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Research Note

Micronutrient deficiencies are a major public health concern in low- and middle-income countries, where conventional supplementation and fortification programs are often limited by low bioavailability, fragile supply chains, cultural resistance, and poor long-term adherence. This research note proposes a food-based alternative model that leverages selected traditional Korean foods (K-foods)— gim (dried seaweed), kimchi (fermented vegetables), and cheonggukjang (fermented soybean paste)—as culturally adaptable and nutritionally dense components of official development assistance nutrition strategies. These foods provide functionally relevant nutrients, such as iodine, vitamin K2, probiotics, and fermentation-derived bioactive peptides, and offer benefits, including shelf stability, microbial resilience, and decentralized production. Employing a multidisciplinary clinical nutrition framework integrating food composition science, fermentation biology, public health nutrition, and development policy, this note presents a five-step research roadmap encompassing nutrient profiling, safety and stability assessment, cultural acceptability evaluation, community-based efficacy trials, and policy translation. By prioritizing food-based, multinutrient dietary interventions over single-nutrient strategies, the proposed model highlights a scalable and clinically relevant pathway for enhancing micronutrient status in resource-limited settings. This work contributes to emerging discussions on nutrition-sensitive official development assistance and highlights K-foods as potential tools for sustainable, culturally responsive global nutrition interventions.
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Case Reports

Association between vitamin B12 deficiency and supraventricular tachycardia: case series
Ankur Verma, Sofiya Rizvi, Mohammad Saif, Vikrant Chouhan, Sanjay Jaiswal
Clin Nutr Res 2026;15(2):122-126.   Published online April 30, 2026
DOI: https://doi.org/10.7762/cnr.2026.0005
The incidence of supraventricular tachycardia (SVT) is approximately 35 cases per 100,000 patients with a prevalence of 2.25 cases per 1,000. This dysrhythmia originates at or above the atrioventricular node and is defined by a narrow complex QRS (<120 msec) at a rate of >100 beats/min. The effects of vitamin B12 deficiency on sympathetic and parasympathetic systems may cause heart rate variability and autonomic dysfunction. In patients with SVT, the underlying mechanism may be further exacerbated by vitamin B12 deficiency or induced by the deficiency. We describe a case series of three patients with no known comorbidity who presented to our department with SVT. Their SVTs were terminated using the modified Valsalva maneuver. All three patients were incidentally found to be severely deficient in vitamin B12 and had hyperhomocysteinemia. They were discharged on medications and dietary advice to increase vitamin B12 levels. Correcting vitamin B12 deficiency and hyperhomocysteinemia could play a preventive role in patients at risk for SVT. Our case series demonstrates a plausible association between vitamin B12 deficiency and SVT occurrence in previously healthy individuals with no known comorbid conditions.
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Exocrine pancreatic insufficiency as an overlooked cause of chronic diarrhea after Billroth II gastrectomy identified through nutrition-focused assessment: a case report
Mijin Kang, Dal Lae Ju, Sookyoung Kim, Jiyoung Song, Youngran Kim
Clin Nutr Res 2026;15(2):117-121.   Published online April 30, 2026
DOI: https://doi.org/10.7762/cnr.2026.0012
Postgastrectomy diarrhea is often attributed to dumping syndrome or functional changes; however, exocrine pancreatic insufficiency (EPI) from anatomical and physiological alterations may be an underrecognized cause of malabsorption and nutritional decline. Because EPI symptoms are often nonspecific, it may remain undiagnosed and lead to progressive malnutrition if untreated. This case report describes severe EPI identified via nutrition-focused assessment in a patient with persistent diarrhea after Billroth II gastrectomy, and the clinical response to pancreatic enzyme replacement therapy (PERT). A patient with a history of subtotal gastrectomy with Billroth II reconstruction for gastric cancer presented with chronic diarrhea, steatorrhea, weight loss, and hypoalbuminemia. Repeated endoscopic and radiologic evaluations identified no structural cause of diarrhea. Comprehensive nutrition-focused assessment indicated fat malabsorption, and fecal pancreatic elastase was markedly reduced (23.8 µg/g), confirming severe EPI. PERT with pancreatin containing 25,000 units of lipase (Norzyme) was initiated with meals. Posttreatment, steatorrhea resolved and bowel movements normalized without dietary fat restriction. Serum albumin levels subsequently normalized, and body weight returned to the normal range, indicating improved nutritional status. This case emphasizes the clinical value of nutrition-focused assessment in identifying treatable causes of malabsorption, such as EPI, in patients with persistent postgastrectomy diarrhea.
  • 589 View
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Original Articles

