• Nutrition Research and Practice
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• 제16권sup1호
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• pp.126-133
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• 2022

Choline is a water-soluble organic compound that is important for the normal functioning of the body. It is an essential dietary component as de novo synthesis by the human body is insufficient. Since the United States set the Adequate Intakes (AIs) for total choline as dietary reference values in 1998, Australia, China, and the European Union have also established the choline AIs. Although choline is clearly essential to life, the 2020 Dietary Reference Intakes for Koreans (KDRIs) has not established the values because very few studies have been done on choline intake in Koreans. Since choline intake levels differ by race and country, human studies on Koreans are essential to set KDRIs. Therefore, the present study was undertaken to provide basic data for developing choline KDRIs in the future by analyzing data on choline intake in Koreans to date and reference values of choline intake and dietary choline intake status by country and race.

• Nutrition Research and Practice
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• 제12권6호
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• pp.459-468
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• 2018

BACKGROUND/OBJECTIVES: The Dietary Reference Intakes for Koreans (KDRIs), a set of reference intake values, have served as a basis for guiding a balanced diet that promotes health and prevents disease in the general Korean population. In the process of developing DRIs, a systematic review has played an important role in helping the DRI committees make evidence-based and transparent decisions for updating the next DRIs. Thus, the 2015 KDRI steering committee applied the systematic review framework to the revision process of the KDRIs. The purpose of this article is to summarize the revision process for the 2015 KDRIs by focusing on the systematic review framework. MATERIALS/METHODS: The methods used to develop the systematic review framework for 2015 KDRIs followed the Agency for Healthcare Research and Quality and the Tufts Evidence-based Practice Center. The framework for systematic review of the 2015 KDRIs comprised of the 3 following steps: (1) development of an analytic framework and refinement of key questions and search terms; (2) literature search and data extraction; and, (3) appraisal of the literature and summarizing the results. RESULTS: A total of 203,237 studies were retrieved through the above procedure, with 2,324 of these studies included in the analysis. General information, main results, comments of reviewers, and results of quality assessment were extracted and organized by study design. The average points of quality appraisals were 3.0 (range, 0-5) points for intervention, 6.1 (0-9) points for cohort, 6.0 (3-9) points for nested case-control, 5.4 (1-8) points for case-control, 14.6 (0-22) points for cross-sectional studies, and 7.0 (0-11) points for reviews. CONCLUSIONS: Systematic review helped to establish the 2015 KDRIs as a useful tool for evidence-based approach. Collaborative efforts to improve the framework for systematic review should be continued for future KDRIs.

• Journal of Nutrition and Health
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• 제55권4호
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• pp.441-449
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• 2022

This review is focused on analyzing the limits and shortage of zinc (Zn) for the 2020 Dietary Reference Intakes for Koreans (KDRIs), and provides suggestions for the future establishment of the 2025 KDRIs for Zn. The 2020 KDRIs for Zn have been established to estimate the adequate requirement (EAR), recommended nutrient intakes (RNI), adequate intake (for only 0-5 mon) and tolerable upper intake level (UL). EAR was estimated in 2-stages: the first stage was to construct of the frame of analysis for Zn requirement and the second stage involved a factorial approach by considering the various factors which affect Zn requirement, such as intestinal and urine Zn loss, Zn requirement for growth and development, and Zn absorption rate. For a more precise and accurate establishment of the Zn requirement, we suggest for the following to be considered: 1) considering that Zn is present in minuscule amounts as a trace element in our body, the present values for Zn EAR (as 6-9 mg/d) should be expressed as a decimal point for more accurate DRIs; 2) the frame of analysis for Zn requirement has to be more specifically and should includes the factors which affect Zn requirement; 3) both, the factorial approach and extrapolation method need to be well reviewed and thoroughly understood for establishing precise Zn requirement; 4) currently, human clinical study and balance study (Zn intake, excretion and absorption rate) are limited and more human Zn subject studies are required. All these suggestions are provided to better establish the Zn requirement in the 2025 KDRIs.

• Nutrition Research and Practice
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• 제16권sup1호
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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.

