This review summarizes the establishment of the 2025 Dietary Reference Intakes for Koreans (KDRIs), the third national standard for nutrient reference values in Korea. The 2025KDRIs build on lessons from revisions in 2010, 2015, and 2020, and chart a path forward by addressing 4 priorities: upgrading the scientific evidence base through systematic evaluation, strengthening intake monitoring using national survey data, advancing international harmonization, and responding to changes in the nutrition and health environment, including those associated with the coronavirus disease 2019 (COVID-19) pandemic. The scientific basis of the KDRIs was advanced by systematically evaluating the findings across exposure indicators, health assessment indicators, and the health outcomes, and reorganizing the indicators to estimate the nutrient requirements. Adequate Intake was set using explicit criteria when an Estimated Average Requirement could not be derived, data gaps, uncertain outcomes, and limited representativeness were documented. Key inputs, including coefficients of variation and uncertainty factors, as well as life stage estimation procedures, were re-evaluated in alignment with current evidence and international standards. The 2025 KDRIs incorporate intake evidence from the Korea National Health and Nutrition Examination Survey to inform policy and practice and support intake monitoring. For international harmonization, the NUQUEST-based literature framework was updated, and recent DRIs from other countries were compared. The shifts in anthropometric characteristics and dietary intake patterns observed during the COVID-19 pandemic were considered to reflect a changing context. The review identified remaining challenges for future revisions, including validating Koreanspecific indicators, developing evidence for infants and older adults, stronger translation of reference values into policy and practice, prioritizing of nutrients for future review within the 5-year revision cycle. Together, these advances will position the 2025 KDRIs as a science-based national reference integrating policy, practice, and evidence to support implementation aimed at improving nutritional status and healthy life expectancy in Korea.

Purpose: This study was conducted to revise the Nutrition Quotient for Preschool children (NQ-P), a tool for evaluating the overall dietary quality and eating behavior among Korean preschool-aged children. Methods: At the first stage, 20 items for assessing dietary behavior were selected based on the previous NQ-P checklist, incorporating the results of the Seventh Korea National Health and Nutrition Examination Survey, national nutrition policies, dietary guidelines, and recent literature reviews. A pilot study was conducted with 100 preschool children residing in Seoul and Gyeonggi Province, using an 18-item checklist. After exploratory factor analysis and expert consultation, 15 items were finalized for use in nationwide survey checklists. The nationwide survey was conducted with a stratified sample of 800 preschool children across six metropolitan cities. Confirmatory factor analysis was used to revise the NQ-P 2021 and make it suitable for the structural equation model. Results: The NQ-P 2021 was developed using 15 checklist items organized into three factors:balance (7 items), moderation (4 items), and practice (4 items). The standardized path coefficients were used as item weights to determine the nutrition quotients. The weights of balance, moderation, and practice were 0.40, 0.15, and 0.45, respectively. In the nationwide survey, the mean NQ-P 2021 score was 59.67. The average scores for balance, moderation, and practice were 51.00, 62.45, and 66.46, respectively. Conclusion The revised NQ-P 2021 provides a validated and practical tool for assessing the dietary quality and eating behaviors of preschool children in Korea.

Objectives: Assessing healthcare quality at the national level is essential for evaluating health system performance and identifying areas requiring improvement. This study examined long-term trends in healthcare quality in Korea from 2008 to 2023 using internationally comparable indicators. Methods: We conducted a trend analysis of healthcare quality in Korea using the Organization for Economic Cooperation and Development (OECD) Health Care Quality and Outcomes framework and quality indicators. Indicators across multiple domains, including acute care, primary care, prescribing in primary care, mental healthcare, and patient experiences, were analyzed and compared with OECD averages. Results: Healthcare quality in Korea improved across several domains. Thirty-day mortality for acute myocardial infarction decreased from 14.2% in 2008 to 10.2% in 2023, while mortality for ischemic stroke declined from 8.7% to 5.5%. Avoidable hospitalizations decreased substantially, with hospitalizations for chronic obstructive pulmonary disease declining by 59.7%. The proportion of patients with diabetes receiving cholesterol-lowering treatment increased from 44.1% to 82.5%. However, the proportion of broad-spectrum antibiotic prescriptions remained substantially higher than the OECD average (40.3 vs. 15.5%). In mental healthcare, excess mortality ratios increased from 4.3 in 2010 to 4.9 in 2023 for schizophrenia and from 3.5 to 4.3 for bipolar disorder, while post-discharge suicide rates showed little improvement. Patient experience indicators related to patient-physician communication improved and approached OECD averages. Conclusions Healthcare quality in Korea improved substantially between 2008 and 2023, particularly in acute care outcomes and chronic disease management. However, persistent challenges remain in areas such as antibiotic use, polypharmacy, and mental healthcare. These findings provide internationally comparable evidence to inform future health policy and healthcare quality improvement efforts.

