Nia Mitchell

Positions:

Associate Professor of Medicine

Medicine, General Internal Medicine
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 2005

Washington University School of Medicine

M.P.H. 2010

University of Colorado School of Medicine

Internal Medicine Residency

University of Colorado School of Medicine

Primary Care Research Fellowship

University of Colorado School of Medicine

Grants:

Changes in Weight and Physical Function for Older African American Women in National, Peer-Led, Community-Based Weight Loss Program

Administered By
Medicine, General Internal Medicine
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

Evaluation of Low Cost National Weight Loss Program in Underserved

Administered By
Medicine, General Internal Medicine
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

Changes in Weight and Physical Function for Older African American Women in National, Peer-Led, Community-Based Weight Loss Program

Administered By
Medicine, General Internal Medicine
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

Changes in Weight and Physical Function for Older African American Women in National, Peer-Led, Community-Based Weight Loss Program

Administered By
Medicine, General Internal Medicine
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

Changes in Weight and Physical Function for Older African American Women in National, Peer-Led, Community-Based Weight Loss Program

Administered By
Medicine, General Internal Medicine
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

Publications:

Weight Change for Pediatric Completers in a National Weight Loss Program

Overweight and obese children in low-income households have limited access to weight loss programs. Low-cost programs should be evaluated in this population. The objective of the current study is to determine weight change among 7 to 17-year-old participants in Take Off Pounds Sensibly (TOPS), a national, low-cost weight loss program. This nonconcurrent prospective study analyzes the cumulative change in weight z-score for overweight and obese children and adolescents who joined TOPS from 2008 to 2011 and consecutively renewed their annual membership. The study includes 586 individuals. At 1-year, cumulative mean (SD) weight z-score change was −0.13 (31). In general, mean change in weight z-scores was no different in subsequent years. Mean weight z-score of children and adolescent TOPS participants who renew their program membership decreased significantly in the first year. Randomized controlled trials should prospectively evaluate this program in children and adolescents.
Authors
Cason-Wilkerson, R; Thompson, D; Mitchell, N
MLA Citation
Cason-Wilkerson, R., et al. “Weight Change for Pediatric Completers in a National Weight Loss Program.” Global Pediatric Health, vol. 8, Nov. 2021. Scopus, doi:10.1177/2333794X211057716.
URI
https://scholars.duke.edu/individual/pub1502998
Source
scopus
Published In
Global Pediatric Health
Volume
8
Published Date
DOI
10.1177/2333794X211057716

Management of Stage 1 Hypertension in Adults With a Low 10-Year Risk for Cardiovascular Disease: Filling a Guidance Gap: A Scientific Statement From the American Heart Association.

High blood pressure (BP) is the leading cause of worldwide cardiovascular disease morbidity and mortality. Patients and clinicians dealing with hypertension have benefited from the evidence of event-based randomized controlled clinical trials. One result from those trials has been the development of evidence-based guidelines. The commitment to using evidence from these event-based randomized trials has been a cornerstone in the development of guideline treatment recommendations. However, in some situations, evidence from event-based trials is not available to guideline writers or clinicians for assistance in treatment decision making. Such is the case for the management of many patients with stage 1 hypertension. The purpose of this scientific statement is to provide information complementary to the 2017 Hypertension Clinical Practice Guidelines for the patient with untreated stage 1 hypertension (systolic BP/diastolic BP, 130-139/80-89 mm Hg) with a 10-year risk for atherosclerotic cardiovascular disease <10% who fails to meet the systolic BP/diastolic goal (<130/80 mm Hg) after 6 months of guideline-recommended lifestyle therapy. This statement provides evidence from sources other than event-based randomized controlled clinical trials and offers therapy options for consideration by clinicians.
Authors
Jones, DW; Whelton, PK; Allen, N; Clark, D; Gidding, SS; Muntner, P; Nesbitt, S; Mitchell, NS; Townsend, R; Falkner, B; American Heart Association Council on Hypertension; Council on the Kidney in Cardiovascular Disease; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular Radiology and Intervention; Council on Lifelong Congenital Heart Disease and Heart Health in the Young; and Stroke Council,
MLA Citation
Jones, Daniel W., et al. “Management of Stage 1 Hypertension in Adults With a Low 10-Year Risk for Cardiovascular Disease: Filling a Guidance Gap: A Scientific Statement From the American Heart Association.Hypertension, vol. 77, no. 6, June 2021, pp. e58–67. Pubmed, doi:10.1161/HYP.0000000000000195.
URI
https://scholars.duke.edu/individual/pub1515966
PMID
33910363
Source
pubmed
Published In
Hypertension
Volume
77
Published Date
Start Page
e58
End Page
e67
DOI
10.1161/HYP.0000000000000195