• 동아시아식생활학회지
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• 제17권4호
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• pp.483-489
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• 2007

This study was performed to investigate dietary habits, and to evaluate the relationship between nutritional status and certain blood parameters in premenopausal and postmenopausal women living in Daejeon. Adult Korean females(n=110) that had visited the Health Promotion Center of Eulji University Hospital were analyzed. We examined blood parameters, body composition, and life style factors such as food habits and physical activity in pre- and post-menopausal women. The collected data were then analyzed to evaluate the various items. Overall, there were no differences between the pre- and post-menopausal women for food habit score, or for intakes of energy, protein, Int, iron, vitamin A, vitamin $B_1$, vitamin $B_2$, niacin, vitamin C, and calcium. However, carbohydrate intake was significantly higher in the postmenopausal women than in the premenopausal women. The Dietary Reference Intakes for Koreans(KDRIs), in terms of energy, fat, calcium, vitamin A and vitamin $B_1$, were less than 100% in both the premenopausal women and postmenopausal women. All intakes of protein, iron, vitamin $B_2$, niacin, and vitamin C satisfied the KDRIs in both groups. Finally, the postmenopausal women had higher serum fasting blood glucose, total cholesterol, LDL-cholesterol and alkaline phosphatase levels than the premenopausal women.

• Nutrition Research and Practice
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• 제16권sup1호
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• pp.70-88
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• 2022

Sodium is a physiologically essential nutrient, but excessive intake is linked to the increased risk of various chronic diseases, particularly cardiovascular. It is, therefore, necessary to accomplish an evidence-based approach and establish the Korean Dietary Reference Intakes (KDRIs) index, to identify both the nutritional adequacy and health effects of sodium. This review presents the rationale for and the process of revising the KDRIs for sodium and, more importantly, establishing the sodium Chronic Disease Risk Reduction Intake (CDRR) level, which is a new specific set of values for chronic disease risk reduction. To establish the 2020 KDRIs for dietary sodium, the committee conducted a systematic literature review of the intake-response relationships between the selected indicators for sodium levels and human chronic diseases. In this review, 43 studies published from January 2014 to December 2018, using databases of PubMed and Web of Science, were finally included for evaluating the risk of bias and strength of evidence (SoE). We determined that SoE of the relationship between dietary sodium and cardiovascular diseases, cerebrovascular disease, and hypertension, was moderate to strong. However, due to insufficient scientific evidence, we were unable to establish the estimated average requirement and the recommended nutrient intake for dietary sodium. Therefore, the adequate intake of sodium for adults was established to be 1,500 mg/day, whereas the CDRR for dietary sodium was established at 2,300 mg/day for adults. Intake goal for dietary sodium established in the 2015 KDRIs instead of the tolerable upper intake level was not presented in the 2020 KDRIs. For the next revision of the KDRIs, there is a requirement to pursue further studies on nutritional adequacy and toxicity of dietary sodium, and their associations with chronic disease endpoint in the Korean population.

• Journal of Nutrition and Health
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• 제55권4호
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• pp.419-429
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• 2022

수분은 인체에서 가장 많은 비율을 차지하는 성분으로 인체의 원활한 생리작용을 위해 필수적인 요소이다. 2013-2017 국민건강영양조사 자료를 근거로 하였을 때 우리나라 사람들의 평균 1일 수분 섭취량은 2,167.3 mL/day이며 그 중 62%가 섭취기준을 충족하지 못하고 있다. 반면 음료 섭취는 계속해서 증가하고 있는 추세다. 수분 섭취기준은 충분섭취량으로 제시되며, 상한섭취량과 만성질환위험감소섭취량은 제시하지 않고 있다. 2015년과 비교해 2020년 수분 충분섭취량은 연령에 따라 소폭 증가하거나 감소되었는데 유아기 1-2세, 남자 6-8세, 9-11세, 여아 6-8세는 100 mL/day씩 감소하였으며, 남자 12-14세는 100 mL/day 증가하였다. 수분 섭취기준으로 제시되는 수분 충분섭취량은 음식 수분 섭취량과 액체 수분 섭취량을 합한 값이며, 액체 수분 섭취량은 물 섭취량 중앙값, 음료 섭취량 중앙값, 우유 섭취량 200 mL/day을 합해서 산출한 수치이다. 이와 같이 수분 섭취기준에는 음식 수분 섭취량도 포함되어 있으므로, 물과 음료의 섭취기준으로 총수분 섭취기준을 적용하는 것은 적절하지 않으며 액체 섭취기준을 적용해야 한다. 그리고 액체 수분을 섭취할 때에는 당류, 카페인 등이 함유된 음료보다 물이나 우유를 섭취하는 것이 바람직하다. 한국인 수분 섭취기준 설정에 있어서 향후 개선하고 보완해야 할 사항으로 한국인 일상식에서 수분 함량비의 정확성 제고, 액체 수분 섭취량에 관한 조사방법 보완, 생애주기별 수분 섭취 실태에 대한 다각적인 검토, 노인기의 생리적 변화와 건강상태 반영, 한국인 대상 수분 섭취와 건강에 관한 연구 활성화와 반영 등을 제안한다.

