1.Health Effects of Sugar-Sweetened and Artificially Sweetened Beverages: Umbrella Review and Evidence-Based Consensus Statement of the Korean Diabetes Association and the Korean Nutrition Society
Jong Han CHOI ; SuJin SONG ; Soo Kyoung KIM ; Jae Won CHO ; Jae Hyun BAE ; Shinje MOON ; Jeong Hyun LIM ; YeonHee LEE ; Ji-Yun HWANG ; YoonJu SONG ; Sang Soo KIM
Diabetes & Metabolism Journal 2026;50(1):32-46
Background:
Excess intake of added sugars contributes to obesity, type 2 diabetes mellitus (T2DM), cardiovascular disease (CVD), and premature mortality. Sugar-sweetened beverages (SSBs), the main source of added sugars, are consistently linked to adverse outcomes. Artificially sweetened beverages (ASBs) have been suggested as short-term substitutes, but evidence regarding benefits and harms remains inconclusive, and guidance is lacking.
Methods:
This consensus statement draws on a structured evidence review combining two approaches: an updated meta-analysis of randomized controlled trials (RCTs) assessing short- to intermediate-term effects of replacing SSBs with ASBs on weight and metabolic outcomes; and an umbrella review of systematic reviews of cohort studies evaluating long-term associations of SSBs and ASBs with major outcomes, including mortality, CVD, and T2DM.
Results:
In 14 RCTs (3–76 weeks), replacing SSBs with ASBs produced modest reductions in body weight (–0.73 kg) and body fat (–0.72%), with inconsistent effects on glycemic and cardiometabolic markers. Evidence from 20 systematic reviews of cohorts (up to 34 years follow-up) showed that higher intake of both SSBs and ASBs was associated with increased risks of T2DM, CVD, and mortality, with relative risks for ASBs similar to those for SSBs.
Conclusion
ASBs may serve as a short-term substitution for individuals with high SSB intake, particularly those at elevated metabolic risk. However, regular or long-term use is not recommended due to uncertain safety and potential reinforcement of sweet preference. Public health strategies should emphasize reducing both SSBs and ASBs, prioritizing water and unsweetened beverages as the ultimate goal.
2.Nutrition Status and Comorbidities Are Important Factors Associated With Mortality During Anti-Tuberculosis Treatment
Oh Beom KWON ; Hyung Woo KIM ; Ju Sang KIM ; Eung Gu LEE ; Yeonhee PARK ; Sung Soo JUNG ; Jin Woo KIM ; Jee Youn OH ; Sang Haak LEE ; Seunghoon KIM ; Sun-Hyung KIM ; Jiwon LYU ; Yousang KO ; Sun Jung KWON ; Ganghee CHAE ; Jinsoo MIN
Journal of Korean Medical Science 2025;40(17):e73-
Background:
The increasing incidence and mortality rates of tuberculosis among older individuals who suffer from multiple morbidities and are vulnerable to malnutrition are major obstacles to efforts to eradicate tuberculosis in the Republic of Korea. Herein, we identified the factors associated with mortality during anti-tuberculosis treatment in patients with pulmonary tuberculosis.
Methods:
We conducted a case-control study and extracted data from the database of a multi-center prospective observational cohort study in Korea. Among the participants with rifampicin-susceptible pulmonary tuberculosis, the survival group was defined as those who successfully completed treatment within one year, whereas the mortality group was defined as those who died during treatment. Univariable and multivariable logistic regression analyses were performed to identify factors associated with TB mortality.
Results:
Among 1,119 participants with pulmonary TB registered between 2019 and 2021, 799 and 59 were grouped in the survival and mortality groups, respectively. Age, positive smear results, alarming symptoms, nutrition risk score, Charlson comorbidity index score, and initial standard treatment regimen were significant based on univariable analysis and were selected for the multivariable logistic regression model. Nutrition risk score (adjusted odds ratio, 2.44; 95% confidence interval, 1.72–3.48) and Charlson comorbidity index score (adjusted odds ratio, 1.62; 95% confidence interval, 1.35–1.94) remained statistically significant in the multivariate analysis.
Conclusion
Nutritional status and comorbidities at baseline were identified as important factors associated with mortality in patients with pulmonary tuberculosis.
