Carbohydrates: Plant-Derived Energy Nutrients

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Carbohydrates
How would you answer these questions? 1) The terms carbohydrate and sugar mean the same thing. True or False 2) Diets high in sugar cause tooth decay, diabetes, and obesity. True or False 3) Carbohydrates are the primary fuel source for your brain and body tissues. True or False. 4) Diabetes is a preventable disease. True or False 5) Carbohydrates are fattening. True or False

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Carbohydrates; cont.
6) Diets high in sugar cause hyperactivity in children. True or False 7) Honey or raw sugar is more nutritious than refined table sugar. True or False 8) Alternative sweeteners, such as aspartame (Equal), are safe for us to consume. True or False

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Carbohydrates
One of the three macronutrients Important source of energy for all cells Preferred energy source for blood, brain and nervous system Composed of carbon, hydrogen, oxygen Good sources: plant foods: fruits, vegetables, grains, and in dairy products Foundation of diets in many countries Asia, Latin America, Mediterranean
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Roles of Carbohydrates
Energy
Each gram of carbohydrate: 4 kcal Red blood cells use only glucose for energy Both carbohydrates and fats supply energy for daily activities Glucose is especially important for energy during exercise

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 2011 Pearson Education, Inc.

What Are Carbohydrates?

Glucose
The most abundant carbohydrate Produced by plants through photosynthesis

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 2011 Pearson Education, Inc.

Carbohydrates
Simple carbohydrates Contains one or two molecules commonly referred to as sugars Monosaccharidesone molecule (3) Disaccharidestwo molecules; pairs of monosaccharides (3) Complex carbohydrates polysaccharides; composed of chains of monosaccharides

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 2011 Pearson Education, Inc.

Simple Carbohydrates
Monosaccharides (3)vary in sweetness (fructose sweetest) because of varying chemical structure (although same chemical formula); ose = sugar
C6H12O6

1) Glucosemost abundant sugar molecule in body; referred to as blood sugar or dextrose; energy source for bodys activities 2) Fructosefruit sugar; sweetest natural sugar; naturally in fruits, some vegetables, and honey; part of high fructose corn syrup
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Simple Carbohydrates
3) GalactoseDoes not occur alone in foods. Binds with glucose to form lactose (milk sugar)

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Condensationchemical reaction to form disaccharides (or polysaccharides); smaller to larger molecules

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Hydrolysischemical reaction to break apart disaccharides (and polysaccharides); occurs during digestion; larger to smaller molecules

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Disaccharides (3)
1) Maltoseglucose + glucose; byproduct of fermentation of barleyanaerobic breakdown sugar to alcohol; malt sugar; small amount in corn syrup 2) Sucroseglucose + fructose; table sugar (sugar cane & sugar beets); brown sugar, molasses, maple syrup

3) Lactoseglucose + galactose; milk sugar

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 2011 Pearson Education, Inc.

Complex Carbohydrates
Polysaccharideschains of monosaccharides (glucose); includes: 1) Glycogenstorage form of glucose in body; muscles and liver; allows for rapid release glucose 2) Starchesplant storage of glucose; grains (richest source), legumes, starchy vegetables (body hydrolyzes to glucose) 3) most Fibers non-digestible structural support parts of plants (plants skeleton) such as leaves, stems, seeds; vegetables, fruits, whole grains, legumes

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Complex Carbohydrates
Cellulose and psyllium functional fibers or resistant starch-health benefits (help alleviate constipation) but unlike starch digestive enzymes cannot break apart bonds; thus little or no energy
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Complex Carbohydrate

Fibersex., cellulose, hemicellulose, pectins, lignins, guar gum Total fiber = sum of dietary fiber and functional fiber
*Classified as to solubility (soluble and insoluble) with health benefits based on solubility
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Food Sources of Fiber

Soluble fiber Insoluble fiber
1. Wheat bran, brown rice, whole grains 2. Some vegetables (cabbage, carrots) 3. Some fruits 4. Beans and peas 5. Seeds 1. Beans and peas 2. Some cereal grains (barley, oats) 3. Many fruits (apples, citrus fruits, berries) 4. Many vegetables (carrots)

