Johanna Dwyer | Tufts University School of Medicine (original) (raw)
Papers by Johanna Dwyer
Nutrients
This study examined total usual micronutrient intakes from foods, beverages, and dietary suppleme... more This study examined total usual micronutrient intakes from foods, beverages, and dietary supplements (DS) compared to the Dietary Reference Intakes among U.S. adults (≥19 years) by sex and food security status using NHANES 2011–2014 data (n = 9954). DS data were collected via an in-home interview; the NCI method was used to estimate distributions of total usual intakes from two 24 h recalls for food and beverages, after which DS were added. Food security status was categorized using the USDA Household Food Security Survey Module. Adults living in food insecure households had a higher prevalence of risk of inadequacy among both men and women for magnesium, potassium, vitamins A, B6, B12, C, D, E, and K; similar findings were apparent for phosphorous, selenium, and zinc in men alone. Meanwhile, no differences in the prevalence of risk for inadequacy were observed for calcium, iron (examined in men only), choline, or folate by food security status. Some DS users, especially food secure...
Advances in nutrition (Bethesda, Md.), 2015
Fortification is the process of adding nutrients or non-nutrient bioactive components to edible p... more Fortification is the process of adding nutrients or non-nutrient bioactive components to edible products (e.g., food, food constituents, or supplements). Fortification can be used to correct or prevent widespread nutrient intake shortfalls and associated deficiencies, to balance the total nutrient profile of a diet, to restore nutrients lost in processing, or to appeal to consumers looking to supplement their diet. Food fortification could be considered as a public health strategy to enhance nutrient intakes of a population. Over the past century, fortification has been effective at reducing the risk of nutrient deficiency diseases such as beriberi, goiter, pellagra, and rickets. However, the world today is very different from when fortification emerged in the 1920s. Although early fortification programs were designed to eliminate deficiency diseases, current fortification programs are based on low dietary intakes rather than a diagnosable condition. Moving forward, we must be dilig...
Nutrition Research, 1988
... J. Am. Diet. Assoc. 1981; 79:547-51 20. Meredith A, Matthews A, Zickefoose M, Weagley E, Waya... more ... J. Am. Diet. Assoc. 1981; 79:547-51 20. Meredith A, Matthews A, Zickefoose M, Weagley E, Wayave M, Brown EG. How well do school children recall what theyhave eaten? J. Am. Diet. Assoc. ... J. Pers. Soc.Psychol. 1978;39. Teasdale JD, recall of positive, 22:163-71 Russell ML. ...
New England Journal of Medicine, 1982
We studied 10 vegetarian and 10 nonvegetarian premenopausal women on four occasions approximately... more We studied 10 vegetarian and 10 nonvegetarian premenopausal women on four occasions approximately four months apart. During each study period, the participants kept three-day dietary records, and estrogens were measured in plasma, urinary, and fecal samples. Vegetarians consumed less total fat than omnivores did (30 per cent of total calories, as compared with 40 per cent) and more dietary fiber (28 g per day, as compared with 12 g). There was a positive correlation between fecal weight and fecal excretion of estrogens in both groups (P less than 0.001), with vegetarians having higher fecal weight and increased fecal excretion of estrogens. Urinary excretion of estriol was lower in vegetarians (P less than 0.05), and their plasma levels of estrone and estradiol were negatively correlated with fecal excretion of estrogen (P = 0.005). Among the vegetarians the beta-glucuronidase activity of fecal bacteria was significantly reduced (P = 0.05). We conclude that vegetarian women have an increased fecal output, which leads to increased fecal excretion of estrogen and a decreased plasma concentration of estrogen.
Nephrology Dialysis Transplantation, 2005
Metabolism, 1989
Relationships between plasma levels of lipoproteins and sex hormones were studied in 24 healthy p... more Relationships between plasma levels of lipoproteins and sex hormones were studied in 24 healthy premenopausal women with no risk factors for coronary heart disease. The women were carefully selected to remove the effects of other environmental factors, such as smoking, drugs, alcohol, and exercise, which are known to influence lipid metabolism. They all ate precisely the same Western-style diet for 1 to 2 weeks before blood samples were obtained in the follicular phase of their menstrual cycle. After adjusting for other hormones by multiple regression, significant positive partial correlations were seen between high density lipoprotein cholesterol (HDL-C) and protein bound estradiol (r = .57, P = .02), as well as between very low density lipoprotein cholesterol (VLDL-C) and protein bound estradiol (r = .63, p = .01). A significant negative partial correlation was seen between VLDL-C and free estradiol (r = -.65 P = .01). Conversely, low density lipoprotein cholesterol (LDL-C) levels were negatively correlated with protein bound estradiol (r = -.77, P less than .001) and positively correlated with free estradiol (r = .71, P less than .001). No associations between plasma lipoproteins and testosterone were seen; however, androstenedione was positively correlated with VLDL-C (r = .59, P = .01). These findings show a close link between plasma lipoproteins and sex hormones, and may help to explain the lower risk of coronary heart disease in women.
