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1.
Meals served through the National School Lunch Program (NSLP) must meet rigorous nutritional standards; however, barriers to student participation may limit the program's health and social equity benefits. Unsubsidized meals and food offerings competing with the NSLP offerings in school lunch environments may be lowering qualified student participation either directly or via identification of subsidized low-income students or stigmatization of the NSLP. We document a pilot intervention conducted in San Francisco in 2009 and 2010 that demonstrated gains in NSLP participation after removal of separate competitive à la carte lunch meal offerings. Our observations suggest the need for greater attention to the potential discriminatory effects of competitive foods and to the issue of stigma by school nutrition program administrators, researchers, regulators, and policymakers.  相似文献   

2.
BACKGROUND: Competitive foods/beverages are those in school vending machines, school stores, snack bars, special sales, and items sold à la carte in the school cafeteria that compete with United States Department of Agriculture (USDA) meal program offerings. Grouping à la carte items with less nutritious items allowed in less regulated venues may obfuscate analysis of the school competitive food environment. Excluding à la carte items from competitive foods, the objectives were to: (1) assess competitive food use by gender, ethnicity, eligibility for free or reduced-price meals, and participation in school meals programs, (2) determine differences between grade levels in energy intakes obtained from food sources, (3) determine the nutrient intake derived from competitive foods for students who consumed them, and (4) determine energy-adjusted differences in 24-hour nutrient intakes of protein, calcium, iron, and other selected nutrients between competitive food consumer and nonconsumers. METHODS: Competitive foods/beverages use, excluding à la carte items, was examined using the third School Nutrition Dietary Assessment Study (SNDA III), a nationally representative sample of 2309 schoolchildren in grades 1 to 12. Mean nutrient intakes were adjusted for energy intake and other covariates, and differences between consumers and nonconsumers of competitive items were determined using analysis of variance and sudaan . RESULTS: Excluding à la carte items, 22% of schoolchildren consumed competitive items in a representative school day and use was highest in high school. Consumers of competitive items other than à la carte had significantly higher mean energy, sugar intakes, and lower sodium, dietary fiber, B vitamins, and iron intakes than nonconsumers. CONCLUSIONS: Use of competitive foods/beverages, excluding à la carte, was detrimental to children's diet quality.  相似文献   

3.
BACKGROUND: The prevalence of childhood "overweight" and "at risk for overweight" has become a major public health concern. School food environments can affect key nutritional risk factors, especially in high schools where foods of poor nutrient value are pervasive in à la carte and vending programs. This study examines à la carte and vending programs in Maine public high schools at baseline and following implementation of low-fat (defined as items相似文献   

4.
We assessed the impact of a pilot middle school a la carte intervention on food and beverage purchases, kilocalories, fat, carbohydrate, and protein sold per student, and nutrient density of the foods sold. A la carte sales were obtained from six middle schools in three states for 1 baseline week and daily during the 6-week intervention. Intervention goals included reducing sizes of sweetened beverages and chips, and increasing the availability of water and reduced-fat/baked chips. Nutrients sold per day were computed and weekly nutrient means per student and per number of items sold were calculated and compared between baseline and week 6. Five schools achieved all goals at 6 weeks. Four schools showed increases in the percentage of kilocalories from protein and decreases in the amount of sweetened beverages sold; five showed substantial increases in water sales. Changes in regular chips varied by school. There were significant changes in energy density of foods sold. School foodservice changes in middle school snack bar/a la carte lines can be implemented and can lead to a reduction in the caloric density of foods purchased.  相似文献   

5.
BACKGROUND: To enhance the impact of school nutrition programs on children's health, more information is needed on the associations between healthy and unhealthy food offerings during school lunch periods and children's eating behavior. The purpose of this study is to evaluate the contributions of food offerings and participation in school lunch programs on children's overall (both in‐ and out‐of‐school) eating behavior. METHODS: A cross‐sectional observational study was conducted in which 2039 students in 12 elementary and 10 middle schools reported their eating behavior and the frequencies with which they purchased meals and à la carte items in the school cafeteria. Food service managers from each school provided information on the availability of foods and beverages during school lunch periods. Multilevel regression analyses were conducted to identify school‐ and student‐level predictors of children's eating behavior. RESULTS: The availability of nutritious foods during school lunch periods was associated with healthier eating behavior among students. However, this effect was observed only among children who infrequently purchased à la carte food items, and not among those who were frequent purchasers. CONCLUSION: Increased availability of fruits, vegetables, whole grains, and low‐fat dairy products as components of school meals may be an effective strategy to promote healthy eating behaviors among children. Improving the nutrition standards for foods offered in competition with federally reimbursable school meals may enhance the positive effects of school meal programs on student eating behavior.  相似文献   

