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Comparative Study
. 2025 May;57(5):435-440.
doi: 10.1016/j.jneb.2025.01.011. Epub 2025 Feb 28.

A Comparison of Dietary Intake Among Rural Americans With and Without Diabetes

Christian A Koziatek  1 , Melissa Rony  2 , Carolina Quintero Arias  2 , Tammy Flores  2 , Matthew Heider  3 , Molly Smith  3 , Sadakat Chowdhury  1 , Haley Motola  4 , Jill Hubert-Simon  4 , Karen Holden  4 , David C Lee  5
Affiliations
Comparative Study

A Comparison of Dietary Intake Among Rural Americans With and Without Diabetes

Christian A Koziatek et al. J Nutr Educ Behav. 2025 May.

Abstract

Objective: To compare alternative Healthy Eating Index (aHEI) scores among residents with or without diabetes in a rural county and analyze food/drink subgroups for notable differences between the 2 groups.

Methods: We performed cross-sectional surveys and validated food frequency questionnaires among rural residents in Sullivan County, New York. We compared total aHEI and component scores between participants with and without diabetes.

Results: The 155 respondents with diabetes were older, less frequently non-Hispanic White, and had higher mean body mass index than the 961 respondents without diabetes. We found lower aHEI scores among participants with diabetes (54.1) than those without (56.7) (P = 0.001). Respondents with diabetes had significantly lower component scores for alcoholic beverages, red meat, nuts/legumes, and trans-fats than those without diabetes.

Conclusions and implications: Our findings highlight the need for nutrition education in high-risk rural communities. We also identified specific food/drink categories among rural residents with diabetes that should be targeted to improve glycemic control.

Keywords: alternative Healthy Eating Index; diabetes; dietary intake; nutrition; rural health.

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Conflict of interest statement

CONFLICT OF INTEREST DISCLOSURE The authors have not stated any conflicts of interest. The findings of the study represent the opinions of the authors and do not reflect the views of any organization or institution with whom they are affiliated.

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