1.Main revisions to carbohydrate intake reference values in the 2025 Dietary Reference Intakes for Koreans
Miae DOO ; YoonJu SONG ; Jeong Hyun LIM ; Ja Young JEON ; Wookyoung KIM
Journal of Nutrition and Health 2026;59(2):148-158
The recommendations for carbohydrate intake were revised in the 2025 Korean Dietary Reference Intakes to reflect updated evidence on chronic disease risk and to clarify the interpretation of the Estimated Average Requirement (EAR) and Recommended Nutrient Intake (RNI). These revisions aim to strengthen both the scientific basis and the practical interpretation of carbohydrate intake guidance across the life course of an individual. For individuals aged 1 year and older, the Acceptable Macronutrient Distribution Range for carbohydrates was lowered from 55–65% of total energy to 50–65%. This adjustment reflects accumulating evidence from prospective cohort studies and meta-analyses indicating that very high carbohydrate intake is associated with an increased risk of adverse health outcomes. In contrast, an intake of approximately 50–55% of total energy is associated with the lowest mortality risk. Importantly, this change does not imply a preference for low-carbohydrate diets, as overall dietary quality, including carbohydrate quality, remains a critical consideration. The EAR (100 g/day) and RNI (130 g/day) are derived from estimates of brain glucose utilization and metabolic adaptation and should be interpreted as physiological minimum intake levels rather than population-based intake targets. In addition, life-stage-specific recommendations were updated based on new evidence, including recalculating the Adequate Intake (AI) for infants (55 g/day for 0–5 months and 85 g/day for 6–11 months) and revising the additional requirements during pregnancy (+35 g/day) and lactation (+55 g/day).Because no Tolerable Upper Intake Level (UL) has been established for total carbohydrate intake, excess intake should be managed through dietary adjustments, including limiting added sugars and refined carbohydrates, ensuring adequate fiber intake, and maintaining overall macronutrient balance. Collectively, these revisions provide an updated evidencebased framework for carbohydrate intake guidance for the Korean population.
2.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.
3.Ultrasonographic evaluation of gastrointestinal wall thickness in Korean raccoon dogs (Nyctereutes procyonoides koreensis)
Yoonju CHOI ; Myeongsu KIM ; Jae-Ik HAN ; Kichang LEE ; Hakyoung YOON
Journal of Veterinary Science 2025;26(6):e84-
Objective:
This study aimed to establish baseline ultrasonographic parameters for GI wall thickness and assess differences based on sex, gastric distension, body weight, and the presence of GI symptoms.
Methods:
A retrospective analysis was conducted on 42 Korean raccoon dogs (35 healthy, seven symptomatic). Total and individual layer thicknesses (mucosa, submucosa, muscularis, and serosa) were measured for the stomach, duodenum, jejunum, ileum (folded and interfolded regions), and colon. Statistical analyses were performed to assess the effects of sex, body weight, gastric distension, and GI symptoms on wall thickness.
Results:
All Korean raccoon dogs exhibited a five-layer GI wall and echogenicity similar to that of domestic dogs. Mean total wall thickness values were: stomach (2.77 ± 0.74 mm), duodenum (2.19 ± 0.31 mm), jejunum (2.06 ± 0.35 mm), ileum (folded, 1.75 ± 0.35 mm, interfolded, 2.31 ± 0.24 mm), and colon (1.06 ± 0.37 mm). Stomach wall thickness was greater in collapsed (3.31 ± 0.37 mm) than in distended (2.15 ± 0.52 mm) states.No statistically significant differences in GI wall thickness were observed based on sex or body weight. Symptomatic Korean raccoon dogs exhibited significant thickening of the duodenum, jejunum, and colon, along with increased mucosal echogenicity, loss of normal wall layering, and intestinal corrugation.
Conclusions
and Relevance: These findings provide essential reference values for GI ultrasonographic evaluation in Korean raccoon dogs, with implications for diagnostic accuracy.
4.Clinical Practice Guidelines for Diagnosis and Non-Surgical Treatment of Primary Frozen Shoulder
Byung Chan LEE ; Gi-Wook KIM ; Keewon KIM ; Nackhwan KIM ; Dong Hwan KIM ; Doo Young KIM ; Du Hwan KIM ; Beom Suk KIM ; Seong Hun KIM ; In Jong KIM ; Hyun Jung KIM ; Yoonju NA ; Kyung Eun NAM ; Sung Gyu MOON ; Chang-Won MOON ; Kyunghoon MIN ; Donghwi PARK ; Myung Woo PARK ; Yong Bok PARK ; Jae Hyeon PARK ; Chul-Hyun PARK ; Hyeng-Kyu PARK ; Yunsoo SOH ; Jaeki AHN ; Seoyon YANG ; Kyeong Eun UHM ; Sun Jae WON ; Yu Hui WON ; Dong Hwan YUN ; Yu Sung YOON ; Jin A YOON ; Byeong-Ju LEE ; Woo Hyung LEE ; Yun Jung LEE ; Jae-Hyun LEE ; Jong Hwa LEE ; Yu Jin IM ; Jae-Young LIM ; Min Cheol CHANG ; Sung Joon CHUNG ; Il Young JUNG ; Sungju JEE ; Kyoung Hyo CHOI ; Jong-Moon HWANG ; Jae-Young HAN
Clinical Pain 2025;24(1):1-26
Objective:
Primary frozen shoulder causes significant pain and progressively restricts shoulder movements. Diagnosis is made clinically based on patient history and physical examination. Management is mainly non-invasive owing to its self-limiting clinical course. However, clinical practice guidelines for frozen shoulder have not yet been developed in Korea. The developed guidelines aim to provide evidence-based recommendations for the diagnosis and treatment of frozen shoulder.