6.
BACKGROUND: The purpose of this research is to evaluate 2 methods of assessing foods available on school à la carte lines for schools' ability to assess the proportion of foods that are healthful options. METHODS: This observational study used data collected at 38 middle schools, October 2006‐May 2007. An inventory method was used to collect detailed information of items available on each school's à la carte line, followed by a simplified checklist form. Using the detailed inventory method, the proportion of items meeting the Institute of Medicine's (IOM) nutrition standards for foods available at each school was calculated. From the checklists, we calculated the proportion of categories representing more healthful foods. Schools were independently ranked according to the percentage of items meeting the IOM criteria, (inventory data) and the percentage of food categories considered “healthy” (checklist data). Wilcoxon rank sum test was used to compare school rankings. RESULTS: The inventory and checklist approaches showed a good level of agreement when both methods were independently used to rank the level of healthy foods available on à la carte (Wilcoxon rank sum = 32.5, p = .62). CONCLUSION: For purposes of ranking schools along a continuum of “healthfulness of foods on à la carte lines,” especially when resources are limited, a checklist approach appears to be satisfactory. This method may also be useful to school stakeholders needing an inexpensive à la carte assessment tool.  相似文献   

7.
BACKGROUND: Food service directors have a concern that federal reimbursement is not meeting the demands of increasing costs of healthier meals. The purpose of this article is to report the food option changes and the annual revenues and expenses of the school food service environment. METHODS: The HEALTHY study was a 3-year (2006 to 2009) randomized, cluster-designed trial conducted in 42 middle schools at 7 field centers. The schools selected had at least 50% of students who were eligible for free or reduced-price lunch or who belonged to a minority group. A randomly assigned half of the HEALTHY schools received a school health intervention program consisting of 4 integrated components: nutrition, physical activity, behavioral knowledge and skills, and social marketing. The nutrition component consisted of changing the meal plans to meet 5 nutrition goals. Revenue and expense data were collected from income statements, federal meal records, à la carte sale sheets, school store sale sheets, donated money/food records, and vending machines. RESULTS: Although more intervention schools reached the nutritional goals than control schools, revenues and expenses were not significantly different between groups. CONCLUSION: The HEALTHY study showed no adverse effect of school food policies on food service finances.  相似文献   

8.
ObjectiveTo present data on trends in foods and beverages offered through the National School Lunch Program (NSLP) in public middle and high schools in the years immediately preceding and following implementation of new NSLP standards.MethodFrom 2011 to 2013, primary data collection through the annual Youth, Education, and Society study involved use of mailed questionnaires to obtain data on NSLP meals from schools attended by nationally representative samples of US 8th, 10th, and 12th grade students (N = 792 middle schools and 751 high schools). Each school was weighted to represent the percentage of target grade students enrolled, thus allowing analyses examining changes over time in the percentage of students enrolled in (attending) schools with specified NSLP measure outcomes, as well as disparities in NSLP measures based on school characteristics.ResultsSignificantly more US secondary students attended schools with specified NSLP measures in 2013 than in 2011; increases were observed at both middle and high school levels. Increase rates for some NSLP measures were moderated by school characteristics; where this was the case, moderating associations decreased prior NSLP nutrition environment disparities that were especially evident in smaller schools and schools with higher percentages of minority students.ConclusionMeaningful improvements have been made in the nutritional content of NSLP meals offered to US secondary students; these improvements have reduced prior NSLP meal disparities associated with school characteristics. Schools will need continued help with implementation and compliance monitoring in order to have the best opportunity to improve the nutrition environments for US students.  相似文献   

