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.

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.

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.

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.

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.

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.

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.

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.

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.

BACKGROUND/OBJECTIVES: The long-term health impacts of dietary sugar have begun to be reported. The committee on the 2020 Dietary Reference Intakes for Koreans for sugar intended to update the scientific evidence on the association of added sugar intake with health outcomes, including mortality. This study evaluated the evidence on the association of dietary sugar with the all-cause and cardiovascular disease mortality from cohort studies. SUBJECTS/METHODS: The PubMed and ScienceDirect databases were searched until July 2021. The search terms were based on multiple combinations of keywords, such as added sugar, beverage, and mortality, included in the title or abstract. Two authors independently assessed the eligibility criteria of study selection and extracted the information from each selected article for this systematic review. RESULTS: The literature search identified 276 articles. Seventeen cohort studies met the inclusion criteria and were included in this systematic review. This study extracted information on the cohort and participants, dietary assessment methods, exposure and its comparison groups, health outcomes, and risk measures. Five articles reported added sugar intake, and 15 articles reported the food sources of the added sugar in the association with mortality. Increased mortality was observed in higher added sugar intake and a lower intake of less than 5% of energy, while higher discrepancies between gender, age groups, and countries were noted. In addition, nutritious sugary foods and beverages did not increase mortality. CONCLUSIONS A ‘U’ or ‘J’ shaped relationship between the added sugar intake and mortality was estimated. The observed discrepancy indicated the need for more evidence to establish the dose-response relationship for Koreans.