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Diabetes Belt Definition

The Southeast Officially Dubbed The

The Southeast Officially Dubbed The "diabetes Belt"

The Southeast Officially Dubbed the "Diabetes Belt" The Southeast Officially Dubbed the "Diabetes Belt" A new study conducted by the Centers for Disease Control and Prevention (CDC) have found that the Southeast is the "diabetes belt" of the U.S. A new study conducted by the Centers for Disease Control and Prevention (CDC) have found that the Southeast is the "diabetes belt" of the U.S. By analyzing data from 644 counties, the CDC found that in the southeastalso called the "stroke belt" and the "heart-failure belt"nearly 12 percent of people living in the region suffer from diabetes, as compared with 8.5 percent in the rest of the U.S. Fifteen states in this region had especially high rates of diabetes: Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, West Virginia and Mississippi. "We have known for a long time that diabetes was more common in the Southeast than it was in the rest of the nation, but in many ways that's not an adequate definition," said the CDC report's lead researcher Lawrence Barker. Researchers found that people living in this area of the country are more likely to be overweight/obese and lead a sedentary lifestyle than other parts of the U.S.all which are major risk factors for developing diabetes. They also mention how race, age and education play a factor in their findings. In a press release, they stated , "People in the diabetes belt are more likely to be African American, and African Americans are at higher risk for type 2 diabetes. People living in the diabetes belt also are less likely to have a college degree. Lower education levels are associated with increased risk for type 2 diabetes." Diabetes is a condition in which someone has abnormal blood-sugar Continue reading >>

15 Us States Make Up Newly Identified 'diabetes Belt'

15 Us States Make Up Newly Identified 'diabetes Belt'

15 US States Make Up Newly Identified 'Diabetes Belt' Health experts have identified a "diabetes belt" that includes 644 counties in 15 states across the southern and southeastern United States, according to a new study from the Centers for Disease Control and Prevention (CDC). Nearly 12 percent of people who live in this region have diabetes , compared with 8.5 percent of people in the rest of the United States, the study said. The diabetes belt area also includes more people who are obese (32.9 percent) than in the rest of the country (26.1 percent), and more people who don't exercise regularly (30.6 percent) than in the rest of the country (24.8 percent), the study said. The main reasons for the prevalence of diabetes in this region are likely dietary habits, lack of physical activity and income level, said study researcher Lawrence E. Barker, of the CDC's Division of Diabetes Translation. "Variations in preference of diet, based on culture, may be a contributor," Barker told MyHealthNewsDaily. The diabetes belt includes counties in Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia and West Virginia. The entire state of Mississippi is also contained within the belt, the study said. The study was published March 7 in the American Journal of Preventive Medicine. Barker and his colleagues analyzed 2007 and 2008 data from the CDC's national Behavioral Risk Factor Surveillance System, which included information on health conditions and risk behaviors, and combined that information with county-level diabetes data. Counties with a diabetes prevalence of 11 percent or more were designated as part of the belt, the study said. Researchers calculated that 30 percent of the heightened risk of Continue reading >>

Diabetes Belt Identified In Southern United States

Diabetes Belt Identified In Southern United States

Follow all of ScienceDaily's latest research news and top science headlines ! Diabetes belt identified in southern United States Researchers were able to identify clustered high prevalence areas, or a "diabetes belt" of 644 counties in 15 mostly southeastern states, using data compiled for the first time of estimates of the prevalence of diagnosed diabetes for every US county. In the 1960s, a group of U.S. states with high age-adjusted stroke mortality defined a "stroke belt." Until recently, geographic patterns of diabetes had not been specifically characterized in the same manner. In an article published in the April 2011 issue of the American Journal of Preventive Medicine, researchers were able to identify clustered high prevalence areas, or a "diabetes belt" of 644 counties in 15 mostly southeastern states using data compiled for the first time of estimates of the prevalence of diagnosed diabetes for every U.S. county. "Identifying a diabetes belt by counties allows community leaders to identify regions most in need of efforts to prevent type 2 diabetes and to manage existing cases of the disease," commented lead investigator Lawrence E. Barker, PhD, Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA. "Although many risk factors for type 2 diabetes can't be changed, others can. Community design that promotes physical activity, along with improved access to healthy food, can encourage the healthy lifestyle changes that reduce the risk of developing type 2 diabetes." Nearly one third of the difference in diabetes prevalence between the diabetes belt and the rest of the U.S. is associated with sedentary lifestyle and obesity. Thirty percent of the excess Continue reading >>

