Chapter 4: Carbohydrates

Professor R. I. Al-Nimr, MS, RD, LD NTRN 201 Spring 2014

Carbohydrates have many functions

1. Primary source of energy, especially for our brain and nervous system 2. Spares protein from being wasted 3. Maintains normal balance of water and sodium 4. Precursor compound for many body tissues 5. Helps in absorption of some nutrients 6. Needed for fat metabolism 7. Helps Central Nervous System function 8. Effects the growth of good bacteria 9. Provides fiber/bulk 10. Adds flavor, color, and texture to the diet

Carbohydrates in Foods
Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Dairy Fruits Grains Grains

Vegetables Vegetables

Protein Protein

ChooseMyplate.gov
Grains
All varieties

MyPlate: Sources of Carbohydrates

Vegetables
All varieties

Fruits
All varieties

Dairy
Milk Yogurt 12 grams per serving

Protein
Beans Nuts 4-10 grams per serving

15 grams per serving

5 grams per serving

18 grams per serving

(grains): Keith Weller/USDA; (vegetables): Mitch Hrdlicka/Getty Images RF; (fruits): Ingram Publishing/SuperStock RF

Top 5 sources of CHO in American diet??

White bread Soft drinks Cookies and cakes (and doughnuts) Sugars/syrups/jams Potatoes

Photosynthesis

Carbohydrates = CHO

Classified as simple or complex Made up of 3 elements: Carbon Hydrogen Oxygen

Monosaccharides = Simple CHO

Glucose Fructose Galactose

Glucose
Major monosaccharide in the body Also known as dextrose In bloodstream called blood sugar Breakdown of starches and sucrose Source of fuel for cells

Fructose (fruit sugar)

In fruit, honey, and high-fructose corn syrup Converted into glucose in the liver

Galactose

Does not occur in foods to any significant extent Primarily is found in food as part of the disaccharide lactose Converted to glucose in the liver

Disaccharides: Simple CHO

Sucrose (Gluc + Fruc) Table sugar Lactose (Galactose + Gluc) Milk products Maltose (Gluc + Gluc) Fermentation Alcohol production

Complex Carbohydrates
Oligosaccharides Starch: Amylose, Amylopectin Glycogen Dietary fiber

Oligosaccharides
3 to 10 monosaccharides Cannot be digested Chicory root, inulin Occur naturally in some foods

Polysaccharides
Starch = glucose units linked in long, occasionally branched chains. Human digestive enzymes can digest these bonds, retrieving glucose. Glycogen = bonds between glucose units, like those of starch, can be broken by human enzymes, but the chains are more highly branched. Dietary fiber = bonds that link glucose units together are different from those of starch and glycogen. Human enzymes cannot digest them.

Common Starches

Glycogen

Storage form of carbohydrate for animals and humans Structure similar to amylopectin Stored in the liver and skeletal muscles

Dietary Fiber

Indigestible CHO Body cannot break the bonds Insoluble fiber Cellulose, hemicellulose, lignin Not fermented by the bacteria in the colon Soluble fiber Gum, pectin, mucilage Fruit, vegetable, rice bran, psyllium seed

Soluble and Insoluble Fiber

Benefits of Dietary Fiber

Sweeteners

High-fructose Corn Syrup

55% fructose Cornstarch mixed with acid and enzymes Starch is broken down to glucose Some glucose is converted to fructose Cheaper than sucrose Does not form crystals

Other Types of Sweeteners

Brown sugar Turbinado sugar (raw sugar) Maple syrup Honey

Sugar Substitutes

Saccharin (Sweet & Low)

First produced in 1879 180-200x sweeter than sucrose No potential risk in humans

Sugar Alcohols
Sorbitol, Xylitol ~2.6 kcals/gram Large quantities can cause diarrhea Do not promote tooth decay Xylitol can actually inhibit bacteria that cause oral caries (cavities)

Gums

Aspartame (Equal, NutraSweet)

Composed of phenylalanine, aspartic acid, and methanol 180-200x sweeter than sucrose 4 kcal/gm Not heat stable Complaints of sensitivity Headaches, dizziness, seizures, nausea, etc. Acceptable daily intake: 50 mg per kg body weight (FDA) (~14 cans of diet soda for average adult per day) Warning label for Phenylketonuria (PKU)

Sucralose (Splenda)

600x sweeter than sucrose Substitutes chlorines for hydroxyl groups on sucrose Heat stable Tiny amount digested

Stevia (Truvia)
Stevia is a plant (specifically, a member of the chrysanthemum family) native to portions of northeastern Paraguay. It has been used to sweeten foods and beverages for more than 200 years. Initially NOT approved by FDA as an additive Heat stable, 300 times sweeter than sugar Made from rebiana, the best tasting part of the stevia leaf, erythritol and natural flavors

Acceptable Daily Intakes (ADI)

Real Sugar?