Medicine & Science in Sports & Exercise, 2006
The Lancet, 1982
Dietary studies and assays of urinary lignans in postmenopausal women showed that lignan excretio... more Dietary studies and assays of urinary lignans in postmenopausal women showed that lignan excretion is significantly lower in urine of women with breast cancer than in normal omnivorous and vegetarian women and confirmed that there is a significant correlation between fibre intake and lignan excretion. It is suggested that the precursors of the human lignans enterolactone and enterodiol formed by the intestinal microflora are to be found in fibre-rich foods such as grains, nuts, and legumes. Excretion of equol, which has antioestrogenic properties, was similar in all groups studied and did not correlate with fibre intake, but occasional high values were found in some subjects.
Kidney International, 2010
Kidney International, 2005
The purpose of this study was to determine if indicators of nutritional status were associated wi... more The purpose of this study was to determine if indicators of nutritional status were associated with subsequent mortality in hemodialysis patients. Twelve selected nutrition indicators were measured prior to randomization in the Mortality and Morbidity in Hemodialysis (HEMO) Study. Relative risks (RR) of mortality were assessed at <6 months and >6 months of follow-up using Cox regression after controlling for case mix, comorbidity, and treatment assignment (high vs. standard Kt/V and high vs. low membrane flux). Low values of most nutritional status indicators were associated with increased RR of mortality. RRs were greatest over the short term (<6 months) and diminished with increasing follow-up (>6 months). Increases in body mass index (BMI) at lower levels (e.g., < or =25 kg/m(2)) and increases in serum albumin at any level were associated with reduced short-term RR, even after adjusting for case mix, treatment assignment, and for the joint effects of equilibrated normalized protein catabolic rate, total cholesterol, and serum creatinine. For >6 months' follow-up, increases in values among those with lower levels of BMI and serum albumin (< or =3.635 g/dL) and increases in all serum creatinine levels were associated with lower RR. Nutrition indicators are associated with subsequent mortality in a time-dependent manner, with greatest effects at <6 months of follow-up. The RR for these indicators may also vary within different ranges of values.
Journal of the International Society of Sports Nutrition, 2012
Journal of the International Society of Sports Nutrition, 2012
Journal of the Association of Nurses in AIDS Care, 1995
This study compared use of unconventional remedies in two groups of HIV-positive men (N = 63). Em... more This study compared use of unconventional remedies in two groups of HIV-positive men (N = 63). Employing a multiple-choice questionnaire, the authors assessed the use of and attitudes toward unconventional remedies among two groups of white HIV-positive men similar in age, socioeconomic status, and severity of illness, all of whom lived in Northern California. One group (n = 36) participated in AIDS clinical trial protocols; the other group (n = 27) received health care at a community health center. Participants at all sites expressed positive views upon increasing unconventional remedies. Individuals enrolled in the clinical trial protocols for investigational drugs used unconventional remedies significantly less than the community health center participants, who were enrolled in an open clinical trial of hypericin, an unproven remedy.
Journal of the American Society of Nephrology, 2002
Journal of the American Dietetic Association, 2009
Journal of the American Dietetic Association, 1994
As the intakes of soy foods rise in the American diet, the weak estrogenic activity of plant phyt... more As the intakes of soy foods rise in the American diet, the weak estrogenic activity of plant phytoestrogens may reach biologically effective levels. We determined the content of phytoestrogens (plant compounds with weak estrogenic activity in human beings) in tofu, a commercially produced soy drink, and three soy-based formulas. A modified isotope dilution gas chromatography-mass spectrometry method was used to analyze samples obtained from supermarkets or manufacturers. Two or three lots of duplicate samples of four brands of tofu, one commercially produced soy drink, and three soy-based specialty formulas were analyzed. Means and standard deviations were calculated for the isoflavones daidzein, Biochanin A, genistein, coumestrol, and formononetin. Tofu soy products were highest in isoflavone content; means of brands ranged from 73.0 to 97.5 micrograms/g daidzein per g wet weight and 187.4 to 215.9 micrograms genistein per g wet weight. The commercial soy drink followed with 7.0 micrograms daidzein per g wet weight and 21.0 micrograms genistein per g wet weight; the soy-based formulas were nearly devoid of these two isoflavones. Mean levels of Biochanin A, formononetin, and coumestrol were very low or nil (eg, 0 to 1.0 microgram/g) in all products. Tofu contained the highest amounts of isoflavones among the products tested, and there was some variability from brand to brand. The soy drink contained lesser amounts, and soy-based formulas were devoid of isoflavones.
