• Journal of Nutrition and Health
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• v.54 no.5
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• pp.425-434
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• 2021

The discovery of the relationship between nutrients and deficiency diseases during the 100 years from the mid-1800s to the mid-1900s was a breakthrough that led to advances in the study of nutrition. The Recommended Dietary Allowances (RDA) were created as a quantitative standard for avoiding diseases caused by nutrient deficiency. In addition, a reductionism paradigm has become generally accepted among nutrition scholars in health and disease, which focused on the properties of individual nutrients, content in foods, cellular levels, and mechanisms of action. The reductionist paradigm worked very well for the prevention and treatment of malnutrition diseases. However, as the incidence of nutrient deficiencies decreased and that of chronic diseases increased, the nutrition goals have been changed to secure safe and adequate nutrient intake and to reduce chronic disease risks. Accordingly, Dietary Reference Intakes (DRIs), a set of nutrient-based reference values, were designed to replace the RDA. The revised Korean DRIs were published for 40 nutrients in 2020. However, there is still room for improvement in the reference intake levels targeted at reducing the risk of chronic disease. The reductionist approach can no longer be practical because chronic diseases are related to the interactions between multi-components in the foods and multi-targets in the body. Therefore, a second innovative leap is needed following the nutrition development breakthrough made over 100 years ago. To this end, the nutrition paradigm must evolve from reductionism to a holism approach. Cutting-edge scientific technologies, such as metabolomics, transcriptomics, microbiomics, and bioinformatics, should also be acceptable in nutrition science based on the knowledge gained from basic nutrition studies.

• Nutrition Research and Practice
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• v.7 no.6
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• pp.503-509
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• 2013

There is little information on dietary vitamin K intake and nutritional status of daily requirements of vitamin K in Korea. The objective of this study was to investigate the vitamin K intake and major food sources of Vitamin K in Koreans. The survey data from the 2010-2011 Korean National Health and Nutrition Examination Survey of 7,792 subjects (aged 19-64 years) were examined. Total vitamin K intake was calculated from 24-hour dietary recall using a vitamin K food database, Computer Aided Nutritional analysis Program and the United States Department of Agriculture database. The geometric mean of vitamin K was estimated as $322.40{\pm}6.33ug/day$ for men and $271.20{\pm}4.92ug/day$ for women. Daily vitamin K intake increased significantly with age (p for trend < 0.001). The main food source of vitamin K was vegetables (72.84%), including cabbage kimchi (19.26%), spinach (17.38%), sesame leaves (7.11%), radish leaves (6.65%), spring onions (6.28%), and laver (4.82%), followed by seaweed, seasonings, and fat and oils. We observed that the vitamin K intake of Koreans was relatively higher than that reported by other studies in Western countries and differed depending on age.

• Korean Journal of Community Nutrition
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• v.16 no.2
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• pp.265-277
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• 2011

This study was conducted to improve the nutritional status of high school girls via lunch menu intervention. Surveys were carried out twice to evaluate basal status and status after lunch menu intervention. In the first survey nutrient intakes of 24-hour and school lunch were each estimated by 24-hour recall dietary survey and self-recording, respectively. Calcium intake was the lowest among nutrients, and stir-frying was the most preferred cooking method. Five dishes of school lunch menus which were included in the first survey were replaced with recipes containing foods with higher calcium level; anchovy stir-fried with red pepper paste, anchovy stir-fried with almond, pork stir-fried with shredded kelp, crab meat soup, and tteokbokki with cheese. In the second survey calcium intake from school lunch was significantly (p < 0.001) increased from 45.5% to 50.2% of one thirds of recommended intake (RI) after calcium enriched lunch menu intervention. Intakes of vitamin A and E were also significantly increased, whereas those of energy, thiamin, and vitamin C were decreased. Index of nutritional quality values of nutrients of 24-hour intakes (except thiamin, vitamin B6, vitamin C) is increased by intervention; however, those of calcium, folic acid, iron are still very low. Even though this study shows a possibility of improving nutrient intakes of students through school lunch menu intervention, lunch intervention by itself is not enough action to improve nutritional status of micronutrient for adolescents.

