National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Behavioral Health (1)
- Cancer (1)
- Cardiovascular Conditions (1)
- Caregiving (1)
- Case Study (1)
- Children/Adolescents (6)
- Chronic Conditions (2)
- Comparative Effectiveness (2)
- Diabetes (1)
- Disparities (1)
- Education (1)
- Education: Patient and Caregiver (2)
- Elderly (2)
- Emergency Department (1)
- Evidence-Based Practice (1)
- Family Health and History (2)
- Health Status (1)
- Heart Disease and Health (1)
- Human Immunodeficiency Virus (HIV) (2)
- Kidney Disease and Health (1)
- Lifestyle Changes (5)
- Long-Term Care (1)
- Low-Income (5)
- Maternal Care (1)
- Medication (1)
- Neurological Disorders (1)
- Newborns/Infants (2)
- Nursing Homes (1)
- (-) Nutrition (24)
- Obesity (9)
- Obesity: Weight Management (2)
- Outcomes (1)
- Policy (2)
- Pregnancy (1)
- Prevention (1)
- Racial and Ethnic Minorities (1)
- Risk (1)
- Social Determinants of Health (3)
- Treatments (1)
- U.S. Preventive Services Task Force (USPSTF) (1)
- Vulnerable Populations (5)
- Women (2)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 24 of 24 Research Studies DisplayedJones SA, Schlundt DG, Bonnet KR
Head Start's role in addressing food and nutrition insecurity: focus group findings.
The purpose of this study was to explore the perspectives of Head Start (HS) families' and employees' on family experiences with food and nutrition insecurity (FNI) and determine if and how HS addresses them. From August 2021 to January 2022, the researchers conducted 4 virtual focus groups with 27 HS employee and family participants. The study found that when addressing multilevel factors affecting FNI, HS's 2-generational method is useful for families. It was also determined that the role of the family advocate is critical. Finally, in addition to improving access to nutritious foods, skills and education to decrease generational unhealthy behaviors should be emphasized.
AHRQ-funded; HS026122.
Citation: Jones SA, Schlundt DG, Bonnet KR .
Head Start's role in addressing food and nutrition insecurity: focus group findings.
J Nutr Educ Behav 2023 Aug; 55(8):612-20. doi: 10.1016/j.jneb.2023.04.004..
Keywords: Children/Adolescents, Nutrition
Heerman WJ, Sneed NM, Sommer EC
Ultra-processed food consumption and BMI-Z among children at risk for obesity from low-income households.
The purpose of this study was to assess the relationship between baseline ultra-processed food consumption in early childhood and child BMI Z-score over 36 months. Among 595 children, median baseline age was 4.3 years, 65.4% had normal weight, 33.8% were overweight, and 0.8% were obese. When compared with low ultra-processed consumption (300 kcals/day), High ultra-processed intake (1300 kcals/day) was related with a 1.2 higher BMI-Z at 36 months for 3-year-olds and a 0.6 higher BMI-Z for 4-year-olds. The difference was not statistically significant for 5-year-olds or overall.
AHRQ-funded; HS026122.
Citation: Heerman WJ, Sneed NM, Sommer EC .
Ultra-processed food consumption and BMI-Z among children at risk for obesity from low-income households.
Pediatr Obes 2023 Aug; 18(8):e13037. doi: 10.1111/ijpo.13037..
Keywords: Children/Adolescents, Obesity, Low-Income, Nutrition, Vulnerable Populations
Sneed NM, Azuero A, Moss J
Total added sugar consumption is not significantly associated with risk for prediabetes among U.S. adults: National Health and Nutrition Examination Survey, 2013-2018.
This study examined if total grams/day and percent intakes of <10%, 10-15%, or >15% added sugar increase the odds for prediabetes in U.S. adults. A cross-sectional secondary analysis of 2013-2018 National Health and Nutrition Examination Survey (NHANES) data was conducted. The study included data from adults ≥ 20 years with normoglycemia (N = 2,154) and prediabetes (N = 3,152) with 1-2 days of dietary recall information. The National Cancer Institute Method was used to estimate odds ratios of prediabetes based on usual intakes of added sugar (total and percent intakes). Total energy intake of the sample from added sugar was 13.9%. Total and percent intakes of added sugar and adjusted intakes were not significantly associated with an increased odds of prediabetes. Prediabetes did not differ by race/ethnicity or percent of added sugar intakes.
