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"Nutrition"

Original Articles

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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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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Case Report

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.
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Original Articles


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.
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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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Case Report

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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Original Article

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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Case Report

Clinical Impact of Nutritional Intervention on Pressure Injury Healing in a Paraplegic Patient: A Case Report
Young ran Kim, Mi young Jang, Jun ho Park
Clin Nutr Res 2025;14(4):241-246.   Published online October 31, 2025
DOI: https://doi.org/10.7762/cnr.2025.14.4.241

Pressure injuries are common complications in patients with limited mobility, particularly those who are bedridden. These wounds not only cause pain and reduce quality of life but also lead to prolonged hospitalization, increased risk of infection, and higher healthcare costs. Among the various contributing factors, malnutrition plays a crucial role by impairing collagen synthesis, weakening immune function, and delaying tissue repair. Adequate nutritional support—particularly sufficient protein and energy intake—is therefore an essential component of comprehensive pressure injury management. We present the case of a paraplegic patient who developed a vulvar pressure injury. A structured, stepwise nutritional intervention was implemented, including adjustment of meal composition based on appetite, supplementation with high-protein oral nutritional supplements, vitamins and minerals, and the use of probiotics to manage diarrhea. As a result, the patient’s daily protein intake increased from less than 10 g to 80–90 g, accompanied by progressive wound improvement. Serial clinical assessments showed reduced slough, increased granulation tissue formation, and epithelialization. This case highlights the vital role of individualized nutritional management within a multidisciplinary approach to pressure injury care. Stepwise nutritional intervention, tailored to the patient’s tolerance and clinical status, contributed significantly to wound healing. Nutritional optimization should be considered an integral component of effective pressure injury treatment strategies.

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Original Articles

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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Association Between Muscle Quality and Quantitative Changes According to Nutritional Intake Differences in Patients Recovering From Trauma
Ji-hyun Lee, Songhee Kwon, Suyoung Yang, Donghwan Choi, Junsik Kwon, Yoo Kyoung Park
Clin Nutr Res 2025;14(4):247-259.   Published online October 28, 2025
DOI: https://doi.org/10.7762/cnr.2025.14.4.247

Adequate nutrition reportedly can help reduce the degree of muscle loss and improve muscle quality in hospitalized patients recovering from trauma. This study investigated the association between nutritional intake and changes in muscle quality and quantity in these patients. The handgrip strength (HGS) and body composition of 52 patients admitted to the trauma ward were measured at 1-week intervals. According to their dietary intake, they were categorized into the hypocaloric nutrition group (HNG; < 70% of recommended caloric intake) and the isocaloric nutrition group (ING; ≥ 70% of recommended caloric intake). Within one week, body mass index (24.3 ± 4.4 kg/m2 vs. 23.4 ± 4.5 kg/m2), body fat percentage (24.1% ± 9.8% vs. 17.2% ± 9.2%), and skeletal muscle mass (28.6 ± 4.9 kg vs. 27.5 ± 4.3 kg) significantly decreased in the ING compared with those in the HNG. Although the skeletal muscle mass decreased, the ING’s left HGS significantly increased (26.6 ± 9.6 kg vs. 28.5 ± 10.1 kg). The ING also consumed a significantly greater amount of protein (beyond the recommended amount) than the HNG (72.6 ± 43.2 → 100.8 ± 27.0% vs. 58.6 ± 25.9 → 49.5 ± 20.1%; p = 0.039). In bioelectrical impedance vector analysis, the vectors of the ING shifted more within the normal range of the 75% tolerance ellipse than those of the HNG (23% vs. 10%). These results suggest that, although the muscle mass quantitatively decreased during trauma recovery, adequate nutritional support helps preserve muscle quality.