Dietary intake patterns and nutritional adequacy in older adults with predialysis chronic kidney disease: a comparison by diabetes status
Jeong Eun Kim, Jisoo Kim, Yu-Jin Kwon, Jung Eun Lee, Jung Joo Lee, Ji-Won Lee, Yoo Kyoung Park
Clin Nutr Res 2026;15(2):108-116.   Published online April 30, 2026
DOI: https://doi.org/10.7762/cnr.2026.0014

Objective

Nutritional management is essential in caring for patients with chronic kidney disease (CKD), older adults at higher risk of malnutrition and comorbidities. However, data on actual dietary intake patterns in older adults with predialysis CKD, especially by diabetes mellitus (DM) status, remain limited. Methods: This cross-sectional study included 106 patients aged ≥65 years with CKD stage G3a or higher, divided into DM (n=67) and non-DM (n=39) groups. Dietary intake was assessed using a single 24-hour recall. Nutrient and food-group intakes were compared with recommended levels. Results: In both groups, energy intake was lower than recommended levels. More than half of the participants exceeded sodium limits, and approximately half consumed excess protein. Patients with DM had significantly higher protein intake and blood urea nitrogen (BUN) levels than those without DM. Most food groups, except protein foods, were consumed below recommended levels. Conclusion: Dietary patterns in older adults with predialysis CKD showed low energy intake, high sodium intake, and relatively high protein intake. Those with DM had higher protein intake and BUN levels, suggesting dietary differences by diabetes status. These findings underscore the need for age-sensitive, individualized nutritional management strategies that consider kidney function and DM status.
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Objective

Because vitamin D deficiency is associated with diabetes and insulin resistance, and the triglyceride-glucose (TyG) index is a reliable marker of metabolic health, this study aimed to clarify the association between vitamin D status and the TyG index. Methods: A cross-sectional analysis was conducted on 4,819 participants from the 2022 Korea National Health and Nutrition Examination survey, stratified by age and sex. Vitamin D deficiency was defined as blood 25-hydroxyvitamin D3 (25(OH)D3) <20 ng/ mL, and a metabolically unhealthy state as a TyG index of ≥8.82 and ≥8.73 for men and women, respectively. Results: Approximately 46.9% of South Korean adults were vitamin D deficient, and 35.5% were metabolically unhealthy. After adjustment, blood 25(OH)D3 levels were inversely correlated with the TyG index in younger women (β=−0.004, standard error [SE]=0.002, P=0.039), middle-aged men (β=−0.006, SE=0.003, P=0.015), and older men (β=−0.008, SE=0.002, P=0.002). Vitamin D deficiency was associated with a higher risk of a metabolically unhealthy state in middle-aged men (odds ratio [OR], 1.59; 95% confidence interval [CI], 1.11−2.28) and older men (OR, 2.15; 95% CI, 1.31−3.55). Conclusion: These findings suggest that adequate vitamin D status may help maintain a metabolically healthy state, and the TyG index may help identify vitamin D insufficiency or deficiency, particularly in middle-aged and older South Korean men.
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Toward a longevity diet framework: integrating global evidence for healthy aging in the South Korean population
Soyoung Jung, Hae Jin Kang, Mijoo Choi, Yoo Kyoung Park
Clin Nutr Res 2026;15(2):91-100.   Published online April 30, 2026
DOI: https://doi.org/10.7762/cnr.2026.0015

