Assessing the Impact of COVID-19 Prevention Measures on Adolescent Growth in Italy
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Anthropometric Measurements
2.3. Body Image Perception
2.4. Statistical Analyses
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Akbulut, S.; Boz, G.; Ozer, A.; Sahin, T.T.; Colak, C. Evaluation of the Turkish Population’s Perspective on COVID-19 Vaccine Hesitancy and Routine Childhood Vaccine Applications: National Survey Study. Vaccines 2023, 11, 779. [Google Scholar] [CrossRef] [PubMed]
- WHO: A Brief History of Vaccination. Available online: https://www.who.int/news-room/spotlight/history-of-vaccination/a-brief-history-of-vaccination?topicsurvey=ht7j2q)&gclid=CjwKCAjw3POhBhBQEiwAqTCuBuO9yczNJHQeLNcQGFhIEQOcBAjZ4xc8PJBeKWwsU23iDdz9G7ragRoCiPQQAvD_BwE (accessed on 28 April 2023).
- Girum, T.; Lentiro, K.; Geremew, M.; Migora, B.; Shewamare, S.; Shimbre, M.S. Optimal strategies for COVID-19 prevention from global evidence achieved through social distancing, stay at home, travel restriction and lockdown: A systematic review. Arch. Public Health 2021, 79, 150. [Google Scholar] [CrossRef] [PubMed]
- Ekienabor, E. Coronavirus (COVID-19): The Lockdown Strategy in Nigeria. Preprints.org 2020, 2020050201. [Google Scholar] [CrossRef]
- Engzell, P.; Frey, A.; Verhagen, M.D. Learning loss due to school closures during the COVID-19 pandemic. Proc. Natl. Acad. Sci. USA 2021, 118, e2022376118. [Google Scholar] [CrossRef]
- Sterpetti, A.V. Lessons Learned During the COVID-19 Virus Pandemic. J. Am. Coll. Surg. 2020, 230, 1092–1093. [Google Scholar] [CrossRef]
- Istituto Superiore di Sanità. Aggiornamento Nazionale Relativo al Periodo 22–28 Maggio 2023 dei Dati della Sorveglianza Integrata COVID-19. Roma. 31 May 2023. Available online: https://www.epicentro.iss.it/coronavirus/bollettino/Bollettino-sorveglianza-integrata-COVID-19_31-maggio-2023.pdf (accessed on 7 June 2023).
- Montanari, M. La scuola ai tempi del Coronavirus: Esperienze, narrazioni, emozioni, riflessioni. J. Health Care Educ. Pract. 2021, 3, 99–104. [Google Scholar]
- Di Renzo, L.; Gualtieri, P.; Cinelli, G.; Bigioni, G.; Soldati, L.; Attinà, A.; Bianco, F.F.; Caparello, G.; Camodeca, V.; Carrano, E.; et al. Psychological aspects and eating habits during COVID-19 home confinement: Results of EHLCCOVID-19 Italian Online Survey. Nutrients 2020, 12, 2152. [Google Scholar] [CrossRef]
- Salman, H.; İssi Irlayici, F.; Akçam, M. The COVID-19 Pandemic and the Prevalence of Childhood Obesity in Turkiye. J. Pediatr. Gastroenterol. Nutr. 2023, 76, e15–e19. [Google Scholar] [CrossRef]
- Julian, V.; Bergsten, P.; Forslund, A.; Ahlstrom, H.; Ciba, I.; Dahlbom, M.; Weghuber, D. Sedentary time has a stronger impact on metabolic health than moderate to vigorous physical activity in adolescents with obesity: A cross—Sectional analysis of the Beta—JUDO study. Pediatr. Obes. 2022, 17, e12897. [Google Scholar] [CrossRef]
- Simmonds, M.; Llewellyn, A.; Owen, C.G.; Woolacott, N. Predicting adult obesity from childhood obesity: A systematic review and meta-analysis. Obes. Rev. 2016, 17, 95–107. [Google Scholar] [CrossRef] [Green Version]