AHRQ-funded; HS026122.
Citation: Sneed NM, Azuero A, Moss J .
Total added sugar consumption is not significantly associated with risk for prediabetes among U.S. adults: National Health and Nutrition Examination Survey, 2013-2018.
PLoS One 2023 Jun 20; 18(6):e0286759. doi: 10.1371/journal.pone.0286759..
Keywords: Diabetes, Nutrition
Brown T, Brody R, Sackey J
Dietary intake correlated to waist-to-hip ratio in patients on maintenance hemodialysis.
Patients with end-stage renal disease (ESRD) undergoing regular hemodialysis (RHD) are susceptible to protein-energy malnutrition (PEM). Insufficient dietary consumption and changes in body measurements are among the diagnostic criteria for PEM. The purpose of this study was to measure the adherence of ESRD patients on RHD to the 2020 National Kidney Foundation Kidney Disease Outcome Quality Initiative (NKF-KDOQI) recommendations for nutritional sufficiency during a dialysis day (DD) and analyze the association between dietary energy (DEI) and protein (DPI) intake and body measurements. The study utilized a secondary review of clinical and demographic data from 142 adults in the Rutgers Nutrition and Kidney Disease database. The correlations between DEI, DPI, and body measurements such as body mass index (BMI), BMI classification, waist circumference, and waist-to-hip ratio (WHR) were evaluated. The study found that the median age of the participants was 55.7 years, with 58% being male and 83.8% identifying as Black/African American. The median time spent on dialysis was 42.0 months (approximately 3.5 years). Seventy-five percent of the participants were classified as overweight or obese. The WHR was 1.0 ± 0.8 cm for males and 0.9 ± 0.1 cm for females. Neither DEI nor DPI on a DD complied with the NKF-KDOQI 2020 recommendations. The median DEI was 17.6 ± 8.4 kcal/kg, and DPI was 0.7 ± 0.4 g/kg. Significant positive correlations were found between DEI and DPI and WHR for the entire sample. In females, a significant positive correlation emerged between DPI and WHR. The researchers concluded that the nutritional consumption of ESRD patients undergoing RHD falls short of the NKF-KDOQI 2020 guidelines on a DD.
AHRQ-funded; HS023434
Citation: Brown T, Brody R, Sackey J .
Dietary intake correlated to waist-to-hip ratio in patients on maintenance hemodialysis.
J Ren Nutr 2023 Mar;33(2):355-62. doi: 10.1053/j.jrn.2022.09.012.
Keywords: Kidney Disease and Health, Nutrition, Chronic Conditions
Sonik RA, Coleman-Jensen A, Creedon TB
SNAP participation and emergency department use.
The objectives of this study were to examine whether Supplemental Nutrition Assistance Program (SNAP) participation is associated with emergency department use among low-income children, and whether any such association is mediated by household food hardship and child health status and/or moderated by special health care needs (SHCN) status. Researched pooled cross-sectional samples of children in low-income households from 2016-19 National Survey of Children's Health. SNAP participation was found to be associated with lower likelihoods of emergency department use. The researchers concluded that food hardship relief may improve outcomes for vulnerable children as well as the health systems that serve them.
poverty food
Citation: Sonik RA, Coleman-Jensen A, Creedon TB .
SNAP participation and emergency department use.
Pediatrics 2023 Feb;151(2):e2022058247. doi: 10.1542/peds.2022-058247.
Keywords: Children/Adolescents, Nutrition, Vulnerable Populations, Low-Income, Emergency Department
Treadwell JR, Kessler SK, Wu M
Pharmacologic and dietary treatments for epilepsies in children aged 1-36 months: a systematic review.