Objective

As global life expectancy rises, the focus has shifted from longevity alone to healthy aging. Although dietary models such as the Mediterranean, Dietary Approaches to Stop Hypertension (DASH), Mediterranean-DASH Intervention for Neurodegenerative Delay, and EAT-Lancet diets show benefits for specific health outcomes, their direct application to South Korean populations is limited by differences in dietary patterns and cultural practices. This study aimed to develop nutritional criteria for a South Korean-adapted longevity diet framework. Methods: A multiphase development approach was used, including a narrative review of major dietary models and clinical nutrition guidelines to identify key components of a longevity diet. Macronutrient distribution, food group intake, and nutrient-specific recommendations were synthesized into a structured framework. The EAT-Lancet reference diet was adjusted from 2,400 to 2,000 kcal/ day to reflect energy requirements of South Korean adults. Results: The proposed framework comprises six domain-specific recommendations, including macronutrient targets of 50%–65% carbohydrates, 10%–20% protein, and 15%–30% fat, with a 1:1 animal to plant protein ratio. Food group recommendations were tailored to South Korean dietary patterns. The framework addresses weight management, glycemic control, cardiovascular health, cognitive function, muscle function, and skin health. It emphasizes whole grains, dietary fiber, plant-based proteins, and unsaturated fats, while limiting refined carbohydrates, added sugars, and saturated fats. Conclusion: This study presents evidence-based nutritional criteria for a South Korean-adapted longevity diet framework that integrates disease prevention with functional health support to promote healthy aging.
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Objective

This study investigated the association between plant-based diet indices—overall plant-based diet index (PDI), healthful PDI (hPDI), and unhealthful PDI (uPDI)—and depressive symptoms in South Korean adults.
Methods
This cross-sectional study analyzed 5,846 participants (aged 19–64 years) using data from the 2014 and 2016 South Korea National Health and Nutrition Examination Survey. Dietary intake was assessed with a semiquantitative food frequency questionnaire, from which PDIs were derived. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). Survey-weighted linear and logistic regression models were applied to assess associations, adjusting for sociodemographic, lifestyle, and clinical factors.
Results
In fully adjusted models, higher overall PDI and hPDI were associated with lower PHQ-9 scores (β=−0.23; 95% confidence interval [CI], −0.41 to −0.04 and β=−0.16; 95% CI, −0.30 to −0.02 per 10-unit increment, respectively), whereas higher uPDI scores were associated with higher PHQ-9 scores (β=0.21; 95% CI, 0.07 to 0.35 per 10-unit increment). For clinical depressive symptoms (PHQ-9 ≥10), each 10-unit increase in overall PDI was associated with a 33% reduction in odds (odds ratio, 0.67; 95% CI, 0.50 to 0.89). Associations for hPDI and uPDI were attenuated and not statistically significant. Subgroup analyses revealed that these associations varied by sex, age, and obesity status.
Conclusion
Greater adherence to healthy plant-based foods and lower intake of less healthy plant-based foods were associated with fewer depressive symptoms among South Korean adults. These findings highlight the importance of plant-based food quality, rather than quantity alone, in supporting mental health.
  • 533 View
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Case Reports

