Evidence map›Paper›PMID 42106585›Full record

Observational studyDiabetes/metabolism research and reviews2026

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

David C Lee, Haley L Motola, Jessie Moore, Tammy Flores, Crystal So, Haeseung Yi, Vittorio Albergamo, Leonardo Trasande, Brian Elbel, Lorna E Thorpe

Abstract readObservational Study
In one paragraph

Observational study in Diabetes/metabolism research and reviews, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

David C LeeDepartment of Emergency Medicine, NYU School of Medicine, New York, New York, USA.
Haley L MotolaSullivan County Public Health Services, Liberty, New York, USA.
Jessie MooreSullivan County Public Health Services, Liberty, New York, USA.
Tammy FloresDepartment of Emergency Medicine, NYU School of Medicine, New York, New York, USA.
Crystal SoDepartment of Emergency Medicine, NYU School of Medicine, New York, New York, USA.
Haeseung YiDepartment of Emergency Medicine, NYU School of Medicine, New York, New York, USA.
Vittorio AlbergamoDepartment of Pediatrics, NYU School of Medicine, New York, New York, USA.
Leonardo TrasandeDepartment of Pediatrics, NYU School of Medicine, New York, New York, USA.
Brian ElbelDepartment of Population Health, NYU School of Medicine, New York, New York, USA.ORCID 0000-0003-1615-9430
Lorna E ThorpeDepartment of Population Health, NYU School of Medicine, New York, New York, USA.

Funding

The Impact of the Food Environment and Other Environmental Exposures on the Risk of Diabetes in Rural SettingsR01DK124400 · NIDDK · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI LEE, DAVID C · 2020 to 2024
$3.5M
Identifying Risk Factors for Poor Glycemic Control among Emergency Department Patients and Improving Linkage to Outpatient CareR01DK134668 · NIDDK · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI David C Lee · 2023 to 2026
$2.8M
NIDDK NIH HHS R01 DK124400NIDDK NIH HHS R01-DK124400NIDDK NIH HHS R01 DK134668
6 · The paper itself

Abstract

aimsRural communities experience a higher prevalence of type 2 diabetes and diabetes-related mortality than urban populations. This study sought to disaggregate the influences of demographic and socioeconomic factors, food environment, diet quality, and dietary chemical exposures on diabetes risk in rural areas. MATERIALS AND

methodsWe enrolled participants from rural Sullivan County in an observational cohort study involving surveys and biospecimen collection measuring bisphenols and phthalates. We measured these endocrine disrupting chemicals found in food packaging, as rural residents generally consume canned foods and other shelf-stable foods more frequently than their urban counterparts. We used LASSO regression to compare the relative influence of these factors had on rural diabetes risk.

resultsBased on values for LASSO regression coefficients among 276 participants, the strongest risk factors for diagnosed diabetes included: older age (+0.486), lower household income (+0.172), Hispanic ethnicity (+0.124), red meat intake (+0.093), proportion of fast food restaurants among nearby restaurants (+0.071), and two phthalates (+0.149 and + 0.107). Among study participants without a history of diabetes, high HbA1c levels were associated with older age (+0.106), being non-Hispanic Black (+0.064), more trans-fat and red meat intake (+0.044 and +0.028), higher BMI (+0.014), higher levels of total bisphenols (+0.005), and higher levels of high-molecular weight phthalates (+0.002).

conclusionsDemographic and socioeconomic factors were the strongest predictors of rural diabetes risk; however, diet quality, food environment, and dietary chemical exposures also each played a key role. Our study identified modifiable risk factors, which could help reduce the burden of rural diabetes.

Indexed as

Diabetes Mellitus, Type 2DietDietary ExposureEndocrine DisruptorsEnvironmental ExposureRural PopulationAdultAgedBenzhydryl CompoundsBisphenol A CompoundsBisphenol B CompoundsBisphenol S CompoundsCohort StudiesFemaleFollow-Up StudiesHumansBenzhydryl Compoundsbisphenol ABisphenol A CompoundsBisphenol B CompoundsBisphenol S CompoundsEndocrine DisruptorsPhenolsphthalic acidPhthalic Acidsbisphenolschemical hazardsdiabetes riskphthalatesrural health

Identifiers

PMID42106585
PMCPMC13157511

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.