1.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.
2.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.
3.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.
4.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.
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.
6.2023 Clinical Practice Guidelines for Diabetes Mellitus of the Korean Diabetes Association
Jong Han CHOI ; Kyung Ae LEE ; Joon Ho MOON ; Suk CHON ; Dae Jung KIM ; Hyun Jin KIM ; Nan Hee KIM ; Ji A SEO ; Mee Kyoung KIM ; Jeong Hyun LIM ; YoonJu SONG ; Ye Seul YANG ; Jae Hyeon KIM ; You-Bin LEE ; Junghyun NOH ; Kyu Yeon HUR ; Jong Suk PARK ; Sang Youl RHEE ; Hae Jin KIM ; Hyun Min KIM ; Jung Hae KO ; Nam Hoon KIM ; Chong Hwa KIM ; Jeeyun AHN ; Tae Jung OH ; Soo-Kyung KIM ; Jaehyun KIM ; Eugene HAN ; Sang-Man JIN ; Won Suk CHOI ; Min Kyong MOON ; ;
Diabetes & Metabolism Journal 2023;47(5):575-594
In May 2023, the Committee of Clinical Practice Guidelines of the Korean Diabetes Association published the revised clinical practice guidelines for Korean adults with diabetes and prediabetes. We incorporated the latest clinical research findings through a comprehensive systematic literature review and applied them in a manner suitable for the Korean population. These guidelines are designed for all healthcare providers nationwide, including physicians, diabetes experts, and certified diabetes educators who manage patients with diabetes or individuals at risk of developing diabetes. Based on recent changes in international guidelines and the results of a Korean epidemiological study, the recommended age for diabetes screening has been lowered. In collaboration with the relevant Korean medical societies, recently revised guidelines for managing hypertension and dyslipidemia in patients with diabetes have been incorporated into this guideline. An abridgment containing practical information on patient education and systematic management in the clinic was published separately.
7.Morus Nigra Extract Attenuates Cognition Impairment and GABAergic Interneuron Degeneration in Aged Rat Brain
Joo Hee LEE ; Yoonju KIM ; Min Kyung SONG ; Youn-Jung KIM
Journal of Korean Biological Nursing Science 2022;24(2):77-85
Purpose:
Aging process comes with cognitive impairment due to decreased neuronal cell number, activity, and neuronal circuit. Alteration of inhibitory neurons contributes to cognitive impairment in normal aging and is responsible for disrupting the excitation/ inhibition balance by reducing the synthesis of gamma-aminobutyric acid (GABA). Morus nigra (Mulberry) is a natural physiologically active substance that has been proven to have anti-oxidant, anti-diabetic, and anti-inflammatory effects through many studies. This study aimed to evaluate the effects of the mulberry extract (ME) on cognitive function through anti-oxidant enzyme and GABAergic neuronal activity in aged rat brain.
Methods:
Sprague Dawley rats were randomly assigned as the young group (8 weeks, n = 8), aging group (67 weeks, n = 8), and aging + mulberry extract group (67 weeks, n = 8). The aging + mulberry extract group was orally administered 500 mg/kg/d mulberry extract for 6 weeks.
Results:
The aging + mulberry extract group improved spatial and short-term memory. The antioxidant potential of ME increased the expression of superoxide dismutase-1 (SOD-1) and decreased inducible nitric oxide synthase (iNOS). Also, the aging + mulberry extract group significantly increased the expression of GABAergic interneuron in hippocampus cornu ammonis1 (CA1) compared to the aging group.
Conclusion
The number of GABAergic inhibitory interneurons was deceased and memory functions in the aging process, but those symptoms were improved and restored by mulberry extract administration.
8.The Consumption Pattern of Sugar-Sweetened Beverages and its Comparison with Body Composition Change from a Four-Week Time-Restricted Eating Intervention in Korean Young Adults
Korean Journal of Community Nutrition 2022;27(1):36-46
Objectives:
The purpose of this study was to evaluate the consumption pattern of sugarsweetened beverages (SSB) and compare body composition changes by SSB consumption based on 28 days of dietary records from a four-week time-restricted eating intervention among young adults in Korea.
Methods:
A total of 33 participants completed the four-week dietary intervention with 8-hour time-restricted eating (TRE). The body composition was measured by bioelectrical impedance analysis at baseline, and daily dietary records were collected for 28 days during the intervention after 4 weeks.
