• Journal of Nutrition and Health
• /
• v.39 no.7
• /
• pp.692-698
• /
• 2006

The voluntary addition of vitamins and minerals to the appropriate foods may help reduce the risks associated with low intakes of these micronutrients, yet the potential of excessive intake, particularly for persons consuming very large amount of foods needs to be addressed. Using the Flynn's model to estimate the level of each vitamins and minerals that can be added safely to foods, maximum levels of fortification to conventional foods per 100 kcal portion were estimated. Critical factors in the Flynn's model included tolerable upper intake level (UL), each micronutrient intake at the $95^{th}$ percentile, the proportion of fortified foods in the diets of individuals, the proportion of foods to which micronutrients could be practically added, and a range of estimates for fractions of foods which might be actually fortified in each nutrient. Food vehicles included all foods except for fresh foods and alcoholic beverages, in general. With fortification of 50% of all potentially fortifiable foods, micrornutrients could be added safely to foods at levels per 100 kcal 1) > 100% Recommended Intake (RI) for vitamin $B_12$, 2) 1,200% RI for vitamin $B_1$ and niacin, 3) 1,000% $B_1$ for vitamins $B_2$ and $B_6$, 4) 400% RI for vitamin E, 5) 30% RI for calcium, 6) 20% RI for folic acid, iron and zinc, 7) 10% RI for manganese, 8) no fortification for magnesium, phosphorous and vitamin A, and 8) further consideration of vitamin D, copper and selenium due to insufficient evidence. Results of this study suggests a wide range of vitamins and minerals that can be added safely to foods in current diets of Koreans.

• Nutritional Sciences
• /
• v.6 no.1
• /
• pp.48-52
• /
• 2003

The Dietary Reference Intakes (DRI's) are new nutrient intake standards that are being set for the United States and Canada. There are currently four types of DRI's: Estimated Average Requirements (EAR), Recommended Dietary Allowances (RDA), Adequate Intakes (AI), and Tolerable Upper Intake Levels (UL). The EAR is the nutrient intake that would be adequate for about half the population, while intake at the RDA should be adequate for 97-98% of the population. When the data are insufficient to set an EAR and RDA, then an AI is set. The UL is the highest intake level that does not pose a risk of adverse effects. The EAR, AI, and UL may be used to assess intakes of both individuals and of groups of people. For individuals, the EAR is used to calculate the probability that intake is inadequate, the AI is used to decide if the probability of inadequacy is low, and the UL is used to determine if a risk of excess intake is present. For groups. the EAR is used to estimate the prevalence of inadequacy, the AI is used to decide if the prevalence of inadequacy is low, and the UL is used to estimate the prevalence of excessive intakes. Because this approach to setting and applying nutrient standards is new, research recommendations include improving estimates of risk, improving dietary data, and improving statistical methods.

• Nutrition Research and Practice
• /
• v.16 no.sup1
• /
• pp.47-56
• /
• 2022

This paper examines the process and evidence used to create the Dietary Reference Intake (DRI) of alpha-linolenic acid (ALA) and eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA) for Koreans. ALA (18:3n3) is an essential fatty acid, and EPA and DHA are known to have beneficial effects on cardiovascular disease risk and reduction of triglyceride levels. Various international organizations have suggested dietary recommendations for n-3 polyunsaturated fatty acids (PUFAs), including ALA, EPA, and DHA. A DRI for Koreans was established for the first time in 2020, specifically for the adequate intake (AI) of ALA and EPA + DHA. This recommendation was based on the average intake of ALA and EPA + DHA from the Korea National Health and Nutrition Examination Survey 2013-2017. For Korean infants, the AI of ALA and DHA was based on the fatty acid composition of maternal milk. Estimated average requirement and a tolerable upper intake level have not been set for n-3 PUFA due to insufficient evidence. In addition, the intake level of n-3 PUFA for prevention of chronic disease has also not been determined. Future studies and randomized controlled trials are required to establish the UL and to define the level for disease prevention.

