Elizabeth Mayer-Davis
· Cary C. Boshamer Distinguished Professor of Nutrition and MedicineUniversity of North Carolina at Chapel Hill · Nutrition
Active 1998–2017
About
Elizabeth Mayer-Davis, PhD, RD, is the Cary C. Boshamer Distinguished Professor of Nutrition and Medicine at the UNC Gillings School of Global Public Health. She has focused her career on diabetes, including the epidemiology and natural history of type 1 and type 2 diabetes in children and adults. Her research addresses the many ways in which nutrition can impact the risk for development of diabetes, and on the risk of complications of either type 1 or type 2 diabetes. Studies have typically included culturally and regionally diverse populations. Her primary focus now is on type 1 diabetes in youth and young adults, with an emphasis on diabetes self-management, energy balance, and weight management for individuals with type 1 diabetes. Dr. Mayer-Davis is the Principal Investigator for the Carolina site of the SEARCH for Diabetes in Youth study and serves as the national co-chairperson for this large multi-center study. Her recent work includes studies on nutritional factors that may improve prognosis for adolescents with type 1 diabetes and behavioral strategies to help youth better manage their disease. Her intervention strategies are patient-centered, utilizing problem solving skills training and motivational interviewing, often incorporating communication technologies. She is actively involved in professional organizations such as the American Diabetes Association and the American Society for Nutrition, serving in leadership roles including past president for health care and education, and she was appointed to the 2020 Dietary Guidelines Advisory Committee by the USDA and HHS. Dr. Mayer-Davis's research interests include diabetes, health equity, nutrition, physical activity, and obesity.
Research topics
- Medicine
- Internal medicine
- Endocrinology
- Gerontology
- Psychology
Selected publications
Diabetes Care · 2022 · 29 citations
- Medicine
- Internal medicine
- Endocrinology
OBJECTIVE: To determine glycemic and nonglycemic risk factors that contribute to the presence of diabetic retinopathy (DR) before and after the onset of type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS: During the Diabetes Prevention Program (DPP) and DPP Outcome Study (DPPOS), we performed fundus photography over time in adults at high risk for developing T2D, including after they developed diabetes. Fundus photographs were graded using the Early Treatment Diabetic Retinopathy Study (ETDRS) grading system, with DR defined as typical lesions of DR (microaneurysms, exudates, hemorrhage, or worse) in either eye. RESULTS: By DPPOS year 16 (∼20 years after random assignment into DPP), 24% of 1,614 participants who had developed T2D and 14% of 885 who remained without diabetes had DR. In univariate analyses, using results from across the entire duration of follow-up, American Indian race was associated with less frequent DR compared with non-Hispanic White (NHW) race, and higher HbA1c, fasting and 2-h plasma glucose levels during an oral glucose tolerance test, weight, and history of hypertension, dyslipidemia, and smoking, but not treatment group assignment, were associated with more frequent DR. On multivariate analysis, American Indian race was associated with less DR compared with NHW (odds ratio [OR] 0.36, 95% CI 0.20-0.66), and average HbA1c was associated with more DR (OR 1.92, 95% CI 1.46-1.74 per SD [0.7%] increase in HbA1c). CONCLUSIONS: DR may occur in adults with prediabetes and early in the course of T2D. HbA1c was an important risk factor for the development of DR across the entire glycemic range from prediabetes to T2D.
Diabetes Care · 2021 · 98 citations
- Medicine
- Internal medicine
- Endocrinology
OBJECTIVE: To determine whether metformin or lifestyle modification can lower rates of all-cause and cause-specific mortality in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study. RESEARCH DESIGN AND METHODS: From 1996 to 1999, 3,234 adults at high risk for type 2 diabetes were randomized to an intensive lifestyle intervention, masked metformin, or placebo. Placebo and lifestyle interventions stopped in 2001, and a modified lifestyle program was offered to everyone, but unmasked study metformin continued in those originally randomized. Causes of deaths through 31 December 2018 were adjudicated by blinded reviews. All-cause and cause-specific mortality hazard ratios (HRs) were estimated from Cox proportional hazards regression models and Fine-Gray models, respectively. RESULTS: = 131). Compared with placebo, metformin did not influence mortality from all causes (HR 0.99 [95% CI 0.79, 1.25]), cancer (HR 1.04 [95% CI 0.72, 1.52]), or cardiovascular disease (HR 1.08 [95% CI 0.70, 1.66]). Similarly, lifestyle modification did not impact all-cause (HR 1.02 [95% CI 0.81, 1.28]), cancer (HR 1.07 [95% CI 0.74, 1.55]), or cardiovascular disease (HR 1.18 [95% CI 0.77, 1.81]) mortality. Analyses adjusted for diabetes status and duration, BMI, cumulative glycemic exposure, and cardiovascular risks yielded results similar to those for all-cause mortality. CONCLUSIONS: Cancer was the leading cause of mortality among adults at high risk for type 2 diabetes. Although metformin and lifestyle modification prevented diabetes, neither strategy reduced all-cause, cancer, or cardiovascular mortality rates.
Diabetes Care · 2020 · 72 citations
- Medicine
- Internal medicine
- Physical therapy
OBJECTIVE: Across the Diabetes Prevention Program (DPP) follow-up, cumulative diabetes incidence remained lower in the lifestyle compared with the placebo and metformin randomized groups and could not be explained by weight. Collection of self-reported physical activity (PA) (yearly) with cross-sectional objective PA (in follow-up) allowed for examination of PA and its long-term impact on diabetes prevention. RESEARCH DESIGN AND METHODS: = 1,793). Mixed models determined PA differences across treatment groups. The association between PA and diabetes incidence was examined using Cox proportional hazards models. RESULTS: = 0.001 and 0.047). All associations remained significant with the addition of weight in the models. CONCLUSIONS: PA was inversely related to incident diabetes in the entire cohort across the study, with cross-sectional accelerometry results supporting these findings. This highlights the importance of PA within lifestyle intervention efforts designed to prevent diabetes and urges health care providers to consider both PA and weight when counseling high-risk patients.
Recent grants
SEARCH for Diabetes in Youth Registry Study, Phase 4: Carolina Center (Component A)
NIH · $1.9M · 2015–2020
Animal Metabolism Phenotyping Core
NIH · $11.3M · 1999–2027
NIH · $4.2M · 2011
NIH · $3.6M · 2015
Frequent coauthors
- 6 shared
Giuseppina Imperatore
University College London
- 6 shared
Dana Dabelea
University of Colorado Anschutz Medical Campus
- 6 shared
Jean M. Lawrence
National Institute of Diabetes and Digestive and Kidney Diseases
- 6 shared
Santica M. Marcovina
- 5 shared
Catherine Pihoker
Seattle Children's Hospital
- 5 shared
Lawrence M. Dolan
Cincinnati Children's Hospital Medical Center
- 4 shared
Gregory L. Burke
Wake Forest University
- 4 shared
Sara A. Ephross
Syneos Health (United States)
Awards & honors
- 2011 President for Health Care and Education, American Diabe…
- Appointed to the 2020 Dietary Guidelines Advisory Committee…
- Appointed by President Obama to serve on the Advisory Group…
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