Journal of the American Dietetic Association, 2006
Journal of the American Dietetic Association, 2008
Nutrients
This study examined total usual micronutrient intakes from foods, beverages, and dietary suppleme... more This study examined total usual micronutrient intakes from foods, beverages, and dietary supplements (DS) compared to the Dietary Reference Intakes among U.S. adults (≥19 years) by sex and food security status using NHANES 2011–2014 data (n = 9954). DS data were collected via an in-home interview; the NCI method was used to estimate distributions of total usual intakes from two 24 h recalls for food and beverages, after which DS were added. Food security status was categorized using the USDA Household Food Security Survey Module. Adults living in food insecure households had a higher prevalence of risk of inadequacy among both men and women for magnesium, potassium, vitamins A, B6, B12, C, D, E, and K; similar findings were apparent for phosphorous, selenium, and zinc in men alone. Meanwhile, no differences in the prevalence of risk for inadequacy were observed for calcium, iron (examined in men only), choline, or folate by food security status. Some DS users, especially food secure...
Advances in nutrition (Bethesda, Md.), 2015
Fortification is the process of adding nutrients or non-nutrient bioactive components to edible p... more Fortification is the process of adding nutrients or non-nutrient bioactive components to edible products (e.g., food, food constituents, or supplements). Fortification can be used to correct or prevent widespread nutrient intake shortfalls and associated deficiencies, to balance the total nutrient profile of a diet, to restore nutrients lost in processing, or to appeal to consumers looking to supplement their diet. Food fortification could be considered as a public health strategy to enhance nutrient intakes of a population. Over the past century, fortification has been effective at reducing the risk of nutrient deficiency diseases such as beriberi, goiter, pellagra, and rickets. However, the world today is very different from when fortification emerged in the 1920s. Although early fortification programs were designed to eliminate deficiency diseases, current fortification programs are based on low dietary intakes rather than a diagnosable condition. Moving forward, we must be dilig...
Nutrition Research, 1988
... J. Am. Diet. Assoc. 1981; 79:547-51 20. Meredith A, Matthews A, Zickefoose M, Weagley E, Waya... more ... J. Am. Diet. Assoc. 1981; 79:547-51 20. Meredith A, Matthews A, Zickefoose M, Weagley E, Wayave M, Brown EG. How well do school children recall what theyhave eaten? J. Am. Diet. Assoc. ... J. Pers. Soc.Psychol. 1978;39. Teasdale JD, recall of positive, 22:163-71 Russell ML. ...
New England Journal of Medicine, 1982
We studied 10 vegetarian and 10 nonvegetarian premenopausal women on four occasions approximately... more We studied 10 vegetarian and 10 nonvegetarian premenopausal women on four occasions approximately four months apart. During each study period, the participants kept three-day dietary records, and estrogens were measured in plasma, urinary, and fecal samples. Vegetarians consumed less total fat than omnivores did (30 per cent of total calories, as compared with 40 per cent) and more dietary fiber (28 g per day, as compared with 12 g). There was a positive correlation between fecal weight and fecal excretion of estrogens in both groups (P less than 0.001), with vegetarians having higher fecal weight and increased fecal excretion of estrogens. Urinary excretion of estriol was lower in vegetarians (P less than 0.05), and their plasma levels of estrone and estradiol were negatively correlated with fecal excretion of estrogen (P = 0.005). Among the vegetarians the beta-glucuronidase activity of fecal bacteria was significantly reduced (P = 0.05). We conclude that vegetarian women have an increased fecal output, which leads to increased fecal excretion of estrogen and a decreased plasma concentration of estrogen.
Nephrology Dialysis Transplantation, 2005
Metabolism, 1989
Relationships between plasma levels of lipoproteins and sex hormones were studied in 24 healthy p... more Relationships between plasma levels of lipoproteins and sex hormones were studied in 24 healthy premenopausal women with no risk factors for coronary heart disease. The women were carefully selected to remove the effects of other environmental factors, such as smoking, drugs, alcohol, and exercise, which are known to influence lipid metabolism. They all ate precisely the same Western-style diet for 1 to 2 weeks before blood samples were obtained in the follicular phase of their menstrual cycle. After adjusting for other hormones by multiple regression, significant positive partial correlations were seen between high density lipoprotein cholesterol (HDL-C) and protein bound estradiol (r = .57, P = .02), as well as between very low density lipoprotein cholesterol (VLDL-C) and protein bound estradiol (r = .63, p = .01). A significant negative partial correlation was seen between VLDL-C and free estradiol (r = -.65 P = .01). Conversely, low density lipoprotein cholesterol (LDL-C) levels were negatively correlated with protein bound estradiol (r = -.77, P less than .001) and positively correlated with free estradiol (r = .71, P less than .001). No associations between plasma lipoproteins and testosterone were seen; however, androstenedione was positively correlated with VLDL-C (r = .59, P = .01). These findings show a close link between plasma lipoproteins and sex hormones, and may help to explain the lower risk of coronary heart disease in women.