• Journal of Nutrition and Health
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• v.55 no.5
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• pp.523-532
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• 2022

Vitamin C is an important physiological antioxidant which neutralizes reactive oxygen species (ROS) and reduces the oxidative stress in the body. Although it has been associated with various diseases, few studies have reported the dose-response relationship between vitamin C intake, storage and functions in the body, including its antioxidant function. The criteria to establish the Dietary Reference Intakes for Koreans (KDRIs) for vitamin C were based on the changes in plasma concentrations and saturation of leukocytes according to intake levels and the effects on antioxidant capacity and risk of metabolic diseases. When establishing the 2020 vitamin C KDRI, while there was no change in the criteria from those of 2015, the reference values were recalculated and revised to reflect changes such as the new standard weight by age. As the number of people consuming dietary supplements has increased over the last decade, only about 10% of adults consume less than the average total vitamin C, but the proportion of adolescents and elderly who consume less than the average is high. On the other hand, as the intake of vitamin C supplements increases, the proportion of people consuming excessive vitamin C is also increasing. There is a body of opinion that it is necessary to establish a vitamin C KDRI for smokers or people with chronic diseases such as the metabolic syndrome, but these standards have not been established due to the lack of supporting scientific evidence. As a result, studies to establish vitamin C KDRI for Korean smokers and patients with the metabolic syndrome, as well as studies on the excessive intake of vitamin C due to supplementation and interactions with other nutrients, are needed.

• Journal of Nutrition and Health
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• v.53 no.2
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• pp.141-154
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• 2020

Purpose: Atopic dermatitis (AD), a typical chronic disease in children, is an allergy disease that is highly associated with food. Thus, attention to food intake is needed to prevent and manage it. Therefore, we analyzed differences in food and nutrient intakes depending on AD status in under 12-year-old children. Methods: A total of 2,690 participants were enrolled in this study from the combined 2013-2015 Korea National Health and Nutrition Examination Survey. Subjects were divided into an AD group and normal group (non-AD group). General characteristic, food and nutrients intakes, and prevalence of insufficient and excessive nutrient intake were analyzed using χ² test and regression analyses. The AD odds ratio (OR) for insufficient and excessive nutrient intakes was analyzed using multiple logistic regression analyses. Results: Food and nutrient intakes were not significantly different between the AD and non-AD groups. However, the ratio of calcium intake to recommended nutrient intake was about 70% in both groups, which can be attributed to the overall lack of calcium intake among Korean children. There were no differences in energy or nutrient intakes between the groups, but compared with Korean Dietary Reference Intakes for Koreans, the appropriate intake ratios of fat and vitamin C in the AD group were higher than those in the non-AD group. The AD OR decreased when fat was consumed at above appropriate levels and vitamin C was consumed at lower or excess levels. Conclusion: In children, AD may be related to the nutrient intake ratio of fats and vitamin C, and we speculate that these results were affected by dietary restrictions for AD management.

• Journal of the East Asian Society of Dietary Life
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• v.10 no.5
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• pp.372-386
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• 2000

This study was conducted to assess anthropemrtric, health status, nutritional status, and their correlations in 120 female college students in Kyunggido area. The questionnaires on general living habits, food habits and energy expenditure were used, and nutrient intakes were estimated by Convenience Method. Anthropometric measurement, blood pressure, hemoglobin(Hb), hematocrit(Hct) were also determined. The mean values for BMI, RBW, and blood pressure of the subjects were 20.4$\pm$2.4, 92.9$\pm$16.0% and 108.9/69.6mmHg, respectively. Estimation of body fat from two sites of skinfolds thickness(20.6$\pm$6.0%) and four sites of skinfolds thickness(20.1 $\pm$8.6%) was similar, but different from BIA method(23.9$\pm$3.9%). The subjects of 36.9% considered themselves healthy, and 15.4% of them considered themselves not healthy. The mean values for Hb and Hct were 13.4$\pm$ 1.6g/dl, and 41.5$\pm$0.4%, respectively. The prevalence rates of iron deficiency assessed by Hb and Hct were found to be 19.8% and 6.3%, accordingly. The mean energy intake of subjects was 1,841 kcal. The proportion of energy derived from carbohydrates, protein and fat was 64.9%, 14.7%, and 20.4%, respectively As nutrient intake was compared to RDA for Koreans, intakes of energy, calcium, iron, and vitamin A fell short of recommendations. Intakes of energy, fat, iron, vitamin B$_2$, and niacin were positively correlated with total energy expenditure. These results suggest that appropriate reference data are important to maintain the health of female college students.