Methods:
A guideline development committee reviewed the literature from four databases (PubMed, Embase, Cochrane Library, and KMbase). Using the Population, Intervention, Comparator, and Outcome (PICO) framework, the committee formulated two backgrounds and 16 key questions to address common clinical concerns. Recommendations were made using the Grading of Recommendations, Assessment, Development, and Evaluation framework.
Results:
Diabetes, thyroid disease, and dyslipidemia significantly increase the risk of developing a frozen shoulder. Although frozen shoulder is often self-limiting, some patients may experience long-term functional disabilities. Ultrasound and magnetic resonance imaging should be used as adjunctive tools alongside clinical diagnosis, and rather than as independent diagnostic methods. Noninvasive approaches, such as medications, physical modalities, exercises, electrical stimulation, and manual therapy, may reduce pain and improve shoulder function. Other noninvasive interventions have limited evidence, and their application should be based on clinical judgment. Intra-articular steroid injections are recommended for treatment, and physiotherapy or hydrodilation with steroid injections can also be beneficial.
Conclusion
These guidelines provide evidence-based recommendations for diagnosing and treating primary frozen shoulder.
5.The Impact of Non-Sugar Sweetener on Health Outcomes in the General Population and Patients with Diabetes
Shinje MOON ; Soo Kyoung KIM ; Jong Han CHOI ; Yoonju SONG ; Jeong Hyun LIM ; Jae Won CHO ; Sang Soo KIM
Journal of Korean Diabetes 2024;25(4):211-216
Non-sugar sweeteners (NSS) are low in calories and can be used in very small amounts. Both the U.S. Food and Drug Administration and Korea Ministry of Food and Drug Safety have stated that consuming NSS within the recommended dosage is not harmful to human health. Nonetheless, the World Health Organization in its 2023 guidelines on NSS use advised the general population against the consumption of NSS as a means of controlling weight and reducing the risk of chronic diseases, including diabetes. However, there is insufficient evidence regarding the health benefits and potential risks of NSS for patients with diabetes. Given the ongoing debate about the efficacy of NSS, the 2023 clinical guidelines of the Korean Diabetes Association recommend minimizing beverages containing sugar or NSS, although NSS may help reduce sugar intake in the short term. This review aims to explore the latest research on the benefits and risks of NSS for the general population and patients with diabetes.
6.The Impact of Non-Sugar Sweetener on Health Outcomes in the General Population and Patients with Diabetes
Shinje MOON ; Soo Kyoung KIM ; Jong Han CHOI ; Yoonju SONG ; Jeong Hyun LIM ; Jae Won CHO ; Sang Soo KIM
Journal of Korean Diabetes 2024;25(4):211-216
Non-sugar sweeteners (NSS) are low in calories and can be used in very small amounts. Both the U.S. Food and Drug Administration and Korea Ministry of Food and Drug Safety have stated that consuming NSS within the recommended dosage is not harmful to human health. Nonetheless, the World Health Organization in its 2023 guidelines on NSS use advised the general population against the consumption of NSS as a means of controlling weight and reducing the risk of chronic diseases, including diabetes. However, there is insufficient evidence regarding the health benefits and potential risks of NSS for patients with diabetes. Given the ongoing debate about the efficacy of NSS, the 2023 clinical guidelines of the Korean Diabetes Association recommend minimizing beverages containing sugar or NSS, although NSS may help reduce sugar intake in the short term. This review aims to explore the latest research on the benefits and risks of NSS for the general population and patients with diabetes.
7.Automated Personalized Self-care Program for Patients With Type 2Diabetes Mellitus: A Pilot Trial *
Gaeun PARK ; Haejung LEE ; Yoonju LEE ; Myoung Soo KIM ; Sunyoung JUNG ; Ah Reum KHANG ; Dongwon YI
Asian Nursing Research 2024;18(2):114-124
Purpose:
Providing continuous self-care support to the growing diabetes population is challenging. Strategies are needed to enhance engagement in self-care, utilizing innovative technologies for personalized feedback. This study aimed to assess the feasibility of the Automated Personalized Self-Care program among type 2 diabetes patients and evaluate its preliminary effectiveness.
