exclude the influence of potential confounders. Finally, we investigated the association between CDAI and ED using threshold effects analysis.</p><p><strong>Results: </strong>We included in our research a total of 2896 persons with data on CDAI from NHANES 2001-2004. Among these, 2,098 participants were thought to be free of ED, whereas 798 participants had ED. We found that compared to the ED group, men in the non-ED group had higher levels of CDAI (p < 0.0001 before PSM and p = 0.0145 after PSM). Additionally, after adjusting for covariates, it was found that an elevated CDAI was associated with a reduced incidence of ED [OR = 0.65(p = 0.001) before PSM and OR = 0.62(p = 0.002) after PSM]. Subgroup analysis indicated stronger associations in high-risk groups, and dose-response curves confirmed a linear negative correlation between CDAI and ED.</p><p><strong>Conclusions: </strong>This study revealed a negative linear relationship between CDAI and the incidence of ED. The CDAI can be used as an indicator for assessing ED risk and for ED prevention.</p>","PeriodicalId":15969,"journal":{"name":"Journal of Health, Population, and Nutrition","volume":"43 1","pages":"184"},"PeriodicalIF":2.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Journal of Health, Population, and Nutrition
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