Identifying Counties Vulnerable To Diabetes From Obesity Prevalence In The United States: A Spatiotemporal Analysis | Li | Geospatial Health

Identifying Counties Vulnerable To Diabetes From Obesity Prevalence In The United States: A Spatiotemporal Analysis | Li | Geospatial Health

Li, Staudt, and Chien: Identifying Counties Vulnerable to Diabetes from Obesity Prevalence in the United States: A Spatiotemporal Analysis Identifying Counties Vulnerable to Diabetes from Obesity Prevalence in the United States: A Spatiotemporal Analysis [1] Department of Biostatistics, University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Houston, TX, USA [2] Department of Epidemiology, Human Genetics & Environmental Sciences, University of Texas Health Science Center at Houston (UTHealth), School of Public Health in San Antonio, San Antonio, TX, USA [3] Department of Biostatistics, University of Texas Health Science Center at Houston (UTHealth), School of Public Health in San Antonio, San Antonio, TX, USA Correspondence to: Department of Biostatistics, University of Texas Health Science Center at Houston (UTHealth), School of Public Health in San Antonio, 7411 John Smith Drive, Suite 1100, 78229 San Antonio, TX, USA. +1.210.276.9051 - +1.210.276.9028. [email protected] [a] Conflict of interest: the authors declare no potential conflict of interest. [b] Contributions: L-CC and XL designed and coordinated this project; AS and L-CC collected data and did literature review; L-CC and XL performed spatiotemporal analyses; XL, L-CC and AS wrote, reviewed, and edited the manuscript. [c] Note: all findings and conclusions in this study are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention, Atlanta, GA, USA. Part of this paper was presented at the 2016 APHA annual meeting, 2016 Nov 1-4, Chicago, IL, USA. Clinical and epidemiological research has reported a strong association between diabetes and obesity. However, whether increased diabetes prevalence is mo Continue reading >>

Diabetes Belt Identified In Southern United States

Diabetes Belt Identified In Southern United States

Diabetes Belt Identified in Southern United States In the 1960s, a group of U.S. states with high age-adjusted stroke mortality defined a "stroke belt." Until recently, geographic patterns of diabetes had not been specifically characterized in the same manner. In an article published in the April 2011 issue of the American Journal of Preventive Medicine, researchers were able to identify clustered high prevalence areas, or a "diabetes belt" of 644 counties in 15 mostly southeastern states using data compiled for the first time of estimates of the prevalence of diagnosed diabetes for every U.S. county. "Identifying a diabetes belt by counties allows community leaders to identify regions most in need of efforts to prevent type 2 diabetes and to manage existing cases of the disease," commented lead investigator Lawrence E. Barker, PhD, Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA. "Although many risk factors for type 2 diabetes can`t be changed, others can. Community design that promotes physical activity, along with improved access to healthy food, can encourage the healthy lifestyle changes that reduce the risk of developing type 2 diabetes." Nearly one third of the difference in diabetes prevalence between the diabetes belt and the rest of the U.S. is associated with sedentary lifestyle and obesity. Thirty percent of the excess risk was associated with modifable risk factors, and 37% with nonmodifable factors, such as age and race/ethnicity. Data from the diabetes belt showed prevalence rates greater than 11.0% or higher. By comparing demographics and risk factors such as gender, age, education, sedentary lifestyle, obesity, and race/ethnicity, they f Continue reading >>

Researchers Find U.s.

