Disentangling the Multifactorial Influences on Diabetes Risk Among Rural Communities: Food Environment, Diet Quality,...

Area of Science:

• Environmental Health
• Epidemiology
• Nutritional Science

Background:

• Rural populations face higher rates of type 2 diabetes and related mortality compared to urban areas.
• Understanding the multifaceted contributors to diabetes in rural settings is crucial for targeted interventions.

Purpose of the Study:

• To investigate the combined impact of demographic, socioeconomic, food environment, diet quality, and chemical exposures on type 2 diabetes risk in rural communities.
• To identify key risk factors for diagnosed diabetes and glycemic control (HbA1c) in a rural cohort.

Main Methods:

• An observational cohort study was conducted in rural Sullivan County, including surveys and biospecimen collection.
• Endocrine-disrupting chemicals (bisphenols, phthalates) were measured, considering higher canned food consumption in rural areas.
• LASSO regression analysis was employed to determine the relative influence of various factors on diabetes risk.

Main Results:

• Strongest predictors of diagnosed diabetes included older age, lower income, Hispanic ethnicity, red meat intake, fast food proximity, and specific phthalates.
• High HbA1c levels were associated with older age, non-Hispanic Black ethnicity, trans-fat/red meat intake, higher BMI, total bisphenols, and high-molecular-weight phthalates.

Conclusions:

• Demographic and socioeconomic factors emerged as the primary drivers of rural diabetes risk.
• Diet quality, food environment, and chemical exposures significantly contributed to diabetes risk, highlighting modifiable targets.
• The study identified actionable risk factors to potentially alleviate the burden of diabetes in rural populations.