• Nutrition Research and Practice
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• v.16 no.sup1
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• pp.89-112
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• 2022

An accurate assessment of the recommended calcium (Ca) intake may contribute to reducing the risk of fractures and chronic diseases, ultimately improving quality of life. This review was performed to summarize key findings of Ca studies, investigate the effect of Ca intake on health outcomes, and determine the adequacy of evidence to revise the 2015 Dietary Reference Intakes for Koreans (KDRIs) for Ca in 2020. Databases were searched for intervention studies that assessed health outcomes by providing Ca in diets or as supplements. The framework of the systematic review comprised conducting literature searches, data extraction, quality assessment of the literature, and summarizing key findings relevant to set the Estimated Average Requirement (EAR) and Tolerable Upper Intake Level (UL) for Ca for the 2020 KDRI. The final search was performed in June 2019. A total of 13,309 studies were identified through databases and manual search. Sixtyfive studies were included in the final quality assessment and were summarized according to health indicators. As bone health was used as an indicator of the EAR for Ca, literature reports on bone health were further categorized by the life-cycle stage of the participants. This systematic review did not find new evidence that could be applied to the general Korean adult population, including postmenopausal women, for defining a new EAR for Ca in the 2020 KDRIs. Evidence in most of the reviewed literature was considered weak; however, some evidence was found that could improve the criteria on how the EAR for Ca was determined in children and adolescents. A review of the literature for the 2020 KDRIs for Ca did not find strong evidence in order to change the recommended values of the 2015 KDRIs. More clinical interventions are required among Koreans to strengthen the body of evidence to warrant the revision of the KDRIs.

• Nutrition Research and Practice
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• v.16 no.sup1
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• pp.1-10
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• 2022

BACKGROUND/OBJECTIVES: The Dietary Reference Intakes for Koreans (KDRIs) were revised in 2020. Due to the rapidly aging Korean population, special consideration was given to reclassify the KDRI age group categories of older adults. This article examines the evidence for modifying the current KDRI age group ranges of older adults (65-74 and ≥ 75 yrs). SUBJECTS/METHODS: We first reviewed the domestic and international data on the elderly, following which we received expert opinions on age classification from the KDRI Advisory Committee. Finally, the 6th and 7th (2013-2017) Korea National Health and Nutrition Examination Survey (KNHANES) data were used to analyze the nutritional intake statuses by considering the age of older adults. RESULTS: According to the review results of domestic and international data and the inputs received from the expert advisory committee, the minimum age considered for the elderly was maintained at 65 yrs. However, the KNHANES data was analyzed to review whether there was a need to subdivide the later periods. Examining the differences in nutrient intakes by age group through the interaction effect term of the piecewise linear regression model revealed the interaction effect was maximum in the groups divided by 65 yrs (50-64 and 65-80), as compared to the groups divided by 70 yrs (50-69 and 70-80) and 75 yrs (50-74 and 75-80). The mean adequacy ratio was calculated per 1 yr of age, and a 3-yr (age) moving average analysis was performed to examine the change in the trends of overall nutrient intake. However, it was challenging to secure a scientific basis for subdivision into age groups in older adults from the results obtained. CONCLUSIONS: This study could not find any scientific evidence for modifying the KDRI age groups for older adults.

• Journal of Nutrition and Health
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• v.41 no.7
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• pp.645-657
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• 2008