The purpose of this systematic review study was to assess the effectiveness and harms of pharmacologic and dietary treatments for epilepsy in children aged 1-36 months without infantile spasms. The researchers searched EMBASE, MEDLINE, PubMed, and the Cochrane Library for studies published from 1/1/1999 to 8/19/21 to identify studies reporting data on children aged 1-36 months receiving pharmacologic or dietary treatments for epilepsy. Twenty-three studies met the inclusion criteria. The study found that Levetiracetam leads to seizure freedom in some infants but the data on 6 other medications (lamotrigine, phenytoin, rufinamide, stiripentol, topiramate, and vigabatrin) were too limited to allow conclusions about their effectiveness. Three medications (lamotrigine, levetiracetam, and topiramate) were rarely discontinued due to adverse effects, and severe events were also rare. In the category of diets, the ketogenic diet lead to seizure freedom in some infants and both the ketogenic diet and modified Atkins diet reduced average seizure frequency.
AHRQ-funded; 75Q80120D00002.
Citation: Treadwell JR, Kessler SK, Wu M .
Pharmacologic and dietary treatments for epilepsies in children aged 1-36 months: a systematic review.
Neurology 2023 Jan 3;100(1):e16-e27. doi: 10.1212/wnl.0000000000201026..
Keywords: Children/Adolescents, Neurological Disorders, Newborns/Infants, Medication, Nutrition, Treatments, Evidence-Based Practice
Egan KA, Lo BK, Haneuse S
Associations of maternal consumption of sugary beverages in pregnancy with infant weight status.
Researchers studied mother-infant dyads from a prospective cohort study in order to examine links between maternal consumption of 100% juice and sugar-sweetened beverages in the third trimester of pregnancy with infant weight status at 6 and 12 months. 100% juice consumption was found to be associated with higher infant weight-for-length at 6 months and higher odds of rapid infant weight gain from birth to 6 months and birth to 12 months. 100% juice consumption was not associated with weight-for-length at 12 months and sugar-sweetened beverage consumption was not associated with any of the outcome measures.
AHRQ-funded; HS022242.
Citation: Egan KA, Lo BK, Haneuse S .
Associations of maternal consumption of sugary beverages in pregnancy with infant weight status.
Acad Pediatr 2023 Jan-Feb; 23(1):109-16. doi: 10.1016/j.acap.2022.05.007..
Keywords: Pregnancy, Nutrition, Newborns/Infants, Maternal Care, Women
Sneed NM, Ukwuani S, Sommer EC
Reliability and validity of assigning ultraprocessed food categories to 24-h dietary recall data.
The objective of this study was to test the reliability and validity of training coders and assigning Nova categories to individual foods collected via 24-hour dietary recalls. The Nutrition Data System for Research (NDSR) software was used to collect 2-3 dietary recalls at baseline and annually for 3 years. Over 3000 unique foods were categorized. This method of Nova classifying NDSR-based 24-hour dietary recalls was found to be reliable and valid for identifying individual intake of processed foods.
AHRQ-funded; HS026122.
Citation: Sneed NM, Ukwuani S, Sommer EC .
Reliability and validity of assigning ultraprocessed food categories to 24-h dietary recall data.
Am J Clin Nutr 2023 Jan; 117(1):182-90. doi: 10.1016/j.ajcnut.2022.10.016..
Keywords: Nutrition
Boles RE, Yun L, Hambidge SJ, et al.
Influencing the home food and activity environment of families of preschool children receiving home-based treatment for obesity.
The goal of this study was to characterize the home food and activity environments of overweight and obese preschool-aged children from low socioeconomic status Latino families. It showed that despite a small, but significant reduction in preschool BMI for a subsample, families showed little change in the home food and activity environment.
AHRQ-funded; HS021138.
Citation: Boles RE, Yun L, Hambidge SJ, et al..
Influencing the home food and activity environment of families of preschool children receiving home-based treatment for obesity.
Clin Pediatr 2015 Dec;54(14):1387-90. doi: 10.1177/0009922815570614..
Keywords: Obesity, Children/Adolescents, Nutrition, Obesity: Weight Management, Family Health and History
Waehrer G, Deb P, Decker SL
AHRQ Author: Decker SL
Did the 2009 American Recovery and Reinvestment Act affect dietary intake of low-income individuals?
