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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.
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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.
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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.
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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.
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 sugar 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.
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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.
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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.
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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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Research Note

Autism spectrum disorder (ASD) is a multifactorial neurodevelopmental condition often accompanied by metabolic and nutritional imbalances. Conventional dietary interventions, such as the gluten-free, casein-free diet, typically fail to consider individual genetic variations. Nutrigenomics, the study of gene-nutrient interactions, offers a promising framework for exploring personalized dietary interventions that may help address the metabolic and neurological complexities associated with ASD, although current evidence remains preliminary. This research note offers recommendations for integrating nutrigenomics into special education through a multidisciplinary approach that combines clinical nutrition, genetics, and educational practice via a 3-phase agenda. Stage 1 focuses on identifying behavioral subgroups within special education settings and using validated tools such as the Child Behavior Checklist Scale to analyze nutritional intake. Stage 2 involves the development and pilot-testing of behavior-specific nutrition protocols that are tailored to these subgroups, incorporating input from practice experts in nutrigenomics. Lastly, in Stage 3, a personalized nutrition model that incorporates genetic screening and metabolic profiling is constructed in collaboration with dietitians, educators, and caregivers. By bridging clinical and educational domains, this study seeks to establish nutrigenomics-based nutrition therapy as a viable and equitable intervention for improving health and developmental outcomes among students with ASD.

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Review Article

Effects of the MIND Diet on the Cognitive Function of Older Adults: A Systematic Review
Seeun Kim, Eun-Hee Jang, Seungmin Lee
Clin Nutr Res 2025;14(4):318-328.   Published online October 28, 2025
DOI: https://doi.org/10.7762/cnr.2025.14.4.318

The Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet is a brain-focused dietary pattern designed to prevent cognitive decline in older adults. This systematic review, conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, aimed to examine the association between the MIND diet and cognitive function in older adults. Relevant studies published between 2015 and 2024 were identified through comprehensive searches of PubMed and the Cochrane Library using keywords including “MIND diet,” “cognitive performance,” and “older adults.” From a total of 138 records screened, 11 studies met the inclusion criteria after excluding reviews, meta-analyses, editorials, and those incorporating other lifestyle interventions such as physical activity or education. These studies included 7 prospective cohort studies, 2 cross-sectional studies, 1 randomized controlled trial (RCT), and 1 case-control study, comprising a total of 17,201 participants aged 57–91 years. Across studies, at least 57% of participants were women, and in the 5 studies reporting race, more than 75% were White. Dietary intake and MIND adherence were assessed primarily via food frequency questionnaires, while cognitive outcomes were evaluated using validated instruments including the Montreal Cognitive Assessment, global cognition scores, Consortium to Establish a Registry for Alzheimer’s Disease tests, and magnetic resonance imaging. Six cohort and two cross-sectional studies reported significant associations between higher MIND adherence and better cognitive outcomes. One cohort study and the single RCT showed no effect. Excluding 2 studies with short durations (≤ 3 years), the remaining nine studies suggest consistent cognitive benefits of MIND adherence. Future studies should include systematic reviews and large-scale RCTs focusing on Asian populations.

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Original Articles
Association Between Serum Vitamin D Levels and Visceral Adipose Tissue in Older Adults in Iran: A Cross-Sectional Study From the Amirkola Health and Aging Project
Marie Behnamzade, Reza Adabi, Manouchehr Ashrafpour, Reza Ghadimi, Ali Bijani, Seyed Reza Hosseini
Clin Nutr Res 2025;14(4):308-317.   Published online October 31, 2025
DOI: https://doi.org/10.7762/cnr.2025.14.4.308

The relationship between vitamin D status and visceral adiposity among older adults remains unclear. This study aimed to investigate the association between serum vitamin D levels and visceral adipose tissue (VAT) among older Iranian adults. This cross-sectional study included older adults aged ≥ 60 years from the Amirkola Health and Aging Project. Serum 25-hydroxyvitamin D levels were measured by enzyme-linked immunosorbent assay. VAT was assessed using dual-energy X-ray absorptiometry. Furthermore, the relationship between vitamin D and VAT was examined through multiple linear regression analysis, adjusting for potential confounders. Of the 600 participants, 345 (57.5%) were males and 255 (42.5%) were females. Their mean age was 68.90 ± 6.97 years, and the mean vitamin D level was 60.50 ± 39.45 ng/mL. Serum vitamin D levels showed a weak negative association with VAT mass (β = −0.062, p = 0.012). In both sexes, VAT mass predictors followed a similar pattern. Body mass index (BMI; β = 0.811, p < 0.001) was identified as a strong predictor, while diabetes status exhibited a positive association with VAT mass (β = 0.078, p = 0.002). Serum vitamin D levels appear to have a weak inverse relationship with visceral adiposity in older Iranian adults. BMI was the most robust predictor of VAT. Further longitudinal research is needed to clarify the causal relationship between vitamin D status and visceral adiposity among older adults.

