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Promotion of physical activity and healthy food choices was hampered by competitiveness, lack of quality food, easy access to non-nutritious food, and time constraints

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Footnotes

  • For correspondence: Dr S B Austin, Division of Adolescent and Young Adult Medicine, Children’s Hospital Boston, Boston, MA, USA. bryn.austintch.harvard.edu

  • Sources of funding: Boston Obesity Nutrition Research Center; Massachusetts Health Research Institute; McCarthy Family Foundation; Maternal and Child Health Bureau, US Department of Health and Human Services.