Choline is an essential nutrient that serves as a fundamental structural component of membrane phospholipids and plays critical roles in one-carbon metabolism, acetylcholine synthesis, lipid transport, and signal transduction. Although it is synthesized endogenously in the human body, the amount produced may not be sufficient to meet the nutrient's total biological demand, necessitating consistent dietary intake from various food sources. Since its recognition as an essential nutrient by the Institute of Medicine (U.S.) in 1998, several countries and regions, including Australia and New Zealand, Europe, and China, have established specific Dietary Reference Intakes (DRIs) to monitor and manage choline intake among their respective populations. In response to the growing demand for national dietary guidelines, the Committee for the Establishment and Revision of the 2025 Dietary Reference Intakes for Koreans (KDRIs) conducted a thorough, systematic review. This initiative was undertaken to re-evaluate the necessity and strength of scientific evidence supporting DRIs for choline in the Korean population. Furthermore, the committee analyzed the distribution of actual choline intake among healthy Koreans by applying a newly developed choline database to the recent five-year data from the Korea National Health and Nutrition Examination Survey. By comprehensively reviewing both the calculated reference values based on existing evidence and the actual intake distribution, the committee successfully established the Adequate Intake and Tolerable Upper Intake Level for choline across different age and gender groups in Korea. This review details the development process and core components of the KDRIs for choline and presents the key issues to be addressed in future revisions of these standards.

Objectives: To apply a healthy dietary program with reduced sodium intake, developed using data from the Korea National Health and Nutrition Examination Survey (KNHANES), focusing on the sodium intake level and eating patterns. Methods: The program was implemented using a living lab model, an open innovation ecosystem for user-centered problem-solving. Analysis of the KNHANES data revealed that older age groups had a low energy intake but a high sodium intake, particularly among those who frequently dined out. The program was designed to improve sodium-reduction literacy and enhance practical competency. Over four weeks, 40 participants tracked their dietary intake and worked with a clinical nutritionist through a process of diagnosis, experience, improvement, and expansion. A self-administered survey was conducted before and after the program to assess effectiveness. Results: Participants were four teenagers (10%), 26 in their twenties (65%), and 10 aged ≥ 30 years (25%), with eight males (20%) and 32 females (80%). Post-program analysis showed significant improvements in sodium-related nutrition knowledge (P < 0.01), with increased agreement on adopting low-sodium intake practices (e.g., interest in sodium content, choosing lower-sodium foods). Nutrient intake analysis showed a decrease in energy, carbohydrates, lipids, and proteins (P < 0.001), with sodium intake decreasing from 3,382.37 mg/d to 2,119.05 mg/d (P < 0.001). Conclusion The community-based, living lab model for the sodium-reduction program effectively improved participant sodium-reduction literacy and practical competency, suggesting that step-by-step, autonomous learning, can reduce sodium intake and promote healthier eating habits.

Objectives: This study aimed to analyze dietary factors associated with sleep duration in postmenopausal middle-aged women using data from the Korea National Health and Nutrition Examination Survey (KNHANES), with particular emphasis on the postmenopausal period. Methods: A total of 3,040 postmenopausal women aged 40–64 years from the 2019–2023 KNHANES were included. Sleep duration was classified into four categories: “appropriate sleep duration” (ASD; 7–9 hours), “short sleep duration” (6–7 hours), “very short sleep duration” (VSSD; < 6 hours), and “long sleep duration” (LSD; > 9 hours). Nutrient and food intake were compared among groups using analysis of covariance. Multinomial logistic and polynomial regression models assessed associations, adjusting for demographic and health covariates. Results: The VSSD group had higher body mass index and waist circumference than the ASD group, despite lower total energy intake, and also consumed more snack energy and skipped breakfast and dinner more often. This group also had lower intakes of monounsaturated fatty acids and nuts and seeds. In the late menopausal group, greater consumption of cereal grains, fish and shellfish, and beverages was associated with elevated LSD risk. Conversely, higher folate intake in the early menopausal group was inversely associated with VSSD risk. Cholesterol intake was positively associated with LSD risk in both groups. A negative nonlinear association between sleep duration and dietary intake was observed in the early menopausal group when polyunsaturated fatty acid intake exceeded 19.86 g/day and riboflavin intake exceeded 1.76 mg/day. In the late menopausal group, riboflavin intake was strongly correlated with increased LSD risk (odds ratio = 4.776, P = 0.004). Sugar and beverage intake showed a positive linear relationship with sleep duration at average intake levels. Conclusion Dietary factors associated with sleep duration differed by postmenopausal period, with specific nutrients and food groups exhibiting variable associations with sleep duration above mean intake levels.meS