- Ten Velde, G.; Lubrecht, J.; Arayess, L.; van Loo, C.; Hesselink, M.; Reijnders, D.; Vreugdenhil, A. Physical activity behaviour and screen time in Dutch children during the COVID-19 pandemic: Pre-, during- and post-school closures. Pediatr. Obes. 2021, 16, e12779. [Google Scholar] [CrossRef]
- NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: A pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet 2017, 390, 2627–2642. [Google Scholar] [CrossRef] [Green Version]
- NCD Risk Factor Collaboration (NCD-RisC). Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight. eLife 2021, 10, e60060. [Google Scholar] [CrossRef]
- Arayess, L.; Knockaert, N.; Winkens, B.; Lubrecht, J.W.; Verweij, M.; Vreugdenhil, A.C.E. The Side-Effects of the COVID-19 Pandemic: Increased BMI z-Score in Children with Overweight and Obesity in a Personalised Lifestyle Intervention One Year after the Start of the Pandemic in The Netherlands. Nutrients 2022, 14, 1942. [Google Scholar] [CrossRef]
- Woo, S.; Yang, H.; Kim, Y.; Lim, H.; Song, H.J.; Park, K.H. Sedentary Time and Fast-Food Consumption Associated With Weight Gain During COVID-19 Lockdown in Children and Adolescents With Overweight or Obesity. J. Korean Med. Sci. 2022, 37, e103. [Google Scholar] [CrossRef]
- Kim, D.; Kim, W.; Choi, M.; Shin, J. Did the increase in sitting time due to COVID-19 lead to obesity in adolescents? BMC Pediatr. 2023, 23, 5. [Google Scholar] [CrossRef]
- Kang, S.; Seo, M.Y.; Kim, S.H.; Park, M.J. Changes in lifestyle and obesity during the COVID-19 pandemic in Korean adolescents: Based on the Korea Youth Risk Behavior Survey 2019 and 2020. Ann. Pediatr. Endocrinol. Metab. 2022, 27, 281–288. [Google Scholar] [CrossRef]
- Lubrecht, J.; Arayess, L.; Reijnders, D.; Hesselink, M.L.; Velde, G.T.; Janse, A.; von Rosenstiel, I.; van Mil, E.G.; Verweij, M.; Vreugdenhil, A.C. Weight Gain in Children during the COVID-19 Pandemic and the Protective Effect of Lifestyle Intervention in Children with Obesity. Obes. Facts 2022, 15, 600–608. [Google Scholar] [CrossRef]
- Toselli, S.; Grigoletto, A.; Zaccagni, L.; Rinaldo, N.; Badicu, G.; Grosz, W.R.; Campa, F. Body image perception and body composition in early adolescents: A longitudinal study of an Italian cohort. BMC Public Health 2021, 21, 1381. [Google Scholar] [CrossRef] [PubMed]
- Gualdi-Russo, E.; Rinaldo, N.; Mazzoni, G.; Mandini, S.; Masotti, S.; Toselli, S.; Zaccagni, L. Age at Menarche, Growth Velocity, and Adiposity Indices in Italian Girls Aged 10 to 14. Children 2022, 9, 1928. [Google Scholar] [CrossRef]
- Bosomworth, N.J. Normal-weight central obesity: Unique hazard of the toxic waist. Can. Fam. Physician 2019, 65, 399–408. [Google Scholar] [PubMed]
- Weiner, J.S.; Lourie, J.A. Practical Human Biology; Academic Press: Cambridge, MA, USA, 1981. [Google Scholar]
- Lohman, T.G.; Roche, A.F.; Martorell, R. Anthropometric Standardization Reference Manual; Human Kinetics Books: Champain, IL, USA, 1988. [Google Scholar]
- Rinaldo, N.; Gualdi-Russo, E. Anthropometric Techniques. Ann. Online Univ. Ferrara 2015, 10, 275–289. Available online: https://iris.unife.it/retrieve/handle/11392/2302816/104785/Annali_Rinaldo_Gualdi_15.pdf (accessed on 25 January 2023).
