1.Main revisions to carbohydrate intake reference values in the 2025 Dietary Reference Intakes for Koreans
Miae DOO ; YoonJu SONG ; Jeong Hyun LIM ; Ja Young JEON ; Wookyoung KIM
Journal of Nutrition and Health 2026;59(2):148-158
The recommendations for carbohydrate intake were revised in the 2025 Korean Dietary Reference Intakes to reflect updated evidence on chronic disease risk and to clarify the interpretation of the Estimated Average Requirement (EAR) and Recommended Nutrient Intake (RNI). These revisions aim to strengthen both the scientific basis and the practical interpretation of carbohydrate intake guidance across the life course of an individual. For individuals aged 1 year and older, the Acceptable Macronutrient Distribution Range for carbohydrates was lowered from 55–65% of total energy to 50–65%. This adjustment reflects accumulating evidence from prospective cohort studies and meta-analyses indicating that very high carbohydrate intake is associated with an increased risk of adverse health outcomes. In contrast, an intake of approximately 50–55% of total energy is associated with the lowest mortality risk. Importantly, this change does not imply a preference for low-carbohydrate diets, as overall dietary quality, including carbohydrate quality, remains a critical consideration. The EAR (100 g/day) and RNI (130 g/day) are derived from estimates of brain glucose utilization and metabolic adaptation and should be interpreted as physiological minimum intake levels rather than population-based intake targets. In addition, life-stage-specific recommendations were updated based on new evidence, including recalculating the Adequate Intake (AI) for infants (55 g/day for 0–5 months and 85 g/day for 6–11 months) and revising the additional requirements during pregnancy (+35 g/day) and lactation (+55 g/day).Because no Tolerable Upper Intake Level (UL) has been established for total carbohydrate intake, excess intake should be managed through dietary adjustments, including limiting added sugars and refined carbohydrates, ensuring adequate fiber intake, and maintaining overall macronutrient balance. Collectively, these revisions provide an updated evidencebased framework for carbohydrate intake guidance for the Korean population.
2.Health Effects of Sugar-Sweetened and Artificially Sweetened Beverages: Umbrella Review and Evidence-Based Consensus Statement of the Korean Diabetes Association and the Korean Nutrition Society
Jong Han CHOI ; SuJin SONG ; Soo Kyoung KIM ; Jae Won CHO ; Jae Hyun BAE ; Shinje MOON ; Jeong Hyun LIM ; YeonHee LEE ; Ji-Yun HWANG ; YoonJu SONG ; Sang Soo KIM
Diabetes & Metabolism Journal 2026;50(1):32-46
Background:
Excess intake of added sugars contributes to obesity, type 2 diabetes mellitus (T2DM), cardiovascular disease (CVD), and premature mortality. Sugar-sweetened beverages (SSBs), the main source of added sugars, are consistently linked to adverse outcomes. Artificially sweetened beverages (ASBs) have been suggested as short-term substitutes, but evidence regarding benefits and harms remains inconclusive, and guidance is lacking.
Methods:
This consensus statement draws on a structured evidence review combining two approaches: an updated meta-analysis of randomized controlled trials (RCTs) assessing short- to intermediate-term effects of replacing SSBs with ASBs on weight and metabolic outcomes; and an umbrella review of systematic reviews of cohort studies evaluating long-term associations of SSBs and ASBs with major outcomes, including mortality, CVD, and T2DM.
Results:
In 14 RCTs (3–76 weeks), replacing SSBs with ASBs produced modest reductions in body weight (–0.73 kg) and body fat (–0.72%), with inconsistent effects on glycemic and cardiometabolic markers. Evidence from 20 systematic reviews of cohorts (up to 34 years follow-up) showed that higher intake of both SSBs and ASBs was associated with increased risks of T2DM, CVD, and mortality, with relative risks for ASBs similar to those for SSBs.
