The Impact of the Food Environment and Other Environmental Exposures on the Risk of Diabetes in Rural Settings

农村地区食品环境和其他环境暴露对糖尿病风险的影响

• 批准号: 10368076
• 负责人: David C Lee
• 金额: $ 70.06万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10368076
• 关键词: Accounting; Address; Affect; Area; Behavior; Canned Foods; Carbohydrates; Centers for Disease Control and Prevention (U.S.); Cessation of life; Characteristics; Chemical Exposure; Chemicals; County; Cross-Sectional Studies; Data; Demographic Factors; Diabetes Mellitus; Diagnosis; Diet; Economics; Endocrine Disruptors; Environmental Exposure; Ethnic Origin; Exposure to; Face; Fatty acid glycerol esters; Food; Food Access; Food Analysis; Food Packaging; Food Supply; Foundations; Frequencies; Geographic Locations; Geography; Glycosylated hemoglobin A; Goals; Health; Health Food; Healthy Eating; Household; Income; Ingestion; Insulin Resistance; Intake; Intervention; Joints; Label; Life; Macronutrients Nutrition; Measures; Modeling; New York; Outcome; Pattern; Population; Poverty; Prevalence; Process; Public Health; Questionnaires; Race; Research; Risk; Risk Factors; Rural; Rural Community; Rural Population; Sampling; Socioeconomic Factors; Source; Surveys; Testing; Time; Unhealthy Diet; base; bisphenol A; clinically significant; cost; diabetes risk; diabetic; dietary; experience; fast food; food consumption; food environment; geographic barrier; geographic difference; geographic disparity; glycemic control; hazard; high risk; improved; indexing; mortality; phthalates; point of care; population based; premature; prevent; response; rural area; rural counties; rural dwellers; rural setting; urban area; urinary

PROJECT SUMMARY Though diabetes prevalence has increased nationally, geographic disparities have widened with higher diabetes-related mortality in rural regions than in urban areas. Evidence suggests that an unhealthy food environment increases diabetes risk in urban areas, but crude measures of the food environment may not capture the risk of rural diabetes. Therefore, robust analyses of the food environment and rural diabetes must measure exposures at the correct geographic scale and quantify how certain food purchases can increase diabetes risk. The hazards of the food environment not only include an unhealthy imbalance of macronutrients, but also dietary chemical exposures such as bisphenols and phthalates. These chemicals are now recognized as endocrine disruptors that may promote insulin resistance and diabetes. Though previous studies of diabetes risk have explored poor diet quality and dietary contaminants in isolation of each other, this study seeks to compare the combined impact of both hazards on diabetes risk among rural residents. To accomplish this goal, the study will obtain detailed dietary data through food frequency questionnaires and receipts of food purchases, measure estimated daily intake and urinary levels of bisphenols and phthalates, and use point-of- care HbA1c testing to identify key risk factors associated with rural diabetes. The study setting will be Sullivan County, New York, a rural county with the second-to-worst health ranking and rate of premature death in New York State, and also a high burden of diabetes. Though not representative of all rural regions, the impoverished, predominately White rural population of Sullivan County is an understudied group at high risk for poor diabetic outcomes. Therefore, the specific aims of this study will be to: 1) determine whether the diet quality of rural residents is influenced by their geographic locations and characteristics of their local food environment, 2) calculate estimated daily intake of bisphenols and phthalates based on the food consumption patterns of rural residents and compare results to urinary levels of these chemicals, and 3) use point-of-care HbA1c tests to identify how poor diet quality and dietary contaminants affect glycemic control among rural residents without a prior diagnosis of diabetes.

项目摘要 虽然糖尿病患病率在全国范围内有所增加，但随着糖尿病发病率的增加， 农村地区与糖尿病有关的死亡率高于城市地区。有证据表明，不健康的食物 环境增加了城市地区的糖尿病风险，但食品环境的粗略措施可能不会 捕捉农村糖尿病的风险。因此，对食品环境和农村糖尿病的可靠分析必须 在正确的地理尺度上测量暴露，并量化某些食品购买量如何增加 糖尿病风险食物环境的危害不仅包括大量营养素的不健康失衡， 还包括饮食化学品暴露，如双酚和邻苯二甲酸盐。这些化学物质现在被认为是 作为内分泌干扰物，可能会促进胰岛素抵抗和糖尿病。虽然之前的糖尿病研究 风险已经探索了不良的饮食质量和饮食污染物彼此隔离，这项研究旨在 比较两种危害对农村居民糖尿病风险的综合影响。为了实现这一目标， 这项研究将通过食物频率问卷和食物收据获得详细的饮食数据， 购买，测量双酚和邻苯二甲酸盐的估计每日摄入量和尿液水平，并使用点- 进行HbA 1c检测，以确定与农村糖尿病相关的关键风险因素。研究环境将是沙利文 县，纽约，一个农村县与第二次最差的健康排名和过早死亡率在新 约克州，也是糖尿病的高负担。虽然不代表所有农村地区， 沙利文县的贫困，主要是白色农村人口是一个未充分研究的高风险群体， 糖尿病预后差。因此，本研究的具体目的将是：1）确定饮食是否 农村居民的素质受其地理位置和当地食物特点的影响 2）根据食物消耗量计算双酚和邻苯二甲酸酯的估计每日摄入量 农村居民的模式，并将结果与这些化学物质的尿液水平进行比较，以及3）使用即时护理 HbA 1c测试以确定不良饮食质量和饮食污染物如何影响农村人群的血糖控制 没有糖尿病诊断的居民。