Some foods contain both soluble and insoluble fibers

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Complex Carbohydrates
Fibers Soluble fibers dissolve in water Viscousform gels Fermentabledigest by bacteria in colon Examples: pectin, gum, mucilage Oats, beans, citrus fruits, apples and berries; may be used as thickening agents for jams and yogurts or dissolvable laxatives Lower blood cholesterol (bad cholesterol) by binding to cholesterol and blocking absorption, slow stomach emptying and glucose absorption; may lower risk heart disease, type 2 diabetes, and obesity
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Complex Carbohydrates
Fibers Insoluble fibers does not dissolve in water; cellulose , hemicellulose, lignins, resistant starch; cannot be digested Nonviscous-does not form gels Found in brown rice and whole grains (outer husk of bran, wheat, rye), legumes, fresh fruits, some vegetables carrots, broccoli, cabbage, beans, seeds; used for thickening and texturizing of foods Help to alleviate constipation, reduce risk for hemorrhoids May reduce risk of colon cancer Provide bulk thus promoting feelings of fullness; delay hunger, thus May help with weight management

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Digestion
Goal of digestion break sugars and starches so body can absorb and use Mouthprocess begins Salivary amylase (ase = enzyme (protein) that facilitates reactions)begins digestion; Hydrolyzes starch smaller polysaccharides Stomachmixing and churning; stomach acid deactivates amylase (halts starch digestion; CHO digestion does not occur in stomach) Fibers and satiety-delay stomach emptying; helps feel full longer

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Digestion
Pancreasproduces CHO digesting enzyme Pancreatic amylase-released into small intestine to further hydrolyze polysaccharides into shorter glucose chains, and Small intestine most digestion of digestive carbohydrates takes place here Maltase, sucrase, lactase enzymes breaks down disaccharides into smallest units (disaccharides monosaccharides) Monosaccharides absorbed into the cells lining the small intestine and then to bloodstream Following digestion: Absorption, nutrients circulate to the liver, cells convert compounds to glucose
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Digestion
Available carbohydrates vs. unavailable carbohydrates Sugars and starches available CHO because digestive enzymes can break down Most Fibers are unavailable because we do not have digestive enzymes to digest

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Digestion
Large intestineafter sugars and starches have been digested (takes about 1-4 hr after meal for digestible CHO from food-ex., bread, to be broken down, absorbed, and circulated to the cells as glucose) only fibers remain and pass undigested to large intestine or colon Fiber attract H20 to help prevent constipation, binds to substances such as bile, cholesterol to lower cholesterol (bad cholesterol = LDL)health benefits
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Digestion
Fermentation of viscous fibers--bacteria in large intestine ferment (digest) some fibers which generate Water, gas, short-chain fatty acid production Small amount energy from small chain fatty acids (1.5 2.5 kcal/g); depends on extent broken down by bacteria and fatty acids are absorbed Generally, fiber has health benefits but contributes little, if any, energy Most fiber remains undigested and is excreted in the feces
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Carbohydrate Digestion
All monosaccharides are converted to glucose by the liver Glucose circulating in the blood is our primary energy source Excess glucose is stored as glycogen in the liver and muscles

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 2011 Pearson Education, Inc.

Absorption

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Digestion and Absorption--CHO

Summary Body breaks down polysaccharides into disaccharides, disaccharides into monosaccharides, monosaccharides into glucose to fuel your body functions (preferred fuel) Majority of digestion takes place in small intestine (digestible carbohydrates) The fibers help regulate the passage of food through the GI (gastrointestinal tract) and slow the absorption of glucose, but contribute little, if any, energy Fibers are soluble and insoluble
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Lactose Intolerance
Symptomsbloating, nausea, cramping, intestinal gas and diarrhea; differs from milk allergy which is caused by an immune reaction to the protein in milk Causes-body does not produce sufficient enzyme lactase in small intestine to break down lactose (milk sugar) before reaches large intestine; undigested lactose attracts water and becomes food for intestinal bacteria; thus intestinal symptoms (gas, bloating, diarrhea) May be the result of aging with diet less reliant on milk, genetics, chemotherapy, surgery or injury to small intestine, or intestinal infections
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Lactose Intolerance
Prevalencevaries among ethnic groups; lowest among Americans of northern European descent (15%) and high among Asian Americans (90%), American Indians, Hispanic Americans, and African Americans (75%) Dietary changesrequires some changes but: Does not require the elimination of milk/milk products; often 1-2 Cups/day can be tolerated with meals (not alone) and spread out during day; milk major source of calcium, vitamin D Acidophilus milk or fermented milk products such as yogurt and hard cheeses may be tolerated; also Lactaid drops (enzyme drops) to add to milk
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Carbohydrate Metabolism
Storing glucose as glycogen-liver stores ~ 1/3; releases glucose into bloodstream as needed Muscle cells also store glucose as glycogen (2/3 bodys glycogen)using it during exercise Using glucose for energyglucose fuels work of most of the bodys cells; chief energy nutrient
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Carbohydrate Metabolism
Glucose preferred fuelbrain, nerve cells, red blood cells But if, insufficient CHO: body forced to alter use of protein and fats Gluconeogenesismaking glucose from non-carbohydrate source (predominantly protein) Protein-sparing action of carbohydrates (and moderate fat)prevent protein from being used to make glucose for energy; allow protein to be used for unique roles

