1.Protein supplementation in South Korea: balancing physiological benefits and metabolic risks for evidence-based guidelines
Kyung Won LEE ; Sangwon CHUNG ; Eunjung KIM ; Yoon Jung PARK ; Kyungho HA
Journal of Nutrition and Health 2026;59(2):159-175
Dietary protein is a crucial macronutrient for systemic homeostasis, and the global interest in protein supplements has surged because of their roles in muscle synthesis, immune function, and sarcopenia prevention. In South Korea, the proportion of energy derived from protein has increased steadily over the past decade, reflecting a significant shift in dietary patterns toward greater reliance on protein. Concurrently, a wide range of protein- and amino acidbased processed foods and dietary supplements has been developed and actively consumed.Nevertheless, comprehensive data on the prevalence of protein supplement users, their characteristics across different life stages, and the contribution of supplements to total daily protein requirements are lacking. Unlike other macronutrients, the human body lacks a dedicated reservoir for protein storage, necessitating a continuous dietary supply to support protein turnover, particularly for older adults facing anabolic resistance and individuals with high physical demands. Although clinical evidence highlights that protein supplementation, particularly when combined with resistance exercise, effectively improves muscle mass and physical performance, the magnitude of these benefits remains inconsistent across different life stages and protein sources. Conversely, emerging concerns about the potential metabolic risks from chronic overconsumption suggest that the validity and safety of protein supplementation are unclear, highlighting the need for a precision nutrition approach. Thus, this review evaluates the status of protein supplement intake among Koreans, synthesizes evidence on its physiological benefits and drawbacks and examines international trends and regulatory frameworks. Developed as part of the technical assessment for the 2025 revision of the Dietary Reference Intakes for Koreans, this review addresses the current lack of longterm safety data on chronic protein overconsumption. It provides a foundational framework for evidence-based dietary guidelines and serves as a critical scientific basis for establishing future tolerable upper intake levels and nutrition policies for protein supplement use in Korea.
2.Electrical Stimulation Using a Low-Frequency and Low-Intensity Alternating Current Modulates Type I Procollagen Production and MMP-1Expression in Dermal Fibroblasts
Bo Mi KANG ; Jung Min AHN ; Jieun KIM ; Kyungho PAIK ; Bo Ri KIM ; Dong Hun LEE ; Sang Woong YOUN ; Keun-Yong EOM ; Chong Won CHOI
Annals of Dermatology 2025;37(3):152-161
Background:
Despite various therapeutic modalities for keloids have been introduced; however, their therapeutic effects are limited. Therefore, the development of a new approach for inhibiting collagen production by scar fibroblasts is needed.
Objective:
To investigate the effect of electrical stimulation using a low-frequency and low-intensity alternating current on collagen and MMP-1 levels in human dermal fibroblasts.
Methods:
Low-frequency (20 kHz) and low-intensity (1 V/cm) electrical stimulations were applied to primary dermal fibroblasts. The production of type I procollagen and expression of matrix metalloproteinase-1 were evaluated. Transcriptomic analyses were conducted to explore the possible modes of action of electrical stimulation.
Results:
Electrical stimulation effectively suppressed type I procollagen production and increased MMP-1 expression. In addition, transcriptomic analyses revealed that electrical stimulation altered the gene expression associated with membrane permeability and the structure of cellular membranes. Validation using real-time polymerase chain reaction revealed that electrical stimulation significantly altered the expression of mechanosensitive ion channels (PIEZO2) and membrane-bound protein organizing caveolae (CAVIN2).
Conclusion
Electrical stimulation using low-frequency and low-intensity alternating currents effectively modulates extracellular matrix homeostasis by altering the cellular membrane structure and function. Our findings suggest a promising therapeutic approach for the management of keloids and hypertrophic scars.
3.Polyunsaturated Fatty Acids and Skin Cancer: Two-Sample Mendelian Randomization Study
Gahyun KIM ; Bo Ri KIM ; Kyungho PAIK ; Seon-Pil JIN ; Hyunsun PARK ; Woojae MYUNG ; Jin-Ku LEE ; Chong Won CHOI ; Jinho KIM
Annals of Dermatology 2025;37(6):363-376
Background:
Observational studies have suggested associations between dietary polyunsaturated fatty acids (PUFAs) and cancer risk; however, causal inference regarding skin cancer remains limited due to potential recall bias, confounding, and reverse causation.
