The Korean Dietary Reference Intakes (KDRIs) are essential guidelines for promoting public health and preventing chronic diseases.For the 2025 KDRI revision, the implementation of a highly standardized and scientifically rigorous systematic review (SR) methodology became dominant to enhance the consistency and reproducibility of evidence synthesis.This paper describes the standardized 8-stage SR and umbrella review (UR) protocol developed for the 2025 KDRIs: 1) formulating research questions and analytic frameworks, 2) establishing selection criteria (PICOTS), 3) literature searching, 4) screening, 5) data extraction, 6) quality assessment, 7) data synthesis, and 8) evidence grading and conclusion derivation.A major hallmark is the transition to the NUtrition QUality Evaluation Strengthening Tools (NUQUEST), which prioritizes the accuracy and maintenance of nutrient exposure while ensuring that the key potential confounders are systematically accounted for.The 2025 protocol expanded its scope by incorporating existing SRs through an UR approach to capture the highest level of global evidence.A case study on sodium and cerebrovascular disease showed that studies previously rated as 'Low Risk' by the generic Newcastle-Ottawa Scale were reclassified as 'Moderate to High Risk' when evaluated using NUQUEST, primarily because of the limitations in dietary assessment validity.The evidence was ultimately synthesized and graded using the Nutrition Evidence Systematic Review grading rubric, considering consistency, directness, precision, and generalizability to the Korean population.The 2025 KDRI protocol minimizes the subjective bias and maximizes scientific integrity by prioritizing nutritional specificity.The adoption of NUQUEST and UR methodologies ensures that the dietary standards are founded on transparent, methodologically sound evidence.This standardized framework provides a robust model for future nutritional evidence synthesis and public health policy development in Korea.
Lee et al. (Thu,) studied this question.