This study was conducted to study the relationship between food intakes, glycemic index (GI), glycemic load (GL), and body weight with high school boys residing in Seoul. The subjects of 329 boys were divided into normal weight group (BMI < $23\;kg/m^2$, n = 212) and overweight group (BMI ${\geq}\;23\;kg/m^2$, n = 117) by body mass index (BMI). The food intakes data obtained by the 3-day food record were analyzed by Can pro 3.0 software. Anthropometric measurements and physical activities were collected from each subject. Daily dietary glycemic index (DGI) and dietary glycemic load (DGL) were calculated from the 3-day food record. Body weights and BMI of normal weight group were 58.8 kg and $19.9\;kg/m^2$ and those of overweight group were 79.2 kg and $26.8\;kg/m^2$, which were significantly different between two groups (p < 0.05). Total food and animal food intakes of normal weight group were significantly higher than overweight group (p < 0.05), and vegetable food and other food intakes of normal weight group showed higher than overweight group. All nutrient intakes of normal weight group were higher than overweight group. Dietary fiber, calcium, potassium and folate intakes of normal weight group and overweight group were under 65% of the dietary reference intakes (DRIs). Major food sources of energy intake for both groups were rice, pork and instant noodle in order. Mean adequacy ratio (MAR), an index of overall dietary quality were 0.83 in normal weight group and 0.79 in overweight group, which showed significantly higher in normal weight group than overweight group (p < 0.05). Mean daily dietary GI of normal weight group and overweight group were 67.7 and 68.2, respectively. Mean daily dietary GL of normal weight group and overweight group were 214.6 and 202.7, respectively, and which was significantly different between the two groups (p < 0.05). Major food sources contributed to DGI and DGL were rice ($\geq$ 55%) in both groups. DGI and DGL were not significantly correlated with anthropometric data. Activity adjusted to energy intake was negatively correlated with percentage of body fat (r = -0.1308, p < 0.01) and that was positively correlated with height (r = 0.1227, p < 0.05) and lean body mass (r = 0.1351, p < 0.05).

• Journal of the East Asian Society of Dietary Life
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• v.27 no.2
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• pp.137-147
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• 2017

This study aimed to evaluate the necessity of updating current nutritional standards for school lunch programs in Korea. The study was performed both theoretically and practically considering the present physiques and nutrient intakes of school students. Theoretically, adequacy of types of nutrients and nutrient reference values were analyzed. Specifically, the adequacy of the types of nutrients were reviewed by applying the same selection procedures used in the 2007 revision of current standards in order to evaluate the necessity of updates. The nutrient reference values were compared with those in the U.S., Japan, and Taiwan in terms of setting year, basic data, and setting method. Practically, a focus group interview with six school nutrition teachers was conducted to investigate any operational difficulties in applying the current standards to school foodservices in Bucheon on October 1, 2015. As a result, nine types of nutrients were decided, which excluded protein and thiamin from the current ones. The nutrient reference values needed updating toward more adequate levels by reflecting more various and recent basic data considering daily nutrient intakes and the actual percentages of intakes from lunches of school students. The results showed that school nutrition teachers found it difficult to apply the current standards to school foodservices, especially as school level increased from elementary through middle to high schools mainly due to protein and calcium. Overall, the study results imply that the current nutritional standards for school lunch programs in Korea need updating to reflect the current physiques and actual nutrient intakes of school students.

• Human Ecology Research
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• v.55 no.4
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• pp.385-397
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• 2017

This study assessed the nutrient intake for Korean adolescents using the estimated usual intake. The usual intake of 1,763 adolescents aged 12-17 years old was estimated from one-day 24-hour recall data in the 2010-2012 Korean National Health and Nutrition Survey. The nutrient intakes of four groups according to sex (male and female) and age (12-14 and 15-17 years old) were then assessed in reference to the 2015 Dietary Reference Intakes for Koreans. For macronutrients, the proportions of subjects below and above the Acceptable Macronutrient Distribution Ranges (AMDR) were calculated. The Estimated Average Requirement (EAR) cut-point method was used to assess insufficient intakes of protein, vitamin C, thiamin, riboflavin, niacin, calcium, phosphorus, and iron; the full probability approach was used to assess the insufficient intake for iron among females. The proportions of subjects over the Tolerable Upper Intake Levels for vitamin C, niacin, calcium, phosphorus, and iron and the proportions over the Intake Goal for sodium were calculated to assess excessive intake. The proportions of subjects above AMDR for carbohydrates ranged from 22.5% to 38.0% by group. The proportions of subjects by group with insufficient intake for vitamin C, riboflavin, calcium, phosphorus, and iron ranged 29.1-39.7%, 22.5-34.3%, 73.1-89.3%, 14.3-43.6%, and 23.2-55.5%, respectively. The proportions of subjects by group with excessive intake for sodium ranged from 91.5% to 99.3%. The results of this study represent important basic information to establish nutritional standards for school lunches as well as to decide on relevant nutrition policies for adolescents.

