Nutrition Commons^™

Analyzing Food Access: An Investigation Of Food Insecurity Amongst Latinos In Rural Nebraska, Natalia Santos

Theses & Dissertations

Background: Food insecurity is a public health issue in the United States, with disproportionately higher rates among Latino/Hispanic households. Rural communities face unique geographical, socioeconomic, and systemic barriers that often exacerbate food access disparities. Despite the growing Latino population in rural areas, particularly in Midwestern states like Nebraska, there remains a critical gap in comprehensive research that integrates both objective and subjective understandings of their food environments. Understanding these multifaceted influences is crucial for developing effective, culturally sensitive interventions.

Problem Statement: This dissertation aims to answer the central question: How does food access and food insecurity manifest amongst Latinos in …

The Diabetes Prevention Program And Its Outcomes Study: Niddk's Journey Into The Prevention Of Type 2 Diabetes And Its Public Health Impact, Jill P Crandall, Dana Dabelea, William C Knowler, David M Nathan, Marinella Temprosa, Dpp Research Group

Children’s Nutrition Research Center Staff Publications

The current-day epidemic of type 2 diabetes, largely driven by increased adiposity and reduced physical activity in the setting of genetic susceptibility, is a major public health challenge. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) presciently proposed the Diabetes Prevention Program (DPP), a multicenter randomized clinical trial, designed by investigators in conjunction with NIDDK staff and initiated in 1996. The primary goal of DPP was to determine whether an intensive lifestyle intervention (ILS) or metformin in comparison with placebo would reduce the development of diabetes in a high-risk population with prediabetes. After mean 2.8 years, ILS …

Living Heritage, Resilience And Ethically Informed Infrastructures In Malawi, Martha B. Lerski, Frank Puluputu Mwale

Publications and Research

Rooted in a rural community’s needs, this paper explores how historically, and ethically informed infrastructures can support community engagement towards identification, documentation, and dissemination of local, traditional, and indigenous knowledge relating to climate change. The paper examines climate adaptation and sustainability issues through the lenses of community organizing and Library & Information Science best practices. It draws on a growing body of literature identifying a role for expanded epistemological and subject discipline perspectives. While the impacts of climate on material culture are increasingly recognized, intangible, and biocultural heritage have not received as much attention. Living heritage traditions and knowledge systems …

Social Eating Role In Ultra-Processed Food Consumption Among Urban Young Adults: The 2018 Indonesian Food Barometer, Imas Arumsari, Nabilla Ayusyah Putri, Siti Nur Lulu Lathifah, Gita Aisyah Astrid Rosalba, Helda Khusun, Judhiastuty Februhartanty, Rahmatika Nur Aini

Kesmas

This study investigated the differences in ultra-processed food (UPF), fruit, vegetable, and total fat consumption in different aspects of social eating among urban young adults. This cross-sectional study used the 2018 Indonesian Food Barometer dataset with 180 participants aged 18–25 years living in urban areas from 6 provinces in Indonesia. The data on social eating (cooking habits, eating out, and eating alone), UPF, fruits, and vegetables were obtained from an extended 24-hour food recall interview. The Mann-Whitney U test (CI 95%) was employed for data analysis. This study found that groups with less frequent cooking habits tended to have more …

Reaching Tomorrow’S Extension Customer: A Food And Health Needs Assessment, Morgan Szczepaniak, Sarah L. Francis, Ruth Litchfield, Ulrike Genschel, Shannon Coleman, Anirudh Naig

Journal of Extension

The food and health needs and preferences of Iowans (n=452) were examined. The leading food and health information sources were online platforms, social media, and print media. Program topics with high participation likelihood were cooking, food preservation, food safety, and gardening. Short, low-cost, online programs were preferred. Extension use was more likely among those who identified as persons of color, Hispanic/Latino, or were food insecure (p < 0.030). Those with less education and chronic disease were less likely to be interested in Extension programming (p < 0.040). These results provide valuable information regarding future directions for Extension programming.