• Nutrition Research and Practice
• /
• v.16 no.sup1
• /
• pp.57-69
• /
• 2022

BACKGROUND/OBJECTIVES: Vitamin D is produced in the skin during sun exposure and is also ingested from foods. The role of vitamin D needs to be considered in the prevention and management of various diseases. Moreover, since the majority of Koreans spend their days indoors, becoming susceptible to the risk of vitamin D deficiency. The current study aims to prepare a basis for determining dietary reference intake of vitamin D in Korea, by reviewing the evidence against various diseases and risks. MATERIALS/METHODS: Literature published in Korea and other countries between 2014 and 2018 was prioritized based on their study design and other criteria, and evaluated using the RoB 2.0 assessment form and United States Department of Agriculture Nutrition Evidence Library Conclusion Statement Evaluation Criteria. RESULTS: Of the 1,709 studies, 128 studies were included in the final systematic analysis after screening. To set the dietary reference intakes of vitamin D based on the selected articles, blood 25(OH)D levels and indicators of bone health were used collectively. Blood vitamin D levels and ultraviolet (UV) exposure time derived from the Korean National Health and Nutrition Examination Survey were analyzed to establish the dietary reference intakes of vitamin D for each stage of the life cycle. The adequate intake levels of vitamin D, according to age and gender, were determined to be in the range of 5-15 ㎍/day, and the tolerable upper intake level was established at 25-100 ㎍/day. CONCLUSIONS: The most important variable for vitamin D nutrition is lifestyle. A balanced diet comprising foods with high contents of vitamin D is important, as is vitamin D synthesis after UV exposure. The adequate intake level of vitamin D mentioned in the 2015 Dietary Reference Intakes for Korean (KDRI) remained unchanged in the 2020 KDRI for the management of vitamin D nutrition in Koreans.

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

• Nutrition Research and Practice
• /
• v.16 no.sup1
• /
• pp.70-88
• /
• 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.

• The Korean Journal of Community Living Science
• /
• v.26 no.4
• /
• pp.661-673
• /
• 2015

This study examines the effects of a low-calorie raw juice diet on the level of serum ferritin in adults and analyzes nutrient intake from the diet. There were significant differences between juices; the highest calorie was provided by pear juice, highest crude protein, vitamin A, and vitamin B2 levels were from green Juice 1; and highest vitamin C and vitamin B1 levels were from fruit juices. The ratio of estimated energy requirements (EER) for the participants was 56.2% from the raw juice diet. The percentages of recommended intake (RI) from the raw juice diet of protein (57.9%), dietary fiber (19.1%), niacin (6.2%), calcium (0.1%), and magnesium (0.2%) were lower than 75%. However, those of RI of vitamin A, vitamin B1, vitamin B2, vitamin B6, and vitamin C were 1796.5%, 7481.7%, 1915.5%, 30858.7%, and 7500%, respectively, exceeding the tolerable upper intake level (UL) for vitamin A, vitamin B6, and vitamin C. There were significant decreases in weight, the body mass index (BMI), body fat mass, and skeletal muscle mass in males and females. After the diet program, serum iron and SOD (superoxide dismutase) showed significant decreases, whereas RBC, hemoglobin, hematocrit, and serum ferritin showed significant increases. There were negative correlations between serum ferritin and weight and between serum ferritin and skeletal muscle mass for all participants. There were negative correlations between serum ferritin and skeletal muscle mass for males and between serum ferritin and body fat mass for females. These results suggest that a raw juice diet can supplement a regular diet to prevent excess or deficient nutrient intake.