9.
The Healthy, Hunger-Free Kids Act of 2010 updated the nutrition standards in the National School Lunch and School Breakfast Programs (NSLP and SBP) and expanded universal free meals’ availability in low-income schools. Past studies have shown that school meals are an important resource for children in food-insecure households. This analysis used data from the School Nutrition and Meal Cost Study to classify students as food insecure (FI), marginally secure (MS), or food secure (FS). Diet quality from school and nonschool foods that students consumed was assessed using Healthy Eating Index (HEI)-2010 scores. Chi-squared and two-tailed t-tests were conducted to compare school meal participation, students’ energy intakes, and diet quality across food security groups. FI and MS students were significantly more likely to participate in NSLP than FS students (79%, 71%, and 49%, respectively). SBP participation followed a similar pattern but was lower (38% FI, 33% MS, and 16% FS). Compared to FS students, FI and MS students more likely attended schools offering SBP, universal free meals, or afterschool snacks and suppers. School meals contributed significantly more energy to FI and MS students’ diets than to FS students (22%, 20%, and 13%, respectively). All groups’ dietary intakes from school foods were of higher quality than non-school foods. These findings highlight the role of school meals in meeting the energy and diet quality needs of FI and MS students.  相似文献   

10.
In response to concerns about childhood obesity, many US states have implemented policies to limit the sale of unhealthy foods and beverages (e.g., snacks, desserts, and sugary drinks) sold in competition with school meal programs (i.e., competitive foods) in order to improve the nutritional environment of schools and support student health. This study measured state-level competitive food and beverage policies that require foods and beverages sold in à la carte lines, vending machines, and school stores to meet strong nutrition standards and tested the hypothesis that students living in states with stronger laws would have lower body mass index (BMI)-for-age percentiles. BMI data from a national sample of 1625 students attending 284 schools from the School Nutrition and Meal Cost Study were linked to state laws coded as part of the National Wellness Policy Study. A survey-adjusted linear regression model accounting for student and school-level characteristics showed that stronger state nutrition policies were associated with lower student BMI scores (coefficient: −0.06, 95% CI: −0.12, −0.00). Additional models indicated that stronger state policies were significantly associated with fewer unhealthy foods and beverages available in schools. These findings suggest that strong regulations on competitive foods and beverages may lead to improvements in the nutritional quality of the school environment and student BMI. Thus, current federal standards regulating snacks in US schools (i.e., Smart Snacks) are an important element of a comprehensive strategy to improve the school nutrition environment and reduce rates of childhood obesity.  相似文献   

11.
OBJECTIVES: We examined the association between young adolescents' dietary behaviors and school vending machines, à la carte programs, and fried potatoes' being served at school lunch. METHODS: Using a cross-sectional study design, we measured à la carte availability and the number of school stores, vending machines, and amounts of fried potatoes served to students at school lunch in 16 schools. Grade 7 students (n = 598) completed 24-hour dietary recall interviews. RESULTS: A la carte availability was inversely associated with fruit and fruit/vegetable consumption and positively associated with total and saturated fat intake. Snack vending machines were negatively correlated with fruit consumption. Fried potatoes' being served at school lunch was positively associated with vegetable and fruit/vegetable intake. CONCLUSIONS: School-based programs that aim to promote healthy eating among youths should target school-level environmental factors.  相似文献   

12.
Background: The USDA child meal programs (CMPs) (National School Lunch Program (NSLP), School Breakfast Program (SBP), and Summer Food Service Program (SFSP) were established in 1946 (NSLP) and 1975 (SBP and SFSP) to improve the diet and nutritional health of US children. There is concern that participation in these programs may in fact be a contributor to the current childhood obesity epidemic. Objective: The purpose of this study was to determine if the CMPs are meeting their intended goal by reviewing the historical changes to nutrition standards of the CMPs in correspondence with the literature that examines the nutritional adequacy of meals served as part of these programs, as well as the dietary intakes and nutritional status of participants. Methods: Public Law and the Federal Register were reviewed and websites and online databases were systematically searched. Results: NSLP and SBP first underwent updates to the nutrition standards in 1994 and subsequently 2010, whereas SFSP last underwent modifications in 2000. The majority of data, all collected prior to 2010, demonstrate that meals served as part of the NSLP and SBP are not meeting nutrition standards. In addition, the dietary intakes of NSLP and SBP participants are high in calories, fat, saturated fat, and sodium, and low in fiber. Studies examining the weight status and other nutrition-related health outcomes of NSLP and SBP participants have produced mixed results. In contrast, no studies published in the peer-reviewed literature have been conducted examining the nutritional adequacy of SFSP meals or the dietary intakes or nutritional health of SFSP participants. There are public reports available on the nutritionally adequacy of SFSP meals, however, they are severely outdated (1988 and 2003). Due to this dearth of information, a case study on a sample SFSP menu from summer 2015 was conducted; results showed that the meals are high in carbohydrate and protein content and insufficient in vegetable servings. Conclusions: There is critical need for policy change that would enable updates to the SFSP nutrition standards to match those of the NSLP and SBP. In addition, strategies are needed to facilitate development of CMP menus that meet current nutrition standards. Finally, rigorously designed studies are needed to understand the direct impact of CMP participation on child diet and health, particularly the SFSP for which there is limited published data.  相似文献   

