1
|
Morselli LL, Amjad R, James R, Kindel TL, Kwitek AE, Williams JS, Grobe JL, Kidambi S. Diet in Food Insecurity: A Mediator of Metabolic Health? J Endocr Soc 2024; 8:bvae062. [PMID: 38623381 PMCID: PMC11017326 DOI: 10.1210/jendso/bvae062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Indexed: 04/17/2024] Open
Abstract
Objective Food insecurity (FI) is associated with poor metabolic health. It is assumed that energy intake and diet quality underlie this association. We tested the hypothesis that dietary factors (quantity and quality) mediate the association of FI with excess weight, waist circumference and glycemic control [glycohemoglobin (A1C)]. Methods A mediation analysis was performed on data from the National Health And Nutrition Examination Survey using FI as an independent variable; body mass index (BMI), waist circumference, and A1C as metabolic outcome variables and total energy intake, macronutrients, and diet quality measured by the Healthy Eating Index-2015 (HEI-2015) as potential mediators. Results Despite a greater prevalence of obesity in participants experiencing FI, daily reported energy intake was similar in food-secure and -insecure subjects. In adjusted analyses of the overall cohort, none of the examined dietary factors mediated associations between FI and metabolic outcomes. In race-stratified analyses, total sugar consumption was a partial mediator of BMI in non-Hispanic Whites, while diet quality measures (HEI-2015 total score and added sugar subscore) were partial mediators of waist circumference and BMI, respectively, for those in the "other" ethnic group. Conclusion Dietary factors are not the main factors underlying the association of FI with metabolic health. Future studies should investigate whether other social determinants of health commonly present in the context of FI play a role in this association.
Collapse
Affiliation(s)
- Lisa L Morselli
- Department of Medicine, Division of Endocrinology and Molecular Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Rabia Amjad
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Roland James
- Department of Medicine, Division of Endocrinology and Molecular Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Tammy L Kindel
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Department of Surgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Anne E Kwitek
- Department of Physiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Department of Biomedical Engineering, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Linda T. and John A. Mellowes Center for Genomic Sciences and Precision Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Joni S Williams
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Justin L Grobe
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Department of Physiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Department of Biomedical Engineering, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Comprehensive Rodent Metabolic Phenotyping Core, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Srividya Kidambi
- Department of Medicine, Division of Endocrinology and Molecular Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| |
Collapse
|
2
|
French SJ, Allison DB. Creativity in energy balance, obesity and feeding behavior research, some thoughts. Physiol Behav 2023; 266:114161. [PMID: 36958458 PMCID: PMC10164077 DOI: 10.1016/j.physbeh.2023.114161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/23/2023] [Accepted: 03/20/2023] [Indexed: 03/25/2023]
Abstract
This review provides an overview of examples of especially creative work related to the fields of ingestive behavior, energetics (defined as the study of the acquisition, storage, and use of metabolizable energy by biological organisms and the causes and consequences of such acquisition, storage, and use), and nutrition, focusing on both individual works and discoveries, as well as bodies of works and in some cases the working styles of particular scientists. The paper then discusses some principles extracted from our observations as well as from the literature on creativity pointing out some factors that seem to make for more creative science and that can be done by individuals to promote creativity in their own work. Finally, we end with a short set of tips for the field in general to promote creativity among our ranks broadly.
Collapse
Affiliation(s)
- Stephen J French
- Adjunct Associate Professor, Department of Applied Health Science, Indiana University School of Public Health-Bloomington, 1025 E. 7th Street, Suite 115, Bloomington, IN, 47405, United States of America
| | - David B Allison
- Dean, Distinguished Professor, Provost Professor, Indiana University School of Public Health-Bloomington, 1025 E 7th Street, PH 111, Bloomington, IN, 47405, United States of America.
| |
Collapse
|
3
|
Herbozo S, Brown KL, Burke NL, LaRose JG. A Call to Reconceptualize Obesity Treatment in Service of Health Equity: Review of Evidence and Future Directions. Curr Obes Rep 2023; 12:24-35. [PMID: 36729299 PMCID: PMC9894524 DOI: 10.1007/s13679-023-00493-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/10/2022] [Indexed: 02/03/2023]
Abstract
PURPOSE OF REVIEW Rates of obesity and associated comorbidities are higher among Black and Latino adults compared to white adults. We sought to provide an overview of both structural and individual factors contributing to obesity inequities and synthesize available evidence regarding treatment outcomes in Black and Latino adults, with an eye towards informing future directions. RECENT FINDINGS Obesity disparities are influenced by myriad systemic issues, yet the vast majority of interventions target individual-level factors only, and most behavioral treatments fail to target drivers beyond eating and physical activity. Extant treatments are not equally accessible, affordable, or effective among Black and Latino adults compared with white counterparts. Asset-based, culturally relevant interventions that target the root causes of obesity and address intersectional stress-designed in partnership with intended beneficiaries-are urgently needed. Treatment trials must improve enrollment of Black and Latino adults and report treatment outcomes by race and ethnicity.