• Korean Journal of Community Nutrition
• /
• v.25 no.4
• /
• pp.329-339
• /
• 2020

Objectives: This study was undertaken to evaluate the intake of vitamins and minerals from dietary supplements (DSs) in Korean adults and elderly. Methods: Data for this study was generated from the 2017 Korea National Health and Nutrition Examination Survey (KNHANES). We analyzed 4,204 individuals aged 19 years and older (2,579 users and 1,625 non-users). The survey included 24-h recall questions on food and DS intakes, as well as questions on DS use over the past year. The nutrient DSs evaluated were calcium, phosphorus, iron, vitamin A, thiamin, riboflavin, niacin, and vitamin C. Total nutrient intakes were obtained by combining nutrient intakes of foods and DSs consumed by each subject. Results: Most micronutrient intakes from food (except for thiamin) in adult users, and the four micronutrient intakes (iron, vitamin A, vitamin B₂ and vitamin C) in elderly users, were significantly higher than values obtained in non-users. For total intake of nutrients and DSs, both adult and elderly users had a significantly higher intake than non-users. While proportions below Estimated Average Requirements for all micronutrients by adding respective DSs in users were significantly reduced in adults and elderly as compared to non-users, the proportions of above Tolerable Upper Intake Levels for calcium and vitamin A in adults, and vitamin A in elderly, were significantly increased. In the total subjects examined, consumption of DSs was associated with lower odds ratios of undernutrition of micronutrients, and with higher odds ratios of overnutrition of calcium, iron, and vitamin A, as compared to non-users of DSs. Conclusions: Although DSs consumption by adults and the elderly improves the micronutrient status, it also increases the risk of excessive intake of certain vitamins and minerals.

• Journal of Preventive Medicine and Public Health
• /
• v.50 no.4
• /
• pp.278-281
• /
• 2017

Since 2006, type 1 diabetes in Finland has plateaued and then decreased after the authorities' decision to fortify dietary milk products with cholecalciferol. The role of vitamin D in innate and adaptive immunity is critical. A statistical error in the estimation of the recommended dietary allowance (RDA) for vitamin D was recently discovered; in a correct analysis of the data used by the Institute of Medicine, it was found that 8895 IU/d was needed for 97.5% of individuals to achieve values ${\geq}50nmol/L$. Another study confirmed that 6201 IU/d was needed to achieve 75 nmol/L and 9122 IU/d was needed to reach 100 nmol/L. The largest meta-analysis ever conducted of studies published between 1966 and 2013 showed that 25-hydroxyvitamin D levels <75 nmol/L may be too low for safety and associated with higher all-cause mortality, demolishing the previously presumed U-shape curve of mortality associated with vitamin D levels. Since all-disease mortality is reduced to 1.0 with serum vitamin D levels ${\geq}100nmol/L$, we call public health authorities to consider designating as the RDA at least three-fourths of the levels proposed by the Endocrine Society Expert Committee as safe upper tolerable daily intake doses. This could lead to a recommendation of 1000 IU for children <1 year on enriched formula and 1500 IU for breastfed children older than 6 months, 3000 IU for children >1 year of age, and around 8000 IU for young adults and thereafter. Actions are urgently needed to protect the global population from vitamin D deficiency.

• Journal of the East Asian Society of Dietary Life
• /
• v.20 no.6
• /
• pp.853-862
• /
• 2010

This study was conducted as a nationwide project in order to obtain data on the content and intake of sodium in school meals. For this purpose, we selected two elementary and two middle schools in Daejeon as well as four elementary schools in the Chungcheong area. We measured the sodium and potassium contents of 842 dishes as well as their intake levels over 154 days. Sodium content was analyzed using an AAS (Atomic Absorption Spectrometer). The average meal intakes of second and fifth grade elementary school students were 244 g/meal and 304 g/meal, respectively. The meal intake of middle school students was 401 g/meal. Boys tended to eat slightly more than did girls, and students tended to eat more in the spring than in the summer. The average sodium intake per meal was 642 mg (570 mg by elementary school students, 1068 mg by middle school students), which was 32.1% of the UL (Tolerable Upper Intake Level, 2,000 mg per day) according to the KDRIs (Dietary Reference Intakes for Koreans). The sodium intake per meal was not significantly differ between boys and girls or between spring and summer (p>0.05). This study provides fundamental data that can be used to establishment a nutrition policy concerning the adequate content of sodium in school meals.