Medicine & Science in Sports & Exercise, 2006
The Lancet, 1982
Dietary studies and assays of urinary lignans in postmenopausal women showed that lignan excretio... more Dietary studies and assays of urinary lignans in postmenopausal women showed that lignan excretion is significantly lower in urine of women with breast cancer than in normal omnivorous and vegetarian women and confirmed that there is a significant correlation between fibre intake and lignan excretion. It is suggested that the precursors of the human lignans enterolactone and enterodiol formed by the intestinal microflora are to be found in fibre-rich foods such as grains, nuts, and legumes. Excretion of equol, which has antioestrogenic properties, was similar in all groups studied and did not correlate with fibre intake, but occasional high values were found in some subjects.
Kidney International, 2010
Kidney International, 2005
The purpose of this study was to determine if indicators of nutritional status were associated wi... more The purpose of this study was to determine if indicators of nutritional status were associated with subsequent mortality in hemodialysis patients. Twelve selected nutrition indicators were measured prior to randomization in the Mortality and Morbidity in Hemodialysis (HEMO) Study. Relative risks (RR) of mortality were assessed at <6 months and >6 months of follow-up using Cox regression after controlling for case mix, comorbidity, and treatment assignment (high vs. standard Kt/V and high vs. low membrane flux). Low values of most nutritional status indicators were associated with increased RR of mortality. RRs were greatest over the short term (<6 months) and diminished with increasing follow-up (>6 months). Increases in body mass index (BMI) at lower levels (e.g., < or =25 kg/m(2)) and increases in serum albumin at any level were associated with reduced short-term RR, even after adjusting for case mix, treatment assignment, and for the joint effects of equilibrated normalized protein catabolic rate, total cholesterol, and serum creatinine. For >6 months' follow-up, increases in values among those with lower levels of BMI and serum albumin (< or =3.635 g/dL) and increases in all serum creatinine levels were associated with lower RR. Nutrition indicators are associated with subsequent mortality in a time-dependent manner, with greatest effects at <6 months of follow-up. The RR for these indicators may also vary within different ranges of values.
Journal of the International Society of Sports Nutrition, 2012
Journal of the International Society of Sports Nutrition, 2012
Journal of the Association of Nurses in AIDS Care, 1995
This study compared use of unconventional remedies in two groups of HIV-positive men (N = 63). Em... more This study compared use of unconventional remedies in two groups of HIV-positive men (N = 63). Employing a multiple-choice questionnaire, the authors assessed the use of and attitudes toward unconventional remedies among two groups of white HIV-positive men similar in age, socioeconomic status, and severity of illness, all of whom lived in Northern California. One group (n = 36) participated in AIDS clinical trial protocols; the other group (n = 27) received health care at a community health center. Participants at all sites expressed positive views upon increasing unconventional remedies. Individuals enrolled in the clinical trial protocols for investigational drugs used unconventional remedies significantly less than the community health center participants, who were enrolled in an open clinical trial of hypericin, an unproven remedy.
Journal of the American Society of Nephrology, 2002
Journal of the American Dietetic Association, 2009
Journal of the American Dietetic Association, 1994
As the intakes of soy foods rise in the American diet, the weak estrogenic activity of plant phyt... more As the intakes of soy foods rise in the American diet, the weak estrogenic activity of plant phytoestrogens may reach biologically effective levels. We determined the content of phytoestrogens (plant compounds with weak estrogenic activity in human beings) in tofu, a commercially produced soy drink, and three soy-based formulas. A modified isotope dilution gas chromatography-mass spectrometry method was used to analyze samples obtained from supermarkets or manufacturers. Two or three lots of duplicate samples of four brands of tofu, one commercially produced soy drink, and three soy-based specialty formulas were analyzed. Means and standard deviations were calculated for the isoflavones daidzein, Biochanin A, genistein, coumestrol, and formononetin. Tofu soy products were highest in isoflavone content; means of brands ranged from 73.0 to 97.5 micrograms/g daidzein per g wet weight and 187.4 to 215.9 micrograms genistein per g wet weight. The commercial soy drink followed with 7.0 micrograms daidzein per g wet weight and 21.0 micrograms genistein per g wet weight; the soy-based formulas were nearly devoid of these two isoflavones. Mean levels of Biochanin A, formononetin, and coumestrol were very low or nil (eg, 0 to 1.0 microgram/g) in all products. Tofu contained the highest amounts of isoflavones among the products tested, and there was some variability from brand to brand. The soy drink contained lesser amounts, and soy-based formulas were devoid of isoflavones.
Journal of the American Dietetic Association, 2006
Journal of the American Dietetic Association, 2008