Collapse
Affiliation(s)
- Sylvia Herbozo
- Department of Surgery, Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Illinois at Chicago, Chicago, USA.
- Department of Psychiatry and Behavioral Sciences and Department of Surgery, Rush University Medical Center, 1725 West Harrison Street, Chicago, IL, 60612, USA.
| | - Kristal Lyn Brown
- Division of General Internal Medicine, School of Medicine, The Johns Hopkins University, Baltimore, USA
| | - Natasha L Burke
- Department of Psychology, Fordham University, The Bronx, USA
| | - Jessica Gokee LaRose
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, USA
| |
Collapse
|
4
|
Rancourt D, Heeren FA, Cardel M. Testing a Biobehavioral Model of Food Insecurity and Chronic Disease in Hispanic Older Adolescents. Nutrients 2023; 15:1027. [PMID: 36839383 PMCID: PMC9962602 DOI: 10.3390/nu15041027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/10/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
The biobehavioral model of food insecurity and chronic disease posits that stress perpetuates the cycle of food insecurity and chronic disease, in part, through changes in eating behaviors and weight gain. The current study conducted a preliminary test of the biobehavioral model in a sample of Hispanic older adolescents. It was hypothesized that older adolescents experiencing food insecurity would report greater depressive symptoms, which would be associated with more disordered eating, which would be associated with worse cardiometabolic indicators. Hispanic older adolescents (N = 113; 60% female; 15-21 years with mean age of 19.1; BMImean = 24.4) completed self-report baseline measures of food insecurity, depression, and disordered eating behaviors as part of a larger experimental study. Anthropometrics and body composition, blood pressure, heart rate, and resting metabolic rate were objectively measured. Hypotheses were tested using structural equation modeling. Experiencing food insecurity was associated with more disordered eating (b = 2.20, p = 0.032). Greater depressive symptoms were associated with more disordered eating (b = 0.28, p = 0.025) and worse cardiometabolic indicators (b = 0.15, p = 0.017). The full biobehavioral model, however, was not supported. Findings underscore the complex interaction of social and psychological functioning and physical health.
Collapse
Affiliation(s)
- Diana Rancourt
- Department of Psychology, University of South Florida, Tampa, FL 33620, USA
| | - Faith A. Heeren
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL 32610, USA
| | - Michelle Cardel
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL 32610, USA
- WW International, Inc., New York, NY 10010, USA
| |
Collapse
|
5
|
Rahal D, Chiang JJ, Huynh VW, Bower JE, McCreath H, Fuligni AJ. Low subjective social status is associated with daily selection of fewer healthy foods and more high-fat/high sugar foods. Appetite 2023; 180:106338. [PMID: 36210016 PMCID: PMC10479967 DOI: 10.1016/j.appet.2022.106338] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/30/2022] [Accepted: 10/01/2022] [Indexed: 11/06/2022]
Abstract
Socioeconomic status has been related to poorer eating behaviors, potentially due to feeling of lower status relative to peers. Despite experimental evidence that temporarily feeling of lower status can contribute to greater caloric intake, it remains unclear how feeling of lower social status relate to eating behavior in daily life. This study aimed to test whether lower subjective social status (SSS)-the feeling of having relatively lower social status-in American society and relative to college peers were related to daily food selection. A sample of 131 young adults (Mage = 20.3, SD = 0.8; 60% female; 46% Latinos; 34% European American; 15% Asian American; 5% of other ethnicities) reported their SSS in society and in college and completed 15 daily reports regarding the number of daily servings they had of fruits, vegetables, fried foods, fast foods, desserts, and sugary drinks. Multilevel models with days nested within individuals were used to test whether low SSS in society or college related to daily food intake. Next, we examined whether associations were driven by young adults' perceived stress and daily stressors. Analyses controlled for age, gender, ethnicity, family and personal income, and parents' education to test the unique associations between subjective status and food intake. Whereas SSS in society was not related to food intake, young adults with lower SSS in their college consumed fewer daily servings of healthy foods and more daily servings of high-fat/high-sugar foods. Although lower college SSS was related to greater perceived stress, perceived stress and daily stressors were consistently unrelated to daily food intake. Findings suggested that lower SSS in local environments (e.g., college) may impact young adults' daily food choices through processes beyond heightened stress.