• Journal of the East Asian Society of Dietary Life
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• v.16 no.2
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• pp.145-155
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• 2006

This study investigated the correlation of the nutritional status of antioxidant vitamins and serum lipids and MDA levels in postmenopausal women. Data about general characteristics, dietary intakes and biochemical parameters, including serum lipids, MDA and antioxidant vitamins levels, were collected from 85 postmenopausal women. The subjects were classified into three groups according to their serum total cholesterol level: normocholesterolemia group (NC, < 200 mg/dL), moderate hypercholesterolemia group (MC, $200{\sim}239mg/dL$) and hypercholesterolemia group(HC, ${\geq}240mg/dL$). The results are as follows. 1) General characteristics and serum MDA levels were not significantly different among the three groups. 2) Daily nutrients intakes adjusted to energy intake were not significantly different among the three groups, and were compatible with dietary reference intakes (DRIs) for Koreans. 3) Dietary Vt. A, ${\beta}-carotene$, Vt. C and Vt. E intake were not significantly different among the groups, while Vt. E intake was positively related with serum TC (r=0.288, p<0.05) and triglyceride (r=0.341, p<0.001) levels. 4) Serum Vt. A level standardized by serum TC level was significantly low and serum Vt. E level was significantly high in the HC group. Serum Vt. E level was positively related with serum TC level (r=0.389, p<0.001). 5) Dietary Vt. E intake was negatively correlated to serum MDA level (r=-0.242 p<0.05). Serum Vt. C and Vt. E levels were also negatively correlated to serum MDA level (r=-0.312, p<0.001 and r=-0.299, p<0.05). When the correlation was analyzed only in the group with hypercholesterolemia, correlation coefficients between the antioxidant vitamin and serum MDA level were higher. We concluded that intakes of antioxidant vitamins can contribute to decreasing the risk of cardiovascular disease by decreasing the oxidative stress of body rather than by controlling serum lipid levels.

• Journal of Nutrition and Health
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• v.39 no.6
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• pp.549-559
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• 2006

The present study determined the estimated dietary fiber (DF) intake per capita of Korean from 1991 to 2001 and analyzed the major food sources of dietary fiber for Korean using the data on per capita consumption of each food reported in the Korean National (Health and) Nutrition Survey Reports and the recently established DF database by the Korean Nutrition Society. The estimated mean daily DF intakes of Korean during the last 11 years $(1991{\sim}2001)$ were in the range of $19.25{\sim}21.22\;g\;or\;9.97{\sim}11.99\;g/1,000\;kcal$ with a small range of fluctuations. As of 2001, average DF intake per capita of Korean was estimated as 20.92 g or 10.59 g/1,000 kcal. The average DF intake level was under the Adequate Intake for DF (12 g per 1,000 kcal) of the Dietary Reference Intakes (DRIs) for Koreans established in 2005. The level of DF intake was relatively lower in small city residents compared to the large city or rural area. The top two major food group sources of DF for Korean were vegetables and cereals, in addition, legumes, fruits, seaweeds and seasonings were included among top five food groups. The ratio of DF intake from fruits was gradually increased but the ratio from legumes was steadily decreased during the last 11 years. The mostly contributed single foods for DF intakes of Korean were Kimchi and rice regardless of year and area. Percentage of DF intake from top ten single foods was continuously decreased from 65% in 1991 to 51 % in 2001. The results of this study revealed that DF intakes of Korean as of 2001 is insufficient compared to the Adequate Intake for DF for Korean and the source of fiber in Korean diet has been more various. Therefore the beneficial health effects of DF and the increased consumption of DF from a variety of food sources should be continuously emphasized through the nutritional education.