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Carbohydrate Metabolism
Amino acids from these proteins cannot be used to make new cells, repair tissue damage, support the immune system, or perform any of their other functions
**Need adequate energy and CHO and fat to spare protein

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Carbohydrate Metabolism
Ketosis-- making ketone bodies from fat fragments with inadequate CHO, ketone bodies provide alternate fuel; product of incomplete breakdown of fat Ketosiscondition disturbs bodys acidbase balance; body needs adequate CHO; ketones spill out in blood and urine; excess ketones increase blood acidity and cause ketoacidosis Causes nausea, fatigue, low blood pressure, stress on kidneys, loss of lean body tissue **Thus, adequate CHO is necessary to spare body protein and prevent ketosis CHO DRI = 130 g per day for adults
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Carbohydrate Metabolism
Converting glucose to fatexcess glucose stored as fat (after meeting energy needs and filling glycogen stores)

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Constancy of Blood Glucose

Regulating hormonesblood glucose regulated by 2 hormones: insulin and glucagon (homeostasis): Insulinafter meal, hormone secreted in pancreas in response to increased blood glucose; key to transporting glucose from bloodstream into muscle and liver; stimulates the liver to take up glucose and convert to glycogen Glucagonbetween meals, hormone released in pancreas in response to low blood glucose; triggers breakdown of liver glycogen to circulate glucose; also involved in gluconeogenesis (production glucose from amino acids)
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 2011 Pearson Education, Inc.

 2011 Pearson Education, Inc.

Constancy of Blood Glucose

Normal blood glucose: without diabetes-fasting-- 70-100 mg/dl; 2 hrs after meal 70140 mg/dl; diabetes diagnosed if fasting is 126 mg/dl after 2 consecutive tests
Source: American Diabetes Association

When low, get glucose from food or glycogen (liver stores) When high, signal body to take in surplus glucose Recommend regular, balanced meals at regular intervals with abundant complex CHO and fiber, Mixture of carbohydrate, protein, and moderate fat for steady, and gradual supply of glucose Goalhomeostasis; concern with individuals with diabetes; at extremes can be fatal

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Constancy of Blood Glucose

3rd Regulating Hormone Epinephrine and norepinephrine Fight or Flight hormone; hormone of adrenal gland that acts quickly to release glucose in response to stress (from liver glycogen to blood); also called adrenaline

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Constancy of Blood Glucose

Usually body regulates blood glucose except when blood glucose regulation fails; diabetes or hypoglycemia Diabetesdisorder resulting from either no insulin or inadequate insulin production; dietary CHO does not cause Type 1 diabetes also called juvenile diabetes; cause unknown but may be an autoimmune disease; requires external insulin to regulate blood glucose Failure of insulin production Type 2 diabetes formally called adult onset but seen with children and adolescents; Obesity and family history Body makes insulin but ineffective
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 2011 Pearson Education, Inc.

 2011 Pearson Education, Inc.

Diabetes
Type 2 Diabetes Maintaining healthy weight important If on medications, weight loss (10 to 20 pounds) with regular physical activity can help improve insulin resistance Diet important part of diabetes treatment (type 1 and 2) In past, sugars were excluded with strict exchange diet; now emphasis is on a balanced diet with complex CHO (simple sugars limited to be eaten with meals) to provide a fairly consistent carbohydrate intake (meals and snacks spaced evenly during the day) to maintain near-normal blood glucose and weight loss for type 2 Individuals learn to count CHO using exchange system

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Constancy of Blood Glucose

Hypoglycemia blood glucose drops dramatically; mimic anxiety attack (sweating, weakness, trembling) Often result of poorly controlled diabetes; too much insulin, inadequate food intake, strenuous physical, illness may cause blood glucose levels to drop dramatically in diabetes Replace simple CHO with complex CHO (fiber-rich) and adequate protein; smaller meals more frequently If result of overuse of insulin, other illnesses need medical intervention
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 2011 Pearson Education, Inc.