13.
OBJECTIVES: This study described the food environment in 20 Minnesota secondary schools. METHODS: Data were collected on school food policies and the availability and nutritional content of foods in school à la carte (ALC) areas and vending machines (VMs). RESULTS: Approximately 36% and 35% of foods in ALC areas and in VMs, respectively, met the lower-fat criterion (< or = 5.5 fat grams/serving). The chips/crackers category constituted the largest share of ALC foods (11.5%). The median number of VMs per school was 12 (4 soft drink, 2 snack, 5 other). Few school food policies were reported. CONCLUSIONS: The availability of healthful foods and beverages in schools as well as school food policies that foster healthful food choices among students needs greater attention.  相似文献   

14.
Objectives. We assessed the effect of the Texas Public School Nutrition Policy on middle school student lunchtime food consumption.Methods. Three years of lunch food records were collected from middle school students in southeast Texas: baseline (2001–2002), after local district changes (2002–2003), and 1 year after implementation of the Texas Public School Nutrition Policy (2005–2006). Students recorded amount and source of foods and beverages they consumed. Analysis of variance and covariance and nonparametric tests were used to compare intake after the policy change with intake during the 2 previous years.Results. After implementation of the nutrition policy, student lunch consumption of vegetables, milk, and several nutrients increased (protein, fiber, vitamins A and C, calcium, and sodium), and consumption of less desirable items (sweetened beverages, snack chips) decreased, as did percentage of energy from fat. Most of the desired nutrients and foods (vegetables and milk) were obtained from the National School Lunch Program meal. Fewer sweetened beverages, candy, chips, and dessert foods were purchased and consumed, but more of these items were brought from home and purchased from the snack bar.Conclusions. Overall, state school nutrition policies can improve the healthfulness of foods consumed by students at lunch.Public health efforts to reduce the increasing rates of childhood obesity1 have recently focused on school food environments.2 Although regulations exist for National School Lunch Program (NSLP) meals, there are no federal rules for competitive foods sold elsewhere in the school such as in snack bars and vending machines, except for foods of minimal nutritional value (e.g., soda).3 This has become an issue because the school environment influences dietary behavior.4 For example, middle school students with access to snack bar and a la carte foods consumed more sweetened beverages and french fries, and fewer fruit and vegetables compared with elementary school students without snack bars.5,6 The number of snack vending machines was negatively related to daily fruit consumption among middle school youth.7 In high schools where soft drink machines were turned off during lunch, students purchased fewer soft drinks compared with students in schools where these machines were on during lunch.8 Improving types and portion sizes of foods available in school snack bars and a la carte could reduce the source of kilojoules available for student purchase and possibly improve energy balance.9States, school districts, and individual schools have enacted laws and policies regarding foods and beverages available in school food environments.10 The beverage industry also developed a voluntary beverage vending policy for schools.11 Such changes are controversial, and barriers to improving school food environments exist. These include the revenue generated from vending and snack bar and a la carte sales,12 school staff, student and parent attitudes toward types of foods expected in schools,13 and the concern that limiting access to these foods at school will not improve overall student dietary intake.14 Critics suggest that if these items are not available in schools, students will compensate by increasing consumption of desired foods in out-of-school environments.14Few data exist for the effect of policy changes on actual food consumption by students at school. One recent study documented significant improvements in food consumption by Texas middle school students (more milk, calcium, and vitamin A; fewer sweetened beverages) after a local school district enacted a snack bar food policy change.15 Consumption of chips purchased from the snack bar declined, but consumption of chips from vending machines increased, because the school administration, which was responsible for vending machines, made no changes. These results suggest that all school food sources have to make similar changes to favorably influence consumption.The Texas Public School Nutrition Policy, an unfunded mandate to promote a healthy school environment for Texas students, was implemented statewide in the fall of 2004. The guidelines apply to all school food sources, including vending machines.16 For middle schools, the policy restricts the portion sizes of high-fat and sugar snacks (limits vary by food group), sweetened beverages (≤ 12 oz), and the fat content of all foods served (≤ 28 grams of fat per serving no more than 2 times per week). It also sets limits on the frequency of serving high-fat vegetables such as french fries (3 oz per serving no more than 3 times per week). We report the results of a naturalistic study that assessed the effect of the Texas Public School Nutrition Policy on lunch consumption of middle school students in southeast Texas. Student lunch consumption data for 2 previous years were available for comparison.15  相似文献   