Objectives: This study is intended to develop a curriculum for kindergarten food and nutrition education aimed at preschool children, reflecting government policy and meeting the demands of preschool settings. Methods: Existing educational materials were analyzed, and key elements of the 2019 Revised Nuri Curriculum (“Nuri Curriculum”) and Guidelines for Nutrition and Food Education in Kindergartens, Elementary, Middle, and High Schools (“Guidelines”) were examined as foundational information for developing the curriculum for food and nutrition education. Results: Basing ourselves on the five domains of the Nuri Curriculum, “Physical Activity and Health,” “Communication,” “Social Relationships,” “Art Experience,” and “Natural Science Inquiry,” we integrated three areas from the Guidelines, namely “Dietary Habits and Health,” “Dietary Habits and Safety,” and “Dietary Habits and Culture,” to structure the curriculum for kindergarten food and nutrition education. Three specific domains, “Nutrition and Health,” “Food and Culture,” and “Safe Dietary Practices,” were tailored for preschool children, each comprising core concepts, content elements, and educational materials. In the “Nutrition and Health” domain, core concepts such as “nutrition” were addressed through content elements such as “balanced eating” and “vegetables and fruit,” while “health” included elements such as “eating regularly” and “nutrients for disease prevention,” each with two educational content components. The “Food and Culture” domain focused on “food” with content on “local foods (vegetable-garden experience)” and “food culture” with content on “our dining table (rice and side dishes),” “our agricultural products,” “global cuisine (multiculture),” and “considerate dietary practices,” each with four educational content components. The “Safe Dietary Practices” domain included core concepts such as “hygiene” with content on “hand-washing habits” and “food poisoning management,” and “safety” with content on “food labeling.” Conclusions The systematized curriculum for kindergarten food and nutrition education aligns with the Nuri Curriculum and is interconnected with the Guidelines. This curriculum can be used as foundational material for developing educational resources tailored to the characteristics of preschoolers, contributing to effective implementation in early childhood education.

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.

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.

Objective To investigate the long-term angiogenic effects of angiopoietin-1 (ANG-1) and vascular endothelial growth factor (VEGF) in a swine model with chronic myocardial ischemia.Method Four-weeks after gradual occlusion of the left circumflex coronary artery by Ameroid constrictor,animals were injected with recombinant adenoviral vectors carrying either human ANG-1 (AdANG-1 group,n =9),human VEGF 165 (AdVEGF group,n =10) or empty vector (n =7) into the left ventricle free wall supplied by the constricted artery.Four and twelve weeks after the gene transfer mediated by the adenovirus,regional blood flow in ischemic myocardium were respectively measured with fluorescent microsphere while immunohistochemical study were also conducted accordingly.Results Left ventricular perfusion in animals in the AdANG-1 group [(3.25 ± 0.16) mL·min-1·g-1]were significantly higher than that in the AdVEGF group [(1.09 ± 0.13) mL·min-1·g-1] and empty vector group [-(1.20 ± 0.03) mL·min-1·g-1] 4 weeks after gene tranfer (P＜0.05).Microvascular densities in the left ventricles of animals in the AdANG-1 group [(19.61 ± 1.76)/0.572 mm2 myocardial tissue] and the AdVEGF group [(18.17 ± 1.43)/0.572 mm2 myocardial tissue] were significantly higher than animals that received empty vector [(13.53 ± 0.92)/0.572 mm2 myocardial tissue] 12 weeks after gene transfer (P＜0.05).ANG-1,but not VEGF,contributed to enhanced regional perfusion by increasing arteriolar density [(1.9 ± 0.4)/0.572 mm2 myocardial tissue vs.(0.7± 0.2)/0.572 mm2 myocardial tissue,P＜0.05] of large-sized (50-100 μm) arterioles.Conclusions Gene transfer of ANG-1 and VEGF can enhance angiogenesis,but only ANG-1 promotes sustained improvement of ventricular perfusion that expedites recovery of ischemic myocardium via arteriogenesis,which provides histoanatomical prerequisite to expedite recovery of ischemic myocardium.