Glycemic Index
A foods potential to raise blood glucose compared to white bread or glucose and subsequent insulin release Foods with a high glycemic index cause a sudden surge in blood glucose, triggering a large increase in insulin, which may be followed by a dramatic fall in blood glucose Foods with a low glycemic index cause low to moderate fluctuations in blood glucose
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Glycemic Index
The rapid absorption of glucose from a highglycemic diet may increase the risk of heart disease and promote overeating; thus although controversial, choosing foods lower glycemic index may improve fat metabolism, prevent heart disease and help with weight management (fiber benefits that raise good cholesterol and lower bad cholesterol)

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Glycemic Index
Low glycemic food choices include whole grains, legumes, fresh vegetables and fruits, and milk products Not provided on food labels and can be deceptive; for ex. Pound Cake would be a low GI food and Baked Potato would be a high GI Also most foods are combined in a meal that affects glycemic index
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 2011 Pearson Education, Inc.

Blood Glucose Regulation: Glycemic Load

Used to determine the effect of a food on a persons glucose response Grams of carbohydrates in a food are multiplied by the glycemic index (ex., carrots have GI=68 but GL=3) Glycemic index and glycemic load remain controversial Evidence of health benefits is weak
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Sugars
Added sugars added in processing and preparation of foods as opposed to natural sugars (lactose from milk, fructose from fruit) Sucrose, invert sugar, high fructose corn syrups, etc.

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Sugars
Health effects of sugars Nutrient deficiencies foods that are energy-dense vs. nutrient-dense provide energy (kcal) with few, if any other nutrients; ex. Soda (200 kcal) but few nutrients other than sugar high fructose corn syrup-- vs. 200 kcal from 1 slice whole-wheat bread, an orange, 1 c. fat-free fortified milk which provides fiber, B vitamins, vitamin C, calcium, riboflavin, vitamin D and A Can fit these foods in limited amounts in an otherwise balanced diet
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Added Sugars
Foods high in added sugar and few other other nutrients a concern if replace foods that are nutrientdense; ex., fruit punch instead of 100% juice (esp. calcium-fortified 100% juice) or milk; or potato chips instead of fresh fruits or cheese and whole grain crackers Sugar is not bad; Goal is Balance, Variety, and Moderation Foods made with natural sugars or honey are not more always more nutritious; fructose (honey) is a monosaccharide; table sugar (sucrose) is a disaccharide but they end up after digestion the same wayas monosaccharides
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 2011 Pearson Education, Inc.

 2011 Pearson Education, Inc.

Sugars
Health effects of sugars Dental cariesdepends on how long remains in mouth ex., Sticky foods (lollipops) more a concern than fresh fruit and sipping fruit juice more concern vs. quickly drinking a juice Nonsugary foods such as milk and cheese and rinsing mouth with water after eating a sugary food may be helpful in minimizing effects of sugars Limiting between meal sugary snacks and brushing and flossing regularly important Dental plaquemass of bacteria that grows on teeth and can lead to caries and gum disease

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Accusations Against Sugars

Sugar causes obesity sugar not sole cause Sugar causes heart disease saturated fat, trans fat, obesity stronger association

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Accusations Against Sugars

Sugar causes misbehavior in children and criminal behavior in adults hyperactivity; mostly anecdotal; lack of scientific evidence Sugar causes cravings and addictions Serotonin-not addictive in biological sense; some CHO elevate serotonin; mood; restrictions causes cravings
Avoid label foods good or bad

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Sugars on the Nutrition Facts Label

The number of grams of Sugars includes both natural and added sugars To find out if a food contains added sugar, look at the ingredient list 4 grams sugar = 1 teaspoon (16 kcal)
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Recommended Intakes of Sugars

New (2010) American Heart Association (AHA) recommendations for added sugars (discretionary kcal) Adult women5 tsp (20 g) per day Adult men9 tsp (36 g) per day Children3 tsp (12 g) per day 1 tsp = 1 tsp honey or 1 tsp jelly or 1 T catsup or 1 1/2 oz soda so 1 tsp added sugars = 16 kcal. A 12 oz soft drink with 150 kcal has 39 g (close to 10 tsp) added sugar

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Recommended Intakes of Sugars

Most people recommended to use added sugars sparingly National surveys estimate, on average, each person in US consumes about 300350 kcal of added sugars per day or about 79 g (22 tsp) of added sugar a day, greatly exceeding new recommendations Common source added sugars in US, avg 40 gallons soft drinks per year = 16,420 g added sugar = 267 C/year of sugar!