Methods:
A parallel randomized pilot trial with qualitative interviews occurred from May 3, 2022, to September 27, 2022. Participants aged 40e69 years with type 2 diabetes and HbA1c ! 7.0% were recruited. The three-month program involved automated personalized goal setting, education, monitoring, and feedback. Feasibility was measured by participants' engagement and intervention usability. Preliminary effectiveness was examined through self-care self-efficacy, self-care behaviors, and health outcomes. Qualitative interviews were conducted with the intervention group.
Results:
A total of 404 patients were screened. Out of the 61 eligible patients, 32 were enrolled, resulting in a recruitment rate of 52.5%. Retention rates at three months were 84.2% and 84.6% in the intervention and control groups, respectively. Among the intervention group, 81.3% satisfied adherence criteria.Mobile application's usability scored 66.25, and participants' satisfaction was 8.06. Intention-to-treat analysis showed improvements in self-measured blood glucose testing, grain intake, and HbA1c in the intervention group. Qualitative content analysis identified nine themes.
Conclusion
Feasibility of the program was verified. A larger randomized controlled trial is needed to determine its effectiveness in self-care self-efficacy, self-care behaviors, and health outcomes among type 2 diabetes patients. This study offers insights for optimizing future trials assessing clinical effectiveness.
8.Influence of Patient Safety Culture, Ethical Nursing Competence, and Nursing Professionalism on the Perception of Disclosure of Patient Safety Incidents among Nurses in Tertiary Hospitals
Journal of Korean Academy of Nursing Administration 2024;30(4):392-403
Purpose:
This study aimed to identify the factors influencing nurses’ perceptions of the disclosure of patient safety incidents in tertiary hospitals.
Methods:
As a descriptive study, data were collected from 315 nurses working in two tertiary hospitals in Busan via structured self-report questionnaires from June 28 to September 3, 2023, through an online survey. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson’s correlation coefficients, and hierarchical regression analysis with SPSS/WIN 27.0.
Results:
Analysis was conducted by controlling for the characteristics of the study participants, which revealed significant differences in their perceptions of the disclosure of patient safety incidents. Ethical nursing competence (β=.30, p<.001) and patient safety culture (β=.15, p=.012) were significant influencing factors on the perception of such disclosure, and the explanatory power of the regression model was 21.0% (F=14.63, p<.001).
Conclusion
To enhance the aforementioned perception among nurses in tertiary hospitals, healthcare institutions should provide learning opportunities to improve their ethical nursing competence. Fostering an organizational culture that promotes and encourages open disclosure of patient safety incidents is also essential.
9.Influence of Patient Safety Culture, Ethical Nursing Competence, and Nursing Professionalism on the Perception of Disclosure of Patient Safety Incidents among Nurses in Tertiary Hospitals
Journal of Korean Academy of Nursing Administration 2024;30(4):392-403
Purpose:
This study aimed to identify the factors influencing nurses’ perceptions of the disclosure of patient safety incidents in tertiary hospitals.
Methods:
As a descriptive study, data were collected from 315 nurses working in two tertiary hospitals in Busan via structured self-report questionnaires from June 28 to September 3, 2023, through an online survey. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson’s correlation coefficients, and hierarchical regression analysis with SPSS/WIN 27.0.
Results:
Analysis was conducted by controlling for the characteristics of the study participants, which revealed significant differences in their perceptions of the disclosure of patient safety incidents. Ethical nursing competence (β=.30, p<.001) and patient safety culture (β=.15, p=.012) were significant influencing factors on the perception of such disclosure, and the explanatory power of the regression model was 21.0% (F=14.63, p<.001).
Conclusion
To enhance the aforementioned perception among nurses in tertiary hospitals, healthcare institutions should provide learning opportunities to improve their ethical nursing competence. Fostering an organizational culture that promotes and encourages open disclosure of patient safety incidents is also essential.
10.The Impact of Non-Sugar Sweetener on Health Outcomes in the General Population and Patients with Diabetes
Shinje MOON ; Soo Kyoung KIM ; Jong Han CHOI ; Yoonju SONG ; Jeong Hyun LIM ; Jae Won CHO ; Sang Soo KIM
Journal of Korean Diabetes 2024;25(4):211-216
Non-sugar sweeteners (NSS) are low in calories and can be used in very small amounts. Both the U.S. Food and Drug Administration and Korea Ministry of Food and Drug Safety have stated that consuming NSS within the recommended dosage is not harmful to human health. Nonetheless, the World Health Organization in its 2023 guidelines on NSS use advised the general population against the consumption of NSS as a means of controlling weight and reducing the risk of chronic diseases, including diabetes. However, there is insufficient evidence regarding the health benefits and potential risks of NSS for patients with diabetes. Given the ongoing debate about the efficacy of NSS, the 2023 clinical guidelines of the Korean Diabetes Association recommend minimizing beverages containing sugar or NSS, although NSS may help reduce sugar intake in the short term. This review aims to explore the latest research on the benefits and risks of NSS for the general population and patients with diabetes.

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