Schistosoma Haematobium Infection In Ethiopian Children: Evaluating Praziquantel Efficacy, Nutritional Effects, And Diagnosis Using Flukecatcher, Louis Fok

Theses & Dissertations

Urogenital schistosomiasis continues to impact the wellbeing of hundreds of millions of people worldwide and remains a significant public health challenge across Ethiopia. Despite existing knowledge on the disease, there remain significant unanswered questions with regard to its treatment and diagnosis. This dissertation evaluated the efficacy of praziquantel at treating urogenital schistosomiasis, improving nutritional parameters among children and the performance of FlukeCatcher at detecting and determining the intensity of infection. In effecting this, a total of 977 children aged 5 through 15 from the Afar and Gambella regions of Ethiopia were screened for S. haematobium infection using urine filtration microscopy …

The Interaction Between Physical Activity And Fruit And Vegetable Intake On Body Composition, Om S. Ghetia

Honors Scholar Theses

Objective: Fruit and Vegetable (FV) intake and Physical Activity (PA) are important lifestyle factors associated with body composition. This study assessed the combined impact of meeting FV intake and PA recommendations on body composition measures including body mass index (BMI), percent body fat (PBF), and waist circumference (WC) in adults aged 20–64 years from diverse backgrounds.

Design: A cross-sectional study conducted in Northeastern Connecticut.

Methods: A total of 124 participants completed a one-week dietary and PA record followed by anthropometric assessments. Participants were categorized into groups based on FV intake (≥400 g/day vs. < 400 g/day) and PA levels (≥600 MET-minutes/week vs. < 600 MET-minutes/week). Independent t-tests and chi-square tests were used to compare dietary intake, PA levels, and body composition outcomes across groups.

Results: Participants meeting FV recommendations had significantly …

Sweet Snacks Effects On Hispanic/Latino Childhood Obesity, Lemlen Belete, Brisa Rodriguez Alcantar

Undergraduate Research Symposium Lightning Talks

Background:

Obesity rates in children has become a growing concern in the Hispanic/Latino community in Nevada. This study examines the availability of sweet snacks in the home and its association with children's dietary behavior.

Methods:

Data was analyzed from a survey of 155 Latina mothers using logistic regression while controlling for income, education, and acculturation. The survey was conducted in Nevada, between October 2022 and March 2024.

Results:

The frequency of keeping sweets in the home was significantly associated with children's consumption of various sweets. For every increase in keeping sweets at home, the odds of children consuming: • Chocolate …

The Small Gtpase Rap1 In Pomc Neurons Regulates Leptin Actions And Glucose Metabolism, Kentaro Kaneko, Weisheng Lu, Yong Xu, Alexei Morozov, Makoto Fukuda

Faculty, Staff and Students Publications

The hypothalamic leptin-proopiomelanocortin (POMC) pathway is critical for regulating metabolism. POMC neurons in the arcuate nucleus respond to leptin and play a pivotal role in mediating energy and glucose balance. However, during diet-induced obesity (DIO), these neurons often develop resistance to exogenous leptin. Recently, the small GTPase Rap1 has been implicated as an inhibitor of neuronal leptin signaling; however, its specific role within POMC neurons remains unexplored. We generated tamoxifen-inducible, POMC neuron-specific Rap1 knockout mice to selectively delete both Rap1a and Rap1b isoforms in POMC neurons. By analyzing these mice through metabolic phenotyping, immunohistochemistry, and biochemical assays, we show that …

Healthy Dietary Patterns’ Impact On Depressive Symptoms: A Meta-Analysis Of Randomized Controlled Trials, Angela Encardone

All Theses

As the search for innovative mental health treatments expands, dietary interventions have emerged as a promising approach for alleviating depressive symptoms. This thesis presents a meta-analysis of randomized controlled trials (RCTs) examining the efficacy of whole-of-diet nutritional interventions in reducing depression symptoms among adults. Grounded in Bronfenbrenner’s Bioecological Model and Engel’s Biopsychosocial Model, this study explores the intersection of biological, psychological, and social factors that influence mental health outcomes. A systematic review identified six eligible RCTs assessing the impact of healthy dietary patterns, including the Mediterranean diet and other plant-based interventions, on depression symptoms. A random-effects meta-analysis revealed a significant …

Awareness And Attitudes Toward Diabetes Among Students In The California State University System, Cesar Fajardo

Electronic Theses, Projects, and Dissertations

Background and Aims: The prevalence of type 2 diabetes has been increasing globally. Studies examining patient awareness and attitudes toward diabetes have been conducted and found that diabetes education does increase patient knowledge but has no effect on attitudes. Additionally, many of these studies did not assess university students’ views on type 2 diabetes. Given that type 2 diabetes incidence is increasing among young adults, more attention must be given to this population. Therefore, the aim of this study was to investigate CSUSB students' understanding and attitudes toward type 2 diabetes.

