Publications by authors named "Margaret R Savoca"

For 30 years, the Atherosclerosis Risk in Communities (ARIC) cohort study has examined the etiology and progression of atherosclerosis and atherosclerotic diseases. This research has evaluated variation in cardiovascular disease (CVD) risk in relation to age, race, gender, location and lifestyle factors, including diet. In this commentary, we describe ARIC research that illustrates an expanded view of the relationship between diet and health and suggest ways that future cohort studies may influence the direction of nutrition and dietetics practice.

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Introduction: To support claims that RCTs can reduce health disparities (i.e., are translational), it is imperative that methodologies exist to evaluate the tenability of external validity in RCTs when probabilistic sampling of participants is not employed.

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The prevalence of type 2 diabetes continues to increase in minority and underserved patients, who are also more likely to have poorer control of diabetes and related risk factors for complications. Although the Look AHEAD trial has demonstrated improved risk factor control among overweight or obese diabetes patients who received an intensive lifestyle intervention, translating such findings into accessible programs is a major public health challenge. The purpose of this paper is to report the design and baseline characteristics of the Lifestyle Interventions for the Treatment of Diabetes study (LIFT Diabetes).

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Background: The use of the electronic medical record (EMR) system in recruitment in clinical trials has the potential for providing a very reliable and cost-effective recruiting methodology which may improve participant recruitment in clinical trials. We examined a recruitment approach centered on the use of the EMR, as well as other traditional methods, in the Lifestyle Intervention for Treatment of Diabetes (LIFT Diabetes) trial.

Methods: LIFT Diabetes is a randomized controlled trial designed to investigate the effects of two contrasting interventions on cardiovascular disease risk: a community-based intensive lifestyle program aimed at achieving weight loss and a clinic-based enhanced diabetes self-management program.

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This analysis examines the associations of oral health with social integration among ethnically diverse (African American, American Indian, White) rural older adults. Data are from a cross-sectional survey of 635 randomly selected community-dwelling adults aged 60+. Measures include self-rated oral health, number of teeth, number of oral health problems, social engagement, and social network size.

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Objectives: This analysis delineates the predisposing, need, and enabling factors that are associated with regular and recent dental care in a multiethnic sample of rural older adults.

Methods: A cross-sectional, comprehensive, oral-health survey conducted with a random, multiethnic (African American, American Indian, white) sample of 635 community-dwelling adults aged 60 years and older was completed in two rural southern counties. Logistic regression models assessed the simultaneous associations of dental care with predisposing, enabling, and need factors.

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Objectives: The objective of this study is to determine the degree to which rural older adults are able to complete a measure of dental anxiety and to assess the prevalence, as well as the demographic and oral health characteristics, of individuals reporting high dental anxiety.

Methods: A population-based sample of 635 African American, American Indian and White older adults (age ≥ 60 years) completed an in-home survey, and 362 dentate participants completed an oral examination. Dental anxiety was measured using the four-item Corah's Dental Anxiety Scale (DAS).

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Although young African-American men are at particularly high risk of developing hypertension at an early age, dietary interventions that have successfully reduced blood pressure among African-American adults have not been translated into programs for this group. Life contexts such as school enrollment, participation in competitive athletics, and employment influence the daily activities and meal patterns of African-American men. This study explored the activities of young African-American men to identify opportunities to increase healthful food choices.

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Objectives: To quantify prevalence of dry mouth, association between dry mouth and beverage intake and dietary quality, and association between dry mouth and self-reported dietary accommodations to oral health deficits.

Design: Cross-sectional study; data from self-reports.

Setting: Rural North Carolina counties with substantial African-American and American Indian populations.

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This study categorizes older adults living in rural areas by denture status, assesses the frequency of wearing dentures during meals, and determines whether denture status or use is associated with dietary quality or the number of foods avoided. A multi-ethnic population-based sample of adults ≥60 years (N = 635) in the rural United States was interviewed. Survey included denture use, removing dentures before eating, and foods avoided due to oral health problems.

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Objectives: To quantify the association between food avoidance and modification due to oral health problems, to examine the association between food practices and dietary quality, and to determine foods associated with these self-management behaviors.

Design: Cross-sectional.

