The leading causes of death for adults in the United States are related to lifestyle—tobacco use, poor diet, physical inactivity, and excessive alcohol consumption.1 US residents with these risk factors have plenty of room for improvement—including those who are asymptomatic and those living with chronic disease. Health behaviors could greatly influence future health and well-being, especially among patients with chronic disease. However, only 11% of patients with diabetes follow accepted dietary recommendations for saturated fat intake,2 and 18% of patients with heart disease continue to smoke, barely better than the general population's smoking rate.3
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