3.Nutrition Status and Comorbidities Are Important Factors Associated With Mortality During Anti-Tuberculosis Treatment
Oh Beom KWON ; Hyung Woo KIM ; Ju Sang KIM ; Eung Gu LEE ; Yeonhee PARK ; Sung Soo JUNG ; Jin Woo KIM ; Jee Youn OH ; Sang Haak LEE ; Seunghoon KIM ; Sun-Hyung KIM ; Jiwon LYU ; Yousang KO ; Sun Jung KWON ; Ganghee CHAE ; Jinsoo MIN
Journal of Korean Medical Science 2025;40(17):e73-
Background:
The increasing incidence and mortality rates of tuberculosis among older individuals who suffer from multiple morbidities and are vulnerable to malnutrition are major obstacles to efforts to eradicate tuberculosis in the Republic of Korea. Herein, we identified the factors associated with mortality during anti-tuberculosis treatment in patients with pulmonary tuberculosis.
Methods:
We conducted a case-control study and extracted data from the database of a multi-center prospective observational cohort study in Korea. Among the participants with rifampicin-susceptible pulmonary tuberculosis, the survival group was defined as those who successfully completed treatment within one year, whereas the mortality group was defined as those who died during treatment. Univariable and multivariable logistic regression analyses were performed to identify factors associated with TB mortality.
Results:
Among 1,119 participants with pulmonary TB registered between 2019 and 2021, 799 and 59 were grouped in the survival and mortality groups, respectively. Age, positive smear results, alarming symptoms, nutrition risk score, Charlson comorbidity index score, and initial standard treatment regimen were significant based on univariable analysis and were selected for the multivariable logistic regression model. Nutrition risk score (adjusted odds ratio, 2.44; 95% confidence interval, 1.72–3.48) and Charlson comorbidity index score (adjusted odds ratio, 1.62; 95% confidence interval, 1.35–1.94) remained statistically significant in the multivariate analysis.
Conclusion
Nutritional status and comorbidities at baseline were identified as important factors associated with mortality in patients with pulmonary tuberculosis.
4.Nutrition Status and Comorbidities Are Important Factors Associated With Mortality During Anti-Tuberculosis Treatment
Oh Beom KWON ; Hyung Woo KIM ; Ju Sang KIM ; Eung Gu LEE ; Yeonhee PARK ; Sung Soo JUNG ; Jin Woo KIM ; Jee Youn OH ; Sang Haak LEE ; Seunghoon KIM ; Sun-Hyung KIM ; Jiwon LYU ; Yousang KO ; Sun Jung KWON ; Ganghee CHAE ; Jinsoo MIN
Journal of Korean Medical Science 2025;40(17):e73-
Background:
The increasing incidence and mortality rates of tuberculosis among older individuals who suffer from multiple morbidities and are vulnerable to malnutrition are major obstacles to efforts to eradicate tuberculosis in the Republic of Korea. Herein, we identified the factors associated with mortality during anti-tuberculosis treatment in patients with pulmonary tuberculosis.
Methods:
We conducted a case-control study and extracted data from the database of a multi-center prospective observational cohort study in Korea. Among the participants with rifampicin-susceptible pulmonary tuberculosis, the survival group was defined as those who successfully completed treatment within one year, whereas the mortality group was defined as those who died during treatment. Univariable and multivariable logistic regression analyses were performed to identify factors associated with TB mortality.
Results:
Among 1,119 participants with pulmonary TB registered between 2019 and 2021, 799 and 59 were grouped in the survival and mortality groups, respectively. Age, positive smear results, alarming symptoms, nutrition risk score, Charlson comorbidity index score, and initial standard treatment regimen were significant based on univariable analysis and were selected for the multivariable logistic regression model. Nutrition risk score (adjusted odds ratio, 2.44; 95% confidence interval, 1.72–3.48) and Charlson comorbidity index score (adjusted odds ratio, 1.62; 95% confidence interval, 1.35–1.94) remained statistically significant in the multivariate analysis.
Conclusion
Nutritional status and comorbidities at baseline were identified as important factors associated with mortality in patients with pulmonary tuberculosis.
5.Nutrition Status and Comorbidities Are Important Factors Associated With Mortality During Anti-Tuberculosis Treatment
Oh Beom KWON ; Hyung Woo KIM ; Ju Sang KIM ; Eung Gu LEE ; Yeonhee PARK ; Sung Soo JUNG ; Jin Woo KIM ; Jee Youn OH ; Sang Haak LEE ; Seunghoon KIM ; Sun-Hyung KIM ; Jiwon LYU ; Yousang KO ; Sun Jung KWON ; Ganghee CHAE ; Jinsoo MIN
Journal of Korean Medical Science 2025;40(17):e73-
Background:
The increasing incidence and mortality rates of tuberculosis among older individuals who suffer from multiple morbidities and are vulnerable to malnutrition are major obstacles to efforts to eradicate tuberculosis in the Republic of Korea. Herein, we identified the factors associated with mortality during anti-tuberculosis treatment in patients with pulmonary tuberculosis.
