Table 1 Overview of recommendations or guidelines for dietary intakes of total carbohydrate

From: Dietary carbohydrates: a review of international recommendations and the methods used to derive them

Country Total carbohydrate intake recommendation/guideline Justification(s) Reference
Australia/New Zealand Acceptable Macronutrient Distribution Ranges (AMDR): 45–65 %En, predominantly from low energy density and/or low glycaemic index food sources Reference is made to the IOM (Food and Nutrition Board: Institute of Medicine, 2002) interpretation that there is an increased risk for CHD at high carbohydrate intakes (>65%) and increased risk of obesity with low carbohydrate, high fat intakes (45%). The upper bound is set to accommodate requirements for fat (20%) and protein (15%) [36] Australian National Health and Medical Research Council (NHMRC) 2006 [22]
European Food Safety Authority (EFSA) Reference intake range: 45–60 %En A high total carbohydrate intake may be detrimental for serum lipids, whilst a low carbohydrate intake coupled with a high fat intake may contribute to body weight gain. However, data are insufficient to specify precise upper or lower limits of consumption EFSA 2010 [12]
   Recommended range meets energy needs when reference intakes for protein and fat intake have been met, fulfils glucose needs of the brain, and reflects the level in diets which, in combination with reduced intakes of fat and SFA, are compatible with the improvement of metabolic risk factors for chronic disease  
Germany, Austria, Switzerland Target value > 50 %Ena The target value for carbohydrate intake should account for the recommended intake level for total protein and the target value for total fat intake. High carbohydrate intakes contribute to the avoidance of high intakes of (saturated) fat intakes, which are linked to the risk for obesity, further cardiovascular risk factors and other diseases D-A-CH Reference values 2011 [11]
Ireland Recommendation: 45–65 %En No evidence cited and no specific justification given Food Safety Authority of Ireland (FSAI) 2011 [25]
Netherlands Lower limit of 40 %En Derived from requirements for the endogenous production of glucose Health Council of the Netherlands. Dietary Reference Intakes: energy, proteins, fats and digestible carbohydrates 2001 [15]
Nordic countries (Denmark, Iceland, Finland, Norway, Sweden) Acceptable range: 45–60 %En Intake ranges in dietary patterns associated with reduced risk of chronic diseases Nordic Nutrition Recommendations (NNR) 2012 [8]
Spain 50–55 %En No evidence cited and no specific justification given Nutritional objectives for the Spanish population. 2001 [23]
UK Reference value: 50 %En Kept at level of previous UK recommendations, as total carbohydrate intake was found to be neither detrimental nor beneficial to cardio-metabolic or colo-rectal health outcomes considered Scientific Advisory Committee on Nutrition SACN (UK) 2015 [9]
USA/Canada Acceptable Macronutrient Distribution Range (AMDR): 45–65 %En The AMDR is set to minimize the potential for chronic disease over the long-term, permit essential nutrients to be consumed at adequate levels. IoM Dietary Reference Intakes, 2005 [17]
  Recommended Daily Allowance (RDA): 130 g/d The RDA is based on requirements for brain glucose utilization  
WHO Goal: 55–75 %En The percentage energy available after taking into account that consumed as protein and fat WHO/FAO Expert Consultation 2003 [14]
  1. This review uses the term “nutritional recommendation” (NR) for documents providing a numerical recommendation and “food-based guideline” (FBG) for documents providing (qualitative) food-specific guidance only. This terminology may deviate from that used in the original documents
  2. aThe recent NR published by the Swiss nutrition society states that the optimal carbohydrate intake cannot be defined, yet they consider that the target of >50% is too high and that the optimal carbohydrate intake is likely to range between 45 and 55% [37]