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Volume 13(4); October 2024

Special Report

[English]
Korean Food Exchange Lists for Diabetes Meal Planning: Revised 2023
Jae Won Cho, Dal Lae Ju, YeonHee Lee, Bo Kyung Min, Meera Kweon, Eun Mi Kim, SuJin Song, Jae Eun Shim, Oh Yoen Kim, Suk Chon, Jeong Hyun Lim
Clin Nutr Res 2024;13(4):227-237.   Published online October 29, 2024
DOI: https://doi.org/10.7762/cnr.2024.13.4.227

A food exchange list is a tool developed to help diabetic patients control their energy intake and plan balanced meals. Korean food exchange lists were first developed in 1988, revised in 1995, and updated again in 2010. With rapidly changing dietary habits and increasing demand for diverse food cultures, the Korean Diabetes Association in cooperation with 4 related organizations established a Task Force Team (TFT) to revise food exchange lists in March 2022. Starting with a workshop, TFT held 11 official revision meetings, culminating in a public hearing in May 2023. The final revised version of Korean food exchange lists was published in December 2023. Key outcomes of the revision are summarized as follows: 1. Based on the National Standard Food Composition Table 10.0 database, the existing classification system and nutrient standards for each food group remain unchanged this time. 2. Based on a survey conducted among diabetes educators, the number of items on the food exchange lists has increased from 339 in 2010 to 435 this time. 3. Considering patients’ usual eating habits, meal planning examples were developed distributing food group exchange units by energy level based on 3 types of proportions of carbohydrate energy (40%–45%, 50%–55%, 60%–65%). 4. Due to limitations in real-time updates for rapidly changing information, detailed guidance on how to access and interpret the data is provided. These revisions will help people with diabetes manage their blood sugar levels and facilitate the implementation of healthy meal planning in various other conditions, including obesity.

Citations

Citations to this article as recorded by  
  • Development of Nutritional Counseling Materials for ASD Children: Focusing on the Food Exchange List
    Seunghyun Won, Youjeong Kim, Jiye Park, Su-In Yoon, Jin Ah Cho
    Clinical Nutrition Research.2025; 14(2): 127.     CrossRef
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Case Report

[English]
Nutritional Management for Chronic Kidney Disease Undergoing Bariatric Surgery: A Case Report
Yunjung Choi, Jiyoung Song, Jeong Hyun Lim, Dal Lae Ju
Clin Nutr Res 2024;13(4):238-243.   Published online October 24, 2024
DOI: https://doi.org/10.7762/cnr.2024.13.4.238

Nutrition support is an essential aspect of treatment after bariatric surgery (BS). A high-protein diet with an intake of up to 1.5 g/kg of ideal body weight (IBW) per day is recommended to minimize loss of lean body mass after BS. However, protein intake recommendations may need to be adjusted for patients with compromised renal function, necessitating an individualized approach tailored to each patient’s clinical status. This case report aimed to demonstrate nutritional evaluation, education, and counseling for a male patient with chronic kidney disease (CKD) who underwent BS one year after surgery. Following BS, the patient adhered to the standard Seoul National University Hospital BS diet protocol. Considering his postoperative renal function, protein requirement was set at 1.0 g/kg of IBW. A total of 10 individualized nutritional counseling sessions were conducted according to renal function and complications. One year after BS, he successfully lost weight with % excess weight loss of 93%, maintained CKD stage 3, reduced prescription of oral hypoglycemic agent, improved glycated hemoglobin levels, and improved eating habits significantly. Thus, individualized nutrition intervention is important for supporting patients with CKD to reach their goal weight after BS, improve nutritional status, and prevent post-operative complications.

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  • Recurrent Weight Gain after Metabolic Bariatric Surgery (MBS): Emerging Insights on Kidney Function
    Seyed Amirhossein Fazeli, Mamdouh I. Elamy, Hamed Soleimani samarkhazan
    Obesity Surgery.2025;[Epub]     CrossRef
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  • 1 Crossref

Original Articles

[English]
5A's Behavior Change Model Improves Nutrition Knowledge and Intake Among Adolescent Athletes
Saningun Lee, Yeongtaek Hwang, Hyunjung Lim
Clin Nutr Res 2024;13(4):244-256.   Published online October 29, 2024
DOI: https://doi.org/10.7762/cnr.2024.13.4.244