Researchers Find U.s. "diabetes Belt"

NEW YORK (Reuters Health) - Already dubbed Americas stroke belt, the southeastern U.S. just earned another dubious distinction as the nations diabetes belt, government researchers said Tuesday. A diabetic patient displays her insulin supplies and blood sugar level-testing device at the J.W.C.H. safety-net clinic in the center of skid row in downtown Los Angeles, July 30, 2007. REUTERS/Lucy Nicholson They used county-by-county data to mark those areas where people are most at risk for the blood sugar disease. We have known for a long time that diabetes was more common in the Southeast than it was in the rest of the nation, but in many ways thats not an adequate definition, said Lawrence Barker of the Centers for Disease Control and Prevention (CDC) in Atlanta, who led the work. Having more specific data and a defined diabetes belt allows us to identify areas where the need is greatest and where we can direct our attention and efforts to prevent and control diabetes, Barker said. Almost 26 million people in the United States have diabetes, according to the American Diabetes Association. Annual treatment costs top $100 billion, and people with the chronic disease are also at risk for other medical conditions, including heart disease, kidney damage, and some kinds of cancer. Using national health surveys, Barker and his colleagues were able to construct a map of the U.S. in terms of diabetes rates. What emerged was a clear trend of high diabetes rates in parts of 15 different states, including Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas ,Virginia, West Virginia and the entire state of Mississippi. Close to 12 percent of people in the diabetes belt had the disease, compared to 8.5 percent in Continue reading >>

Diabetes Prevalence Is Associated With Different Community Factors In The Diabetes Belt Versus The Rest Of The United States: Diabetes Prevalence And Related Community Factors

Diabetes Prevalence Is Associated With Different Community Factors In The Diabetes Belt Versus The Rest Of The United States: Diabetes Prevalence And Related Community Factors

Objective: To investigate differences in community characteristics associated with diabetes prevalence between the Diabetes Belt and the rest of the contiguous United States (U.S.) Methods: County-level adult diabetes prevalence estimates (i.e., percent of people [20 years] with diag- nosed diabetes 2009) were used from the Centers for Disease Control and Prevention, in addition to data from the U.S. Census Bureau, U.S. Department of Agriculture, and U.S. Department of Health and Human Services, to carry out a spatial regime analysis to identify county-level factors correlated with dia- betes prevalence in the Diabetes Belt versus the remainder of the U.S. Results: Counties outside of the Diabetes Belt demonstrated stronger positive associations between dia- betes prevalence and persistent poverty and greater percentages of unemployed labor forces. For coun- ties in the Diabetes Belt, diabetes prevalence showed a stronger positive association with natural amenities (e.g., temperate climate and topographic features) and a stronger negative association with fit- Conclusions: Community-level correlates of diabetes prevalence differed between the Diabetes Belt and elsewhere in the U.S. Economic hardship was shown to be more relevant outside the Diabetes Belt, while recreational context effects were more pronounced among counties within the region. Prevention and treatment targets are geographically unique, and public health efforts should acknowledge these differen- Obesity (2017) 25, 452-459. doi:10.1002/oby.21725 In the United States (U.S.), upward trends in diabetes prevalence wit- nessed in previous decades (19902008) have more recently plateaued (1-3). While this is hopeful news, diabetes prevalence remains an important public health issue and requires continued resea Continue reading >>

Diabetes Belt Identified In Southern Us

Diabetes Belt Identified In Southern Us

Diabetes belt identified in southern US Researchers have identified a diabetes belt, a cluster of 644 counties in 15 mostly southeastern states that have a prevalence of diabetes of 11% or more. The belt includes portions of Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, West Virginia, and the entire state of Mississippi. Using data from the 2007 and 2008 Behavioral Risk Factor Surveillance System and county-level diagnosed diabetes prevalence estimates, researchers found that the prevalence of diabetes in the diabetes belt was 11.7% vs. 8.5% in the rest of the country. Nearly one-third of the difference in diabetes prevalence between the diabetes belt and the rest of the United States is associated with sedentary lifestyle and obesity, researchers wrote in the When researchers compared demographics and risk factors such as age, sex, sedentary lifestyle, race/ethnicity, education and obesity, four factors distinguished the diabetes belt from the rest of the United States: Diabetes belt counties contained substantially more non-Hispanic blacks (23.8% vs. 8.6%). Obesity was greater in the diabetes belt (32.9% vs. 26.1%). Sedentary lifestyle was more common (30.6% vs. 24.8%). The proportion of people with a college degree was smaller in the diabetes belt (24.1% vs. 34.3%). Additionally, 30% of the excess diabetes risk in the diabetes belt was associated with modifiable risk factors, whereas 37% was associated with nonmodifiable factors such as age and race/ethnicity. Tailored interventions that target obese, sedentary, non-Hispanic black people should be considered in appropriate locations within the diabetes belt, the researchers said. Identifying a diabetes belt by counties allows Continue reading >>

