• Journal of Nutrition and Health
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• v.54 no.6
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• pp.584-593
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• 2021

In the 2020 Dietary Reference Intakes for Koreans, an acceptable macronutrient distribution range (AMDR), similar to the one established in 2015, was determined for carbohydrates. AMDR is the ratio that signifies energy intake from carbohydrates to the total energy intake, and is a reference that indicates a decreasing risk of chronic diseases. The AMDR of carbohydrate was determined to be optimal at 55-65% for all ages above 1 year. For the first time, in the year 2020, the estimated average requirement (EAR) and recommended nutrient intake (RNI) for carbohydrates were established. The EAR was based on the amount of glucose used per day in the brain, and was set at 100 g/day for all ages above 1 year. The RNI was set at 130 g/day, by adding a double coefficient of variation using a 15% coefficient of variation, for all ages above 1 year. In pregnant women, the amount of glucose utilized by the fetus brain was considered additionally, and for lactating women the amount of lactose secreted into maternal milk was additionally taken into consideration. Since the EAR of carbohydrate indicates the minimum amount of glucose required by the brain and is not an appropriate intake amount as an energy source, it is incorrect to compare the carbohydrate intake with the EAR or RNI. To evaluate the nutritional status of carbohydrate, it is appropriate to use the AMDR. Carbohydrate intakes within the AMDR range has the possibility in reducing the risk of chronic diseases. Hence, it is important to consider the quality as well as quantity of carbohydrates consumed.

• 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.

• Journal of Nutrition and Health
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• v.40 no.sup
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• pp.29-38
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• 2007

The purpose of this study was to establish an association between the percent of energy from total sugar and disease prevalence of obesity, hypertension, dyslipidemia, insulin resistance, and metabolic syndrome with the context of the current population dietary practice in Korea. The Korean National Health and Nutrition Survey, 2001 and 2002 dataset were used as the source of data for this research. Usual nutritional intakes for over 20 years old people were calculated from the two non-consecutive dietary intake data from KNHANES 2001 and 2002 dataset. SAS and SUDAAN were used for statistical analyses. Sample weighted means, standard errors, and population percentages were calculated, and multiple logistic regression model with adjustment for covariates were used to determine the odds ratios(ORs) and 95% confidence intervals. Subjects were categorized as 3 ways and compared the LS means and ORs for heath factors. First, subjects excluding pregnant women, were categorized according to percent of energy from the usual total sugar intakes as ${\leq}10%$, 11-15%, 16-20%, 21-25%, >25%. Risk of LDL cholesterol showed a tendency to increase in the '>25%' group compared to the '<10%' group. The risks of the other health effects did not show any significant differences. Second, the subjects were categorized considering both Acceptable Macronutrient Distribution Range(AMDR) from carbohydrate and %Energy from total sugar as 'CHO<55% & Total sugar ${\leq}10%$', 'CHO 55-70% & Total sugar 11-25%', and '$CHO{\geq}70%$ & Total sugar ${\geq}25%$'. The risk of obesity tended to increase in the '$CHO{\geq}70%$ & Total sugar ${\geq}25%$' group compared to the 'CHO<55% & Total sugar ${\leq}10%$'. Third, the subjects were categorized as 'CHO<55% & Total sugar ${\leq}10%$', 'CHO 55-70% & Total sugar 11-20%', and '$CHO{\geq}70%$ & Total sugar ${\geq}20%$'. The risk of obesity also tended to increase in the '$CHO{\geq}70%$ & Total sugar ${\geq}20%$' group compared to the 'CHO<55% & Total sugar ${\geq}20%$' group. In conclusion, risk of LDL cholesterol showed a tendency to increase in the over 25% total sugar intake group, and the risk of obesity tended to increase in the 20-25% total sugar intake and high carbohydrate intake group. The risks of hypertension, hyperlipidemia, insulin resistance, and metabolic syndrome were not associated with total sugar intakes. More research to elucidate the association for Korean between the intakes of total sugar, added sugar, glucose, fructose, and sweeteners and diseases prevalences shoud be excuted in the future.

• Journal of Nutrition and Health
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• v.55 no.5
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• pp.558-571
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• 2022