Collapse
Affiliation(s)
- Danny Rahal
- Edna Bennett Pierce Prevention Research Center, Pennsylvania State University, State College, PA, USA.
| | - Jessica J Chiang
- Department of Psychology, Georgetown University, Washington, DC, USA
| | - Virginia W Huynh
- Department of Child and Adolescent Development, California State University, Northridge, Northridge, CA, USA
| | - Julienne E Bower
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA; Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA; Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Heather McCreath
- Division of Geriatrics, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Andrew J Fuligni
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA; Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA; Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| |
Collapse
|
6
|
Lee AM, Huo T, Miller D, Gurka MJ, Thompson LA, Modave FP, Hong YR, Pavela G, Cardel MI. The effects of experimentally manipulated social status and subjective social status on physical activity among Hispanic adolescents: An RCT. Pediatr Obes 2022; 17:e12877. [PMID: 34859604 PMCID: PMC9010353 DOI: 10.1111/ijpo.12877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 10/20/2021] [Accepted: 11/15/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Low objective socioeconomic status (SES) and subjective social status (SSS), one's perceived social rank, are associated with obesity. This association may be due, in part, to social status-related differences in energy expenditure. Experimental studies are needed to assess the extent to which SES and SSS relate to energy expenditure. OBJECTIVE Assess the effects of experimentally manipulated social status and SSS on moderate-to-vigorous physical activity (MVPA) and sedentary behaviour. METHODS One hundred thirty-three Hispanic adolescents aged 15-21 were randomized to a high or low social status position, facilitated through a rigged game of Monopoly™. SSS was assessed with MacArthur Scales. Post-manipulation 24-h MVPA and sedentary behaviour were assessed via accelerometry. Analyses were conducted with general linear regression models. RESULTS Experimentally manipulated social status did not significantly affect the total time spent in MVPA or sedentary behaviour; however, identifying as low SSS was significantly associated with less MVPA (p = 0.0060; 18.76 min less). CONCLUSIONS Tewnty-four-hour MVPA and sedentary behaviour are not affected by an acute experimental manipulation of social status. However, low SSS, independent of SES, was associated with clinically significant differences in MVPA. SSS may be a better predictor of MVPA than SES among Hispanic adolescents, potentially influencing obesity, and other health-related outcomes.
Collapse
Affiliation(s)
- Alexandra M. Lee
- Dept. of Health Outcomes and Biomedical Informatics, University of Florida
| | - Tianyao Huo
- Dept. of Health Outcomes and Biomedical Informatics, University of Florida
| | - Darci Miller
- Dept. of Health Outcomes and Biomedical Informatics, University of Florida
| | - Matthew J. Gurka
- Dept. of Health Outcomes and Biomedical Informatics, University of Florida
| | - Lindsay A. Thompson
- Dept. of Health Outcomes and Biomedical Informatics, University of Florida,Department of Pediatrics, UF Health
| | - François P. Modave
- Dept. of Health Outcomes and Biomedical Informatics, University of Florida
| | - Young-Rock Hong
- Dept. of Health Services Research, Management, and Policy, University of Florida
| | - Gregory Pavela
- Dept. of Health Behavior, University of Alabama at Birmingham
| | - Michelle I. Cardel
- Dept. of Health Outcomes and Biomedical Informatics, University of Florida,WW International, Inc
| |
Collapse
|
7
|
Newsome FA, Gravlee CC, Cardel MI. Systemic and Environmental Contributors to Obesity Inequities in Marginalized Racial and Ethnic Groups. Nurs Clin North Am 2021; 56:619-634. [PMID: 34749900 DOI: 10.1016/j.cnur.2021.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Obesity is a multifactorial disease that disproportionally affects diverse racial and ethnic groups. Structural racism influences racial inequities in obesity prevalence through environmental factors, such as racism and discrimination, socioeconomic status, increased levels of stress, and bias in the health care delivery system. Researchers, clinicians, and policy makers must work to address the environmental and systematic barriers that contribute to health inequities in the United States. Specifically, clinicians should quantitatively and qualitatively assess environmental and social factors and proactively engage in patient-centered care to tailor available treatments based on identified needs and experiences.