This paper examines the relationship between increased Supplemental Nutritional Assistance Program (SNAP) benefits following the 2009 American Recovery and Reinvestment Act (ARRA) and the diet quality of individuals from SNAP-eligible compared to ineligible (those with somewhat higher income). In the full sample, we find that these increases in SNAP benefits are not associated with changes in nutrient intake and diet quality.
AHRQ-authored.
Citation: Waehrer G, Deb P, Decker SL .
Did the 2009 American Recovery and Reinvestment Act affect dietary intake of low-income individuals?
Econ Hum Biol 2015 Dec;19:170-83. doi: 10.1016/j.ehb.2015.08.006..
Keywords: Nutrition, Social Determinants of Health, Low-Income, Vulnerable Populations
Whittle HJ, Palar K, Napoles T
Experiences with food insecurity and risky sex among low-income people living with HIV/AIDS in a resource-rich setting.
The researchers investigated the perceived effects of food insecurity on risky sexual behaviors among a population of low-income people living with HIV/AIDS (PLHIV) in San Francisco and Alameda County, California. Their study demonstrated that food insecurity contributes to transactional and unprotected sex among urban poor individuals in a resource-rich setting, including among men who have sex with men.
AHRQ-funded; HS000046.
Citation: Whittle HJ, Palar K, Napoles T .
Experiences with food insecurity and risky sex among low-income people living with HIV/AIDS in a resource-rich setting.
J Int AIDS Soc 2015 Nov 4;18:20293. doi: 10.7448/ias.18.1.20293..
Keywords: Human Immunodeficiency Virus (HIV), Nutrition, Lifestyle Changes, Low-Income, Social Determinants of Health
Simmons SF, Keeler E, An R
Cost-effectiveness of nutrition intervention in long-term care.
The researchers sought to determine the cost-effectiveness of two nutrition interventions on food, beverage, and supplement intake and body weight. They found that oral liquid nutrition supplements and snack offers were efficacious in promoting caloric intake when coupled with assistance to promote consumption and a variety of options, but neither intervention resulted in significant weight gain.
AHRQ-funded; HS018580.
Citation: Simmons SF, Keeler E, An R .
Cost-effectiveness of nutrition intervention in long-term care.
J Am Geriatr Soc 2015 Nov;63(11):2308-16. doi: 10.1111/jgs.13709..
Keywords: Elderly, Long-Term Care, Nursing Homes, Nutrition, Comparative Effectiveness
Kenzik KM, Morey MC, Cohen HJ
Symptoms, weight loss, and physical function in a lifestyle intervention study of older cancer survivors.
This study examined how overweight long-term survivors’ symptom severity associated with comorbidity prior to a diet and exercise intervention was associated with post-intervention function. It found that symptom severity of older, overweight cancer survivors negatively affects physical function. However, greater weight loss and more physical activity were associated with higher functioning scores, regardless of symptom severity.
AHRQ-funded; HS013852.
Citation: Kenzik KM, Morey MC, Cohen HJ .
Symptoms, weight loss, and physical function in a lifestyle intervention study of older cancer survivors.
J Geriatr Oncol 2015 Nov;6(6):424-32. doi: 10.1016/j.jgo.2015.08.004..
Keywords: Cancer, Elderly, Obesity, Nutrition
Horner-Johnson W, Dobbertin K, Kulkarni-Rajasekhara S
Food insecurity, hunger, and obesity among informal caregivers.
Increasing numbers of US residents rely on informal caregiving from friends and family members. Caregiving can have substantial health and financial impacts on caregivers. This study addressed whether those impacts include adverse nutritional states. It concluded that caregiving is associated with increased risk of food insecurity and hunger in Oregon.
AHRQ-funded; HS022981.
Citation: Horner-Johnson W, Dobbertin K, Kulkarni-Rajasekhara S .
Food insecurity, hunger, and obesity among informal caregivers.
Prev Chronic Dis 2015 Oct 8;12:E170. doi: 10.5888/pcd12.150129..
Keywords: Caregiving, Obesity, Nutrition, Health Status
Whittle HJ, Palar K, Hufstedler LL
Food insecurity, chronic illness, and gentrification in the San Francisco Bay Area: an example of structural violence in United States public policy.