Geographic Distribution Of Diagnosed Diabetes In The U.s.: A Diabetes Belt.

Geographic Distribution Of Diagnosed Diabetes In The U.s.: A Diabetes Belt.

1. Am J Prev Med. 2011 Apr;40(4):434-9. doi: 10.1016/j.amepre.2010.12.019. Geographic distribution of diagnosed diabetes in the U.S.: a diabetes belt. Barker LE(1), Kirtland KA, Gregg EW, Geiss LS, Thompson TJ. (1)CDC, Atlanta, Georgia 30341, USA. [email protected] BACKGROUND: The American "stroke belt" has contributed to the study of stroke.However, U.S. geographic patterns of diabetes have not been as specificallycharacterized.PURPOSE: This study identifies a geographically coherent region of the U.S. wherethe prevalence of diagnosed diabetes is especially high, called the "diabetesbelt."METHODS: In 2010, data from the 2007 and 2008 Behavioral Risk Factor SurveillanceSystem were combined with county-level diagnosed diabetes prevalence estimates.Counties in close proximity with an estimated prevalence of diagnosed diabetes11.0% were considered to define the diabetes belt. Prevalence of risk factors inthe diabetes belt was compared to that in the rest of the U.S. The fraction ofthe excess risk associated with living in the diabetes belt associated withselected risk factors, both modifiable (sedentary lifestyle, obesity) andnonmodifiable (age, gender, race/ethnicity, education), was calculated.RESULTS: A diabetes belt consisting of 644 counties in 15 mostly southern states was identified. People in the diabetes belt were more likely to be non-HispanicAfrican-American, lead a sedentary lifestyle, and be obese than in the rest ofthe U.S. Thirty percent of the excess risk was associated with modifiable riskfactors, and 37% with nonmodifiable factors.CONCLUSIONS: Nearly one third of the difference in diabetes prevalence betweenthe diabetes belt and the rest of the U.S. is associated with sedentary lifestyleand obesity. Culturally appropriate interventions aimed at decreasing obe Continue reading >>

Is The Term 'type 2 Diabetes' Too Generic?

Is The Term 'type 2 Diabetes' Too Generic?

Is the Term 'Type 2 Diabetes' Too Generic? In a journal article published today in The Lancet , Professor Edwin Gale of the University of Bristol in the United Kingdom questions the current clinical definition and categorization of type 2 diabetes saying, Type 2 diabetes is a disease in search of a definition. It has no hallmark clinical features, is generally diagnosed by default (no other cause for diabetes being evident), he goes on to explain that people who are diagnosed with Type 2 diabetes dont all have the same symptoms prior to diagnosis, and these symptoms vary widely between populations in clinical presentation and consequences; yet despite this, laboratory and clinical research is typically done as if type 2 diabetes were one disease with uniform characteristics. Although what he is saying is not new, I think it is clinically relevant and timely. And I agree with him. As researchers and physicians, we cant seem to fully understand the cause of type 2 diabetes and this is likely due to the fact that we are inappropriately lumping together several (if not many) different types of diabetes. Our definition of type 2 diabetes is definitely too broad and I believe it is really several diseases that have a common denominator, hyperglycemia, or high blood sugar. In his article Dr. Gale proposes that until the origin of type 2 diabetes is understood, the name of type 2 diabetes should be changed to idiopathic hyperglycemia, and while I agree that a more descriptive term should be used to define the type of diabetes a patient has, I am not sure that, by itself, would be enough. We really need to do a better job in characterizing and studying these different types of diabetes in the research setting. Because there are likely different forms of type 2 diabetes, in my p Continue reading >>