Conclusion
ASBs may serve as a short-term substitution for individuals with high SSB intake, particularly those at elevated metabolic risk. However, regular or long-term use is not recommended due to uncertain safety and potential reinforcement of sweet preference. Public health strategies should emphasize reducing both SSBs and ASBs, prioritizing water and unsweetened beverages as the ultimate goal.
3.The Impact of Non-Sugar Sweetener on Health Outcomes in the General Population and Patients with Diabetes
Shinje MOON ; Soo Kyoung KIM ; Jong Han CHOI ; Yoonju SONG ; Jeong Hyun LIM ; Jae Won CHO ; Sang Soo KIM
Journal of Korean Diabetes 2024;25(4):211-216
Non-sugar sweeteners (NSS) are low in calories and can be used in very small amounts. Both the U.S. Food and Drug Administration and Korea Ministry of Food and Drug Safety have stated that consuming NSS within the recommended dosage is not harmful to human health. Nonetheless, the World Health Organization in its 2023 guidelines on NSS use advised the general population against the consumption of NSS as a means of controlling weight and reducing the risk of chronic diseases, including diabetes. However, there is insufficient evidence regarding the health benefits and potential risks of NSS for patients with diabetes. Given the ongoing debate about the efficacy of NSS, the 2023 clinical guidelines of the Korean Diabetes Association recommend minimizing beverages containing sugar or NSS, although NSS may help reduce sugar intake in the short term. This review aims to explore the latest research on the benefits and risks of NSS for the general population and patients with diabetes.
4.The Impact of Non-Sugar Sweetener on Health Outcomes in the General Population and Patients with Diabetes
Shinje MOON ; Soo Kyoung KIM ; Jong Han CHOI ; Yoonju SONG ; Jeong Hyun LIM ; Jae Won CHO ; Sang Soo KIM
Journal of Korean Diabetes 2024;25(4):211-216
Non-sugar sweeteners (NSS) are low in calories and can be used in very small amounts. Both the U.S. Food and Drug Administration and Korea Ministry of Food and Drug Safety have stated that consuming NSS within the recommended dosage is not harmful to human health. Nonetheless, the World Health Organization in its 2023 guidelines on NSS use advised the general population against the consumption of NSS as a means of controlling weight and reducing the risk of chronic diseases, including diabetes. However, there is insufficient evidence regarding the health benefits and potential risks of NSS for patients with diabetes. Given the ongoing debate about the efficacy of NSS, the 2023 clinical guidelines of the Korean Diabetes Association recommend minimizing beverages containing sugar or NSS, although NSS may help reduce sugar intake in the short term. This review aims to explore the latest research on the benefits and risks of NSS for the general population and patients with diabetes.
5.The Impact of Non-Sugar Sweetener on Health Outcomes in the General Population and Patients with Diabetes
Shinje MOON ; Soo Kyoung KIM ; Jong Han CHOI ; Yoonju SONG ; Jeong Hyun LIM ; Jae Won CHO ; Sang Soo KIM
Journal of Korean Diabetes 2024;25(4):211-216
Non-sugar sweeteners (NSS) are low in calories and can be used in very small amounts. Both the U.S. Food and Drug Administration and Korea Ministry of Food and Drug Safety have stated that consuming NSS within the recommended dosage is not harmful to human health. Nonetheless, the World Health Organization in its 2023 guidelines on NSS use advised the general population against the consumption of NSS as a means of controlling weight and reducing the risk of chronic diseases, including diabetes. However, there is insufficient evidence regarding the health benefits and potential risks of NSS for patients with diabetes. Given the ongoing debate about the efficacy of NSS, the 2023 clinical guidelines of the Korean Diabetes Association recommend minimizing beverages containing sugar or NSS, although NSS may help reduce sugar intake in the short term. This review aims to explore the latest research on the benefits and risks of NSS for the general population and patients with diabetes.