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Effects of Replacing Skipped Meals With Oral Nutritional Supplement on Nutritional Status and Physical Function in Older Adults
Jiyeon Lee, Seong Ah Cho, Seoyoon Choi, Eunbi Han, Hyeri Shin, Yoo Kyoung Park
Clin Nutr Res 2025;14(3):191-203.   Published online July 29, 2025
DOI: https://doi.org/10.7762/cnr.2025.14.3.191

This study evaluated the effects of replacing skipped meals with oral nutritional supplements (ONS) on the nutritional status and functional health of older adults. A total of 29 participants aged ≥ 65 years who regularly skipped at least one meal per day were included in this single-arm study. For 8 weeks, participants consumed two packs of ONS daily (150 mL each, providing 400 kcal and 18 g of protein) as a substitute for skipped meals. Nutritional status, nutrient intake, body composition, and physical function were assessed before and after the intervention. The Nutrition Quotient for the Elderly score significantly increased from 58.97 to 63.62 (p = 0.014). Total nutrient intake, including ONS, significantly improved compared with baseline (p < 0.01). Body weight and body mass index increased significantly from 58.87 to 59.47 kg (p = 0.028) and from 23.9 to 24.18 kg/m2 (p = 0.016), respectively. Calf circumference decreased significantly from 34.1 to 33.39 cm (p = 0.010). Physical function, assessed using the Short Physical Performance Battery, showed significant improvement (p = 0.003). In conclusion, replacing skipped meals with ONS may enhance nutritional status and support functional health in older adults.

Trial Registration

Clinical Research Information Service Identifier: KCT0010184

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Cataracts are a major cause of vision impairment in older adults and pose a growing concern in aging societies. This study examined the association between dietary macronutrient intake and the odds of having cataracts among 1,619 Korean adults aged ≥ 60 years using data from the 2015–2017 Korea National Health and Nutrition Examination Survey. Cataracts were present in 51.8% of participants. Dietary intake was assessed via 24-hour recall and macronutrient intake was categorized by quartiles and energy ratios. After adjusting for covariates, individuals in the highest quartile of carbohydrate-to-energy intake (> 80%) had 41% higher odds of having cataracts (odds ratio [OR], 1.41; 95% confidence interval [CI], 0.99–2.01), with a significant trend (p for trend = 0.022). In contrast, the highest quartile of protein intake (Q3: 12%–15% energy) was associated with significantly lower odds of having cataracts in women (OR, 0.59; 95% CI, 0.40–0.88). Likewise, fat intake exceeding 18% of total energy was associated with reduced odds of having cataracts (OR, 0.69; 95% CI, 0.49–0.97). Saturated and monounsaturated fat intake also showed inverse associations with the odds of having cataracts. These results suggest that excessive carbohydrate intake, particularly when replacing fats and proteins, may increase the odds of having cataracts in older adults, especially among women. Dietary adjustments aimed at reducing the proportion of carbohydrates and increasing high-quality protein and fat intake may help prevent cataracts in aging populations. Further longitudinal studies are needed to clarify causal relationships and to inform nutritional guideline development.

Citations

Citations to this article as recorded by  
  • Development and Comparison of AI Algorithms for a Predictive Model of Cataracts: Analysis of the Korea National Health and Nutrition Examination Survey (2015–2017)
    Jiyoung Choi, Eunju Park
    Clinical Nutrition Research.2025; 14(4): 297.     CrossRef
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Chronic obstructive pulmonary disease (COPD) is a major respiratory disorder characterized by irreversible airflow limitation. The role of diet in the prevention and management of COPD is receiving increasing attention. This study aimed to examine the association between the composite intake of vegetables, fruits, meat, and fish and pulmonary function as well as COPD prevalence in a representative sample of Korean adults aged ≥ 40 years using data from the 7th Korea National Health and Nutrition Examination Survey. Higher vegetable intake was associated with significantly better pulmonary function parameters, including forced vital capacity (p < 0.001), forced vital capacity percent predicted (p = 0.050), forced expiratory volume (FEV) in 1 second (FEV1; p < 0.001), FEV1 percent predicted (p = 0.038), FEV in 6 seconds (p < 0.001), and peak expiratory flow (p < 0.001). Furthermore, individuals with a high combined intake of vegetables, fruits, meat, and fish demonstrated a 0.261-fold lower COPD prevalence than those without such intake (p = 0.039). The dietary inflammatory index (DII) was significantly lower among participants without COPD than among those with COPD (mean DII = −3.6947, p = 0.002), indicating that a diet rich in anti-inflammatory nutrients can help reduce COPD risk. These findings suggest that vegetable consumption supports improved respiratory function, and a composite dietary pattern incorporating various food groups may help reduce the prevalence of COPD in the adult population.

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