Carbohydrate Digestion

Effects of Cooking
Softens fibrous tissues Easier to chew and swallow

Digestion of Carbohydrate in the Mouth

Salivary amylase Breaks starch to shorter saccharides Prolonged chewing Short duration in the mouth

Digestion of Carbohydrate in the Stomach

Acidic environment No further starch digestion

Digestion of Carbohydrate in the Small Intestine

Pancreas releases enzymes Pancreatic amylase Cells in the small intestine release Maltase Sucrase Lactase Monosaccharides are absorbed

Carbohydrate Digestion

Lactose Maldigestion
Reduction in lactase (enzyme that digests lactose) Lactose is undigested and not absorbed Lactose is metabolized by large intestinal bacteria Causes gas, bloating, cramping, discomfort Primary lactose maldigestion Secondary lactose maldigestion Severe cases are called lactose intolerance

What To Do if You Have Lactose Maldigestion or Lactose Intolerance

Determine amount you can tolerate Eat dairy with fat Cheese & yogurt are usually well tolerated Use lactase-treated milk or take enzyme pills before dairy

After Absorption
Monosaccharides are transpoted to the liver via the portal vein Liver can: Transform monosaccharides into glucose Release glucose back into the bloodstream Store as glycogen (or fat)

Undigested Carbohydrates
Only a minor amount escapes digestion Travels to the colon Fermentation by the bacteria Acids and gases produced are absorbed May promote health of the colon

Functions of Carbohydrate
Supplies energy Adds sweetness to foods Spares protein Prevents ketosis

Protein-sparing action of CHO

Allows protein to be used in the body as intended Ketones = intermediate products from fat oxidation Water loss (dehydration) Sodium imbalance Stress on the kidneys Nausea Decreased appetite Fatigue Ketosis = a condition when an undesirably high concentration of ketone bodies, such as acetone, is in the blood or urine. This disturbs normal acid-base balance and leads to other health problems.

Regulation of Blood Glucose

Hyperglycemia Hypoglycemia

Blood Glucose Control

Role of the liver
Regulates glucose that enters bloodstream

Role of the pancreas

Release of insulin Release of glucagon

Functions of Insulin
Promotes glycogen synthesis Increases glucose uptake by the cells Reduces gluconeogenesis Net effect: lowers blood glucose

Functions of Glucagon
Breakdown glycogen Enhances gluconeogenesis Net effect: raises blood glucose

Epinephrine / Norepinephrine
Fight or flight response Breakdown glycogen Raises blood glucose

Regulation of Blood Glucose

Glycemic Response
Glycemic Index Ratio of blood glucose response to a given food Glycemic Load Grams of carbohydrate in a food multiplied by the glycemic index of that food Divide result by 100

Dietary Fiber and Health

Diverticulosis/Diverticulitis

Weight Control and Soluble Fiber

Slows down gastric emptying time Low in kcal Satisfied after eating

Colon Cancer and Fiber

Conflicting research study results Focus on fruits, vegetables, beans, and whole grains Higher-fiber foods are more nutrient dense

Glucose Absorption and Fiber

Soluble fiber slows glucose absorption

Better blood glucose regulation

Cholesterol and (Soluble) Fiber

Absorption of cholesterol inhibited Bile acid absorption reduced Risk for cardiovascular disease and gallstones reduced Insulin release decreased Decrease cholesterol synthesis in the liver Blood cholesterol lowered

Carbohydrate Needs
RDA is 130 grams/day for adults Average U.S. intake is 180-330 grams Recommendations vary FNB: 45%-65% of total calories Nutrition Facts panel: 60% Focus on fruits, vegetables, whole grains

Recommendations for Complex Carbohydrates

Daily Value 300 grams of complex carbohydrate or 60% of total calories Healthy People 2020 Increase the contribution of whole grains to the diets of the population aged 2 years and older World Health Organization (WHO) Lower limit: 50% of total calories from complex carbohydrates Upper limit: 75% of total calories from complex carbohydrates

We can easily get the 130 grams of CHO per day from:
1 cup of cereal = 30 grams 2 slices of bread = 30 grams 1.5 cups of fruit = 45 grams 1.5 cup of milk = 18 grams 1 cup vegetables = 10 grams TOTAL = 133 grams

1 tsp. of sugar = 4 grams

Recommended Dietary Fiber Intake

AI is 25 grams/day for women AI is 38 grams/day for men (Goal of 14 grams/1000 kcal) DV is 25 grams for 2000 kcal diet Average U.S. intake: 14 grams/day for women 17 grams/day for men

Too Much Fiber

> 60 grams/day Extra fluid needed May decrease availability of some minerals

Recommendations for Simple Sugar Intake

Low nutrient density Dental caries Added to food and beverages < 10% of total kcal/day with a maximum of 50 grams (12 tsp) per day--WHO Average U.S. intake: 16% of total kcal/day ~82 grams per day

How to control simple carbohydrates in your own diet

Decrease your sweets (cut down the soft drinks, increase water and milk) Avoid presweetened items (i.e. cereals) Add your own sugar, so that you can control the amounts -Every teaspoonful of sugar gives us 16 calories and 4 grams of CHO Learn to like a less sweet tastewean yourself off sugar Combine sweet foods with more nutritious ones. Avoid the "caffeine & calories" breaks. Have cereal, toast, milk, juice instead (or go for a "walk break"). Read labels. Look for sugar, sucrose, fructose, corn syrup, honey, molasses, etc. Watch out for low fat productssugar is often used to make the product taste good

EXAMPLES OF WHOLE GRAINS

WHOLE GRAIN WHOLE WHEAT Whole-wheat bread Whole-wheat pasta Brown or wild rice Whole grain cereal Popcorn Oatmeal Whole-wheat tortillas Bulgur Quinoa Whole grain barley

WHOLE GRAIN WHOLE WHEAT

http://www.celiac.com/

Dental Caries
Begin oral hygiene when teeth appear Seek early dental care Fluoridated water Fluoridated toothpaste Snacks in moderation Tooth sealants Avoid sticky foods Sugarless gum