This study compared the effects of 12 weeks of intensive nutrition education (IE) using the 5A's behavioral change model and basic nutrition education (BE) on nutritional knowledge and nutrient intake among Korean adolescent athletes. This study included elite adolescent athletes (IE group: n = 65, BE group: n = 65) at a physical education high school in Seoul. In this prospective, randomized, controlled trial, the athletes' body composition, nutritional knowledge, nutrient intake, and self-management practices were evaluated at the beginning and end of the intervention. Both groups had increased levels of nutrition knowledge between pre- and post-test, but the change in total score for nutrition knowledge was significantly higher in the IE group than in the BE group (p < 0.001). Energy intake post-test increased significantly in the IE group (from 2,185 to 2,651 kcal/day, p < 0.001) but not in the BE group. The intake of carbohydrates, protein, and fat also increased significantly in the IE group (carbohydrates: from 298 to 352 g/day, protein: from 86 to 106 g/day, fat: from 71 to 88 g/day, all p < 0.001), but the change in the BE group was not significant. Additionally, the IE group showed a significant overall increase in vitamins and minerals compared to the BE group at post-test. Adolescent athletes in the IE group showed improved nutritional knowledge and intake compared to those in the BE group 12 weeks after the intervention.

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[English]

Nutrition fact labels (NFLs) have advantages because they are an intuitive tool that provides unified information regulated by the government and does not require any devices or special skills. During pandemic, with increased interest in information about healthy food choices and optimum nutrition, frequent exposure to NFLs on pre-packaged foods and dietary supplements may have helped consumers become aware of and/or use NFLs. We aimed to evaluate NFL usage changes from the pre- and early to the late pandemic years in the Korean adult population, using data from the Korean Community Health Survey (3-year total respondents n = 687,610) conducted from 2019 to 2021. NFL awareness, effect, and utilization ratios in each subgroup (sex, age, diabetes mellitus/hypertension, subjective health status, and physical activity) were analyzed for the 3 years by the cross-tabulation test of weighted complex sample analysis. Despite the declining awareness of NFLs in the Korean population, the proportion of individuals who were affected by the NFL content in the entire population and the utilization ratio among those who were aware of NFLs increased continuously during the early and late pandemic periods. Thus, Nutrition experts and policy-makers need to increase efforts to maintain interest in NFLs that emerged during the pandemic. NFLs, a conventional but well-regulated and effective tool, may have enabled the Korean population to make healthy food choices during the pandemic.

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[English]
The Effect of Synbiotic Supplementation on Bone Complications, Anemia, and Gastrointestinal Function in Hemodialysis Patients: A Double-Blind Randomized Clinical Trial
Yasaman Azamian, Hadi Abdollahzad, Shahab Rezaeian, Mohammad Hossein Rouhani, Mohammad Hossein Fatehi
Clin Nutr Res 2024;13(4):272-283.   Published online October 29, 2024
DOI: https://doi.org/10.7762/cnr.2024.13.4.272

Probiotics affect biomarkers indicative of bone formation, such as alkaline phosphatase (ALP), calcium status, bone mineralization, bone turnover markers and metabolism. This study aims to investigate the effects of synbiotic on gastrointestinal (GI) disorder, bone complications and anemia in hemodialysis (HD) patients. In this randomized, double-blind, placebo-controlled clinical trial study, HD patients received 2 symbiotic (n = 19) or placebo (n = 17) capsules daily for 12 weeks. GI function, serum levels of bone-specific biomarkers, and serum levels of anemia-specific biomarkers were assessed at the beginning and the end of study. GI function was assessed with gastrointestinal symptom rating scale questionnaire. The data were analyzed using SPSS. At the end of this study, parathyroid hormone levels decreased significantly in the synbiotic group (p = 0.039); however, in comparison to placebo group, the difference was not significant. Decrease of ALP levels in the synbiotic group were not statistically significant. However, a significant difference was seen between the 2 groups at the end of intervention (p = 0.037). Improvement in GI symptoms was observed in both groups, but the reduction rate was higher in the synbiotic group. Additionally, at the end of the study, a significant difference between the 2 groups was observed (p < 0.05). No statistically significant difference was observed in the levels of other factors within each group and between the 2 groups (p > 0.05). Symbiotic supplements after 12 weeks led to an improvement in GI function and ALP levels in HD patients. Further investigation into bone-mineral disorders in HD patients is necessary.