Methods: A cross-sectional study using electronic surveys with …

Analyzing The Association Of Competitive Food Policy On Competitive Food Content In U.S. Schools., Mary E. Curnutte

Electronic Theses and Dissertations

OBJECTIVES: School food can have a profound effect on the population’s health. Thirty million children receive food at school and consume half their daily calorie intake at school. Competitive foods are foods sold outside of school breakfast and lunch, such as those sold in vending machines. A new ruling for Smart Snacks Standards, a set of competitive food guidelines, started in the school year 2014-2015. It is known that competitive foods undermine school lunch participation, and a decrease in school lunch consumption is associated with poorer student health. Additionally, an increase in competitive foods tends to be of nutrient-poor …

Improving Nutrition Outcomes Through Enhanced Allocative Efficiency Of Investments In 24 High Risk Counties In Kenya: An Optima Nutrition Modelling Study, Morris Ogero, Nick Scott, Veronica Kirogo, Anthony Ngugi

Population Health, East Africa

Introduction ;Undernutrition remains a significant global challenge, severely impacting children’s development and growth. To address this, the Sustainable Development Goals target a substantial reduction in stunting and wasting by 2025. Achieving these goals requires scaling up evidence-based nutritional interventions; however, limited budgets pose challenges in funding all necessary programs. To assist policymakers in making informed decisions, the World Bank developed the Optima Nutrition Modelling tool, which optimizes the allocation of nutrition investments. Kenya, with its high prevalence of stunting, was the focus of this study. Using the Optima Nutrition model, we aimed to (1) assess the impact of scaling up …

Maternal Dietary, Nutritional Status, And Its Association With Low-Birth Weight: A Scoping Review, Tri Siswati, Devi Septia Ningrum, Adinda Safitri, Almira Sitasari

Indonesian Journal of Public Health Nutrition (IJPHN)

Maternal diet and nutritional status during pregnancy influence birth outcomes. This review article aims to synthesize key studies examining the relationship between maternal dietary intake, nutritional status, and the occurrence of low birth weight (LBW). This study applies a scoping review from PubMed and Google Scholar (2018–2023). Observational and experimental studies were included. Articles met the criteria if they involved pregnant women aged 17+, human studies, full-text availability, and were in English or Indonesian. Fourteen studies met the inclusion criteria and were analyzed. The findings revealed that maternal intake of essential macronutrients, including energy and protein, along with key micronutrients …

Factors Related To The Incidence Of Hypertension Among People Above 18 Years At The Cibatu Public Health Center, Bekasi Regency, Verizka Azra, Yustiyani Yustiyani, Minsarnawati Minsarnawati, Catur Rosidati

Indonesian Journal of Public Health Nutrition (IJPHN)

Hypertension is a non-communicable disease that still becomes a public health issue. The percentage of hypertension cases at Cibatu Public Health Center increased from 31.7% in 2021 to 37% in 2022. Based on a preliminary study, hypertension was found to be the most common non-communicable disease at Cibatu Public Health Center. This study aimed to identify factors associated with the incidence of hypertension among individuals aged 18 years and older at Cibatu Public Health Center, Bekasi Regency, in 2024.We conducted a cross-sectional study in May involving 121 respondents. This study used standardized questionnaires that had been validated in previous research, …

The Relationship Between Ultra-Processed Food (Upf) Consumption, Sedentary Behavior, And Overweight Status Among Students At Sman 1 Tangerang, Banten, Indonesia, Husna Dzakya Azzahra, Zenia Elsa Fitri, Imas Arumsari

Indonesian Journal of Public Health Nutrition (IJPHN)

Overweight is a condition where excess body fat accumulates, leading to increased risks of diseases such as heart disease, stroke, diabetes, hypertension, arthritis, and cancer. The prevalence of overnutrition in adolescents aged 16-18 years has been rising over the years, from 5.7% in 2013 to 9.5% in 2018. This study aims to analyze the relationship between Ultra-Processed Food (UPF) consumption and sedentary behavior on overweight status among students at SMAN 1 Tangerang. A cross-sectional design, data were collected through interviews with 114 respondents using the SQ-FFQ Ultra-Processed Food questionnaire and the Sedentary Behavior Questionnaire (SBQ), with quota sampling employed. The …