- Gualdi Russo, E. Metodi Antropometrici: Generalità e principali caratteri antropometrici. In Manuale di Antropologia. Evoluzione e Biodiversità Umana; Sineo, L., Moggi Cecchi, J., Eds.; UTET: Torino, Italy, 2022; pp. 55–75. [Google Scholar]
- Cole, T.J.; Bellizzi, M.C.; Flegal, K.M.; Dietz, W.H. Establishing a standard definition for child overweight and obesity worldwide: International survey. Br. Med. J. 2000, 320, 1240–1243. [Google Scholar] [CrossRef] [Green Version]
- Cole, T.J.; Flegal, K.M.; Nicholls, D.; Jackson, A.A. Body mass index cut offs to define thinness in children and adolescents: International survey. Br. Med. J. 2007, 335, 194–197. [Google Scholar] [CrossRef] [Green Version]
- Rinaldo, N.; Toselli, S.; Gualdi-Russo, E.; Khyatti, M.; Gihbid, A.; Zaccagni, L. Anthropometric Assessment of General and Central Obesity in Urban Moroccan Women. Int. J. Environ. Res. Public Health 2022, 19, 6819. [Google Scholar] [CrossRef]
- Browning, L.M.; Hsieh, S.D.; Ashwell, M. A systematic review of waist-to height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0.5 could be a suitable global boundary value. Nutr. Res. Rev. 2010, 23, 247–269. [Google Scholar] [CrossRef] [Green Version]
- Xi, B.; Zong, X.; Kelishadi, R.; Litwin, M.; Hong, Y.M.; Poh, B.K.; Steffen, L.M.; Galcheva, S.V.; Herter-Aeberli, I.; Nawarycz, T.; et al. International Waist Circumference Percentile Cutoffs for Central Obesity in Children and Adolescents Aged 6 to 18 Years. J. Clin. Endocrinol. Metab. 2020, 105, e1569-83. [Google Scholar] [CrossRef]
- Childress, A.C.; Brewerton, T.D.; Hodges, E.L.; Jarrel, M.P. The Kids’ Eating Disorders Survey (KEDS): A Study of Middle School Students. J. Am. Acad. Child. Adolesc. Psychiatry 1993, 32, 843–850. [Google Scholar] [CrossRef]
- Stunkard, A.J.; Sørensen, T.; Schulsinger, F. Use of the Danish Adoption Register for the study of obesity and thinness. Res. Publ. Assoc. Res. Nerv. Ment. Dis. 1983, 60, 115–120. [Google Scholar]
- Tanner, J.M. Foetus into Man: Physical Growth from Conception to Maturity; Open Books Publishing: London, UK, 1978. [Google Scholar]
- Semproli, S.; Gualdi-Russo, E. Childhood malnutrition and growth in a rural area of Western Kenya. Am. J. Phys. Anthropol. 2007, 132, 463–469. [Google Scholar] [CrossRef]
- Argnani, L.; Cogo, A.; Gualdi-Russo, E. Growth and nutritional status of Tibetan children at high altitude. Coll. Antropol. 2008, 32, 807–812. [Google Scholar]
- Wolanski, N. Heterozygosity and human evolution. J. Hum. Evol. 1975, 4, 565–571. [Google Scholar] [CrossRef]
- Zaccagni, L.; Barbieri, D.; Cogo, A.; Gualdi-Russo, E. Anthropometric and body composition changes during expeditions at high altitude. High. Alt. Med. Biol. 2014, 15, 176–182. [Google Scholar] [CrossRef] [PubMed]
- Nikitovic, D.; Bogin, B. Ontogeny of sexual size dimorphism and environmental quality in Guatemalan children. Am. J. Hum. Biol. 2014, 26, 117–123. [Google Scholar] [CrossRef] [PubMed]
- Zimina, S.N.; Negasheva, M.A.; Godina, E.Z. Sex-Specific Phenotypic Plasticity as a Complex Reaction of Human Organism to Different Environmental Conditions. Coll. Antropol. 2019, 43, 175–182. Available online: https://hrcak.srce.hr/235118 (accessed on 25 January 2023).