Objective:
This study aimed to evaluate the causal association between genetically predicted circulating PUFA levels and the risk of skin cancers, including basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma.
Methods:
We conducted a 2-sample Mendelian randomization (MR) study using genome-wide association study summary statistics from the UK Biobank (PUFAs, n=115,006) and the FinnGen consortium (BCC, n=26,272; SCC, n=4,663; melanoma, n=5,753). Genetic instruments were derived for omega-3, docosahexaenoic acid, omega-6, linoleic acid, and the omega-6:3 ratio.Multiple MR methods—including inverse-variance weighted, MR-Egger, weighted median, weighted mode, and MR-PRESSO—were applied to test for consistency and assess pleiotropy and heterogeneity.
Results:
A higher genetically predicted linoleic acid to total fatty acid ratio was associated with a significantly lower risk of BCC and SCC. Conversely, higher genetically proxied serum omega-3 levels were associated with increased risks of BCC, SCC, and melanoma. The risk effect on SCC was attenuated upon exclusion of rs174528, a variant in the fatty acid desaturase 1 (FADS1) gene, suggesting a role for endogenous PUFA metabolism in carcinogenesis.
Conclusion
This MR analysis supports a causal role of circulating PUFAs in skin cancer development and highlights the importance of FADS-mediated endogenous PUFA metabolism. These findings provide novel insights into the genetic and metabolic underpinnings of skin cancer susceptibility.
4.Clinical consequence of hypophosphatemia during antiviral therapy for chronic hepatitis B
Mee Yeon PARK ; Hojin JEON ; Kyungho PARK ; Junseok JEON ; Minsu PARK ; Sang Ah CHI ; Kyunga KIM ; Dong Hyun SINN ; Jung Eun LEE ; Geum-Youn GWAK ; Wooseong HUH ; Yoon-Goo KIM ; Hye Ryoun JANG
Kidney Research and Clinical Practice 2025;44(1):123-131
Antiviral therapy is an essential treatment for chronic hepatitis B (CHB) infection. Although hypophosphatemia is an important adverse effect of antiviral agents, its clinical significance remains unclear. We investigated the incidence and clinical consequences of hypophosphatemia in a large cohort of CHB patients. Methods: This retrospective cohort study included CHB patients who started antiviral therapy between 2005 and 2015 and continued it for at least 1 year. Patients with decompensated liver cirrhosis, diabetes mellitus, hypertension, concomitant diuretic administration, and end-stage renal disease were excluded. The primary outcome was a change in renal function. Secondary outcomes included the incidence of infection and changes in serum potassium, uric acid, and total carbon dioxide (tCO2). Results: Among the 4,335 patients, hypophosphatemia developed in 75 (1.7%). During the median 2-year follow-up period, patients with hypophosphatemia showed a lower estimated glomerular filtration rate than those in the control group. The incidence of infection and changes in serum potassium, uric acid, and tCO2 were similar between groups. Conclusion: Hypophosphatemia was associated with a renal function decline in patients with CHB receiving antiviral therapy.
5.Differences of nutritional intake habits and Dietary Inflammatory Index score between occupational classifications in the Korean working population
Seung Hee WOO ; Yangwoo KIM ; Kyungho JU ; Juhyeong KIM ; Jaechul SONG ; Soo-Jin LEE ; Jeehee MIN
Annals of Occupational and Environmental Medicine 2024;36(1):e5-
Human nutrient intake is closely related to the conditions of their workplace. This study used data from the Korean National Health and Nutritional Examination Survey (KNHANES) conducted between 2016 and 2020. The study population comprised individuals aged 19 to 65 years who were engaged in paid work, excluding soldiers (total = 12,201, male = 5,872, female = 6,329). The primary outcome of interest was the Dietary Inflammatory Index (DII) score, which was calculated using dietary intake data. Generalized linear models were used for statistical analyses. Pink-collar workers had higher DII scores, indicating a potentially higher inflammatory diet than white-collar workers (mean: 2.18 vs. 1.89, DII scores and dietary patterns differed among occupational groups and genders.