This study sought to explore the experiences and structural determinants of food insecurity among a group of low-income PLHIV in the San Francisco Bay Area. It found that the lived experience of food insecurity among participants included periods of insufficient quantity of food and resultant hunger, as well as long-term struggles with quality of food that led to concerns about the poor health effects of a cheap diet.
AHRQ-funded; HS000046.
Citation: Whittle HJ, Palar K, Hufstedler LL .
Food insecurity, chronic illness, and gentrification in the San Francisco Bay Area: an example of structural violence in United States public policy.
Soc Sci Med 2015 Oct;143:154-61. doi: 10.1016/j.socscimed.2015.08.027..
Keywords: Chronic Conditions, Policy, Social Determinants of Health, Nutrition, Vulnerable Populations
Higashi RT, Craddock Lee SJ, Leonard T
Multiple comorbidities and interest in research participation among clients of a nonprofit food distribution site.
The researchers sought to better understand the health needs of a nonclinical population to inform future research and interventions. Their analysis of focus group findings led them to conclude that Crossroads Community Services clients represent a high-need, under-reached population willing to engage in health-related research that affords them opportunity to connect with peers in group settings and obtain information to improve management of daily life challenges.
AHRQ-funded; HS022418.
Citation: Higashi RT, Craddock Lee SJ, Leonard T .
Multiple comorbidities and interest in research participation among clients of a nonprofit food distribution site.
Clin Transl Sci 2015 Oct;8(5):584-90. doi: 10.1111/cts.12325.
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Keywords: Nutrition, Racial and Ethnic Minorities, Disparities, Low-Income, Vulnerable Populations
McNellis R, Lewis P
AHRQ Author: McNellis R
Behavioral counseling to promote a healthful diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors.
This case study quiz is based on the recommendations of the USPSTF. The case concerns a 34-year-old man who smokes. When he presents for his annual checkup for hypertension, his blood pressure is elevated (142/95 mm Hg), and he has gained 10 lb (4.5 kg) since his last visit.
AHRQ-authored.
Citation: McNellis R, Lewis P .
Behavioral counseling to promote a healthful diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors.
Am Fam Physician 2015 Sep 15;92(6):509-10.
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Keywords: Behavioral Health, Cardiovascular Conditions, Case Study, Lifestyle Changes, Nutrition, Prevention, Risk, U.S. Preventive Services Task Force (USPSTF)
Hoffman JA, Rosenfeld L, Schmidt N
Implementation of competitive food and beverage standards in a sample of Massachusetts Schools: the NOURISH Study (Nutrition Opportunities to Understand Reforms Involving Student Health).
This study examined the extent to which a sample of Massachusetts middle schools and high schools sold foods and beverages that were compliant with the state competitive food and beverage standards after the first year of implementation, and complied with four additional aspects of the regulation. The multilevel models used in the study demonstrated a 47-percentage-point increase in food and 46-percentage-point increase in beverage compliance in Massachusetts schools from 2012 to 2013.
AHRQ-funded; HS000055.
Citation: Hoffman JA, Rosenfeld L, Schmidt N .
Implementation of competitive food and beverage standards in a sample of Massachusetts Schools: the NOURISH Study (Nutrition Opportunities to Understand Reforms Involving Student Health).
J Acad Nutr Diet 2015 Aug;115(8):1299-307.e2. doi: 10.1016/j.jand.2015.04.019..
Keywords: Nutrition, Children/Adolescents, Education, Policy
Yaghjyan L, Sites S, Ruan Y
Associations of urinary phthalates with body mass index, waist circumference and serum lipids among females: National Health and Nutrition Examination Survey 1999-2004.
This study investigated the association of urinary phthalate metabolites and, for the first time, the ratios of the major metabolites of the most common phthalate, di-2-ethylhexyl phthalate, with body mass index (BMI), waist circumference and serum lipid levels in the US female population. It found that a higher metabolic ratio of monobutyl phthalate (MBP) and mono-2-ethylhexyl phthalate (MEHP), reflective of slower oxidative conversion of MEHP, is associated with greater BMI and waist circumference.
AHRQ-funded; HS022330.
Citation: Yaghjyan L, Sites S, Ruan Y .
Associations of urinary phthalates with body mass index, waist circumference and serum lipids among females: National Health and Nutrition Examination Survey 1999-2004.