- Stinson, S. Sex differences in environmental sensitivity during growth and development. Yearb. Phys. Anthr. 1985, 28, 123–147. [Google Scholar] [CrossRef]
- Tanner, J.M. Growth at adolescence, 2nd ed.; Blackwell Scientific Publications: Oxford, UK, 1962. [Google Scholar]
- Jenssen, B.P.; Kelly, M.K.; Powell, M.; Bouchelle, Z.; Mayne, S.L.; Fiks, A.G. COVID-19 and changes in child obesity. Pediatrics 2021, 147, e2021050123. [Google Scholar] [CrossRef]
- Kang, H.M.; Jeong, D.C.; Suh, B.K.; Ahn, M.B. The Impact of the Coronavirus Disease-2019 Pandemic on Childhood Obesity and Vitamin D Status. J. Korean Med. Sci. 2021, 36, e21. [Google Scholar] [CrossRef]
- Khan, M.A.; Moverley Smith, J.E. “Covibesity,” a new pandemic. Obes. Med. 2020, 19, 100282. [Google Scholar] [CrossRef]
- Spitzer, M. Open schools! Weighing the effects of viruses and lockdowns on children. Trends Neurosci. Educ. 2021, 22, 100151. [Google Scholar] [CrossRef]
- Italian Government Official Gazette of the Italian Republic. Decree of the President of the Council of Ministers (DPCM). Italy. 9 March 2020. Available online: https://www.gazzettaufficiale.it/eli/id/2020/03/09/20A01558/sg (accessed on 27 March 2023).
- Gallè, F.; Sabella, E.A.; Ferracuti, S.; De Giglio, O.; Caggiano, G.; Protano, C.; Valeriani, F.; Parisi, E.A.; Valerio, G.; Liguori, G.; et al. Sedentary Behaviors and Physical Activity of Italian Undergraduate Students during Lockdown at the Time of COVID-19 Pandemic. Int. J. Environ. Res. Public Health 2020, 17, 6171. [Google Scholar] [CrossRef]
- Pujia, R.; Ferro, Y.; Maurotti, S.; Khoory, J.; Gazzaruso, C.; Pujia, A.; Montalcini, T.; Mazza, E. The effects of COVID-19 on the eating habits of children and adolescents in Italy: A pilot survey study. Nutrients 2021, 13, 2641. [Google Scholar] [CrossRef]
- Pietrobelli, A.; Pecoraro, L.; Ferruzzi, A.; Heo, M.; Faith, M.; Zoller, T.; Antoniazzi, F.; Piacentini, G.; Fearnbach, S.N.; Heymsfield, S.B. Effects of COVID-19 Lockdown on Lifestyle Behaviors in Children with Obesity Living in Verona, Italy: A Longitudinal Study. Obesity 2020, 28, 1382–1385. [Google Scholar] [CrossRef]
- Ruiz-Roso, M.B.; de Carvalho Padilha, P.C.; Mantilla-Escalante, D.C.; Ulloa, N.; Brun, P.; Acevedo-Correa, D.; Arantes Ferreira Peres, W.; Martorell, M.; Aires, M.T.; de Oliveira Cardoso, L.; et al. COVID-19 Confinement and Changes of Adolescent’s Dietary Trends in Italy, Spain, Chile, Colombia and Brazil. Nutrients 2020, 12, 1807. [Google Scholar] [CrossRef]
- Androutsos, O.; Perperidi, M.; Georgiou, C.; Chouliaras, G. Lifestyle changes and determinants of children’s and adolescents’ body weight increase during the first COVID-19 lockdown in Greece: The COV-EAT study. Nutrients 2021, 13, 930. [Google Scholar] [CrossRef]
- Mazzolani, B.C.; Smaira, F.I.; Astley, C.; Iraha, A.Y.; Pinto, A.J.; Marques, I.G.; Cordeiro Amarante, M.; Rezende, N.S.; Sieczkowska, S.M.; Franco, T.C.; et al. Changes in eating habits and sedentary behavior during the COVID-19 pandemic in adolescents with chronic conditions. Front. Pediatr. 2021, 9, 714120. [Google Scholar] [CrossRef]