6.The impact of long working hours on daily sodium intake
Kyungho JU ; Yangwoo KIM ; Seung Hee WOO ; Juhyeong KIM ; Inah KIM ; Jaechul SONG ; Soo-Jin LEE ; Jeehee MIN
Annals of Occupational and Environmental Medicine 2024;36(1):e9-
Long working hours are associated with an increased risk of cardiovascular disease, yet the underlying mechanism(s) remain unclear. The study examines how occupational factors like working hours, shift work, and employment status correlate with dietary choices and sodium intake, impacting hypertension risk. This study used data from the Korea National Health and Nutrition Examination Survey conducted between 2013 and 2020. The dataset included 8,471 respondents, all of whom were wage workers aged 20 or older and reported working at least 36 hours per week. Individuals who have been previously diagnosed with or are currently diagnosed with hypertension, diabetes, or dyslipidemia were excluded. The average daily sodium intake was assessed via a 24-hour dietary recall method. Average weekly working hours were categorized into 3 groups: 36–40 hours, 41–52 hours, and over 52 hours. Multiple logistic regression models were used. Study findings revealed that 83.7% of participants exceeded the recommended daily sodium intake of 2 g set by the World Health Organization. After adjusting for confounding factors, a positive correlation was observed between average working hours and daily sodium intake. Among males, statistical significance was found in the group with average weekly working hours of 41–52 hours (prevalence ratio [PR]: 1.17; 95% confidence interval [CI]: 1.05–1.30) and the group exceeding 52 hours (PR: 1.22; 95% CI: 1.09–1.38) when comparing the fourth quartile of daily sodium intake to the combined quartiles of Q1, Q2, and Q3. Among females, no significance was noted. Long working hours were associated with increased sodium intake, primarily among male workers. This connection is likely attributed to having less time for home-cooked meals, resulting in higher fast food consumption and dining out. A workplace intervention promoting healthy eating and reducing stress is essential to lower sodium consumption and mitigate hypertension risk.
7.Differences of nutritional intake habits and Dietary Inflammatory Index score between occupational classifications in the Korean working population
Seung Hee WOO ; Yangwoo KIM ; Kyungho JU ; Juhyeong KIM ; Jaechul SONG ; Soo-Jin LEE ; Jeehee MIN
Annals of Occupational and Environmental Medicine 2024;36(1):e5-
Human nutrient intake is closely related to the conditions of their workplace. This study used data from the Korean National Health and Nutritional Examination Survey (KNHANES) conducted between 2016 and 2020. The study population comprised individuals aged 19 to 65 years who were engaged in paid work, excluding soldiers (total = 12,201, male = 5,872, female = 6,329). The primary outcome of interest was the Dietary Inflammatory Index (DII) score, which was calculated using dietary intake data. Generalized linear models were used for statistical analyses. Pink-collar workers had higher DII scores, indicating a potentially higher inflammatory diet than white-collar workers (mean: 2.18 vs. 1.89, DII scores and dietary patterns differed among occupational groups and genders.
