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Article History

Accepted: 14 April 2025

First Online: 30 May 2025

Declarations

:

: No funding was received to conduct this study or prepare this article.

: Alan M. Nevill, Justin J. Lang, Mark Niemz, and Grant R. Tomkinson have no conflicts of interest that are directly relevant to the content of this article.

: The NHANES protocols (Protocol #2011-17) were approved by the National Center for Health Statistics Research Ethics Review Board in compliance with the revised Declaration of Helsinki. We did not seek additional approval because the data used in this study were free from personal identifiers.

: Signed parental consent (participants aged 0–6 years), signed parental consent and child assent (participants aged 7–17 years), and signed consent (participants aged 18 + years) were provided as part of the original NHANES data collection. No consent was required for our study.

: Not applicable.

: Data are publicly available from the Centers for Disease Control and Prevention, National Center for Health Statistics (, ).

: Not applicable.

: AMN, JJL, and GRT conceptualized/designed the study and drafted the manuscript. AMN analyzed the data. All authors contributed to the interpretation of the results, edited and critically reviewed the manuscript for important intellectual content, approved the manuscript as submitted, and agreed to be accountable for all aspects of the work.

: The content and views expressed in this article are those of the authors and do not necessarily reflect those of the Government of Canada.