Objectives: Ischemic stroke is influenced by long-term metabolic and renal deterioration; however, many risk prediction frameworks rely on single time-point measurements. We examined whether multi-period patterns in national health screening indicators are associated with incident ischemic stroke in Korea. Methods: Using customized National Health Insurance Service data with 3 biennial screenings (P1: 2013–2014; P2: 2015–2016; P3: 2017–2018), we identified incident ischemic stroke during 2019–2023 (Korean Standard Classification of Diseases-7 I63). After applying eligibility criteria and excluding individuals with missing screening values, we performed 1:1 propensity score matching on sex, 1-year age strata, and insurance type (97 454 matched pairs; n=194 908). Multi-period indicators included waist circumference increase ≥10%, sustained blood pressure ≥130/80 mmHg, sustained fasting glucose ≥126 mg/dL, proteinuria progression, and creatinine elevation in ≥2 periods (sex-specific thresholds). Associations were evaluated using conditional logistic regression; a comparator model used P3-only indicators. Results: In the multi-period model, stroke was associated with waist circumference increase ≥10% (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.01 to 1.08), sustained blood pressure ≥130/80 mmHg (OR, 1.34; 95% CI, 1.31 to 1.37), sustained fasting glucose ≥126 mg/dL (OR, 1.66; 95% CI, 1.60 to 1.73), creatinine elevation in ≥2 periods (OR, 1.08; 95% CI, 1.06 to 1.10), and proteinuria progression (OR, 1.36; 95% CI, 1.32 to 1.39). In the P3-only model, all single-time-point indicators were associated with incident stroke (ORs, 1.08 to 1.47). Conclusions Multi-year patterns in metabolic screening indicators were associated with incident ischemic stroke. Repeated health screening measurements may complement single time-point assessments and support continuous risk-factor monitoring and patient-centered prevention.

Objective: In this study, we aimed to investigate the incidence and risk factors for interstitial nephritis in patients with ankylosing spondylitis (AS). Methods: We retrospectively analyzed the claims records of patients diagnosed with AS in Korea’s Health Insurance Review and Assessment Service Database between 2016 and 2019. The Assessment of Spondyloarthritis International Society nonsteroidal anti-inflammatory drugs (NSAIDs) intake score was used to calculate the NSAID dosage over 1 year after AS diagnosis. The incidence rate of interstitial kidney disease was calculated as the number of events per 1,000 person-years. The risks associated with sex, age, Charlson Comorbidity Index, comorbidities, and concomitant medications were assessed using the Cox proportional hazards model, with results presented as hazard ratios (HRs) and 95% confidence intervals (CIs). Results: In total, 11,749 patients with AS were included in this study. Of these, 79 patients had interstitial nephritis, with an incidence rate of 2.50 per 1,000 person-years. In multivariable analysis, female sex (HR, 2.44; 95% CI, 1.56~3.83), hypertension (HR, 2.08; 95% CI, 1.15~3.76), and renal failure (HR, 3.70; 95% CI, 1.30~10.55) showed significant associations. However, NSAID use in the first year after AS diagnosis was not associated with interstitial nephritis occurrence. Conclusion The incidence of interstitial nephritis in patients with AS was 2.50 per 1,000 person-years, with female sex and comorbidities identified as significant risk factors. However, NSAID use during the first year after AS diagnosis was not associated with interstitial nephritis development.

Purpose: This study employed latent class analysis (LCA) to classify medical students based on their pre-admission characteristics and examine differences in academic performance, mental health, and post-graduation career paths. Methods: A total of 314 medical students who matriculated from 2015–2018 at a Korean medical school participated for this study. LCA was performed with their gender, region of origin, admission type, and gap years (i.e., a period for retaking the college entrance examination) as classification variables. Mental health was assessed using BDI-II (Beck Depression Inventory-II), SSI-Beck (Scale for Suicidal Ideation-Beck), and K-Scale (Korean Internet Addiction Scale). Academic outcomes and career paths were compared across latent classes through analysis of variance and regression analyses. Results: Three distinct latent classes were identified in the total sample (n=314): the rolling admission–regional talent group (25.0% of the total sample), the regular admission–male retaker group (57.3%), and the non-local female group (17.7%). The regular admission-male retaker group showed significantly higher internet over- dependency levels (p<0.001), lower academic performance (p<0.001), and higher grade repetition rates (p<0.05) than the others. The rolling admission-regional talent group had the highest proportion of students working at their alma mater-affiliated hospitals (p<0.05). Conclusion The research findings could present practical implications to the medical school systems because this research analyzed the mental health status, academic performance, and career paths based on the admission types of medical school students. Furthermore, the results imply that a specific policy and/or a student support system should be required for medical students’ achievement and their successful transition to career.