8.The impact of long working hours on daily sodium intake
Kyungho JU ; Yangwoo KIM ; Seung Hee WOO ; Juhyeong KIM ; Inah KIM ; Jaechul SONG ; Soo-Jin LEE ; Jeehee MIN
Annals of Occupational and Environmental Medicine 2024;36(1):e9-
Long working hours are associated with an increased risk of cardiovascular disease, yet the underlying mechanism(s) remain unclear. The study examines how occupational factors like working hours, shift work, and employment status correlate with dietary choices and sodium intake, impacting hypertension risk. This study used data from the Korea National Health and Nutrition Examination Survey conducted between 2013 and 2020. The dataset included 8,471 respondents, all of whom were wage workers aged 20 or older and reported working at least 36 hours per week. Individuals who have been previously diagnosed with or are currently diagnosed with hypertension, diabetes, or dyslipidemia were excluded. The average daily sodium intake was assessed via a 24-hour dietary recall method. Average weekly working hours were categorized into 3 groups: 36–40 hours, 41–52 hours, and over 52 hours. Multiple logistic regression models were used. Study findings revealed that 83.7% of participants exceeded the recommended daily sodium intake of 2 g set by the World Health Organization. After adjusting for confounding factors, a positive correlation was observed between average working hours and daily sodium intake. Among males, statistical significance was found in the group with average weekly working hours of 41–52 hours (prevalence ratio [PR]: 1.17; 95% confidence interval [CI]: 1.05–1.30) and the group exceeding 52 hours (PR: 1.22; 95% CI: 1.09–1.38) when comparing the fourth quartile of daily sodium intake to the combined quartiles of Q1, Q2, and Q3. Among females, no significance was noted. Long working hours were associated with increased sodium intake, primarily among male workers. This connection is likely attributed to having less time for home-cooked meals, resulting in higher fast food consumption and dining out. A workplace intervention promoting healthy eating and reducing stress is essential to lower sodium consumption and mitigate hypertension risk.
9.Differences of nutritional intake habits and Dietary Inflammatory Index score between occupational classifications in the Korean working population
Seung Hee WOO ; Yangwoo KIM ; Kyungho JU ; Juhyeong KIM ; Jaechul SONG ; Soo-Jin LEE ; Jeehee MIN
Annals of Occupational and Environmental Medicine 2024;36(1):e5-
Human nutrient intake is closely related to the conditions of their workplace. This study used data from the Korean National Health and Nutritional Examination Survey (KNHANES) conducted between 2016 and 2020. The study population comprised individuals aged 19 to 65 years who were engaged in paid work, excluding soldiers (total = 12,201, male = 5,872, female = 6,329). The primary outcome of interest was the Dietary Inflammatory Index (DII) score, which was calculated using dietary intake data. Generalized linear models were used for statistical analyses. Pink-collar workers had higher DII scores, indicating a potentially higher inflammatory diet than white-collar workers (mean: 2.18 vs. 1.89, DII scores and dietary patterns differed among occupational groups and genders.
10.The impact of long working hours on daily sodium intake
Kyungho JU ; Yangwoo KIM ; Seung Hee WOO ; Juhyeong KIM ; Inah KIM ; Jaechul SONG ; Soo-Jin LEE ; Jeehee MIN
Annals of Occupational and Environmental Medicine 2024;36(1):e9-
Long working hours are associated with an increased risk of cardiovascular disease, yet the underlying mechanism(s) remain unclear. The study examines how occupational factors like working hours, shift work, and employment status correlate with dietary choices and sodium intake, impacting hypertension risk. This study used data from the Korea National Health and Nutrition Examination Survey conducted between 2013 and 2020. The dataset included 8,471 respondents, all of whom were wage workers aged 20 or older and reported working at least 36 hours per week. Individuals who have been previously diagnosed with or are currently diagnosed with hypertension, diabetes, or dyslipidemia were excluded. The average daily sodium intake was assessed via a 24-hour dietary recall method. Average weekly working hours were categorized into 3 groups: 36–40 hours, 41–52 hours, and over 52 hours. Multiple logistic regression models were used. Study findings revealed that 83.7% of participants exceeded the recommended daily sodium intake of 2 g set by the World Health Organization. After adjusting for confounding factors, a positive correlation was observed between average working hours and daily sodium intake. Among males, statistical significance was found in the group with average weekly working hours of 41–52 hours (prevalence ratio [PR]: 1.17; 95% confidence interval [CI]: 1.05–1.30) and the group exceeding 52 hours (PR: 1.22; 95% CI: 1.09–1.38) when comparing the fourth quartile of daily sodium intake to the combined quartiles of Q1, Q2, and Q3. Among females, no significance was noted. Long working hours were associated with increased sodium intake, primarily among male workers. This connection is likely attributed to having less time for home-cooked meals, resulting in higher fast food consumption and dining out. A workplace intervention promoting healthy eating and reducing stress is essential to lower sodium consumption and mitigate hypertension risk.

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