Results:
Based on 924 days of dietary records, the average eating occasion of SSB was 0.9 times per day, and the average amount of SSB was 205.8 g/times. Based on an individual’s usual intake of 28 days, the average eating frequency of SSB was 16.6 times out of 28 days, and the average amount of SSB was 184.0 g/day. The average energy intake from SSB was 131.0 kcal /day (8.7% of energy), and sugar intake from SSB was 18.2 g/day (4.9% of energy). The sugar intake was 2.6% of energy from sweetened dairy products, followed by 2.0% from coffee drinks, 0.5% from soda and juice and 0.2% from others.When subjects were divided into high (14 days or more) and low (less than 14 days) SSB groups based on eating frequency, the weight change in the low SSB group was -2.0 kg over 4 weeks, which was significantly lower than -0.7 kg in the high SSB group. However, no significant difference was found in muscle mass, fat mass and body fat percent between the two groups.
Conclusions
This study suggests that low consumption of sugar-sweetened beverages is more desirable in weight management despite having the dietary intervention of timerestricted eating without counting calories. Thus, further longitudinal studies on the association between SSB and obesity in Korean adults are necessary.
9.Association of added sugar intake with all-cause and cardiovascular disease mortality: a systematic review of cohort studies
SuJin SONG ; Jae Eun SHIM ; YoonJu SONG
Nutrition Research and Practice 2022;16(S1):s21-s36
BACKGROUND/OBJECTIVES:
The long-term health impacts of dietary sugar have begun to be reported. The committee on the 2020 Dietary Reference Intakes for Koreans for sugar intended to update the scientific evidence on the association of added sugar intake with health outcomes, including mortality. This study evaluated the evidence on the association of dietary sugar with the all-cause and cardiovascular disease mortality from cohort studies.
SUBJECTS/METHODS:
The PubMed and ScienceDirect databases were searched until July 2021. The search terms were based on multiple combinations of keywords, such as added sugar, beverage, and mortality, included in the title or abstract. Two authors independently assessed the eligibility criteria of study selection and extracted the information from each selected article for this systematic review.
RESULTS:
The literature search identified 276 articles. Seventeen cohort studies met the inclusion criteria and were included in this systematic review. This study extracted information on the cohort and participants, dietary assessment methods, exposure and its comparison groups, health outcomes, and risk measures. Five articles reported added sugar intake, and 15 articles reported the food sources of the added sugar in the association with mortality. Increased mortality was observed in higher added sugar intake and a lower intake of less than 5% of energy, while higher discrepancies between gender, age groups, and countries were noted. In addition, nutritious sugary foods and beverages did not increase mortality.
CONCLUSIONS
A ‘U’ or ‘J’ shaped relationship between the added sugar intake and mortality was estimated. The observed discrepancy indicated the need for more evidence to establish the dose-response relationship for Koreans.
10.Evaluation of Iodine Status among Korean Patients with Papillary Thyroid Cancer Using Dietary and Urinary Iodine
Ji Yeon CHOI ; Joon-Hyop LEE ; YoonJu SONG
Endocrinology and Metabolism 2021;36(3):607-618
Background:
Concerns have been raised regarding thyroid disorders caused by excessive iodine in Koreans, who have iodine-rich diets. This study evaluated iodine status using dietary iodine intake and urinary iodine in papillary thyroid cancer (PTC) patients.
Methods:
Dietary data of PTC patients were assessed using a 24-hour recall and food frequency questionnaire (FFQ), and urinary iodine concentrations (UICs) were also obtained. To compare the iodine status of PTC patients, Korean adults with or without thyroid disease from the Korea National Health and Nutrition Examination Survey, which had 24-hour recall data and urinary iodine measurements, were analyzed.
Results:
The median daily iodine intake by 24-hour recall was 341.7 μg/day in PTC patients, similar to the levels of other Korean adults. Based on UICs, the prevalence of excessive iodine was 54.4% in PTC patients, which was similar to the prevalence among subjects with thyroid disease (55.4%) but slightly higher than that in subjects without thyroid disease (47.7%). Based on dietary iodine by 24-hour recall, the prevalence of excessive iodine intake was 7.2%, which was higher than that among subjects with (4.4%) or without (3.9%) thyroid disease. The dietary iodine intake based on 24-hour recall was closely correlated with the UIC (r=0.4826) in PTC patients, but dietary iodine by FFQ was not significantly correlated with either 24-hour recall or UIC-based dietary iodine.
Conclusion
Excessive iodine intake was more common in PTC patients than in subjects without thyroid disease. Further longitudinal research is necessary to elucidate the role of dietary iodine in PTC.

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