A 76-year-old male presented with dizziness and disequilibrium. Magnetic resonance imaging revealed an acute ischemic stroke in the left anterior inferior cerebellar artery (AICA) territory. Three days after admission the patient developed peripheral facial palsy with no radiological exacerbation of the infarction. He was managed with antiplatelet therapy and supportive care. Both the facial palsy and initial cerebellar symptoms resolved within 1 month. This case highlights delayed facial palsy as a rare presentation of AICA infarction.

A unified consensus statement on medication-related osteonecrosis of the jaw (MRONJ) has not yet been established among the Asian member countries or regions of the Asian Federation of Osteoporosis Societies (AFOS). This study aimed to develop a consensus on MRONJ in patients with osteoporosis across these countries and regions. In this study, the term “Asia-Pacific” refers specifically to the Asian member countries and regions of AFOS. A structured survey consisting of nine MRONJ-related questions was distributed across 10 countries and regions to assess the level of agreement and summarize regional perspectives. In addition, a manual literature review and voting were conducted to evaluate the current evidence on MRONJ. The key aspects of MRONJ, including definition, staging, diagnosis, pathogenesis, risk factors, management, and prevention, were generally consistent among the AFOS countries and regions. The annual incidence and incidence rate of MRONJ associated with low-dose antiresorptive therapy in patients with osteoporosis ranged from 0.025% to 0.136% and 21 to 283 cases per 100,000 person-years, respectively. However, evidence regarding the benefits of drug discontinuation before dental surgery, such as tooth extraction, remains insufficient. Large-scale, multinational studies across AFOS countries and regions are warranted to determine the incidence of MRONJ better and evaluate the impact of antiresorptive drug discontinuation before dental procedures. These findings may contribute to the devel opment of effective evidence-based strategies for preventing MRONJ in patients with osteoporosis.

Purpose: This study was performed to compare clinical features and emergency department (ED) outcomes between children and adults with non‑typhoidal Salmonella (NTS) gastroenteritis in a single‑center cohort. Methods: We retrospectively reviewed electronic medical records of ED patients with stool multiplex polymerase chain reaction-confirmed NTS at CHA Bundang Medical Center from January 2016 through December 2021. Demographics, presentation, laboratory and imaging findings, microbiology, and treatments were abstracted. Primary outcomes were the high acuity (a Korean Triage and Acuity Scale level 1-2), ED length of stay, and disposition. Results: Of 189 patients, 134 were children and 55 adults. The children had fewer comorbidities (5.2% vs. 56.4%; P < 0.001) and high acuity (children, 0% vs. adults, 14.5%), shorter median ED length of stay (237.0 minutes [interquartile range, 188.0-336.0] vs. 360.0 minutes [335.0-569.0]; difference, 123.0 minutes [95% confidence interval, 85.0-328.0]; P < 0.001), and less frequent hospitalizations to the intensive care unit (children, 0% vs. adults, 14.5%; P < 0.001). Fever (94.8% vs. 63.6%) and hematochezia (37.3% vs. 0%) were more common in the children (Ps < 0.001), while adults had higher frequencies of abdominal pain (87.3% vs. 71.6%; P = 0.020) and enteritis/ileus on radiography (63.3% vs. 45.3%; P = 0.033), and higher median values of segmented white blood cells (79.0% vs. 69.4%; P = 0.010) and C‑reactive protein concentration (7.2 vs. 6.3mg/dL; P < 0.001). Ceftriaxone was more commonly used in the children (children, 72.7% vs. adults, 51.9%; P < 0.001). Conclusion Compared with the adults, the children with NTS gastroenteritis presented with lower clinical acuity, shorter ED stays, and no hospitalizations to the intensive care unit, despite more common fever and hematochezia. These findings may support a conservative ED approach in children with careful, indication‑based antibiotic use and highlight opportunities for antimicrobial stewardship.