• Journal of Nutrition and Health
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• v.54 no.6
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• pp.573-583
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• 2021

Energy requirement is defined as energy expenditure in an energy equilibrium state. The doubly labeled water (DLW) method is considered the gold standard for measuring total energy expenditure (TEE). In 2002, the Institute of Medicine (IOM) of the National Academies established dietary reference intakes (DRIs) for Americans and Canadians, and the equations for estimated energy requirement (EER) were developed by using pooled data from studies that had applied the DLW method. Since 2005, these equations have been used for establishing EER in the DRI for Koreans. These equations based on age group include the physical activity (PA) coefficient determined by the PA level (PAL; sedentary, low active, active and very active) as well as body weight and height. The PAL values of Koreans calculated using the DLW method and PA diaries were determined to fall in the low active category (1.40~1.59). Therefore, the PA coefficient corresponding to 'low active' was applied to the EER equations. In recent years, with increasing number of people regularly engaging in various physical activities in Korea, EER is now separately presented for people with 'active' and 'very active' PALs. In the future, like the United States and Japan, Korea needs to expand the DLW research for developing EER predictive equations for Koreans. In addition, standardized guidelines should be prepared to accurately evaluate the PAL using the physical activity diary and the new PA classification table for Koreans.

• Journal of Nutrition and Health
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• v.40 no.sup
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• pp.3-8
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• 2007

Sugars are a ubiquitous component of our food supply and are consumed as a naturally occurring component of many foods and as additions to foods during processing, preparation, or at the table. Most fruits and dairy products are high in sugars and thus naturally occurring sugars are consumed as part of a healthy diet. Some countries developed recommended daily intake figures(daily values : DVs or guideline daily amounts: GDA) for nutrients, and some countries, but not most have developed DV/GDA for total sugars. Dietary Reference Intakes for Koreans established by the Korean Nutrition Society in 2005, did not include the reference values for total sugar or added sugar. The committee on Dietary Reference Intakes for sugar was constituted in 2006 and discussed whether to special added sugars or total sugar. Although added sugars are not chemically or physiologically different from naturally occurring sugars, many foods and beverages that are major sources of added sugars have lower micronutrient densities compared with foods and beverages that are major sources of naturally occuring sugars. But it was so hard to calculate a dietary intake of added sugar for Korean people, because there was insufficient information about contents of added sugar during processing or preparation of Korean food. Currently Korean or US food labels contain information on total sugars per serving but do not distinguish between sugars naturally present in food and added sugars. Therefore the committee decided to set the reference value for total sugar for Koreans. According to the recommended diet pattern for Koreans suggested by the Korean Nutrition Society, estimated sugar intake from the sugar containing food based on 2,000 kilocalories is 67 g or 13% of total energy. Based on the data available on risk of obesity, hypertension, hyperlipidemia, insulin resistance, and metabolic syndrome from the analysis of Korean NHANES, it was insufficient evidence to set a UL for total sugar, but tended to increase serum LDL cholesterol and obesity at over 20-25% of energy from total sugar when consumed with high carbohydrates. Therefore the committee on Dietary Reference Intakes for sugar set the Acceptable Macronutrient Distribution Range for total sugar as 10-20% of total energy intake.

• Nutrition Research and Practice
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• v.3 no.3
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• pp.212-219
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• 2009

This study was performed to investigate the association between hair mineral levels and nutrient intakes, age, and BMI in female adults who visited a woman's clinic located in Seoul. Dietary intakes were assessed by food frequency questionnaire and mineral levels were measured in collected hairs, and the relationship between these was examined. The average daily nutrient intakes of subjects were compared to those of the KDRIs, and the energy intake status was fair. The average intake of calcium in women of 50 years and over was 91.35% of KDRls and the potassium intake was greatly below the recommended levels in all age groups. In the average hair mineral contents in subjects, calcium and copper exceeded far more than the reference range while selenium was very low with 85.19% of subjects being lower than the reference value. In addition, the concentrations of sodium, potassium, iron, and manganese in the hair were below the reference ranges in over 15% of subjects. The concentrations of sodium, chromium, sulfur, and cadmium in the hair showed positive correlations (P < 0.05) with age, but the hair zinc level showed a negative correlation (P < 0.05) with age. The concentrations of sodium, potassium, chromium, and cadmium in the hair showed positive correlations (P < 0.05) with BMI. Some mineral levels in subjects of this study showed significant correlations with nutrient intakes, but it seems that the hair mineral content is not directly influenced by each mineral intake. As described above, some hair mineral levels in female adults deviated from the normal range, and it is considered that nutritional intervention to control the imbalance of mineral nutrition is required. Also, as some correlations were shown between hair mineral levels and age, BMI, and nutrient intakes, the possibility of utilizing hair mineral analysis for specific purposes in the future is suggested.