Mandy Fretts

Associate Professor, Epidemiology



PhD Epidemiology, University of Washington, 2011
MPH Epidemiology, University of Washington, 2007



University of Washington
Box 351619
Department of Epidemiology
Hans Rosling Center for Population Health, 873
Seattle, WA 98195


Dr. Fretts is a cardiovascular and nutritional epidemiologist with a focus on observational and interventional research aimed at improving cardio-metabolic health in underserved and rural communities (with a focus on American Indian communities). Her work aims to work with community partners to integrate observational and interventional research to mitigate obesity-related health disparities and improve health behaviors and health outcomes. Dr. Fretts’ research primarily focuses on nutrition, food insecurity, the food environment, physical activity, obesity, fatty acids, and diabetes. She is the Principal Investigator of the Dakotas field site for the Strong Heart Study, a large cohort study of heart disease and its risk factors in 12 American Indian communities in Arizona, Oklahoma, North Dakota and South Dakota, that has been on-going since 1988. She is also Principal Investigator of a community-based diet and cooking skills intervention (randomized trial) designed to improve blood sugar control and other cardiovascular risk factors for American Indians with type 2 diabetes. In addition to her work with American Indian communities, she is involved in several on-going projects related to fatty acids, diet, diet*gene interactions, diabetes, and cardiovascular outcomes in the Cardiovascular Health Study and the Fatty Acids and Outcomes Research Consortium (FORCE) consortium.

Research Interests

  • American Indian health
  • Diabetes
  • Interventions
  • Nutrition
  • Physical activity
  • Lifestyle
  • Social epidemiology
  • Health disparities
  • Obesity
  • Fatty acids
  • Cardio-metabolic disease prevention

Recent Publications (PubMed)

Geographic and dietary differences of urinary uranium levels in the Strong Heart Family Study.
(2024 Jul 3)
J Expo Sci Environ Epidemiol
Patterson KP, Nigra AE, Olmedo P, Grau-Perez M, O'Leary R, O'Leary M, Fretts AM, Umans JG, Best LG, Goessler W, Cole SA, Navas-Acien A

Circulating Sphingolipids and All-Cause Mortality: The Strong Heart Family Study.
(2024 Jul 2)
J Am Heart Assoc 13(13): e032536
Fretts AM, Jensen PN, Sitlani CM, Hoofnagle A, Lidgard B, Umans JG, Siscovick DS, King IB, Howard BV, Cole SA, Lemaitre RN

Association of Water Arsenic With Incident Diabetes in U.S. Adults: The Multi-Ethnic Study of Atherosclerosis and the Strong Heart Study.
(2024 Jul 1)
Diabetes Care 47(7): 1143-1151
Spaur M, Galvez-Fernandez M, Chen Q, Lombard MA, Bostick BC, Factor-Litvak P, Fretts AM, Shea SJ, Navas-Acien A, Nigra AE

The Gut Microbial Metabolite Trimethylamine N -oxide, Incident CKD, and Kidney Function Decline.
(2024 Jun 1)
J Am Soc Nephrol 35(6): 749-760
Wang M, Tang WHW, Li XS, de Oliveira Otto MC, Lee Y, Lemaitre RN, Fretts A, Nemet I, Sotoodehnia N, Sitlani CM, Budoff M, DiDonato JA, Wang Z, Bansal N, Shlipak MG, Psaty BM, Siscovick DS, Sarnak MJ, Mozaffarian D, Hazen SL

Assessing the use of GEE methods for analyzing binary outcomes in family studies: the Strong Heart Family Study.
(2024 Mar 29)
J Biopharm Stat
Chen X, Zhang Y, Fretts AM, Ali T, Umans JG, Devereux RB, Lee ET, Cole SA, Zhao YD

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