Purpose: The purpose of this study was to analyze the dietary intake of Korean adults with atopic dermatitis (AD) to determine whether the risk of developing AD was related to their diet. Methods: Among the participants in the 7th National Health and Nutrition Survey (2016 to 2018), 10,571 adults aged 19-64 were divided into AD (AD group, n = 366) and control groups (non-AD group, n = 10,205) to compare and analyze their nutrient intake status and Korean Healthy Eating Index (KHEI) score. Depending on the prevalence of AD, the nutrient intake, nutrient intake per 1,000 kcal, acceptable macronutrient distribution range, and KHEI score were tested for significance by correcting for age, sex, body mass index, education, marriage, occupation, residence area, physical activity, and energy intake variables that were derived for confounding factors. Results: The acceptable macronutrient distribution range for protein was lower in the AD group than in the non-AD group. Comparing the nutrient intake per 1,000 kcal, the intakes of protein, phosphorus, iron, and potassium of the AD group were significantly lower than those of the non-AD group. In the KHEI, the scores of total vegetables, vegetables excluding kimchi and pickles, meat, fish, eggs, and legumes of the AD group were significantly lower than those of the non-AD group. In addition, as these food intake scores increased, the risk of AD significantly decreased. Conclusion: In conclusion, adult AD patients had low intakes of vegetables, meat, fish, eggs, and legumes, and it was confirmed that high intakes of these foods may be associated with low AD risk. Therefore, we suggest that an adequate intake of vegetables and foods containing protein would be necessary for the management and treatment of AD in adults.

• Korean Journal of Community Nutrition
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• v.20 no.2
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• pp.87-95
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• 2015

Objectives: Maintaining a balanced diet and thus health is crucial for adolescents, and the first step for balanced diet practice is meal planning. Adolescents, however, find it difficult to plan their meals. This study thus was set out to design an easier way of planning meals for adolescent girls. Methods: A dish-based target pattern for adolescent girls was tabulated, and validity of this was examined. Meal plan applying a dish-based target pattern was prepared by 150 female middle school students, and nutritional adequacies of those meal plans were examined. Validity and adequacy were tested by energy content, energy contribution ratio, nutrient adequacy ratio (NAR), probability of nutrient inadequacy, index of nutritional quality (INQ) calculation. Results: A dish-based target pattern with 11 dish groups was validated for nutritional adequacy. Though the NAR of calcium was 0.96, the INQ of calcium was 1.00. The average energy supply from the meal plans was 2,379 kcal, higher than the estimated energy requirement of a female middle school student, but the energy contribution ratio of carbohydrates, proteins, and fats were all adequate according to the acceptable macronutrient distribution range (AMDR). NAR of all nutrients examined were 1.0, except for calcium. The NAR and INQ of calcium were 0.87 and 0.75, respectively, and the meal plans at risk for calcium inadequacy was 19.30%. Conclusions: A dish-based target pattern proposed for adolescent girls was valid, but the meal plan prepared by female middle school students using this approach was high in energy and low in calcium supply. To cut down the energy supply from the meal plan, it is necessary to recommend dishes low in fat and use low fat cooking methods. To increase the calcium supply, it is important to recommend seaweed and legume group dishes with higher Ca INQ food items.

• Korean Journal of Community Nutrition
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• v.19 no.3
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• pp.274-282
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• 2014

Objectives: The objective of this study was to revise the target pattern in food guidance system for adolescents' balanced menu planning. Methods: The food groups in the target pattern were divided into detailed food items, and intake number were assigned to each food items based on the revised standard food composition table. The validity of revised target pattern was examined. Menu planning according to the revised target pattern was made available to 305 male and female middle school students and the nutritional assessment of the menu plan were carried out using SPSS WIN 12.0. Results: The energy contents, energy contribution ratios of carbohydrate, fat, and protein, and 4 minerals' and 6 vitamins' contents of the revised target pattern were adequate. The average energy contents of the menu planned according to revised target pattern were 400~500 kcal higher than that of the revised target pattern when the revised standard food composition was applied. The energy contribution ratios of fat were 28.9%, close to maximum of acceptable macronutrient distribution range (AMDR) (30%), and that of carbohydrate were 54.5%, lower than minimum of AMDR (55%). The nutrient adequacy ratios (NARs) of calcium and vitamin C were less than 1.0. According to index of nutritional quality (INQ) of food items, kimchi, milk dairy products, and soybean curd were energy efficient source for calcium, kimchi, fruit, vegetable and seaweed were energy efficient source for vitamin C, with INQ of food items were higher or close to 2.0. Kimchi was the best energy efficient source of calcium and vitamin C. Conclusions: Revised target pattern based on the adolescent's foods intake was not good enough for balanced menu planning by adolescents, because what they ate and what they wanted to eat were very much different. Detailed guidance for food selection is necessary in each food items.

• 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.