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Starch and Fiber

Health effects Heart disease soluble fibers and diets high in complex CHO tend to be lower in fat Diabetes-soluble fiber benefits GI health insoluble fibers

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Starch and Fiber

Health effects Cancerfiber may reduce risk by removing cancer-causing agents from the colon or lower the pH thus inhibiting cancer growth in colon Weight managementdiets high in complex CHO tend to be low in fat and kcal and high fiber causes feelings of fullness (satiety) Harmful effects of excessive fiber intake young children and elderly may get full on high fiber diet and not meet energy needs; high fiber diet at first may cause discomfort
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Carbohydrate, Starch and Fiber

AMDR for CHO 45% - 65% total daily energy intake 45% of 2,000 kcal = 225 g/day; 65% of 2,000 kcal = 325 g/day Recommended Dietary Allowance (RDA) is 130 grams/day to supply adequate glucose to the brain Daily Value (food labels): 300 g/day (based on 60% of kcal; 2,000 kcal/day)
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 2011 Pearson Education, Inc.

Starch and Fiber

Adequate Intake (AI) for fiber
25 g per day for women 38 g per day for men, or 14 g of fiber for every 1,000 kcal per day (remember AI established when RDA not available) **DRI25-35 g/day; ~2 times higher than average intake in US currently Adequate fluid is recommended with high fiber intake Best to get fiber from foods (also sources of vitamins and minerals)

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Guidelines to Groceries

Grainsat least 3-aday whole grains; a serving provides 15 g CHO, mostly starch
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Guidelines to Groceries
Vegetablesamount of CHO depends on starchy content; ex., starchy vegetablescorn, potatoes, peas provide 15 g/1/2 c. serving, mostly starch; vs. green beans, broccoli, spinachprovide 5 g/ c. serving Fruitssmall fresh fruitapple, orange, c. cannedCHO mostly as sugars, including fructose. Fruits and vegetables vary in fiber content.

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 2011 Pearson Education, Inc.

Fiber (cont)
Legumes (navy beans, kidney beans, black beans) provide the highest amount of fiber per serving (6-8 g/serving)

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Guidelines to Groceries
Milk and milk products-1 C milk provides 12 g CHO including lactose; cottage cheese provides 6 g CHO; cheeses little or no CHO Meats and meat alternativesnuts and legumes provide CHO; starch and fiber; c legumes provides 15 g CHO, ~1/2 from fiber Food labelsTotal gm including starch, fibers and sugars per serving. Fiber and gm sugars are listed separately. By subtracting gm fiber and sugars from total CHO you calculate starch gm. There are no DV for sugars (recommended in moderation
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Alternatives to Sugar
Artificial sweeteners vs. sugar replacers (nutritive sweeteners) Artificialprovide little, if any energy; nonnutritive sweeteners; allow person to enjoy sweetness yet keep energy intake down Sugar sweetenersyield some energy; nutritive sweetener; slowabsorbing sugar alcohols (2-3 kcal/g)
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Copyright 2005 Wadsworth Group, a division of Thomson Learning

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 2011 Pearson Education, Inc.

 2011 Pearson Education, Inc.

Alternatives to Sugar
Saccharine and cancerequivalent to hundreds of cans of diet soda/day may increase risk of cancer; approved in over 100 countries Aspartame and PKUmost studied of all food additives; people with PKU (inherited disease) cannot metabolize phenylalanine; phenylalanine also found in other proteinrich foods studies show aspartame to be safe; approved in more than 100 countries
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Alternatives to Sugar
Acceptable Daily Intake (ADI)level of consumption that if maintained daily for life would be considered safe (ex., ADI for aspartame is 50 mg/kg body weight; for 150 lb person, 97 pkts Equal or 20 cans diet soft drinks sweetened with aspartame/day) Artificial sweeteners and weight control--using artificial sweeteners will not automatically lower energy intake; to lose weight, a person needs to select diet carefully and increase physical activity Reduced calorie food does not mean you can eat more of it
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Sugar Replacers
Sugar free or reduced calorie does not mean calorie free; but less than those containing sugar Excess sugar alcohol may have laxative effect Benefitdo not cause dental caries; bacteria cannot metabolize as rapidly as sugar Sugar replacers like artificial sweeteners, in moderation, are alternatives for diabetics
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Sugar Alternatives on Food Labels

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Sugar Terms
Look for:
Brown sugar Confectioners sugar Corn syrup and high fructose corn syrup Concentrated fruit juice sweeteners Dextrose, fructose, galactose, lactose Granulated sugar Honey Invert sugar Maple sugar, molasses Raw sugar

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 2011 Pearson Education, Inc.

 2011 Pearson Education, Inc.