Reversing 20 years of diabetes using the carnivore diet in India: a case report
Ankur Verma
Clin Nutr Res 2026;15(1):72-78.   Published online January 31, 2026
DOI: https://doi.org/10.7762/cnr.2025.0026
Diabetes has been well established as one of the deadliest chronic diseases globally. Currently, India is known as the diabetes capital of the world although this disease had been documented in the country for centuries. Current treatment strategies center around oral hypoglycemic drugs, insulin, and the standard ‘diabetic diet.’ Nonetheless, millions continued to suffer from this chronic disease and its multiple complications. We herein present a case involving a male patient suffering from diabetes for 20 years despite being on medications and a diabetic diet who finally achieved remission of diabetes and hypertension by removing carbohydrates and following a carnivore diet.
  • 5,955 View
  • 174 Download
Nutritional management of an adolescent undergoing bariatric surgery: a case report
Yooeun Yoon, Hosun Lee, Soo Min Ahn
Clin Nutr Res 2026;15(1):64-71.   Published online January 31, 2026
DOI: https://doi.org/10.7762/cnr.2025.0035
This case report describes the nutritional management and long-term outcomes of an adolescent undergoing bariatric surgery. A 13-year-old female patient with morbid obesity complicated by nonalcoholic steatohepatitis (NASH), impaired glucose tolerance (IGT), and polycystic ovary syndrome (PCOS) underwent sleeve gastrectomy in July 2021. The patient achieved significant weight loss, with a total weight loss of 43.3% and a body mass index reduction of 16.6 kg/m2 at 3 years post-surgery, which further increased to 18.6 kg/m2 by the fourth year. Remission of NASH, IGT, and PCOS was observed after 1 year. Postoperatively, vitamin D deficiency developed, whereas other biochemical parameters remained within normal reference ranges. Adherence to recommended nutritional supplementation was suboptimal; however, with continuous nutritional education and regular follow-up, the patient ultimately established and maintained a balanced dietary pattern. The case highlights the effectiveness of bariatric surgery in achieving sustained weight loss and improving obesity-related comorbidities in adolescents, while underscoring the critical role of continuous nutritional management, patient education, and individualized multidisciplinary care in supporting long-term postoperative success.
  • 1,012 View
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Review Article

Effects of meal sequence intervention on blood glucose response in healthy adults: a systematic review
Jinmin Kim, Eun-Hee Jang, Seungmin Lee
Clin Nutr Res 2026;15(1):55-63.   Published online January 31, 2026
DOI: https://doi.org/10.7762/cnr.2025.0027

Objective

Achieving glycemic control is essential in the prevention and management of metabolic disorders, with several dietary strategies having been proposed. Meal sequence, which is defined as the order of food consumption while maintaining the overall composition and intake, may attenuate postprandial glycemic responses. This systematic review aimed to assess the effects of meal sequences on postprandial glycemic responses in healthy adults and explore its potential as a preventive strategy for glycemic control.
Methods
Literature published between January 2015 and March 2025 in PubMed, Cochrane Library, Web of Science, KoreaMed, and RISS was searched using the keywords “healthy adult,” “food order,” “meal sequence,” and “glucose response.”
Results
Among the 2,442 records identified, one randomized controlled trial, four randomized crossover studies, and one repeated-measures design with a total of 107 participants aged 20–36.7 years met the inclusion criteria. Most of the studies reported that consuming vegetables, fruits, or protein-rich foods before carbohydrate-rich foods reduced postprandial glucose responses and incremental area under the curve compared with mixed or carbohydrate-first meals. These effects were also noted in randomized controlled trials and randomized crossover design.
Conclusion
Our findings indicate that adjusting the order of food consumption can effectively mitigate acute postprandial glucose responses in healthy individuals. Further large-scale and long-term randomized controlled trials across diverse populations and standardized protocols are warranted to strengthen the evidence base.
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Original Articles
Effects of propolis supplementation on blood glucose and lipid profiles in individuals with metabolic syndrome and type 2 diabetes: a systematic review and meta-analysis
Ezatollah Fazeli Moghadam, Elham Afshari, Leili Khaghani, Parivash Shekarchizadeh-Esfahani
Clin Nutr Res 2026;15(1):45-54.   Published online January 31, 2026
DOI: https://doi.org/10.7762/cnr.2025.0004