Setting: Rural North Carolina.

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The 2005 Dietary Guidelines for Americans publication placed increased emphasis on the importance of consuming a wide range of healthful foods and further reducing the consumption of less healthful ones. These recommendations are challenging for rural elders whose functional limitations, fewer resources, and limited access to foods negatively affect the quality of their diets. The purpose of this study was to characterize the diet quality of a multiethnic population-based sample of older adults (N=635) in the southern United States.

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Objective: Poor oral health influences the dietary quality of older individuals. The objective of the present study was to relate the number of teeth to adherence to the 2005 Dietary Guidelines for Americans among an ethnically diverse sample of older adults.

Design: A block cluster design was used to obtain a sample of older adults.

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Purpose: Dietary variation is important for health maintenance and disease prevention among older adults. However, oral health deficits impair ability to bite and chew foods. This study examines the association between oral health and foods avoided or modified in a multiethnic rural population of older adults.

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Objectives: To compare oral health status according to ethnicity and socioeconomic status in African-American, American-Indian, and white dentate and edentulous community-dwelling older adults.

Design: Cross-sectional study; data from self-reports and oral examinations.

Participants: A multistage cluster sampling design was used to recruit 635 participants aged 60 and older from rural North Carolina counties with substantial African-American and American-Indian populations.

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Objectives: This analysis describes the dental self-care behaviors used by a multiethnic sample of older adults and delineates the associations of self-care behaviors with personal characteristics and oral health problems.

Methods: A cross-sectional comprehensive oral health survey conducted with a random, multiethnic (African-American, American Indian, white) sample of 635 community-dwelling rural adults aged 60 years and older was completed in two rural southern counties.

Results: Rural older adults engage in a variety of self-care behaviors, including the use of over-the-counter (OTC) medicine (12.

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Tobacco use is a well-documented contributor to morbidity and mortality in the US and worldwide. Information on the comprehensive use of tobacco products is lacking, particularly smokeless tobacco in its various forms. Data from 635 older (>/=60 years) African American, American Indian and White adults in rural North Carolina were analyzed to assess current and lifetime use of cigarettes, cigars, pipe, snuff and chewing tobacco.

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Objectives: To describe beliefs about hypertension and health education of young African American adults varying in their hypertension risk status.

Design: Fifty-eight African American young adults (17-20 years) were selected based on low and high risk criteria for hypertension assessed in earlier investigations of hemodynamic responses to stress. The sample included 15 high risk males, 13 low risk males, 14 high risk females, and 16 low risk females who were interviewed indepth about their hypertension beliefs and health education experiences.

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The present analysis examined changes in the variability of overnight sodium excretion in 84 free-living adolescents (ages 15 to 19 years) on a 4-day sodium-controlled diet in which foods provided were selected by adolescents from an extensive list of menu items. The only selection criterion imposed was that foods selected for each day contain 4,000+/-200 mg sodium. Adolescents collected overnight urine samples.

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Background: Although relatively little is known about the responsible factors, there is an increased prevalence of essential hypertension in youth. Our previous research using casual blood pressure (BP) suggests a role for caffeine intake. The objective of this study was to assess the association between caffeine intake and ambulatory BP patterns among adolescents and to replicate our previous findings that compared caffeine intake to BP values obtained at a single time point.

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Objective: To assess the association between the consumption of caffeinated beverages and blood pressure in African American and white adolescents.

Design: This study was part of ongoing research examining stress-induced hemodynamic responses in adolescents. African American and white adolescents (n = 159) selected foods and beverages for a 3-day sodium-controlled diet.

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For people with diabetes, hemoglobin A1c (HbA1c) is a measure of blood glucose control and an indication of the risk of developing diabetes complications. However, a given HbA1c value does not provide information about the diabetes self-management practices or philosophies of individuals in poor (HbA1c > 8.0%) or excellent (HbA1c < 6.

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Objective: To investigate the food habits of people with type 2 diabetes and to identify those habits related to glycemic control.

Design: The purposive sampling plan targeted people (40 to 65 years old) living in two urban communities in the Southeastern United States with type 2 diabetes for >1 year (60% women, 50% African Americans and low-income individuals). In-depth interviews were used to identify food habits.

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