Retrospective cohort study of changes in estimated glomerular filtration rate for patients prescribed a low carb diet.

PURPOSE OF REVIEW: Obesity and diabetes contribute to chronic kidney disease (CKD) and accelerate the loss of kidney function. Low carbohydrate diets (LCDs) are associated with weight loss and improved diabetes control. Compared to the typical Western diet, LCDs contain more protein, so individuals with CKD are not included in studies of LCDs. Therefore, there are no studies of LCDs for weight loss and their effects on kidney function. RECENT FINDINGS: Obesity, hyperglycemia, and hyperinsulinemia can be detrimental to kidney function. LCDs may improve kidney function in patients with obesity and diabetes because they are associated with weight loss, improve blood sugar control, and decrease endogenous insulin production and exogenous insulin requirements. SUMMARY: In this study, for patients with mildly reduced and moderately to severely reduced kidney function who were prescribed an LCD, their estimated glomerular filtration rate (eGFR) was either unchanged or improved. For those with normal or elevated eGFR, their kidney function was slightly decreased. For those without diabetes, greater weight loss was associated with improved eGFR. Future studies should prospectively measure low carbohydrate dietary adherence and physical activity and directly measure changes in GFR and albuminuria for participants with CKD before and during that diet.
Authors
Mitchell, NS; Batch, BC; Tyson, CC
MLA Citation
Mitchell, Nia S., et al. “Retrospective cohort study of changes in estimated glomerular filtration rate for patients prescribed a low carb diet.Curr Opin Endocrinol Diabetes Obes, vol. 28, no. 5, Oct. 2021, pp. 480–87. Pubmed, doi:10.1097/MED.0000000000000673.
URI
https://scholars.duke.edu/individual/pub1494312
PMID
34392262
Source
pubmed
Published In
Curr Opin Endocrinol Diabetes Obes
Volume
28
Published Date
Start Page
480
End Page
487
DOI
10.1097/MED.0000000000000673

Predictors of long-term weight loss trajectories during a behavioral weight loss intervention: An exploratory analysis.