Intermittent Fasting And Cardiometabolic Health In Adults With Obesity: A Scoping Review, Tri Siswati, Lathifa Zahra Putri Nugroho, Natasya Nurul Gina, Almira Sitasari, Agus Wijanarka

Indonesian Journal of Public Health Nutrition (IJPHN)

Obesity is a significant global health challenge, with adverse impacts on cardiometabolic health such as hypertension, dyslipidemia, and insulin resistance. One promising intervention in obesity management is intermittent fasting (PI). However, scientific evidence on the impact of IF on cardiometabolic health is still limited. This study used a scoping review design to evaluate the association between IF and cardiometabolic health in obese adults. Reference sources are available in English at least abstract between 2015–2023 as well as from PubMed and Google Scholar web sources. The search keywords on PubMed are "Adult AND intermittent fasting AND cardiometabolic" and on Google Scholar …

Exploring The Non-Communicable Disease Burden In Indonesia – Findings From The 2023 Health Survey, Akifa Laila Rusyda

Indonesian Journal of Public Health Nutrition (IJPHN)

The present study rigorously examines the correlation between obesity, high-risk dietary consumption, and unhealthy lifestyles with the prevalence of non-communicable diseases (NCDs) in Indonesia. The study employed a cross-sectional study design using secondary data from the 2023 Indonesian Health Survey, analyzing 38 units (n) representing Indonesia's provinces in 2023. The correlation analysis, conducted using Pearson's test with a significance level of 95% (α<0.05), revealed significant regional disparities in the prevalence of NCDs, dietary consumption, and lifestyle factors across Indonesia. Moreover, the findings reveal a statistically significant positive correlation between obesity, high-risk food consumption, and lifestyle risk factors with the prevalence of several NCDs, including diabetes mellitus, heart disease, hypertension, and chronic kidney disease. These results underscore the potential impact of our research on public health in Indonesia. The results highlight also the urgent need for targeted public health initiatives, such as policies promoting healthier food choices, controlling the food environment, encouraging physical activity, and supporting smoking cessation to mitigate the growing burden of NCDs in Indonesia.

Food For Thought: The Impact Of The Gut-Brain Axis On Mental Health, Emily S. Miiller

Honors Thesis

Research regarding the role of the human microbiome has grown over the years as professionals develop a better understanding of the gut-brain axis. New studies and expanding knowledge on the relationship between the nervous system and gut microbiome promote a deeper understanding of the impact of diet on mental health. Diet plays a crucial role in maintaining a healthy balance between the gut and the brain. Incorporating nutritional modulators, such as probiotics, prebiotics, and vitamins, is crucial for supporting the gut-brain axis by influencing neurotransmitter production, managing inflammation, and promoting the growth of beneficial gut bacteria. On the other hand, …

Exploring Profiles Of Fathers Integrating Food And Physical Activity Parenting Practices, John A Jimenez-Garcia, Louise C Mâsse, Robert L Newton, Salma M Musaad, Alicia Beltran, Teresia M O'Connor

Children’s Nutrition Research Center Staff Publications

Objective: This study aims to identify fathers' profiles integrating food parenting practices (FPP) and physical activity parenting practices (PAPP).

Design: We analysed cross-sectional data. The fathers completed the reduced FPP and PAPP item banks and socio-demographic and family dynamics (co-parenting and household responsibility) questionnaires. We identified fathers' profiles via latent profile analysis. We explored the influence of social determinants, child characteristics and family dynamics on fathers' profiles using multinomial logistic regression.

Setting: Online survey in the USA.

Participants: Fathers of 5-11-year-old children.