Collapse
Affiliation(s)
- Faith A Newsome
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, 2197 Mowry Road, Gainesville, FL 32610, USA.
| | - Clarence C Gravlee
- Department of Anthropology, University of Florida College of Liberal Arts and Sciences, 1112 Turlington Hall, PO Box 117305, Gainesville, FL 32611, USA
| | - Michelle I Cardel
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, 2197 Mowry Road, Gainesville, FL 32610, USA; WW International, Inc, New York, NY, USA
| |
Collapse
|
8
|
Andrade JL, Hong YR, Lee AM, Miller DR, Williams C, Thompson LA, Bright MA, Cardel MI. Adverse Childhood Experiences Are Associated with Cardiometabolic Risk among Hispanic American Adolescents. J Pediatr 2021; 237:267-275.e1. [PMID: 34147498 DOI: 10.1016/j.jpeds.2021.06.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/31/2021] [Accepted: 06/14/2021] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To assess the relationship between adverse childhood experiences (ACEs) and cardiometabolic risk among Hispanic adolescents. STUDY DESIGN This cross-sectional study was conducted at an academic research center in Gainesville, Florida. Participants were locally recruited, and data were collected from June 2016 to July 2018. Participants (n = 133, 60.2% female) were healthy adolescents aged 15-21 years who self-identified as Hispanic, were born in the US, and had a body mass index (BMI) between ≥18.5 and ≤40 kg/m2. Primary outcomes were BMI, body fat percentage, waist circumference, and resting blood pressure. Associations between ACEs and cardiometabolic measures were assessed by multivariable logistic regression models, which controlled for sex, age, parental education, and food insecurity. Results were sex-stratified to assess potential variations. RESULTS Reporting ≥4 ACEs (28.6%) was significantly associated with a greater BMI (P = .004), body fat percentage (P = .02), and diastolic blood pressure (P = .05) compared with reporting <4 ACEs. Female participants reporting ≥4 ACEs were significantly more likely to have a greater BMI (P = .04) and body fat percentage (P = .03) whereas male participants reporting ≥4 ACEs were significantly more likely to have a greater BMI (P = .04), systolic blood pressure (P = .03), and diastolic blood pressure (P = .03). CONCLUSIONS Hispanic adolescent participants who experienced ≥4 ACEs were more likely to have elevated risk markers of obesity and cardiometabolic disease. Further research is needed to elucidate the physiological mechanisms driving these relationships.
Collapse
Affiliation(s)
- Joanne L Andrade
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL
| | - Young-Rock Hong
- Department of Health Services Research, Management, and Policy, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL
| | - Alexandra M Lee
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL
| | - Darci R Miller
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL
| | - Charlette Williams
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL
| | - Lindsay A Thompson
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL; Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL
| | - Melissa A Bright
- Department of Obstetrics and Gynecology, College of Medicine, University of Florida, Gainesville, FL
| | - Michelle I Cardel
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL; Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL; Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, FL; WW International, Inc, New York, NY.
| |
Collapse
|
9
|
Guazzelli Williamson V, Lee AM, Miller D, Huo T, Maner JK, Cardel M. Psychological Resilience, Experimentally Manipulated Social Status, and Dietary Intake among Adolescents. Nutrients 2021; 13:nu13030806. [PMID: 33804409 PMCID: PMC7998543 DOI: 10.3390/nu13030806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/23/2021] [Accepted: 02/25/2021] [Indexed: 11/17/2022] Open
Abstract
Relative to other racial/ethnic groups in the United States, Hispanic American (HA) youth have higher rates of overweight and obesity. Previous work suggests that low perceived social status (SS) promotes excess caloric intake and, thereby, development of obesity. Psychological resilience may play a role in reducing adverse eating behaviors and risk for obesity. The objective of this study was to investigate whether resilience (as measured by the Connor Davidson Resilience Scale) interacts with experimentally manipulated SS to affect dietary intake among HA adolescents (n = 132). Using a rigged game of Monopoly (Hasbro, Inc.), participants were randomized to a high or low SS condition. Following the Monopoly game, participants consumed an ad libitum lunch and their dietary intake was assessed. There was a significant interaction between resilience and experimentally manipulated SS for total energy intake (p = 0.006), percent energy needs consumed (p = 0.005), and sugar intake (p = 0.004). For the high SS condition, for each increase in resilience score, total energy intake decreased by 7.165 ± 2.866 kcal (p = 0.014) and percent energy needs consumed decreased by 0.394 ± 0.153 (p = 0.011). In the low SS condition, sugar intake increased by 0.621 ± 0.240 g for each increase in resilience score (p = 0.011). After correction for multiple comparisons, the aforementioned interactions, but not simple slopes, were statistically significant.
Collapse
Affiliation(s)
| | - Alexandra M. Lee
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL 32611, USA; (A.M.L.); (D.M.); (T.H.); (M.C.)
| | - Darci Miller
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL 32611, USA; (A.M.L.); (D.M.); (T.H.); (M.C.)
| | - Tianyao Huo
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL 32611, USA; (A.M.L.); (D.M.); (T.H.); (M.C.)
| | - Jon K. Maner
- Department of Psychology, Florida State University, Tallahassee, FL 32306, USA;
| | - Michelle Cardel
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL 32611, USA; (A.M.L.); (D.M.); (T.H.); (M.C.)
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL 32611, USA
| |
Collapse
|