15.
It is the position of the American Dietetic Association (ADA) that schools and communities have a shared responsibility to provide students with access to high-quality, affordable, nutritious foods and beverages. School-based nutrition services, including the provision of meals through the National School Lunch Program and the School Breakfast Program, are an integral part of the total education program. Strong wellness policies promote environments that enhance nutrition integrity and help students to develop lifelong healthy behaviors. ADA actively supported the 2004 and proposed 2010 Child Nutrition reauthorization which determines school nutrition policy. ADA believes that the Dietary Guidelines for Americans should serve as the foundation for all food and nutrition assistance programs and should apply to all foods and beverages sold or served to students during the school day. Local wellness policies are mandated by federal legislation for all school districts participating in the National School Lunch Program. These policies support nutrition integrity, including a healthy school environment. Nutrition integrity also requires coordinating nutrition education and promotion and funding research on program outcomes. Registered dietitians and dietetic technicians, registered, and other credentialed staff, are essential for nutrition integrity in schools to perform in policy-making, management, education, and community-building roles. A healthy school environment can be achieved through adequate funding of school meals programs and through implementation and evaluation of strong local wellness policies.  相似文献   

16.
BACKGROUND: The international prevalence of childhood obesity and obesity-related diseases has received increasing attention. Applying data from the Centers for Disease Control and Prevention, we explore relationships between childhood obesity and school type, National School Lunch Program (NSLP) and School Breakfast Program (SBP) eligibility, membership in sports clubs and other sociodemographic, and household factors. METHODS: Nonlinear regression models with interaction terms were developed to investigate the effects of school type, physical activity, and NSLP/SBP, etc, on children's body mass index (BMI). Probit models then examine the probability of a child being overweight. RESULTS: Though clinically small, statistically significant effects on BMI were found for children from households eligible for the NSLP/SBP, attending public schools. They have a mean BMI value 0.401 higher than counterparts attending private schools (p < .05). If the child both attends public school and is eligible for the NSLP/SBP, then his or her BMI is 0.725 higher (p < .001). Children taking part in the NSLP or SBP have a 4.5% higher probability of being overweight (p < .001). CONCLUSIONS: Regardless of household socioeconomic status, children attending public schools have higher BMI than those attending private schools. Eligibility for free or reduced-cost lunch or breakfast programs at public schools is positively correlated with children's BMI. Children attending public schools are more likely to be overweight. In lower socioeconomic status households, school type does not have a significant effect on the probability of being overweight. Policy recommendations for factors to address childhood obesity are discussed.  相似文献   

17.
BACKGROUND: This article seeks to inform state and local school food policies by evaluating the impact of Connecticut's Healthy Food Certification (HFC), a program which provides monetary incentives to school districts that choose to implement state nutrition standards for all foods sold to students outside reimbursable school meals. METHODS: Food service directors from all school districts participating in the National School Lunch Program (NSLP) (N = 151) in Connecticut were surveyed about the availability of competitive foods before and after the 2006-2007 implementation of HFC. Food categories were coded as healthy or unhealthy based on whether they met the Connecticut Nutrition Standards. Data on NSLP participation were provided by the State Department of Education. Changes in NSLP participation and availability of unhealthy competitive foods in elementary, middle, and high schools were compared pre- and post-HFC across districts participating (n = 74) versus not participating (n = 77) in HFC. RESULTS: On average, all districts in Connecticut reduced the availability of unhealthy competitive foods, with a significantly greater reduction among HFC districts. Average NSLP participation also increased across the state. Participating in HFC was associated with significantly greater NSLP participation for paid meals in middle school; however, implementing HFC did not increase overall NSLP participation beyond the statewide upward trend. CONCLUSION: The 2006–2007 school year was marked by a significant decrease in unhealthy competitive foods and an increase in NSLP participation across the state. Participation in Connecticut's voluntary HFC further reduced the availability of unhealthy competitive foods in local school districts, and had either a positive or neutral effect on NSLP participation.  相似文献   