Results: We analysed data from 606 fathers (age = 38 ± 8·0; Hispanic = 37·5 %). Most fathers …

Associations Among Shopping Methods, Diet Adherence, And Nutrition Knowledge Of Employed Primary Grocery Shoppers In Households With Children, Baylee Schneider

Master's Theses

Obesity is a prominent risk factor for chronic disease, which is the leading cause of death in the United States. Obesity and chronic disease rates continue to rise, requiring a need for prevention and intervention efforts. The future role of dietetics is to provide treatment and prevention through holistic approaches, by understanding individuals’ habits that contribute to the onset of disease, specifically their food choices, grocery shopping methods, and influences that waver these selections. The purpose of this study is to evaluate the relationship between grocery shopping methods (online or in-store), Mediterranean diet adherence, nutrition knowledge, and food purchase patterns …

Altered Thermal Preference By Preoptic Estrogen Receptor Alpha Neurons In Postpartum Females, Nan Zhang, Meng Yu, Qianru Zhao, Bing Feng, Yue Deng, Jonathan C Bean, Qingzhuo Liu, Benjamin P Eappen, Yang He, Kristine M Conde, Hailan Liu, Yongjie Yang, Longlong Tu, Mengjie Wang, Yongxiang Li, Na Yin, Hesong Liu, Junying Han, Darah Ave Threat, Nathan Xu, Taylor Smiley, Pingwen Xu, Lulu Chen, Tianshu Zeng, Yanlin He, Chunmei Wang

Faculty, Staff and Students Publications

OBJECTIVE: This study aims to investigate how reproductive experience (RE) alters thermal preference and thermoregulation in female mice, with a focus on estrogen receptor alpha (ERα)-expressing neurons in the preoptic area (POA).

METHODS: Thermal preference and body temperature were measured in female mice with and without RE, and virgin female mice with selective deletion of ERα from the POA (ERα

RESULTS: We showed that female mice prefer a cooler environment starting from late pregnancy and persisting long term postpartum. Female mice with RE (>4 weeks post-weaning) displayed lower body temperature and a lower thermal preferred temperature, and lost preference …

Red Meat Consumption And Hypertension: An Updated Review, Tara S Allen, Michael Najem, Alexis C Wood, Danielle J Lee, Lorena S Pacheco, Lori B Daniels, Matthew A Allison

Faculty, Staff and Students Publications

PURPOSE OF REVIEW: Hypertension (HTN) is a major risk factor for cardiovascular diseases (CVD). The global prevalence of HTN and related CVD mortality continues to rise. The development of HTN is influenced by genetic predisposition and modifiable risk factors, including diet. One area of ongoing debate is the relationship between red meat consumption and risk of HTN.

RECENT FINDINGS: Processed red meat has become increasingly implicated in the pathogenesis and morbidity of HTN, though randomized control trials comparing HTN-related outcomes associated with red meat subtypes have yielded heterogenous results. This review summarizes the existing relevant literature and highlights the methodological …

Sex-Specific Astrocyte Regulation Of Spinal Motor Circuits By Nkx61, Navish A Bosquez Huerta, Zhung-Fu Lee, Eun-Ah Christine Song, Junsung Woo, Yi-Ting Cheng, Debosmita Sardar, Ozlem Sert, Ehson Maleki, Kwanha Yu, Ekin Su Akdemir, Kaitlyn Sanchez, Juyeon Jo, Matthew N Rasband, Hyun Kyoung Lee, Akdes Serin Harmanci, Benjamin Deneen

Faculty, Staff and Students Publications

Astrocytes exhibit diverse cellular and molecular properties across the central nervous system (CNS). Recent studies identified region-specific transcription factors (TF) that oversee these diverse properties; how sex differences intersect with region-specific transcriptional programs to regulate astrocyte function is unknown. Here, we show that the TF Nkx6.1 is specifically expressed in ventral astrocytes of the spinal cord and that its deletion results in sex-specific effects on astrocyte morphology. Astrocytes from males exhibit enhanced morphological complexity, accompanied by increased motor function and cholinergic synapses. In contrast, female astrocytes exhibit reduced complexity and no changes in motor function. Mechanistically, we found that Nkx6.1 …

The Adiponectin-Pparγ Axis In Hepatic Stellate Cells Regulates Liver Fibrosis, Shangang Zhao, Qingzhang Zhu, Wang-Hsin Lee, Jan-Bernd Funcke, Zhuzhen Zhang, May-Yun Wang, Qian Lin, Bianca Field, Xue-Nan Sun, Guannan Li, Mbolle Ekane, Toshiharu Onodera, Na Li, Yi Zhu, Christine M Kusminski, Terry D Hinds, Philipp E Scherer