Methods:
We conducted a case-control study and extracted data from the database of a multi-center prospective observational cohort study in Korea. Among the participants with rifampicin-susceptible pulmonary tuberculosis, the survival group was defined as those who successfully completed treatment within one year, whereas the mortality group was defined as those who died during treatment. Univariable and multivariable logistic regression analyses were performed to identify factors associated with TB mortality.
Results:
Among 1,119 participants with pulmonary TB registered between 2019 and 2021, 799 and 59 were grouped in the survival and mortality groups, respectively. Age, positive smear results, alarming symptoms, nutrition risk score, Charlson comorbidity index score, and initial standard treatment regimen were significant based on univariable analysis and were selected for the multivariable logistic regression model. Nutrition risk score (adjusted odds ratio, 2.44; 95% confidence interval, 1.72–3.48) and Charlson comorbidity index score (adjusted odds ratio, 1.62; 95% confidence interval, 1.35–1.94) remained statistically significant in the multivariate analysis.
Conclusion
Nutritional status and comorbidities at baseline were identified as important factors associated with mortality in patients with pulmonary tuberculosis.
6.Combined Effects of Sleep Duration and Physical Activity on Stress in Korean Adolescents: An Analysis of the 2019–2020 Korea National Health and Nutrition Examination Survey
Yeonhee RYU ; Ji Young YOON ; Jung Ah LEE
Korean Journal of Family Practice 2025;15(4):210-216
Background:
Sleep and physical activity are crucial for adolescent health. However, their combined effects on stress remain unclear. This study examined the combined effects of sleep duration and physical activity on stress in Korean adolescents.
Methods:
Data from 918 adolescents aged 12–18 years (502 boys and 416 girls) were analyzed using the 2019–2020 Korea National Health and Nutrition Examination Survey. Participants were classified into four groups based on sleep duration and physical activity levels: active with sufficient sleep, inactive with sufficient sleep, active with insufficient sleep, and inactive with insufficient sleep. Stress was assessed using a single question on the perceived level of stress in daily life. Multivariate logistic regression analysis was performed to evaluate stress levels according to sleep duration and physical activity levels.
Results:
Adolescents in the inactive with insufficient sleep group showed significantly higher stress levels than those in the active with sufficient sleep group (odds ratio [OR], 2.52; 95% confidence interval [CI], 1.37–4.62). Stratified analysis revealed higher stress in boys with insufficient sleep and low activity (OR, 4.90; 95% CI, 1.85–13.00), whereas no significant associations were found in girls (OR, 1.25; 95% CI, 0.57–2.73).
Conclusion
Insufficient sleep with low physical activity is associated with higher stress levels in adolescents, particularly in boys. Adequate sleep and physical activity have been associated with improved health in adolescents.
7.Evaluation of N95 Respirator Fit Changes in Nurses Working in High-risk Airborne Infection Units
Si-Hyeon HAN ; Kyung-Sook CHA ; Hyunsun LEE ; Yeonhee CHOUNG
Korean Journal of healthcare-associated Infection Control and Prevention 2024;29(2):137-145
Background:
Healthcare workers (HCWs) face an increased risk of airborne infections owing to close patient contact and extended shifts. N95 respirators require routine fit testing to ensure effective protection. This study assessed the fit stability of N95 masks among nurses working in airborne infection units, using annual fit tests to observe changes over time.
Methods:
From May 2020 to January 2023, 37 nurses from the high-risk airborne infection units of a university hospital participated in this study. The fit tests followed the Occupational Safety and Health Administration’s Quantitative Fit Testing protocol, and non-parametric statistical analyses were applied. Nurses received formal annual training on N95 mask use and individualized guidance before each fit test.
Results:
In the initial test, 46.0% passed; of these, 15 consistently passed the second test (Group 1, Pass-Pass) and 2 failed (Group 2, Pass-Fail). No significant associations were found between demographic or job factors and the fit test outcomes. Average fit scores decreased from 100.79 (±58.22) initially to 32.25 (±66.54) in the second test, showing variability.
Conclusion
Ongoing training and experience improved fit consistency over time, emphasizing the importance of regular education. Rather than testing annually, targeted testing when selecting a new respirator or performing subsequent facial changes may enhance the protection of HCWs and reduce costs.