18.
Background: This study examined foods packed and consumed by children with autism spectrum disorder (ASD) and calculated the percentage of packed school lunches meeting National School Lunch Program (NSLP) standards. Fruit and vegetable (FV) consumption was further examined by investigating its association with the number and type of foods packed. Methods: Participants included 59 private school students observed for five school meals. Servings of foods and beverages packed and consumed and the percentages of correspondence between food packed and consumed were calculated. Next, the percentages of lunches meeting NSLP guidelines were calculated. Finally, mealtime means were calculated for the number of foods packed, FVs packed, and FVs consumed. Results: There was a high correspondence between foods packed and consumed. Fresh fruits and sugar-added drinks were most often packed and consumed. The percentage of meals meeting NSLP guidelines was higher than previous non-ASD samples. More FV consumption was associated with more FVs packed and fewer total foods packed. FV consumption was highest with 4 < 5 foods packed, including 2+ FVs. Conclusions: Future studies should compare foods packed and consumed by children with and without ASD. The FV consumption findings suggest parents may increase children’s FV consumption by packing approximately four total foods with two FVs.  相似文献   

19.
BACKGROUND: Across the nation, schools have become actively involved in developing obesity prevention strategies both in classrooms and in cafeterias. We sought to determine the type of foods being offered during lunch in the cafeteria of 3 public high schools in 1 county and if this reflects the purchasing patterns of students. By labeling foods based on nutrient density using a stoplight approach of green, yellow, and red colors, we were able to categorize all foods including the National School Lunch Program (NSLP) and competitive foods available in the cafeteria. METHODS: Over a 4-week cycle, daily food purchases were gathered and the proportions of green, yellow, and red foods offered and purchased was compared. RESULTS: Findings from this study suggest that students in these 3 high schools purchased foods in relative proportion to what was available in the school cafeteria for the NSLP. Green and yellow foods included in the NSLP comprised 77% of the offerings and 73% of the purchases. In contrast, 61% of the competitive foods were classified as red foods, and the purchasing of red foods made up 83% of competitive food sales. These results indicate that students purchase foods of minimal nutritional value at greater proportions in the school cafeteria. CONCLUSIONS: These results suggest that the nutritional policy for the NSLP promotes the offerings of a wide array of foods. Schools should consider a nutrition policy that regulates the sale of competitive foods.  相似文献   

20.
It is the position of the American Dietetic Association that the schools and the community have a shared responsibility to provide all students with access to high-quality foods and school-based nutrition services as an integral part of the total education program. Educational goals, including the nutrition goals of the National School Lunch Program and the School Breakfast Program, should be supported and extended through school district wellness policies that create overall school environments that promote access to healthful school meals and physical activity and provide learning experiences that enable students to develop lifelong healthful eating habits. The National School Lunch and School Breakfast Programs are an important source of nutrients for school-age children, and especially for those of low-income status. The American Dietetic Association was actively involved in the 2004 reauthorization of these programs, ensuring access through continued funding, promoting nutrition education and physical activity to combat overweight and prevent chronic disease, and promoting local wellness policies. The standards established for school meal programs result in school meals that provide nutrients that meet dietary guidelines, but standards do not apply to foods and beverages served and sold outside of the school meal. Labeled as competitive foods by the US Department of Agriculture, there is a growing concern that standards should be applied to food in the entire school environment. Legislation has mandated that all school districts that participate in the US Department of Agriculture's Child Nutrition Program develop and implement a local wellness policy by the school year 2006-2007. Resources are available to assist in the development of wellness policies, and dietetics professionals can assist schools in developing policies that meet nutrition integrity standards.  相似文献   

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