• Journal of Nutrition and Health
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• 제55권4호
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• pp.430-440
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• 2022

셀레늄은 산화스트레스 방어 기능으로 인체의 면역기능 유지에 필수적 역할을 하고, 세포의 항산화기능, 면역기능, 갑상선호르몬 조절, 약물이나 중금속 위해에 대한 방어, 만성질환의 위험 감소에 필수 역할을 하는 미량무기질이다. 셀레늄 섭취의 부족은 암, 심혈관질환, 당뇨병, 신경질환, 골관절 및 근육괴사와 약화, 갑상선질환, 염증성 질환 등 다양한 만성적 질환의 위험을 높인다. 본 논문은 2020 한국인 영양소 섭취기준에서 셀레늄의 제정과 개정 근거 기준에 대해 설명하고, 셀레늄 데이터베이스의 현황과 향후 2025 한국인 영양소 섭취기준 설정을 위한 필요 연구에 대해 논의하였다. 셀레늄의 2020 한국인 영양소 섭취기준은 2015년에 이어 혈장 셀레노프로테인 P 수준이 최대가 되는 셀레늄의 평균필요량을 지표로 사용하였고, 중국인 대상의 보고치에 한국인의 기준체중과 변이계수를 적용하는 방법이 적용되었으며, 2015년에 비해 참고체중치의 변경에 따라 성별, 연령별 셀레늄 섭취기준에서 약간의 개정이 있었다. 향후 셀레늄 섭취기준 설정의 발전을 위해서는 1) 한국인 대상의 혈장 셀레노프로테인 P의 최대수준을 나타내는 셀레늄 섭취량을 파악하기 위한 셀레늄 중재연구가 필요하고, 2) 셀레늄 섭취량 판정의 정확성을 높이기 위한 영양평가 프로그램내 식품 셀레늄 데이터베이스의 검토와 식품의 셀레늄 함량 분석을 확대해야 하며, 3) 국민의 셀레늄 섭취와 체내 생물학적 지표와의 관계를 건강한 일반인뿐만 아니라 질환자 및 운동선수와 같은 특수 환경의 대상자들로 확대하는 연구가 요구된다.

• Nutrition Research and Practice
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• 제13권1호
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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.

• Nutrition Research and Practice
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• 제16권sup1호
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• pp.113-125
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• 2022

In the current years, it has now become necessary to establish standards for micronutrient intake based on scientific evidence. This review discusses issues related to the development of the 2020 Dietary Reference Intakes for Koreans (KDRI) for magnesium (Mg), zinc (Zn), and copper (Cu), and future research directions. Following issues were encountered when establishing the KDRI for these minerals. First, characteristics of Korean subjects need to be applied to estimate nutrient requirements. When calculating the estimated average requirement (EAR), the KDRI used the results of balance studies for Mg absorption and factorial analysis for Zn, which is defined as the minimum amount to offset endogenous losses for Zn and Mg. For Cu, a combination of indicators, such as depletion/repletion studies, were applied, wherein all reference values were based on data obtained from other countries. Second, there was a limitation in that it was difficult to determine whether reference values of Mg, Zn, and Cu intakes in the 2020 KDRI were achievable. This might be due to the lack of representative previous studies on intakes of these nutrients, and an insufficient database for Mg, Zn, and Cu contents in foods. This lack of database for mineral content in food poses a problem when evaluating the appropriateness of intake. Third, data was insufficient to assess the adequacy of Mg, Zn, and Cu intakes from supplements when calculating reference values, considering the rise in both demand and intake of mineral supplements. Mg is more likely to be consumed as a multi-nutrient supplement in combination with other minerals than as a single supplement. Moreover, Zn-Cu interactions in the body need to be considered when determining the reference intake values of Zn and Cu. It is recommended to discuss these issues present in the 2020 KDRI development for Mg, Zn, and Cu intakes in a systematic way, and to find relevant solutions.