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Keywords: Nutrition, Obesity, Women
Chen R, Smyser M, Chan N
Changes in awareness and use of calorie information after mandatory menu labeling in restaurants in King County, Washington.
This study reports on countywide and subpopulation changes in menu-labeling awareness (i.e., seeing calorie information) and use (i.e., using calorie information) before and after policy implementation. It found that awareness and use of calorie information among residents who ate at regulated chains increased significantly and across all demographic subgroups.
AHRQ-funded; HS013853.
Citation: Chen R, Smyser M, Chan N .
Changes in awareness and use of calorie information after mandatory menu labeling in restaurants in King County, Washington.
Am J Public Health 2015 Mar;105(3):546-53. doi: 10.2105/ajph.2014.302262..
Keywords: Education: Patient and Caregiver, Nutrition, Obesity, Lifestyle Changes
Chen R, Smyser M, Chan N
Changes in awareness and use of calorie information after mandatory menu labeling in restaurants in King County, Washington.
This study reports on countywide and subpopulation changes in menu-labeling awareness (i.e., seeing calorie information) and use (i.e., using calorie information) before and after policy implementation. It found that awareness and use of calorie information among residents who ate at regulated chains increased significantly and across all demographic subgroups.
AHRQ-funded; HS013853.
Citation: Chen R, Smyser M, Chan N .
Changes in awareness and use of calorie information after mandatory menu labeling in restaurants in King County, Washington.
Am J Public Health 2015 Mar;105(3):546-53. doi: 10.2105/ajph.2014.302262..
Keywords: Education: Patient and Caregiver, Nutrition, Obesity, Lifestyle Changes
McVay MA, Jeffreys AS, King HA
The relationship between pretreatment dietary composition and weight loss during a randomised trial of different diet approaches.
Identifying pretreatment dietary habits that are associated with weight-loss intervention outcomes could help guide individuals’ selection of weight-loss approach among competing options. This study concluded that selection of a weight-loss approach on the basis of pretreatment macronutrient intake is unlikely to improve weight outcomes at the end of a 1-year treatment.
AHRQ-funded; HS000079.
Citation: McVay MA, Jeffreys AS, King HA .
The relationship between pretreatment dietary composition and weight loss during a randomised trial of different diet approaches.
J Hum Nutr Diet 2015 Feb;28 Suppl 2:16-23. doi: 10.1111/jhn.12188..
Keywords: Nutrition, Obesity: Weight Management, Obesity, Outcomes, Comparative Effectiveness
Palar K, Derose KP, Linnemayr S
Impact of food support on food security and body weight among HIV antiretroviral therapy recipients in Honduras: a pilot intervention trial.
This study assessed the effect of food support on food insecurity and body weight in a population of persons living with HIV with high prevalence of overweight and obesity by implementing a pilot intervention trial in four government-run HIV clinics in Honduras. At 6 months, the probability of severe food insecurity decreased by 48.3 percent in the food support group, compared to 11.6 percent in the education-only group.
AHRQ-funded; HS00046.
Citation: Palar K, Derose KP, Linnemayr S .
Impact of food support on food security and body weight among HIV antiretroviral therapy recipients in Honduras: a pilot intervention trial.
AIDS Care 2015;27(4):409-15. doi: 10.1080/09540121.2014.983041..
Keywords: Human Immunodeficiency Virus (HIV), Obesity, Nutrition
McVay MA, King HA, Jeffreys AS
Mechanisms of patient health behavior change in a randomized controlled trial of a spouse-assisted intervention.
The authors evaluated mediators of dietary and physical activity outcomes during a spouse-assisted intervention to improve low-density lipoprotein cholesterol. They found that intervention-induced changes in spousal support and dietary self-efficacy did not translate into behavior change.
AHRQ-funded; HS000079.
Citation: McVay MA, King HA, Jeffreys AS .
Mechanisms of patient health behavior change in a randomized controlled trial of a spouse-assisted intervention.
Psychol Health Med 2015;20(7):753-66. doi: 10.1080/13548506.2015.1020817.
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Keywords: Heart Disease and Health, Family Health and History, Lifestyle Changes, Nutrition