- Nuvoli, G. Family meal frequency, weight status and healthy management in children, young adults and seniors. A study in Sardinia, Italy. Appetite 2015, 89, 160–166. [Google Scholar] [CrossRef]
- Rosi, A.; Calestani, M.V.; Parrino, L.; Milioli, G.; Palla, L.; Volta, E.; Brighenti, F.; Scazzina, F. Weight Status Is Related with Gender and Sleep Duration but Not with Dietary Habits and Physical Activity in Primary School Italian Children. Nutrients 2017, 9, 579. [Google Scholar] [CrossRef] [Green Version]
- Rosi, A.; Giopp, F.; Milioli, G.; Melegari, G.; Goldoni, M.; Parrino, L.; Scazzina, F. Weight Status, Adherence to the Mediterranean Diet, Physical Activity Level, and Sleep Behavior of Italian Junior High School Adolescents. Nutrients 2020, 12, 478. [Google Scholar] [CrossRef] [Green Version]
- Cellini, N.; Canale, N.; Mioni, G.; Costa, S. Changes in sleep pattern, sense of time and digital media use during COVID-19 lockdown in Italy. J. Sleep Res. 2020, 29, e13074. [Google Scholar] [CrossRef]
- Gualdi-Russo, E.; Rinaldo, N.; Zaccagni, L. Physical Activity and Body Image Perception in Adolescents: A Systematic Review. Int. J. Environ. Res. Public Health 2022, 19, 13190. [Google Scholar] [CrossRef] [PubMed]
- Sabiston, C.M.; Pila, E.; Vani, M.; Thogersen-Ntoumani, C. Body image, physical activity, and sport: A scoping review. Psychol. Sport. Exerc. 2019, 42, 48–57. [Google Scholar] [CrossRef]
- Kovacs, V.A.; Starc, G.; Brandes, M.; Kaj, M.; Blagus, R.; Leskošek, B.; Suesse, T.; Dinya, E.; Guinhouya, B.C.; Zito, V.; et al. Physical activity, screen time and the COVID-19 school closures in Europe—An observational study in 10 countries. Eur. J. Sport Sci. 2021, 22, 1094–1103. [Google Scholar] [CrossRef] [PubMed]
- Toselli, S.; Rinaldo, N.; Mauro, M.; Grigoletto, A.; Zaccagni, L. Body Image Perception in Adolescents: The Role of Sports Practice and Sex. Int. J. Environ. Res. Public Health 2022, 19, 15119. [Google Scholar] [CrossRef]
- Gerner, B.; Wilson, P.H. The relationship between friendship factors and adolescent girls’ body image concern, body dissatisfaction, and restrained eating. Int. J. Eat. Disord. 2005, 37, 313–320. [Google Scholar] [CrossRef]
- Holsen, I.; Carlson Jones, D.; Skogbrott Birkeland, M. Body image satisfaction among Norwegian adolescents and young adults: A longitudinal study of the influence of interpersonal relationships and BMI. Body Image 2012, 9, 201–208. [Google Scholar] [CrossRef]
- Haimovitz, D.; Lansky, L.M.; O’Reilly, P. Fluctuations in body satisfaction across situations. Int. J. Eat. Disord. 1993, 13, 77–84. [Google Scholar] [CrossRef]
Lockdown N = 25 | Control N = 32 | ||||
---|---|---|---|---|---|
Mean | SD | Mean | SD | p | |
FEMALES | |||||
Anthropometric traits | |||||
Stature (cm) | 150.98 | 7.22 | 152.41 | 5.23 | 0.390 a |
Weight (kg) | 44.76 | 7.80 | 46.66 | 11.64 | 0.487 a |
BMI (kg/m2) | 19.63 | 3.12 | 20.03 | 4.55 | 0.711 a |
WC (cm) | 64.85 | 6.53 | 65.98 | 9.31 | 0.608 a |
WHtR | 0.43 | 0.05 | 0.43 | 0.06 | 0.870 a |
Body image perception | |||||
Feel figure | 4.16 | 1.11 | 4.07 | 1.31 | 0.627 b |