BACKGROUND AND OBJECTIVES: Supervised lifestyle interventions, including dietary and exercise programs, may be infeasible to implement in real-world settings. Therefore, this study aimed to evaluate the effectiveness of a home-based lifestyle modification intervention on blood pressure (BP) management. METHODS: Eighty-five patients aged over 20 years and diagnosed with prehypertension or mild hypertension were randomly assigned to an advice-only comparison group (C group, n=28), a Dietary Approaches to Stop Hypertension (DASH) diet education group (D group, n=30), or a DASH and home-based exercise group (D+Ex group, n=27). The intervention lasted for 8 weeks. The primary outcome was the difference in office systolic blood pressure (SBP) before and after the study period (Trial registry at ClinicalTrials.gov, NCT01637909). RESULTS: Seventy-two participants (87.8%) completed the trial. The degree of change in office SBP did not significantly differ among the intervention groups; however, the D+Ex group demonstrated a tendency toward decreased SBP. Upon analysis of 24-hour ambulatory BP measurements, daytime ambulatory SBP was significantly lower in the D+Ex group (134 mmHg; 95% confidence interval [CI], 131 to 137; p=0.011) than in the C group (139.5 mmHg; 95% CI, 130.9 to 137), and daytime ambulatory SBP was significantly decreased in the D+Ex group (−5.2 mmHg; 95% CI, −8.3 to −2.1; p=0.011) compared to the C group (0.4 mmHg, 95% CI, −2.5 to 3.3). CONCLUSIONS In conclusion, lifestyle modification emphasizing both diet and exercise was effective for lowering BP and should be favored over diet-only modifications.

BACKGROUND AND OBJECTIVES: Supervised lifestyle interventions, including dietary and exercise programs, may be infeasible to implement in real-world settings. Therefore, this study aimed to evaluate the effectiveness of a home-based lifestyle modification intervention on blood pressure (BP) management. METHODS: Eighty-five patients aged over 20 years and diagnosed with prehypertension or mild hypertension were randomly assigned to an advice-only comparison group (C group, n=28), a Dietary Approaches to Stop Hypertension (DASH) diet education group (D group, n=30), or a DASH and home-based exercise group (D+Ex group, n=27). The intervention lasted for 8 weeks. The primary outcome was the difference in office systolic blood pressure (SBP) before and after the study period (Trial registry at ClinicalTrials.gov, NCT01637909). RESULTS: Seventy-two participants (87.8%) completed the trial. The degree of change in office SBP did not significantly differ among the intervention groups; however, the D+Ex group demonstrated a tendency toward decreased SBP. Upon analysis of 24-hour ambulatory BP measurements, daytime ambulatory SBP was significantly lower in the D+Ex group (134 mmHg; 95% confidence interval [CI], 131 to 137; p=0.011) than in the C group (139.5 mmHg; 95% CI, 130.9 to 137), and daytime ambulatory SBP was significantly decreased in the D+Ex group (−5.2 mmHg; 95% CI, −8.3 to −2.1; p=0.011) compared to the C group (0.4 mmHg, 95% CI, −2.5 to 3.3). CONCLUSIONS: In conclusion, lifestyle modification emphasizing both diet and exercise was effective for lowering BP and should be favored over diet-only modifications.
Blood Pressure ; Diet ; Education ; Humans ; Hypertension ; Life Style ; Prehypertension

BACKGROUND/OBJECTIVES: A pivotal role of oxidative stress has been emphasized in the pathogenesis as well as in the disease progression of Parkinson's disease (PD). We aimed at investigating serum levels of antioxidant vitamins and elucidating whether they could be associated with the pathogenesis and progression of PD. MATERIALS/METHODS: Serum levels of retinol, α- and γ-tocopherols, α- and β-carotenes, lutein, lycopene, zeaxanthin and β-cryptoxanthin were measured and compared between 104 patients with idiopathic PD and 52 healthy controls matched for age and gender. In order to examine the relationship between antioxidant vitamins and the disease progression, multiple group comparisons were performed among the early PD (Hoehn and Yahr stage I and II, N = 47), advanced PD (stage III and IV, N = 57) and control groups. Separate correlation analyses were performed between the measured antioxidant vitamins and clinical variables, such as Hoehn and Yahr stage and Unified Parkinson's Disease Rating Scale (UPDRS) motor score. RESULTS: Compared to controls, PD patients had lower levels of α- and β-carotenes and lycopene. α-carotene, β-carotene and lycopene levels were significantly reduced in advanced PD patients relative to early PD patients and were negatively correlated with Hoehn and Yahr stage and UPDRS motor score in PD patients. No significant differences were found in serum levels of retinol, α- and γ-tocopherols, and other carotenoids between PD patients and controls. No significant correlations were found between these vitamin levels and clinical variables in PD patients. CONCLUSIONS: We found that serum levels of some carotenoids, α-carotene, β-carotene and lycopene, were lower in PD patients, and that these carotenoids inversely correlated with clinical variables representing disease progression. Our findings suggest that decreases in serum α-carotene, β-carotene and lycopene may be associated with the pathogenesis as well as progression of PD.
Carotenoids ; Disease Progression ; Humans ; Lutein ; Oxidative Stress ; Parkinson Disease* ; Tocopherols* ; Vitamin A* ; Vitamins ; Zeaxanthins