Objective

Propolis has been suggested as a complementary therapy for improving glycemic control and lipid metabolism. However, evidence from clinical trials remains inconsistent. This systematic review and meta-analysis aimed to provide a clear and updated assessment of the effects of propolis supplementation on fasting blood sugar (FBS) and lipid profiles in individuals with type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS).
Methods
A comprehensive search was conducted on the PubMed, Scopus, Cochrane Library, and Web of Science databases through December 2024 to identify randomized controlled trials (RCTs) evaluating the impact of propolis supplementation on FBS and lipid parameters. Eligible data were pooled using a random-effects model, and weighted mean differences (WMDs) were calculated as pooled effect sizes.
Results
A total of 12 RCTs were included, encompassing 736 participants. Propolis supplementation significantly reduced FBS (WMD, −12.08 mg/dL; 95% confidence interval [CI], −19.13 to −5.04; P=0.001) and triglyceride (TG) levels (WMD, −25.40 mg/dL; 95% CI, −44.21 to −6.59; P=0.008) without significantly affecting the levels of total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol.
Conclusion
These findings suggest that propolis supplementation may modestly improve glycemic control and reduce TG levels in individuals with T2DM and MetS. However, the limited number of available studies and relatively small sample sizes highlight the need for large, high-quality RCTs to verify these findings and clarify the metabolic effects of propolis.
  • 2,347 View
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Comparative nutritional assessment of vegetarian and nonvegetarian ready-to-eat foods
Jungeun Park, Su-Ryeon Han, Mi-Kyeong Choi
Clin Nutr Res 2026;15(1):36-44.   Published online January 31, 2026
DOI: https://doi.org/10.7762/cnr.2025.0032

Objective

This study aimed to assess the nutritional adequacy of vegetarian ready-to-eat convenience foods, focusing on gimbap, rice ball, and sandwich products. Methods: We examined 114 vegetarian and 414 nonvegetarian ready-to-eat products and compared their energy and nutrient contents to gain useful insights for consumers when making informed choices and for producers when developing nutritionally balanced vegetarian convenience foods. Results: Compared with nonvegetarian products, vegetarian convenience foods had a significantly greater carbohydrate content per serving and significantly lower protein, sodium, and cholesterol contents. Although vegetarian gimbap was significantly more costly than the nonvegetarian gimbap, its cholesterol and saturated fat contents were significantly lower. Vegetarian rice balls had a significantly lower trans fat content than their nonvegetarian counterparts. Sandwiches in the vegetarian options had a significantly higher sugars content but had significantly lower protein and sodium contents than those in the nonvegetarian options. Vegetarian convenience foods did not meet one-third of the daily nutrient reference values for a single meal, similar to their nonvegetarian counterparts, but their sodium content exceeded the daily reference value. However, unlike the nonvegetarian options, the sodium content of vegetarian sandwiches did not exceed the daily value. Conclusion: Vegetarian convenience foods contain higher levels of carbohydrates and sugars and lower levels of protein, sodium, and cholesterol than nonvegetarian convenience foods. Foods such as vegetarian gimbap, rice balls, and sandwiches do not provide sufficient energy or nutrients to meet the nutritional requirements for a single meal. Creating nutritionally balanced vegetarian convenience foods should be the focus when developing new vegetarian food products.
  • 1,093 View
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Objective

Cigarette smoking leads to oxidative stress and high cholesterolemia, which are key drivers of cardiovascular disease (CVD). Whey is known for its antioxidant and hypolipidemic properties. This study investigated whether whey protein concentrate (WPC) and hydrolysate of WPC (HWPC) can alleviate CVD risk in South Korean smokers by lowering oxidative stress and blood lipids.
Methods
A total of 25 male smokers were screened, of which 18 eligible participants (72.0%), randomly assigned to either the WPC (n=9) or the HWPC (n=9) group, completed the 8-week intervention. Before (week 0, baseline) and after the intervention, participants visited the laboratory for blood collection and anthropometric measurements (body weight, height, waist circumference, body fat mass, nutritional intake). Blood samples were analyzed for plasma lipid profiles, plasma fat-soluble antioxidants, and leukocyte oxidative DNA damage using the comet assay.
Results
There were no significant differences in anthropometric measurements, dietary food intake, plasma conjugated dienes, total radical-trapping antioxidant potential, and erythrocytes’ glutathione peroxidase and catalase activities in both WPC and HWPC groups. However, we observed a significant decrease in the tail moments of leukocytes, low-density lipoprotein cholesterol, atherogenic index, and high coenzyme Q10 levels in both groups. In the WPC group, total cholesterol decreased, while plasma retinol, α-tocopherol, lycopene, α-carotene, and β-carotene increased.
Conclusion
WPC or HWPC significantly decreases blood cholesterol levels and oxidative DNA damage and increases plasma fat-soluble antioxidant levels. Thus, WPC or HWPC might be used as oral supplementation to lower the risk for CVD in South Korean male smokers.
  • 1,694 View
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Clinical field survey and multidisciplinary expert in-depth interview study on food for special medical purpose products for patients
Ju Hee Kang, Hee-Jung Park, Hyo Jeong Lim, Jung Joo Lee, Bo-Eun Kim, Eun Joo Bae, Yeon Hee Lee, Dal Lae Ju, Young Ran Kim, Jin-Hee Yeom, Hee-Sook Lim, Ha-Neul Kim, Seul Bi Lee, Seo-Yeon Park, Hee Joon Baek, Yoo Kyoung Park
Clin Nutr Res 2026;15(1):12-24.   Published online January 31, 2026
DOI: https://doi.org/10.7762/cnr.2026.0002