'diabetes Belt' Tightens Around The South

'diabetes Belt' Tightens Around The South

'Diabetes Belt' Tightens Around the South by Kristina Fiore Kristina Fiore, Staff Writer, MedPage Today Much of the South and Appalachia fall into the newly defined "diabetes belt" identified by CDC researchers, a section of country that nearly parallels the so-called stroke belt. The 644 counties in the diabetes belt have a significantly higher prevalence of the disease than the rest of the country: 11.7% versus 8.5%, according to Lawrence Barker, PhD, of the CDC, and colleagues, who reported their findings in the American Journal of Preventive Medicine. The diabetes belt includes portions of Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and West Virginia. That's very similar to the stroke belt, the researchers say, but there are a few differences. For instance, much of West Virginia falls in the diabetes belt but not in the stroke belt. Conversely, Indiana is part of the stroke belt but not the diabetes belt. The diabetes belt also corresponds, to some extent, with patterns of physical inactivity that CDC researchers reported earlier this month. In that study, they found that in the majority of counties in the South and Appalachia more than 29% of adults report getting no exercise outside their regular jobs. The same CDC report also found higher levels of obesity in those regions as well. Barker and colleagues said that residents of the diabetes belt were also more likely to be non-Hispanic African American. The data come from the 2007-2008 Behavioral Risk Factor Surveillance system combined with county-level diagnosed diabetes prevalence estimates. The researchers reported no conflicts of interest. Continue reading >>

Diabetes Belt Identified In Southern United States

Diabetes Belt Identified In Southern United States

Diabetes Belt Identified in Southern United States Diabetes Belt Identified in Southern United States According to new study in the American Journal of Preventive Medicine San Diego, CA, March 8, 2011 In the 1960s, a group of U.S. states with high age-adjusted stroke mortality defined a "stroke belt." Until recently, geographic patterns of diabetes had not been specifically characterized in the same manner. In an article published in the April 2011 issue of theAmerican Journal of Preventive Medicine, researchers were able to identify clustered high prevalence areas, or a "diabetes belt" of 644 counties in 15 mostly southeastern states using data compiled for the first time of estimates of the prevalence of diagnosed diabetes for every U.S. county. Identifying a diabetes belt by counties allows community leaders to identify regions most in need of efforts to prevent type 2 diabetes and to manage existing cases of the disease, commented lead investigator Lawrence E. Barker, PhD, Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Although many risk factors for type 2 diabetes cant be changed, others can. Community design that promotes physical activity, along with improved access to healthy food, can encourage the healthy lifestyle changes that reduce the risk of developing type 2 diabetes. Nearly one third of the difference in diabetes prevalence between the diabetes belt and the rest of the U.S. is associated with sedentary lifestyle and obesity. Thirty percent of the excess risk was associated with modifable risk factors, and 37% with nonmodifable factors, such as age and race/ethnicity. Data from the diabetes belt showed prevalence rates greater than 11.0 Continue reading >>

Stroke Belt - Wikipedia

Stroke Belt - Wikipedia

Stroke Belt or Stroke Alley is a name given to a region in the southeastern United States that has been recognized by public health authorities for having an unusually high incidence of stroke and other forms of cardiovascular disease . It is typically defined as a 9-state region consisting of Alabama , Arkansas , Georgia , Kentucky , Louisiana , Mississippi , North Carolina , South Carolina , and Tennessee . Although many possible causes for the high stroke incidence have been investigated, the reasons for the phenomenon have not been determined. Stroke death rates 2002-2007, adults 35+ by US county. The stroke belt is typically defined to include the states of Alabama, Arkansas, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, and Tennessee. [1] In 1980 these nine states had age-adjusted stroke mortality rates more than 10% above the national average. [2] Some investigators also consider North Florida to be a part of the stroke belt, based on a stroke mortality rate higher than several states included in the region. [3] East Texas also is characterized as a stroke belt. [4] High rates of lung cancer (indicated in this map by brown colors) are highly correlated with the Stroke Belt. The stroke belt was first identified in 1962 by Centers for Disease Control (CDC) researchers who noted a concentration of high stroke death rates in the Atlantic coastal plain counties of North Carolina , South Carolina and Georgia . [5] Similar high stroke rates were later observed in the Mississippi Delta region as well. [5] [6] Analysis by the CDC of U.S. mortality statistics from the period 1991 to 1998 found that for both blacks and whites the counties with the highest stroke death rates were in the southeastern states and the Mississippi Delta region. Strok Continue reading >>

