Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun 23;64(5):226.
doi: 10.1007/s00394-025-03744-4.

Dietary carbohydrate intake and health-related outcomes: a protocol for the evidence evaluation methodology for the new guideline on dietary carbohydrate intake of the German nutrition society

Sabrina Schlesinger  1   2 , Johanna Conrad  3 , Anna Maria Amini  3 , Anette Buyken  4 , Sarah Egert  5 , Julia Haardt  3 , Nicole Kalotai  3 , Anja Kroke  6 , Lukas Schwingshackl  7 ; German Nutrition Society
Affiliations

Dietary carbohydrate intake and health-related outcomes: a protocol for the evidence evaluation methodology for the new guideline on dietary carbohydrate intake of the German nutrition society

Sabrina Schlesinger et al. Eur J Nutr. .

Abstract

Purpose: This protocol outlines the rigorous process for developing the new German guideline on dietary carbohydrate intake and its impact on health-related outcomes, building on a substantial body of evidence regarding carbohydrate quantity and quality.

Methods: A professional guideline panel has been established, and research questions have been formulated a-priori. The novel methodological approach follows a structured process and adheres to established recommendations for guidelines.

Results: Umbrella reviews of systematic reviews with meta-analyses of randomized controlled trials or prospective observational studies on carbohydrate quantity and quality in relation to health-related outcomes will be conducted. Relevant aspects of carbohydrate intake include total carbohydrates, dietary sugars, starch, the dietary glycaemic index, the dietary insulin index, dietary glycaemic load, dietary insulin load, dietary fibre, and whole grains. The prioritized outcomes include body weight-related outcomes, type 2 diabetes, dyslipidemia, elevated blood pressure, cardiovascular diseases, cancer, and dental caries and periodontal diseases. The literature search will be conducted in MEDLINE and Epistemonikos starting from 2015, as older reports are likely covered or superseded by more recent ones. The most comprehensive systematic review with meta-analysis with the highest methodological quality standards (according to a modified version of AMSTAR 2) will be selected for each specific association or effect. The certainty of evidence will be rated using the GRADE approach. The guideline development will follow the Evidence-to-Decision (EtD) framework.

Conclusions: This methodological protocol is in line with international standards and provides transparent framework for the guideline on dietary carbohydrate intake and health-related outcomes of the Germany Nutrition Society.

PubMed Disclaimer

Conflict of interest statement

Declarations. Conflict of interest: AEB is a member of the International Carbohydrate Quality Consortium (ICQC), a member of the Scientific committee of the transnational governance of the Nutri-Score system, a member of the Scientific Advisory Council for Agricultural Policy, Nutrition and Consumer Health Protection, Federal Ministry of Food and Agriculture Germany and a co-author of the popular cookbook “Nordisch abnehmen”. These contributions are unrelated to the work under consideration and have no influence on its conduct or conclusions.

References

    1. Zeraatkar D, Johnston BC, Guyatt G (2019) Evidence collection and evaluation for the development of dietary guidelines and public policy on nutrition. Annu Rev Nutr 39:227–247. 10.1146/annurev-nutr-082018-124610 - PubMed
    1. Neale EP, Tapsell LC (2019) Perspective: the Evidence-Based framework in nutrition and dietetics: implementation, challenges, and future directions. Adv Nutr 10(1):1–8. 10.1093/advances/nmy113 - PMC - PubMed
    1. Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, Norris S, Falck-Ytter Y, Glasziou P, DeBeer H, Jaeschke R, Rind D, Meerpohl J, Dahm P, Schunemann HJ (2011) GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol 64(4):383–394. 10.1016/j.jclinepi.2010.04.026 - PubMed
    1. Schunemann HJ, Cuello C, Akl EA, Mustafa RA, Meerpohl JJ, Thayer K, Morgan RL, Gartlehner G, Kunz R, Katikireddi SV, Sterne J, Higgins JP, Guyatt G, Group GW (2019) GRADE guidelines: 18. How ROBINS-I and other tools to assess risk of bias in nonrandomized studies should be used to rate the certainty of a body of evidence. J Clin Epidemiol 111:105–114. 10.1016/j.jclinepi.2018.01.012 - PMC - PubMed
    1. Moberg J, Oxman AD, Rosenbaum S, Schunemann HJ, Guyatt G, Flottorp S, Glenton C, Lewin S, Morelli A, Rada G, Alonso-Coello P, Group GW (2018) The GRADE evidence to decision (EtD) framework for health system and public health decisions. Health Res Policy Syst 16(1):45. 10.1186/s12961-018-0320-2 - PMC - PubMed

LinkOut - more resources