BACKGROUND: Substantial interindividual variability in response to behavioral weight loss interventions remains a critical challenge in obesity treatment. An improved understanding of the complex factors that contribute to this variability may improve obesity treatment outcomes. OBJECTIVE: To identify weight change trajectories during a behavioral weight loss intervention and to explore differences between trajectory groups in sociodemographic, biologic, behavioral, and psychosocial factors. METHODS: Adults (n = 170, 40 ± 9 years, BMI 34 ± 4 kg/m2, 84% female) participated in an 18-month behavioral weight loss intervention. Weight was measured at 0, 3, 6, 9, 12, 15, 18, and 24 months. Among participants with at least two weights after baseline (n = 140), clusters of longitudinal trajectories of changes in weight were identified using a latent class growth mixture model. The association between baseline factors or changes in factors over time and trajectory group was examined. RESULTS: Two weight change trajectories were identified: "weight regainers" (n = 91) and "weight loss maintainers" (n = 49). Black participants (90%, 19/21) were more likely than non-Black participants to be regainers versus maintainers (p < 0.01). Maintainers demonstrated greater increases in device-measured physical activity, autonomous motivation for exercise, diet self-efficacy, cognitive restraint, and engagement in weight management behaviors and greater reductions in barriers for exercise, disinhibition, and depressive symptoms over 24 months versus regainers (p < 0.05). CONCLUSION: Maintainers and regainers appear to be distinct trajectories that are associated with specific sociodemographic, behavioral, and psychosocial factors. Study results suggest potential targets for more tailored, multifaceted interventions to improve obesity treatment outcomes.
Authors
Ostendorf, DM; Blankenship, JM; Grau, L; Arbet, J; Mitchell, NS; Creasy, SA; Caldwell, AE; Melanson, EL; Phelan, S; Bessesen, DH; Catenacci, VA
MLA Citation
Ostendorf, Danielle M., et al. “Predictors of long-term weight loss trajectories during a behavioral weight loss intervention: An exploratory analysis.Obes Sci Pract, vol. 7, no. 5, Oct. 2021, pp. 569–82. Pubmed, doi:10.1002/osp4.530.
URI
https://scholars.duke.edu/individual/pub1485150
PMID
34631135
Source
pubmed
Published In
Obesity Science & Practice
Volume
7
Published Date
Start Page
569
End Page
582
DOI
10.1002/osp4.530

Outpatient metformin use is associated with reduced severity of COVID-19 disease in adults with overweight or obesity.

Observational studies suggest outpatient metformin use is associated with reduced mortality from coronavirus disease-2019 (COVID-19). Metformin is known to decrease interleukin-6 and tumor-necrosis factor-α, which appear to contribute to morbidity in COVID-19. We sought to understand whether outpatient metformin use was associated with reduced odds of severe COVID-19 disease in a large US healthcare data set. Retrospective cohort analysis of electronic health record (EHR) data that was pooled across multiple EHR systems from 12 hospitals and 60 primary care clinics in the Midwest between March 4, 2020 and December 4, 2020. Inclusion criteria: data for body mass index (BMI) > 25 kg/m2 and a positive SARS-CoV-2 polymerase chain reaction test; age ≥ 30 and ≤85 years. Exclusion criteria: patient opt-out of research. Metformin is the exposure of interest, and death, admission, and intensive care unit admission are the outcomes of interest. Metformin was associated with a decrease in mortality from COVID-19, OR 0.32 (0.15, 0.66; p = .002), and in the propensity-matched cohorts, OR 0.38 (0.16, 0.91; p = .030). Metformin was associated with a nonsignificant decrease in hospital admission for COVID-19 in the overall cohort, OR 0.78 (0.58-1.04, p = .087). Among the subgroup with a hemoglobin HbA1c available (n = 1193), the adjusted odds of hospitalization (including adjustment for HbA1c) for metformin users was OR 0.75 (0.53-1.06, p = .105). Outpatient metformin use was associated with lower mortality and a trend towards decreased admission for COVID-19. Given metformin's low cost, established safety, and the mounting evidence of reduced severity of COVID-19 disease, metformin should be prospectively assessed for outpatient treatment of COVID-19.
Authors
Bramante, CT; Buse, J; Tamaritz, L; Palacio, A; Cohen, K; Vojta, D; Liebovitz, D; Mitchell, N; Nicklas, J; Lingvay, I; Clark, JM; Aronne, LJ; Anderson, E; Usher, M; Demmer, R; Melton, GB; Ingraham, N; Tignanelli, CJ
MLA Citation
Bramante, Carolyn T., et al. “Outpatient metformin use is associated with reduced severity of COVID-19 disease in adults with overweight or obesity.J Med Virol, vol. 93, no. 7, July 2021, pp. 4273–79. Pubmed, doi:10.1002/jmv.26873.
URI
https://scholars.duke.edu/individual/pub1474863
PMID
33580540
Source
pubmed
Published In
J Med Virol
Volume
93
Published Date
Start Page
4273
End Page
4279
DOI
10.1002/jmv.26873