8.A Case of Dasatinib Induced Nephrotic Syndrome in a Chronic Myeloid Leukemia Patient with Steroid Dependent Nephrotic Syndrome
Jeongjin LEE ; Nack-Gyun CHUNG ; Yeong Jin CHOI ; Yeonhee LEE
Clinical Pediatric Hematology-Oncology 2024;31(1):5-9
Tyrosine kinase (TK) inhibitors are most common used to treat chronic myeloid leukemia (CML). Several studies describe a range of adverse effects of TK inhibitors on the kidney in adult patients, including nephrotic syndrome. However, there are only a few pediatric case reports on TK inhibitor-associated nephrotic syndrome. We report a case of nephrotic syndrome associated with dasatinib, a type of TK inhibitor, in a child who suffered from both the underlying idiopathic nephrotic syndrome and CML. A 14-year-old Korean boy was diagnosed with steroid dependent nephrotic syndrome at 4 years old and CML at 11 years old. He developed a relapse of nephrotic syndrome after treatment with TK inhibitors, especially dasatinib, which he used for four months. Despite receiving steroid pulse therapy due to his underlying steroid dependent nephrotic syndrome, his proteinuria did not respond. He discontinued dasatinib medication due to the possibility to dasatinib induced nephrotic syndrome.After one week, his nephrotic syndrome improved. The case is important because if a CML patient that has been on a TK inhibitor develops a newly onset nephrotic range proteinuria, TK inhibitor-induced nephrotic syndrome should be included in the differential diagnosis.
9.Development and application of an evaluation tool for school food culture in elementary, middle, and high schools in Gyeonggi Province, South Korea
Meeyoung KIM ; Sooyoun KWON ; Sub-Keun HONG ; Yeonhee KOO ; Youngmi LEE
Nutrition Research and Practice 2024;18(5):746-759
BACKGROUND/OBJECTIVES:
To encourage schools to transform school meal programs to be more educational, it is necessary to evaluate the related environment using a whole school approach. We developed a school food culture evaluation tool to quantitatively evaluate school food culture in Gyeonggi Province, Korea.
SUBJECTS/METHODS:
Based on a literature review, a school food culture evaluation system consisting of areas, subareas, indicators, and questions (scored on a 5-point scale) was constructed. The validity of the tool was reviewed using focus group interviews, the Delphi technique, and a preliminary survey. Subsequently, evaluation tool was applied to elementary, middle, and high schools in Gyeonggi Province. Data from 115 schools were used for the final analysis. This included 64 elementary schools, 29 middle schools, and 22 high schools. At least one respondent from each group—school administrators, teachers, and nutrition teachers (or dietitians)—participated. The results were compared at the school level.
RESULTS:
The evaluation tool consisted of 66 questions in 5 areas (institutional environment, physical environment, educational environment, educational governance, and school meal quality). The total average score for school food culture was 3.83 points (elementary school 3.89 points, middle school 3.76 points, and high school 3.76 points) and did not differ significantly among school levels. Among the 5 evaluation areas, scores were highest for institutional environment (4.43 points) and lowest for physical environment (3.07 points).Scores for educational environment, educational governance, and school meal quality were 3.86, 3.85, and 3.97 points, respectively.
CONCLUSION
It is necessary to improve the physical environment to create a desirable school food culture in Gyeonggi Province. To effectively promote healthy eating, ongoing investment and interventions by local authorities at improving school food culture are needed, with an emphasis on particular factors, such as the eating environment and staff training.
10.Evaluation of N95 Respirator Fit Changes in Nurses Working in High-risk Airborne Infection Units
Si-Hyeon HAN ; Kyung-Sook CHA ; Hyunsun LEE ; Yeonhee CHOUNG
Korean Journal of healthcare-associated Infection Control and Prevention 2024;29(2):137-145
Background:
Healthcare workers (HCWs) face an increased risk of airborne infections owing to close patient contact and extended shifts. N95 respirators require routine fit testing to ensure effective protection. This study assessed the fit stability of N95 masks among nurses working in airborne infection units, using annual fit tests to observe changes over time.
Methods:
From May 2020 to January 2023, 37 nurses from the high-risk airborne infection units of a university hospital participated in this study. The fit tests followed the Occupational Safety and Health Administration’s Quantitative Fit Testing protocol, and non-parametric statistical analyses were applied. Nurses received formal annual training on N95 mask use and individualized guidance before each fit test.
Results:
In the initial test, 46.0% passed; of these, 15 consistently passed the second test (Group 1, Pass-Pass) and 2 failed (Group 2, Pass-Fail). No significant associations were found between demographic or job factors and the fit test outcomes. Average fit scores decreased from 100.79 (±58.22) initially to 32.25 (±66.54) in the second test, showing variability.
Conclusion
Ongoing training and experience improved fit consistency over time, emphasizing the importance of regular education. Rather than testing annually, targeted testing when selecting a new respirator or performing subsequent facial changes may enhance the protection of HCWs and reduce costs.

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