• Nutrition Research and Practice
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• v.5 no.5
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• pp.455-463
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• 2011

The aim of the present study was to assess the effects of skipping breakfast on diet quality and metabolic disease risk factors in healthy Korean adults. Subjects included 415 employees (118 men, 297 women; 30-50 years old) of Jaesang Hospital in Korea and their acquaintances. Data collected from each subject included anthropometric measurements, 3-day dietary intake, blood pressure, and blood analyses. The subjects were classified into three groups based on the number of days they skipped breakfast: 'Regular breakfast eater', 'Often breakfast eater', or 'Rare breakfast eater'. Participants in the 'Rare breakfast eater' group consumed less rice, potatoes, kimchi, vegetables, fish and shellfish, milk and dairy products, and sweets than did participants in the other two groups (P for trend <0.05) and ate more cookies, cakes, and meat for dinner (P for trend <0.05). Participants in the 'Rare breakfast eater' group consumed less daily energy, fat, dietary fiber, calcium, and potassium than did participants in the other groups (P for trend <0.05). The percent energy from carbohydrates was lower and fat intake was higher in the 'Rare breakfast eater' group than in the other groups (P for trend <0.01). When diets were compared using the Acceptable Macronutrient Distribution Range for Koreans, 59.1% of subjects in the 'Rare breakfast eater' group consumed more energy from fat compared with the other two groups (P <0.005). According to the Estimated Average Requirements for Koreans, intake of selected nutrients was lower in the 'Rare breakfast eater' group than in the other two groups (P <0.05). The risk of elevated serum triglycerides was decreased in the 'Rare breakfast eater' group (OR, 0.3 [0.1-1.0], P for trend=0.0232). We conclude that eating breakfast regularly enhances diet quality, but may increase the risk of elevated serum triglycerides.

• Journal of Nutrition and Health
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• v.40 no.1
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• pp.78-88
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• 2007

The purpose of this study was to investigate dietary fat and individual fatty acids intake pattern of 174 college women living in Seoul and Gyong-gi province through internet nutritional assessment system. Each of the subjects was required to input their own food intake for three days, which included two days during the week and one day of the weekend, on the web program directly and all of the data collected were used for statistical analysis. The mean daily caloric intake of the subjects was 1,500.9 kcal which was at 71.5% of Estimated Energy Requirement (EER). Dietary fat contributed 27.6% of the total caloric intake which was slightly higher than the recommended limit of 25%. Daily cholesterol intake was 310.0 mg, which was also high to some degree. Mean daily N6 and N3 fatty acid intake was 6.1 g and 0.9 g, respectively, and calory % calculated from each were 3.63% and 0.53%. This result showed the intake of N3 fatty acid fell in Acceptable Macronutrient Distribution Ranges (AMR) $0.5\sim1.0%$ but that of N6 fatty acid was somewhat lower than the AMDR $4\sim8%$. N6/N3 ratio 8.5/l, however, was within the desirable range $4\sim10/1$. Considering overall dietary fatty acids intake, oleic acid was the most abundant, followed by linoleic and palmitic acid. And among polyunsaturated fatty acids intake, linoleic acid was exclusively high, accounting for 97.4% of total N6 fatty acid intake. On the contrary, three fatty acids, linolenic (67.3%), DHA (21.1%) and EPA (10.0%), together supplied 98.4% of total N3 fatty acid intake. Mean P/M/S was 0.9/l.1/1.0. The subjects' intake of fat, many fatty acids and cholesterol came from diverse food groups including meats, fats and oils, milk and milk products, eggs, fish, and soybean products. Nevertheless, the subjects tended to show unfavorable fat and fatty acids intake pattern in terms of quantity and quality. Based on these results, it is important to monitor dietary fat intake pattern of the general population continuously and an internet program such as the one used for this study would be valuable, especially for assessing dietary patterns in the younger generation.

• Journal of Nutrition and Health
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• v.47 no.4
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• pp.247-257
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• 2014

Purpose: It is reported that most senior people consume a high carbohydrate diet, while a high carbohydrate diet could contribute to the risk of chronic disease. The aim of this study is to determine whether a high carbohydrate diet can increase the risk of chronic disease in elderly Koreans. Methods: Using the 2007-2009 Korean National Health Nutrition Examination Survey data, out of a total of 3,917 individuals aged 65 and above, final 1,535 subjects were analyzed, divided by dietary carbohydrate energy ratio into two groups of moderate carbohydrate ratio (MCR, 55-70%) and excessive carbohydrate ratio (ECR, > 70%). All data were processed after the application of weighted value, using a general linear model or logistic regression. Results: Eighty one percent of elderly Koreans consumed diets with carbohydrate energy ratio above 70%. The ECR group included more female subjects, rural residents, lower income, and lower education level. The ECR group showed lower waist circumference, lower diastolic blood pressure, and lower frequency of consumption of meat and egg, milk, and alcohol. The intake of energy and most nutrients, with the exception of fiber, potassium, vitamin A, and carotene, was lower in the ECR group compared to the MCR group. When analyzed by gender, the ECR group showed lower risk of dyslipidemia in male and obesity in female subjects, even though the ECR group showed low intake of some nutrients. No difference in the risk of hypertension, diabetes, and anemia was observed between the two groups in male or female subjects. Conclusion: This result suggested that a high carbohydrate diet would not be a cause to increase the risk of chronic disease in the elderly. Further study is needed in order to determine an appropriate carbohydrate energy ratio for elderly Koreans to reduce the risk of chronic disease.