Trial Registration

Iranian Registry of Clinical Trials Identifier: IRCT20131013014994N7

Citations

Citations to this article as recorded by  
  • Gut microbiome-targeted therapeutics for chronic kidney disease: comparative efficacy of probiotic and microbial preparations
    Yi-Ke Li, Wen-Ru Li, Huan Ren, Chen-Lin Xiao, Zhen Guo, Jian-Quan Luo
    Inflammopharmacology.2025; 33(12): 7569.     CrossRef
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Review Articles
[English]
Calcium Intake and the Pancreatic Cancer Risk: A Systematic Review and Meta-Analysis of Observational Studies
Alireza Bahrami, Milad Mohammadzadeh, Fatemeh Abdi, Amin Paydareh, Saman Khalesi, Ehsan Hejazi
Clin Nutr Res 2024;13(4):284-294.   Published online October 30, 2024
DOI: https://doi.org/10.7762/cnr.2024.13.4.284

Calcium plays a major role in apoptosis, cell proliferation, and various cellular mechanisms. It is also essential for the function of the pancreas. However, the association between calcium intake and pancreatic cancer is not clear. This study aims to clarify the links between calcium intake and pancreatic cancer risk using a systematic review and meta-analysis of observational studies. PubMed, Web of Science, Scopus, and Google Scholar were searched for eligible articles published through 31 August 2023. Case-control and cohort studies reporting the association between dietary and/or supplemental calcium intake and risk of pancreatic cancer using relative risk (RR), hazard ratio (HR), or odds ratio (OR) with 95% confidence interval (CI) were included. Meta-analysis using a random effect model was used to estimate the significance of the association. Eight studies were included. An inverse association between total calcium intake (dietary and supplement) and pancreatic cancer risk (RR, 0.83; 95% CI, 0.72–0.97; I2 = 0%) was observed. However, the association between dietary calcium intake alone and pancreatic cancer risk did not reach a statistically significant level (RR, 0.91; 95% CI, 0.78–1.06; I2 = 48%). Higher total calcium intake may reduce the risk of pancreatic cancer but the difference between sources of calcium (dietary vs. supplementation) requires further investigation. Also, due to the heterogeneity between the articles, the results of this study should be interpreted with caution.

Trial Registration

PROSPERO Identifier: CRD42022331647

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[English]
Flaxseed Lowers Blood Pressure in Hypertensive Subjects: A Meta-Analysis of Randomized Controlled Trials
Ezatollah Fazeli Moghadam, Leili Khaghani, Parivash Shekarchizadeh-Esfahani
Clin Nutr Res 2024;13(4):295-306.   Published online October 29, 2024
DOI: https://doi.org/10.7762/cnr.2024.13.4.295

This systematic review and meta-analysis study aimed to evaluate the effectiveness of flaxseed supplementation on blood pressure (BP) in patients with hypertension based on the data from randomized clinical trials (RCTs). Three databases (PubMed [MEDLINE], Scopus, and ISI Web of Science) were searched from inception up to August 10, 2024. Relevant studies meeting our eligibility criteria were obtained. A random-effects model was used to estimate pooled weighted mean differences (WMDs) with 95% confidence intervals (CIs). The methodological quality of individual studies was assessed using the Cochrane Collaboration risk of bias tool. A total of 5 studies were included and analyzed using STATA software version 12. The results show that there is a significant decrease in systolic BP (WMD, −8.64 mmHg; 95% CI, −15.41 to −1.87; p ≤ 0.001) and diastolic BP (WMD, −4.87 mmHg; 95% CI, −8.37 to −1.37; p = 0.006) of patients with hypertension as compared to control groups. This study supported that flaxseed supplementation had favorable effects on BP control in hypertensive patients. It may be a promising adjuvant therapy for patients with hypertension.

Citations

Citations to this article as recorded by  
  • Albumin-Bound Fatty Acids Modulate Endogenous Angiotensin-Converting Enzyme (ACE) Inhibition
    Enikő Edit Enyedi, Attila Ádám Szabó, Tamás Bence Pintér, Ivetta Siket Mányiné, Anna Pluhár, Csongor Váradi, Emese Bányai, Attila Tóth, Zoltán Papp, Miklós Fagyas
    Biomedicines.2026; 14(1): 103.     CrossRef
  • Dietary flaxseed: Cardiometabolic benefits and its role in promoting healthy aging
    Setor K. Kunutsor, Davinder S. Jassal, Amir Ravandi, Andrea Lehoczki
    GeroScience.2025; 47(3): 2895.     CrossRef
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