• Nutrition Research and Practice
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• v.13 no.1
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• pp.32-40
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• 2019

BACKGOUND/OBJECTIVES: This study investigated nutritional status of the elderly with dementia in a care facility with the aim of improving the meal quality of the facility. SUBJECTS/METHODS: Data were collected from 30 dementia patients aged more than 65 years in a long-term care facility in Hongseong. The data were obtained from questionnaires and medical records. The food intake data was obtained using food photographs and the nutrient intakes were calculated using the CAN-Pro 5.0. The data were compared with the dietary reference intakes for Koreans (KDRIs). The nutrient density, diet quality such as nutrient adequacy ratio (NAR), mean adequacy ratio (MAR), and index of nutritional quality (INQ), as well as dietary diversity score (DDS) were evaluated. The data were analyzed using SPSS statistical programs. RESULTS: The average daily energy intakes for men and women were much lower than the estimated energy requirements of the KDRIs. The average intakes of energy and most nutrients in the general diet group were significantly higher than those of the other two groups. Significant differences in diet quality and diet diversity were observed according to the meal type groups. The NARs of some minerals (calcium, iron, and zinc) and vitamins (vitamin $B_6$ and folic acid) were less than 0.5 in all study groups. The NARs of protein, iron and MAR of the general diet group were significantly higher than those of the liquid diet group. The DDS scores of meats, fruits and diary food group were very low in all meal type groups, meaning that the diet qualities of the study subjects were not appropriate in all meal type groups. CONCLUSIONS: The food intakes of the study groups showed some limitations by a direct comparison with KDRIs because of the very low physical activities of the study subjects. The diet quality and diet diversity indices suggest the need for improvements in the nutritional quality in all types of diet. Overall, new intervention strategies targeting facility residents with dementia in Korea are needed as soon as possible.

• Journal of Nutrition and Health
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• v.55 no.2
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• pp.211-226
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• 2022

Choline, an essential nutrient for humans, is required for the structural integrity of the cell membranes, methyl-group metabolism, synthesis of the neurotransmitter acetylcholine, synthesis of the membrane phospholipid components of the cell membranes, and the transport of lipids and cholesterol. Choline can be synthesized in the body, but it is insufficient to meet the daily requirements and hence it must be obtained through the diet. In the United States/Canada, Australia/New Zealand, Europe, China, and Taiwan, the adequate intake (AI) and tolerable upper intake level (UL) of choline have been established, while the establishment of the 2020 Dietary Reference Intakes for Koreans (KDRI) for choline was postponed due to the lack of a choline database for Korean foods and studies on the choline intake of Koreans. However, as part of the preparation work for the 2020 DRI revision and finalization, choline intake and the possibility of disease occurrence were verified through analysis of published data. The groundwork for the subsequent establishment of a choline DRI was laid through a literature search, evaluation, and review of the literature reported from 1949 up to 2019. This can be regarded as the culmination of this project. According to the results of randomized controlled trials (RCTs), cohort studies, case-control studies, and cross-sectional observational studies in humans, approximately 400-500 mg/day of choline intake was effective in preventing liver function damage (fatty liver), neural tube damage, cardiovascular disease, breast cancer, and cognitive function improvement. The same amount of choline intake, however, also correlated with the risk of prostate and colorectal cancer. At present, there is limited information available on choline intake and health outcomes, particularly for the Korean population. More human studies, including clinical trials on the requirements and the physiological benefits associated with dietary intake, are needed to establish the KDRI for choline.