Changes In Disparity In County-level Diagnosed Diabetes Prevalence And Incidence In The United States, Between 2004 And 2012

Changes In Disparity In County-level Diagnosed Diabetes Prevalence And Incidence In The United States, Between 2004 And 2012

Abstract In recent decades, the United States experienced increasing prevalence and incidence of diabetes, accompanied by large disparities in county-level diabetes prevalence and incidence. However, whether these disparities are widening, narrowing, or staying the same has not been studied. We examined changes in disparity among U.S. counties in diagnosed diabetes prevalence and incidence between 2004 and 2012. We used 2004 and 2012 county-level diabetes (type 1 and type 2) prevalence and incidence data, along with demographic, socio-economic, and risk factor data from various sources. To determine whether disparities widened or narrowed over the time period, we used a regression-based β-convergence approach, accounting for spatial autocorrelation. We calculated diabetes prevalence/incidence percentage point (ppt) changes between 2004 and 2012 and modeled these changes as a function of baseline diabetes prevalence/incidence in 2004. Covariates included county-level demographic and, socio-economic data, and known type 2 diabetes risk factors (obesity and leisure-time physical inactivity). For each county-level ppt increase in diabetes prevalence in 2004 there was an annual average increase of 0.02 ppt (p<0.001) in diabetes prevalence between 2004 and 2012, indicating a widening of disparities. However, after accounting for covariates, diabetes prevalence decreased by an annual average of 0.04 ppt (p<0.001). In contrast, changes in diabetes incidence decreased by an average of 0.04 ppt (unadjusted) and 0.09 ppt (adjusted) for each ppt increase in diabetes incidence in 2004, indicating a narrowing of county-level disparities. County-level disparities in diagnosed diabetes prevalence in the United States widened between 2004 and 2012, while disparities in incidence narrow Continue reading >>

Diabetes Belt Identified In Southern United States

Diabetes Belt Identified In Southern United States

Diabetes Belt Identified in Southern United States TUESDAY, March 8 (HealthDay News) -- A geographically congruent "diabetes belt" with high prevalence of diabetes exists in the United States, according to a study published online March 8 in the American Journal of Preventive Medicine. Lawrence E. Barker, Ph.D., of the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues examined data from CDC estimates of diabetes prevalence to identify a diabetes belt. They compared its residents and their risk factors to those of the rest of the country, and calculated the fraction of excess diabetes risk associated with living in the diabetes belt that is attributable to modifiable and nonmodifiable risk factors. The diabetes belt was defined as counties in close proximity with an estimated prevalence of diagnosed diabetes greater than or equal to 11 percent. The researchers identified a diabetes belt composed of 644 counties in 15 states, mostly in the southeastern United States. Compared to people living in the rest of the country, people in the diabetes belt were more likely to be non-Hispanic African-American, live a sedentary lifestyle, and be obese. Modifiable risk factors, such as sedentary lifestyle and obesity, accounted for 30 percent of the excess risk; whereas, 37 percent was due to nonmodifiable risk factors, such as age, gender, race/ethnicity, and education. "Nearly one-third of the difference in diabetes prevalence between the diabetes belt and the rest of the United States is associated with sedentary lifestyle and obesity. Culturally appropriate interventions aimed at decreasing obesity and sedentary lifestyle in counties within the diabetes belt should be considered," the authors write. Continue reading >>

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