The Carbohydrates Sugars Starches Fiber Objectives • After reading Chapter 3 and class discussion, you will be able to: – Describe the functions of CHO – Identify the classification of CHO – Describe CHO digestion & absorption – Identify food sources of CHO – Calculate calories from CHO Objectives • Differentiate between soluble and insoluble fiber • Identify foods that are a significant source of fiber • Discuss health related effects of CHO in – Diabetes – Obesity -GI -Heart Disease -Cancer Photosynthesis • Plants make their own carbohydrates from – carbon dioxide in air – water from the soil • Photosynthesis converts energy from sunlight into energy stored in carbohydrates 4 Categories of Carbohydrate • Simple carbohydrates – Natural sugars – Added (Refined) sugars • Complex carbohydrates (polysaccharides) – Starch – Fiber 5 Carbohydrates • Simple carbohydrates –Monosacchares –Disaccharides • Complex carbohydrates –Glycogen –Starches –Fibers Glucose Fructose & Galactose p. 84 Monosaccharides and Disaccharides p. 84 9 Disaccharides • Maltose – Glucose + glucose – Starch breakdown; fermentation – Barley • Sucrose – Glucose + fructose – Table sugar from sugarcane, sugar beet • Lactose – Gucose + galactose – Milk Complex Carbohydrates • Polysaccharides –Glycogen •Storage form of glucose •Stored in liver and muscles –Starches •Long chains of glucose linked together •Straight or branched chains –Fibers •Soluble or viscous •Insoluble or nonviscous Complex Carbohydrates Chemical Structure p. 91 Fig 3-6 Complex Carbohydrate: Starch • Amylose - straight glucose chain • Amylopectin – branched glucose chain • Found only in plant foods: grains, legumes, vegetables, some fruits. • Gelatinization – When starches are heated, they absorb water and swell in size. 13 Complex Carbohydrates • Fibers –Cellulose –Hemicelluloses –Pectins –Legnin –Gums and muscilages –Resistant starches p. 92-98 Complex Carbohydrates • Fibers –Soluble fibers-dissolve in water •Viscous-form gels •Fermentable-digested in colon by bacteria Complex Carbohydrates • Fibers –Insoluble fibers •Nonviscous •Fermented less readily • Phytic acid-binds minerals Carbohydrate Categories • Sugars • Starches • Fibers OR • Simple • Complex Carbohydrate Categories • Monosaccharide – Glucose -Fructose -Galactose • Disaccharide – Maltose -Sucrose -Lactose • Polysaccharide – Glycogen -Starches -Fibers Functions of Carbohydrate • Primary source of body’s energy – Central nervous system and red blood cells rely almost exclusively on glucose. – Glucose stored in liver & muscles as glycogen. • Protein sparing – Prevents breakdown of protein for energy (gluconeogenesis) • Prevents ketone bodies & ketosis – Breakdown of fat for energy 20 Digestion • Mouth –Salivary amylase –Mechanical mixing; chewing • Stomach – Continued mixing of bolus – Fibers and satiety • Small intestine – Maltase, Sucrase, Lactase Digestion • Pancreas – Pancreatic amylase • Large intestine – Colon – Fermentation of viscous fibers • Water, gas, short-chain fatty-acid production Absorption Carbohydrates and Health • Lactose Intolerance • Diabetes • Dental caries • Constipation • Hyperactivity • Obesity • Heart Disease Lactose Intolerance • Symptoms – Abdominal discomfort – Bloating; Intestinal gas formation – Diarrhea • Causes –Primary: Lactase deficiency –Secondary: Mucosal damage p. 89-90 Lactose Intolerance • Prevalence (p. 111) • Ethnic <10% to >80% – – – – – – – – <10% Northern Europeans (Scandinavians) 20% Caucasians 50% Hispanics 60% Inuits 70% Mediterranean peoples 75% African Americans 80% Native Americans >80% Southeast Asians Lactose Content of Food • Whole wheat bread 1 slice • Cheese 1 oz • • • • • • • – Cheddar/American – Parmesan/Cream Doughnut, cake type Chocolate 1 oz Sherbet 1c Cottage cheese Ice Cream 1 c Milk 1c Yogurt 1c 0.5gm 0.5-0.8 1.2 2.3 4.0 7.5 9.0 12.0 15.0 Lactose Intolerance • Dietary changes –May not require the elimination of milk/milk products –Acidophilus milk –Kefir, yogurt –Adequate calcium intake –Conservative vs liberal approach Blood Glucose • Regulating hormones –Insulin •Controls transport of glucose –Glucagon •Release glycogen from liver stores –Epinephrine •Signals liver to release glucose p. 82, 89 • How the body regulates blood glucose p. 96 Blood Glucose • Hypoglycemia – Rare in healthy people • Diabetes –Type 1 diabetes •Failure of insulin production –Type 2 diabetes •Obesity Blood Glucose • Glycemic response – How quickly and how high blood sugar rises after eating • Glycemic index – Method of classifying foods according to their potential for raising blood glucose p. 118 Blood Glucose CAUTION • Glycemic Load – Refers to both the Glycemic Index and the total amount of carbohydrate contained in the food • Factors Influencing Glycemic Index – Effect of mixed meal – Fat, fiber, protein content of food – Amount and type of CHO eaten Added Sugars • Sugars added to a food for sweetening or other purposes – Do not include natural sugars • Other purposes: – Prevent spoilage – Browning – Food for yeast – Hold moisture p. 88 Examples of Added Sugars • White sugar (sucrose) • High-fructose corn syrup or corn syrup • Invert sugar • Brown sugar • Molasses • Honey • Powdered sugar • Raw sugar • Demerara sugar 38 Sugars • Nutrient density • Overused in USA Sugars • Health effects of sugars –Dental caries •Dental plaque p. 88 Oral Health and …… • 20% increase in CVD risk • Risk for stroke even stronger • Release cytokines, CRP, TNF • Endothelial damage • Plaque attachment http://www.videomd.com/OralHealthandCardiovascularD isease-fv-4794.aspx Controversies Of Sugar • Sugar causes obesity • Sugar causes heart disease • What about HFCS? p. 88-89 Controversies Of Sugar • Sugar causes misbehavior in children and criminal behavior in adults • Sugar causes cravings and addictions –Serotonin- mood elevator p. 89 Recommended Intakes of Sugars • DRI –No more than 25% of total daily energy intake •Average U.S. Intake=105#/yr » 30 teaspoons/day Starch and Fiber • Health effects –Heart disease –Diabetes –GI health –Cancer –Weight management Viscous Fibers • SOLUBLE and more fermentable • Gums and mucilages • Pectins • Psyllium • Some hemicelluloses Viscous Fibers • Sources –Wholegrains, fruits, legumes, seeds and husks, vegetables Viscous Fibers • Lower blood cholesterol • Slow glucose absorption • Slow transit of food through upper GI tract • Holds moisture in stools, softening them Viscous Fibers • Yield small fat molecules that the colon can use for energy • Lower risk of heart disease • Lower risk of diabetes Viscous Fibers Nonviscous Fibers • INSOLUBLE and less fermentable • Cellulose • Lignins • Psyllium • Resistant starch • Many hemicelluloses Nonviscous Fibers • Sources –Brown rice, fruits, legumes, seeds, vegetables, wheat bran, whole grains Nonviscous Fibers • Increase fecal weight • Speed fecal passage through colon • Provide bulk and feelings of fullness Nonviscous Fibers • Alleviate constipation • Lower risks of diverticulosis, hemorrhoids, appendicitis • May help with weight management Nonviscous Fibers Starch and Fiber • RDA for carbohydrate –130 g/day –45% - 65% total daily energy intake • Daily Value: 300 g/day; 60% of 2000 kcal diet • Fiber – Daily Value: 25 gm/day – AI: 14 gm/1000 kcal/day Fiber • Grains – Whole Wheat or – 100% Wheat vs – Wheat Bread More on Fiber • Vegetables – ½ c. dry beans, carrots=5-7 gms – ½ c. corn=2 gm; 1c. tomatoes=2 gm – ½ c. broccoli=3-6 gm • Fruits – 1 pear=4-6 gm; canned=4 gm/1c – 1 apple=3-5 – 1 banana, orange=3 Fiber and Food Processing • How much fiber is there in each food? 1 apple 1 c. applesauce 1 c. apple juice Robertson’s Rule of 2’s Food Item Amount Dietary Fiber 100% Bran cereal 1/2 cup or or Miller’s Bran 2 Tablespoons 10-14 grams Whole Wheat Bread 2 slices 4 grams Fresh Fruit 2 pieces 4 grams Vegetables 2 servings 4 grams Total 22-26 grams Alternatives to Sugar • Artificial sweeteners & sugar replacers (nutritive sweeteners) • Stevia-natural, herbal alternative • Guidelines for Use: –More sweet than sugar; use less –FDA approved (p.119 ) –Caution when used in cooking Hot Topic p. 119-121 Alternatives to Sugar • Caution: Patients with PKU • Acceptable Daily Intake (ADI) p. 119 Objectives • After reading Chapter 3 and class discussion, you will be able to: – Describe the functions of CHO – Identify the classification of CHO – Describe CHO digestion & absorption – Identify food sources of CHO – Calculate calories from CHO Objectives • Differentiate between soluble and insoluble fiber • Identify foods that are a significant source of fiber • Discuss health related effects of CHO in – Diabetes – Obesity -GI -Heart Disease -Cancer