6.The Impact of Non-Sugar Sweetener on Health Outcomes in the General Population and Patients with Diabetes
Shinje MOON ; Soo Kyoung KIM ; Jong Han CHOI ; Yoonju SONG ; Jeong Hyun LIM ; Jae Won CHO ; Sang Soo KIM
Journal of Korean Diabetes 2024;25(4):211-216
Non-sugar sweeteners (NSS) are low in calories and can be used in very small amounts. Both the U.S. Food and Drug Administration and Korea Ministry of Food and Drug Safety have stated that consuming NSS within the recommended dosage is not harmful to human health. Nonetheless, the World Health Organization in its 2023 guidelines on NSS use advised the general population against the consumption of NSS as a means of controlling weight and reducing the risk of chronic diseases, including diabetes. However, there is insufficient evidence regarding the health benefits and potential risks of NSS for patients with diabetes. Given the ongoing debate about the efficacy of NSS, the 2023 clinical guidelines of the Korean Diabetes Association recommend minimizing beverages containing sugar or NSS, although NSS may help reduce sugar intake in the short term. This review aims to explore the latest research on the benefits and risks of NSS for the general population and patients with diabetes.
7.The Impact of Non-Sugar Sweetener on Health Outcomes in the General Population and Patients with Diabetes
Shinje MOON ; Soo Kyoung KIM ; Jong Han CHOI ; Yoonju SONG ; Jeong Hyun LIM ; Jae Won CHO ; Sang Soo KIM
Journal of Korean Diabetes 2024;25(4):211-216
Non-sugar sweeteners (NSS) are low in calories and can be used in very small amounts. Both the U.S. Food and Drug Administration and Korea Ministry of Food and Drug Safety have stated that consuming NSS within the recommended dosage is not harmful to human health. Nonetheless, the World Health Organization in its 2023 guidelines on NSS use advised the general population against the consumption of NSS as a means of controlling weight and reducing the risk of chronic diseases, including diabetes. However, there is insufficient evidence regarding the health benefits and potential risks of NSS for patients with diabetes. Given the ongoing debate about the efficacy of NSS, the 2023 clinical guidelines of the Korean Diabetes Association recommend minimizing beverages containing sugar or NSS, although NSS may help reduce sugar intake in the short term. This review aims to explore the latest research on the benefits and risks of NSS for the general population and patients with diabetes.
8.2023 Clinical Practice Guidelines for Diabetes Mellitus of the Korean Diabetes Association
Jong Han CHOI ; Kyung Ae LEE ; Joon Ho MOON ; Suk CHON ; Dae Jung KIM ; Hyun Jin KIM ; Nan Hee KIM ; Ji A SEO ; Mee Kyoung KIM ; Jeong Hyun LIM ; YoonJu SONG ; Ye Seul YANG ; Jae Hyeon KIM ; You-Bin LEE ; Junghyun NOH ; Kyu Yeon HUR ; Jong Suk PARK ; Sang Youl RHEE ; Hae Jin KIM ; Hyun Min KIM ; Jung Hae KO ; Nam Hoon KIM ; Chong Hwa KIM ; Jeeyun AHN ; Tae Jung OH ; Soo-Kyung KIM ; Jaehyun KIM ; Eugene HAN ; Sang-Man JIN ; Won Suk CHOI ; Min Kyong MOON ; ;
Diabetes & Metabolism Journal 2023;47(5):575-594
In May 2023, the Committee of Clinical Practice Guidelines of the Korean Diabetes Association published the revised clinical practice guidelines for Korean adults with diabetes and prediabetes. We incorporated the latest clinical research findings through a comprehensive systematic literature review and applied them in a manner suitable for the Korean population. These guidelines are designed for all healthcare providers nationwide, including physicians, diabetes experts, and certified diabetes educators who manage patients with diabetes or individuals at risk of developing diabetes. Based on recent changes in international guidelines and the results of a Korean epidemiological study, the recommended age for diabetes screening has been lowered. In collaboration with the relevant Korean medical societies, recently revised guidelines for managing hypertension and dyslipidemia in patients with diabetes have been incorporated into this guideline. An abridgment containing practical information on patient education and systematic management in the clinic was published separately.