Ideal figure | 3.20 | 0.87 | 3.52 | 0.74 | 0.274 b |
FID | 0.96 | 1.14 | 0.55 | 1.21 | 0.094 b |
MALES | N = 35 | N = 36 | |||
Anthropometric traits | |||||
Stature (cm) | 147.19 | 6.46 | 149.01 | 8.96 | 0.331 a |
Weight (kg) | 41.00 | 7.97 | 44.90 | 10.48 | 0.082 a |
BMI (kg/m2) | 18.81 | 2.85 | 20.13 | 3.98 | 0.114 a |
WC (cm) | 65.93 | 7.78 | 69.60 | 9.84 | 0.086 a |
WHtR | 0.45 | 0.05 | 0.47 | 0.07 | 0.143 a |
Body image perception | |||||
Feel figure | 4.09 | 1.20 | 4.55 | 1.30 | 0.152 b |
Ideal figure | 3.71 | 0.57 | 4.03 | 1.30 | 0.227 b |
FID | 0.37 | 1.17 | 0.42 | 1.32 | 0.936 b |
Lockdown N = 25 | Control N = 32 | |||
---|---|---|---|---|
I Survey | II Survey | I Survey | II Survey | |
FEMALES | ||||
Underweight | 1 (4.0) | 1 (4.0) | 2 (6.3) | 3 (9.4) |
Normal weight | 17 (68.0) | 16 (64.0) | 21 (65.6) | 21 (65.6) |
Overweight/obese | 7 (28.0) | 8 (32.0) | 9 (28.1) | 8 (25.0) |
MALES | N = 35 | N = 36 | ||
Underweight | 2 (5.7) | 3 (8.6) | 3 (8.3) | 2 (5.6) |
Normal weight | 26 (74.3) | 21 (60.0) | 19 (52.8) | 23 (63.9) |
Overweight/obese | 7 (20.0) | 11 (31.4) | 14 (38.9) | 11 (30.6) |
Lockdown | Control | ||||
---|---|---|---|---|---|
Mean | SD | Mean | SD | p | |
FEMALES | |||||
Stature rate (cm/year) | 5.68 | 2.26 | 4.69 | 2.36 | 0.117 |
Weight rate (kg/year) | 5.37 | 3.27 | 4.00 | 4.44 | 0.203 |
WC rate (cm/year) | 2.77 | 3.25 | 1.48 | 5.48 | 0.302 |
BMI rate ((kg/m2)/year) | 0.84 | 1.31 | 0.48 | 1.77 | 0.400 |
WHtR rate (cm/cm/year) | 0.002 | 0.021 | −0.004 | 0.035 | 0.469 |
Change in FID | −0.20 | 0.58 | −0.10 | 0.49 | 0.509 |
MALES | |||||
Stature rate (cm/year) | 7.00 | 2.40 | 7.07 | 2.99 | 0.910 |
Weight rate (kg/year) | 6.80 | 3.30 | 4.31 | 3.45 | 0.003 |
WC rate (cm/year) | 4.18 | 3.60 | 0.84 | 3.03 | 0.000 |
BMI rate (kg/m2/year) | 1.13 | 1.15 | −0.09 | 1.67 | 0.001 |
WHtR rate (cm/cm/year) | 0.007 | 0.026 | −0.016 | 0.025 | 0.000 |
Change in FID | 0.09 | 0.78 | 0.24 | 1.48 | 0.592 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Zaccagni, L.; Rinaldo, N.; Mazzoni, G.; Mandini, S.; Masotti, S.; Toselli, S.; De Luca, F.; Gualdi-Russo, E. Assessing the Impact of COVID-19 Prevention Measures on Adolescent Growth in Italy. Healthcare 2023, 11, 2101. https://doi.org/10.3390/healthcare11142101
Zaccagni L, Rinaldo N, Mazzoni G, Mandini S, Masotti S, Toselli S, De Luca F, Gualdi-Russo E. Assessing the Impact of COVID-19 Prevention Measures on Adolescent Growth in Italy. Healthcare. 2023; 11(14):2101. https://doi.org/10.3390/healthcare11142101
Chicago/Turabian StyleZaccagni, Luciana, Natascia Rinaldo, Gianni Mazzoni, Simona Mandini, Sabrina Masotti, Stefania Toselli, Federica De Luca, and Emanuela Gualdi-Russo. 2023. "Assessing the Impact of COVID-19 Prevention Measures on Adolescent Growth in Italy" Healthcare 11, no. 14: 2101. https://doi.org/10.3390/healthcare11142101
APA StyleZaccagni, L., Rinaldo, N., Mazzoni, G., Mandini, S., Masotti, S., Toselli, S., De Luca, F., & Gualdi-Russo, E. (2023). Assessing the Impact of COVID-19 Prevention Measures on Adolescent Growth in Italy. Healthcare, 11(14), 2101. https://doi.org/10.3390/healthcare11142101