• Korean Journal of Community Nutrition
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• v.21 no.1
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• pp.25-36
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• 2016

Objectives: The purpose of this study was to investigate effects of nutrition education providing school lunch by personalized daily needed food exchange units using Food Exchange System for adolescent athletes. Methods: The subjects were 60 sports high school students (educated group, 30 vs. noneducated group 30). Nutrition education was provided for 4 weeks (40 min/lesson/week). In addition, personalized school lunch was served for 4 weeks, nutrition education period. The personalized lunch were provided Food Exchange Units according to personalized daily needed energy. The lessons were '5 Major nutrients, functions and foods', 'My daily needed energy and food exchange units by Food Exchange System', 'My meal plan by food exchange units according to my daily needed energy' and 'Smart choice of healthy snacks and eating outs'. After nutrition education, we examined the differences in anthropometric characteristics, nutrition knowledge, dietary attitude and dietary intake between the educated and the non-educated group. Results: We observed improvements in lean body mass in the educated group. With regard to nutrition knowledge, there were improvements in 'Functions of vitamins', 'Functions of minerals', 'Foods of fat', 'Foods of vitamin', and 'Foods of mineral' in the educated group. In relation to dietary attitude, there were improvements in 'Taking a meal with family and friend', 'Taking a meal at ease', 'Taking a meal with kimchi and vegetables', 'Taking a meal with three kinds of side dishes', 'Priority of choosing snacks' and 'Type of snacks' in the educated group. With regard to dietary intakes according to Dietary Reference Intakes for Koreans, there were improvements in intakes levels of fiber, vitamin A, vitamin C, folate, calcium, iron and zinc. The index of nutrition quality, as indicated by nutrition adequacy ratio also improved in the educated group. Conclusions: These results showed that a nutrition education program providing education lessons and personalized school lunch by food exchange units according to daily needed energy showed positive changes in nutrition knowledge, dietary attitude and dietary intake of adolescent athletes. Nutrition education program providing personalized school lunch by Food Exchange Units may improve dietary behaviors and dietary intakes of adolescents.

• Korean Journal of Community Nutrition
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• v.27 no.1
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• pp.47-60
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• 2022

Objectives: This study aimed to evaluate dietary protein intake and its adequacy among Korean adults during recent 10 years. Methods: Based on the 2010 ~ 2019 Korea National Health and Nutrition Examination Survey (KNHANES) data, a total of 51,296 adults aged 19 years old or more who participated in a one-day 24-hr dietary recall were included. Dietary protein intake was estimated as percentages of total energy (% of energy) and grams per body weight (g/kg/day) and compared with the 2020 Dietary Reference Intakes for Koreans to evaluate the adequacy of protein intake. In addition, proportions of people whose protein intakes were less than the estimated average requirement (EAR) and above the upper limit of the acceptable macronutrient distribution range (AMDR) (> 20% of energy) were calculated according to sociodemographic characteristics. Results: Protein intake was increased from 14.7% of energy in 2010 to 15.6% of energy in 2019 among Korean adults. However, there was no increase in protein intake relative to the recommended nutrient intake (% RNI) during the recent 10 years. Protein intake relative to the RNI was decreased from 130.2% in 2010 to 121.1% in 2019 (P for trend < 0.0001) among total participants, and a significant decreasing trend was observed in all age groups except for over 65 years old. However, protein intake relative to the RNI was lowest in the elderly (98.6%). Proportions of low protein intake (< EAR) and high protein intake (> AMDR) increased in the past 10 years (P for trend < 0.0001 for all), and these were associated with socioeconomic statuses, such as education and household income levels. Conclusions: These findings suggest that protein adequacy in Korean adults has not been improved over the past decade compared with recommended levels. Nutritional education and intervention programs should consider different intake levels according to sociodemographic characteristics.