9.Morus Nigra Extract Attenuates Cognition Impairment and GABAergic Interneuron Degeneration in Aged Rat Brain
Joo Hee LEE ; Yoonju KIM ; Min Kyung SONG ; Youn-Jung KIM
Journal of Korean Biological Nursing Science 2022;24(2):77-85
Purpose:
Aging process comes with cognitive impairment due to decreased neuronal cell number, activity, and neuronal circuit. Alteration of inhibitory neurons contributes to cognitive impairment in normal aging and is responsible for disrupting the excitation/ inhibition balance by reducing the synthesis of gamma-aminobutyric acid (GABA). Morus nigra (Mulberry) is a natural physiologically active substance that has been proven to have anti-oxidant, anti-diabetic, and anti-inflammatory effects through many studies. This study aimed to evaluate the effects of the mulberry extract (ME) on cognitive function through anti-oxidant enzyme and GABAergic neuronal activity in aged rat brain.
Methods:
Sprague Dawley rats were randomly assigned as the young group (8 weeks, n = 8), aging group (67 weeks, n = 8), and aging + mulberry extract group (67 weeks, n = 8). The aging + mulberry extract group was orally administered 500 mg/kg/d mulberry extract for 6 weeks.
Results:
The aging + mulberry extract group improved spatial and short-term memory. The antioxidant potential of ME increased the expression of superoxide dismutase-1 (SOD-1) and decreased inducible nitric oxide synthase (iNOS). Also, the aging + mulberry extract group significantly increased the expression of GABAergic interneuron in hippocampus cornu ammonis1 (CA1) compared to the aging group.
Conclusion
The number of GABAergic inhibitory interneurons was deceased and memory functions in the aging process, but those symptoms were improved and restored by mulberry extract administration.
10.The Consumption Pattern of Sugar-Sweetened Beverages and its Comparison with Body Composition Change from a Four-Week Time-Restricted Eating Intervention in Korean Young Adults
Korean Journal of Community Nutrition 2022;27(1):36-46
Objectives:
The purpose of this study was to evaluate the consumption pattern of sugarsweetened beverages (SSB) and compare body composition changes by SSB consumption based on 28 days of dietary records from a four-week time-restricted eating intervention among young adults in Korea.
Methods:
A total of 33 participants completed the four-week dietary intervention with 8-hour time-restricted eating (TRE). The body composition was measured by bioelectrical impedance analysis at baseline, and daily dietary records were collected for 28 days during the intervention after 4 weeks.
Results:
Based on 924 days of dietary records, the average eating occasion of SSB was 0.9 times per day, and the average amount of SSB was 205.8 g/times. Based on an individual’s usual intake of 28 days, the average eating frequency of SSB was 16.6 times out of 28 days, and the average amount of SSB was 184.0 g/day. The average energy intake from SSB was 131.0 kcal /day (8.7% of energy), and sugar intake from SSB was 18.2 g/day (4.9% of energy). The sugar intake was 2.6% of energy from sweetened dairy products, followed by 2.0% from coffee drinks, 0.5% from soda and juice and 0.2% from others.When subjects were divided into high (14 days or more) and low (less than 14 days) SSB groups based on eating frequency, the weight change in the low SSB group was -2.0 kg over 4 weeks, which was significantly lower than -0.7 kg in the high SSB group. However, no significant difference was found in muscle mass, fat mass and body fat percent between the two groups.
Conclusions
This study suggests that low consumption of sugar-sweetened beverages is more desirable in weight management despite having the dietary intervention of timerestricted eating without counting calories. Thus, further longitudinal studies on the association between SSB and obesity in Korean adults are necessary.

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