Faculty, Staff and Students Publications

Hepatic stellate cells (HSCs) are key drivers of local fibrosis. Adiponectin, conventionally thought of as an adipokine, is also expressed in quiescent HSCs. However, the impact of its local expression on the progression of liver fibrosis remains unclear. We recently generated a transgenic mouse line (Lrat-rtTA) that expresses the doxycycline-responsive transcriptional activator rtTA under the control of the HSC-specific lecithin retinol acyltransferase (Lrat) promoter, which enables us to specifically and inducibly overexpress or eliminate genes in these cells. The inducible elimination of HSCs protects mice from methionine/choline-deficient (MCD) diet-induced liver fibrosis, confirming their causal involvement in fibrosis development. We generated …

Sex Differences In Response To Diet Enriched With Glutathione Precursors In The Aging Heart, Aude Angelini, Grecia Garcia Marquez, Anna Malovannaya, Marta L Fiorotto, Alexander Saltzman, Antrix Jain, Joann Trial, George E Taffet, Katarzyna A Cieslik

Faculty, Staff and Students Publications

Common features of the aging heart are dysregulated metabolism, inflammation, and fibrosis. Elevated oxidative stress is another hallmark of cardiac aging that can exacerbate each of these conditions. We hypothesize that by increasing natural antioxidant levels (glutathione), we will improve cardiac function. Twenty-one-month-old mice were fed glycine and N-acetyl cysteine (GlyNAC; glutathione precursors)-supplemented or control diets for 12 weeks. Heart function was monitored longitudinally, and the exercise performance was determined at the end of the study. We found that the GlyNAC diet was beneficial for old male but not old female mice, leading to an increase of Ndufb8 expression (a …

Understanding Food Insecurity Among International Students At Ohio University, Kyle Butler, Joshua Osondu

Sustainable Living Hub Reports and Publications

Recently, food insecurity has emerged as a concern among the student body of Ohio University (OHIO), particularly among its international graduate students. This survey study was undertaken to provide data to inform OHIO’s response to food insecurity among its international graduate students.

Faktor Risiko Kejadian Hipertensi Dalam Kehamilan Pada Ibu Hamil Di Provinsi Jawa Timur (Analisis Data Riset Kesehatan Dasar Tahun 2018), Putri Amalia Firjatillah, Sudarto Ronoatmodjo

Jurnal Epidemiologi Kesehatan Indonesia

Hypertension during pregnancy is one of the most common pregnancy complications and the leading cause of maternal mortality in Indonesia. One of the regions in Indonesia with a high number of hypertension-related pregnancy complications is East-Java Province with a prevalence rate of 17,8%. This study aims to analyze the risk factors associated with hypertension during pregnancy among pregnant women in East Java. The study adopts a cross-sectional design using secondary data from 758 pregnant women aged 15-54 years in East Java Province who participated in 2018 Riskesdas Survey during which blood pressure measurements were taken. The dependent variable analyzed in …

Impacts Of Ramadan Fasting During Pregnancy On Pregnancy And Birth Outcomes: An Umbrella Review, Abdullah Al-Taiar, Md Estiar Rahman, May Salama, Ali H. Ziyab, Wilfried Karmaus

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background

Despite a large number of primary research studies, and systematic and narrative reviews, there is no consensus on the impact of fasting during Ramadan while pregnant on pregnancy and birth outcomes. Currently, there is no evidence-based guideline for Muslim women regarding Ramadan fasting during pregnancy and clinicians cannot provide firm recommendations.

Objectives

To review the current evidence regarding the impact of Ramadan fasting during pregnancy on pregnancy and birth outcomes.

Search Strategy

We conducted an umbrella review of all systematic and narrative reviews examining the impacts of fasting during Ramadan while pregnant on pregnancy and birth outcomes by searching …

The Impact Of Diabetes Education & Post Discharge Interventions For African American Adults At Risk For & After Myocardial Infarction, Trinity L. Billingsley

Nursing | Student Research Posters

Cardiovascular disease or CVD refers to a multitude of conditions that affect both the heart and blood vessels. Being the leading cause of death in the United States, heart disease claims 919,032 lives; the risk of death becomes more likely when accompanied with comorbidities like diabetes (CDC, 2024). While heart disease is a leading cause of death across all populations, it accounts for a larger proportion of deaths in African American, or AA, adults at 22.6% compared to White adults at 18.0% and Hispanic adults at 11.9%, highlighting persistent racial disparities in cardiovascular outcomes (CDC, 2024). Diabetes as a comorbidity …