Objective

Food for special medical purpose (FSMP) has become essential in clinical nutrition care. However, comprehensive data on FSMP utilization practices among healthcare professionals in South Korea are limited. This study aimed to investigate perceptions, current practices, and needs regarding FSMP among healthcare professionals.
Methods
A mixed-methods approach was employed, combining a cross-sectional survey of 417 healthcare professionals (47 physicians, 219 nurses, and 151 dietitians) from 90 institutions with focus group interviews of 24 Nutrition Support Team members from six institutions. Data were collected from May to October 2025.
Results
Substantial interphysician variability was observed in documentation for enteral formula prescriptions. Infusion rates were documented in 9.2% of the physician orders; feeding method was recorded in 14.1%. Across all professional groups, diarrhea was the most common reason for changing enteral formulas (36%–39%). In education related enteral formulas, 59.6% of the physicians expected dietitians to educate patients; however, this role was most commonly performed by nurses (59.8%). Dietitians prioritized hygiene (66.9%) and safety (64.2%) when selecting products, and 84.1% of the institutions were providing oral nutritional supplements.
Conclusion
These findings highlight the need for standardized prescription documentation, evidence-based feeding protocols, and clearly defined professional roles in multidisciplinary frameworks, to optimize FSMP utilization.
  • 1,557 View
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Dietary management of pediatric patients with kidney disease: recommendations by the Korean Society of Pediatric Nephrology and the Korean Society of Clinical Nutrition
Yo Han Ahn, Hee Gyung Kang, Jiyoung Song, Sangmi Han, Eujin Park, Jin-Soon Suh, Jeong Yeon Kim, Min Ji Park, Keum Hwa Lee, Seon Hee Lim, Kyeong Hun Shin, Hyunji Ko, Hyun Joo Lee, Eunyoung Jeong, Jinsu Kim, Sohyun Park, Eonju Choi, Yuri Seo, Kyooyung Oh, Jin Kyoung Kim, Hyun Kyung Lee
Clin Nutr Res 2026;15(1):1-11.   Published online January 31, 2026
DOI: https://doi.org/10.7762/cnr.2025.0033
Pediatric kidney disease has a lower prevalence than other pediatric conditions and has a notably different etiology from kidney diseases occurring in adults. Furthermore, the pediatric population is unique in that they experience ongoing growth and development, distinguishing them from adult patients. Consequently, pediatric patients with kidney disease require a more specialized and meticulous nutritional management plan compared with adult patients. To address this need and promote optimal dietary practices for pediatric patients with kidney disease, pediatric nephrologists from the Korean Society of Pediatric Nephrology and nutritionists from the Korean Society of Clinical Nutrition have collaborated to formulate nutritional guidelines specifically tailored to Korean dietary patterns. These guidelines offer detailed, nutrient-specific recommendations regarding the consumption of energy, protein, calcium, phosphorus, and potassium while providing practical, culturally relevant guidance intended to support both pediatric patients and their caregivers.
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