The development of the 2020 dietary reference intakes for korean population: Lessons and challenges

The discovery of the relationship between nutrients and deficiency diseases during the 100 years from the mid-1800s to the mid-1900s was a breakthrough that led to advances in the study of nutrition. The Recommended Dietary Allowances (RDA) were created as a quantitative standard for avoiding diseases caused by nutrient deficiency. In addition, a reductionism paradigm has become generally accepted among nutrition scholars in health and disease, which focused on the properties of individual nutrients, content in foods, cellular levels, and mechanisms of action. The reductionist paradigm worked very well for the prevention and treatment of malnutrition diseases. However, as the incidence of nutrient deficiencies decreased and that of chronic diseases increased, the nutrition goals have been changed to secure safe and adequate nutrient intake and to reduce chronic disease risks. Accordingly, Dietary Reference Intakes (DRIs), a set of nutrient-based reference values, were designed to replace the RDA. The revised Korean DRIs were published for 40 nutrients in 2020. However, there is still room for improvement in the reference intake levels targeted at reducing the risk of chronic disease. The reductionist approach can no longer be practical because chronic diseases are related to the interactions between multi-components in the foods and multi-targets in the body. Therefore, a second innovative leap is needed following the nutrition development breakthrough made over 100 years ago. To this end, the nutrition paradigm must evolve from reductionism to a holism approach. Cutting-edge scientific technologies, such as metabolomics, transcriptomics, microbiomics, and bioinformatics, should also be acceptable in nutrition science based on the knowledge gained from basic nutrition studies.