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Cataracts are a major cause of visual impairment worldwide, particularly among older adults, with an increasing prevalence due to population aging. Surgery is the primary treatment; however, preventive strategies are crucial for reducing the disease burden. This study aimed to investigate dietary and health-related factors associated with cataract occurrence and develop a predictive model using machine learning. Data were derived from the Korea National Health and Nutrition Examination Survey 2015–2017. The study included 190 women aged 60–79 years: 124 with cataracts and 66 controls. Analyzed variables included sociodemographic, behavioral, chronic disease, and dietary intake factors. After data preprocessing, 4 machine learning algorithms: support vector machine (SVM), random forest (RF), eXtreme gradient boosting, and multilayer perceptron were used. Model performance was evaluated using accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve (AUROC) and precision-recall curves. Among the tested models, the SVM achieved the best performance under stratified 10-fold cross-validation, with 71% accuracy, 86% precision, 73% recall, 79% F1-score, 65% AUROC, and 81% AUPRC. According to our findings, the odds of having cataracts can be effectively predicted using dietary and health data without relying on specialized ophthalmic equipment. The proposed model demonstrates the potential of machine learning-based tools for early identification and prevention of cataracts. Future studies with larger and more diverse samples, as well as integrating additional data sources such as genomics and lifestyle factors, are warranted to refine predictive accuracy and enhance personalized nutrition-based interventions.

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This study provides the first national update on phase angle (PhA) as a biomarker of body composition, nutritional status, and health outcomes in Korean adults. Using data from 5,035 adults aged 20–80 years from the 2023 Korea National Health and Nutrition Examination Survey (KNHANES), we analyzed age-related variations in PhA, body composition, metabolic diseases, and nutrient intake. The mean PhA declined from 5.57° in participants aged 20–39 to 4.23° in those aged 80+, corresponding with decreases in height and weight. Individuals with higher PhA exhibited significantly greater lean body mass and lower body fat; for example, among those aged 20–39, the high PhA group showed 56.02 kg of lean mass versus 40.71 kg in the low group (p < 0.001) and total body water of 41.07 L versus 29.84 L (p < 0.001). Regarding metabolic diseases, 35.2% of the high PhA group aged 20–39 had grade 1 obesity compared with 17.4% in the low group, with similar associations observed for diabetes and hypertension across age groups. Nutritional intake was also higher in the high PhA group, with mean energy intake of 2,180.84 versus 1,710.16 kcal (p < 0.001). Overall, PhA was positively associated with favorable body composition, nutritional intake, and metabolic profiles across all age groups, suggesting its potential as a comprehensive biomarker for assessing physiological health and guiding nutritional interventions in the Korean population.

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This study aimed to identify major dietary patterns among Korean adolescents, examine their changes over the past 16 years, and evaluate differences by sex. Data were analyzed from 7,679 adolescents aged 12–18 years who participated in the 2007–2022 Korea National Health and Nutrition Examination Survey and completed health, examination, and nutrition surveys. Dietary intake was assessed using a 24-hour recall, and cluster analysis was performed based on the energy contribution of 26 food groups. Associations between dietary patterns and nutrient intake were examined using survey-weighted linear regression. Three dietary patterns were identified: Bread, Meat, & Dairy (33.1%); Rice-based Diet (45.5%); and Convenient Foods (21.3%). Among boys, the Rice-based Diet group showed the highest prevalence of obesity and the largest proportion of low-income households, whereas the Bread, Meat, & Dairy group exhibited higher rates of supplement use and high-income status (all p < 0.05). Among girls, the Convenient Foods group tended to be older and was more likely to skip breakfast, consume alcohol, eat out daily, and perceive themselves as overweight (all p < 0.05). Over the 16-year period, adherence to the Bread, Meat, & Dairy pattern increased, whereas adherence to the Rice-based Diet pattern declined in both sexes (p < 0.01). These findings highlight a shift toward Westernized dietary patterns among Korean adolescents. Accordingly, nutrition policies and interventions should adopt tailored strategies that account for both sex and socioeconomic differences to promote healthier eating habits and support long-term adolescent health.

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Meal Patterns and Protein Food Utilization in Public and Private Geriatric Long-term Care Hospitals
Ga-Eun Choi, Hye-Yeon Lee, Mi-Hyun Kim
Clin Nutr Res 2025;14(4):260-269.   Published online October 28, 2025
DOI: https://doi.org/10.7762/cnr.2025.14.4.260

This study examined meal patterns and protein-rich food utilization in the foodservice practices of public and private geriatric long-term care hospitals in South Korea. Over a period of 6 months, a total of 612 daily menus (306 from each hospital type, breakfast, lunch, and dinner) were collected from four hospitals (two public, two private). Each menu was categorized by meal composition, included staple food, soup, main dish, side dishes, and kimchi. The most common meal pattern consisted of a staple food, soup, main dish, two side dishes, and kimchi. Compared with private hospitals, public hospitals offered a greater variety in meal composition, staple foods, soups, and main dishes. However, no significant differences were observed in protein foods of main dishes. Overall, meat accounted for about half, whereas fish accounted for one-third. Approximately 30% of protein foods in main dishes were processed. In side dish 1, the proportion of protein-rich foods was lower in public than in private hospitals, whereas the proportion of processed foods exceeded two-thirds in both hospital, but was significantly higher in public hospitals. Soup was the second most important protein source after the main dish, with fish as the most often used; however, processed protein foods were also common. These findings indicate that the main dish and soup are the principal protein sources, and the relatively high inclusion of fish reflects a favorable pattern. However, to ensure intake of high-quality proteins by older adults, the high reliance on processed protein foods highlights the need to reconsider foodservice practices.

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