P. 1
Role of Carbohydrate in Health and Diseases Ppt

Role of Carbohydrate in Health and Diseases Ppt

|Views: 1,575|Likes:
Published by uttarasingh

More info:

Published by: uttarasingh on Oct 06, 2010
Copyright:Attribution Non-commercial


Read on Scribd mobile: iPhone, iPad and Android.
download as PPTX, PDF, TXT or read online from Scribd
See more
See less





Role of Carbohydrate in Health and Diseases

Presented By: Uttara Singh L-2008.H.Sc.-46D


Carbohydrates are polyhydroxy aldehydes, ketones, alcohols, acids, their simple derivatives and their polymers having linkages of the acetal type.  They may be classified according to their degree of polymerization and may be divided initially into three principal groups:   

sugars oligosaccharides polysaccharides

The major dietary carbohydrates
Class (DP*) Sub-Group Monosaccharides Sugars (1-2) Disaccharides Polyols Malto-oligosaccharides Oligosacchar ides (3-9) Other oligosaccharides Starch Polisacchari des (>9) Non-starch polisaccharides Components Glucose, galactose, fructose Sucrose, lactose, trehalose Sorbitol, mannitol Maltodextrins Raffinose, stachyose, fructo-oligosaccharides Amylose, amylopectin, modified starches Cellulose, hemicellulose, pectins, hydrocolloids

DP * = Degree of polymerization

Terminology Related to Carbohydrates

‡ The term "sugars" is conventionally used to describe the mono and disaccharides. ‡ "Sugar", by contrast, is used to describe purified sucrose as are the terms "refined sugar" and "added sugar".

Intrinsic and extrinsic sugars
‡ Intrinsic sugars occur within the cell walls of plants. ‡ Extrinsic sugars were those which were usually added to foods.

within intact cell structures (RS1). starch.g. Resistant starch ‡ Resistant starch is defined as "starch and starch degradation products not absorbed in the small intestine of healthy humans". Raw starch granules (RS2) Retrograded amylose (RS3) Chemically modified RS4 . ‡     The main forms of resistant starch are: Physically enclosed starch. e.Complex carbohydrates ‡ Complex carbohydrate has encompassed. dietary fibre and non-digestible oligosaccharides.

Dietary fibre ‡ Dietary fibre is "that portion of food which is derived from cellular walls of plants which is digested very poorly by human beings". ‡ It is misleading to talk of carbohydrate as "unavailable" because some indigestible carbohydrate is able to provide the body with energy through fermentation. a non-carbohydrate component of the cell wall is also often included. .Available and unavailable carbohydrate ‡ Available carbohydrate are starch and soluble sugars ‡ Unavailable as "mainly hemicellulose and fibre (cellulose) . hemicellulose and pectin. ‡ Lignin. ‡ The main components of dietary fibre are derived from the cell walls of plant material in the diet and comprise cellulose.

mouthfeel. ‡ High amylose corn starch and high amylopectin (waxy) corn starch have been available for functional as well as nutritional properties.  Physical modifications of starches include pregelatinization and dextrinization.  Chemical modification is mainly the introduction of side groups and crosslinking or oxidation. . ‡ High amylose starches require higher temperatures for gelatinization and are more prone to retrograde and to form amylose-lipid complexes. ‡ Genetic engineering are used for the production of genetically modify crop. These modifications may be used to decrease viscosity and to improve gel stability.Modified starch ‡ The proportions of amylose and amylopectin in a starchy food can be altered by plant breeding. and resistance for heat treatment . appearance and texture. ‡ These properties can be utilized in the formulation of foods with low glycemic index and/or high resistant starch content.

Soluble and insoluble fibre ‡ Those dietary fibre. allowing a simple division and has glucose and lipid absorption from the small intestine known as soluble and those which were slowly and incompletely fermented and has more pronounced effects on bowel habit referred as insoluble. .

.Digestion and Absorption of Carbohydrates ‡ Polysaccharides and oligosaccharides must be hydrolyzed to their component monosaccharides before being absorbed. and is shifted toward the ileum when the diet contains less readily digested carbohydrates. ‡ The upper small intestine exhibits wide villous structures with leaf-like arrays. and some glucose is also produced. while in the ileum the villi become longer and more finger-like. ‡ The digestion of starch begins with salivary amylase. maltotriose. isomaltase and lactase. ‡ The products of -amylase digestion are hydrolyzed into their component monosaccharides by enzymes like maltase. sucrase. ‡ Carbohydrate absorption occurs primarily in the upper small intestine due to the presence of finger-like villi in the mucosa of the upper small intestine. and -dextrins. ‡ Carbohydrate digestion and absorption can occur along the entire length of the small intestine. ‡ Amylase hydrolyzes starch into maltose.

‡ The GI is considered to be a valid index of the biological value of dietary carbohydrates. ‡ It is defined as the glycemic response elicited by a 50g carbohydrate portion of a food expressed as a percent of that elicited by a 50g carbohydrate portion of a standard food The standard food has been glucose or white bread. ‡ If glucose is the standard. GI of glucose = 100) the GI values of foods are lower than if white bread is the standard by a factor of 1. .38 because the glycemic response of glucose is 1. (ie.38 times that of white bread.The Glycemic Index ‡ The blood glucose responses of carbohydrate foods can be classified by the glycemic index (GI).

Implications of the Glycemic Index ‡ GI improves overall blood glucose control in subjects with diabetes and reduces serum triglycerides in subjects with hypertriglyceridemia. high GI foods led to faster replenishment of muscle glycogen after exercise. ‡ Low GI foods eaten before prolonged strenuous exercise increased endurance time and provided higher concentrations of plasma fuels toward the end of exercise. . ‡ However.

Physiological effect of carbohydrate ‡ Carbohydrates have a wide range of physiological effects which may be important to health:  Provision of energy  Effects on satiety/gastric emptying  Control of blood glucose and insulin metabolism  Protein glycosylation  Cholesterol and triglyceride metabolism  Bile acid dehydroxylation  Fermentation Hydrogen/methane production  Short-chain fatty acids production  Control of colonic epithelial cell function  Bowel habit/laxation/motor activity  Effects on large bowel microflora .

Energy balance ‡ It is important that the amount of energy ingested be matched to the amount of energy expended.Carbohydrate as an energy source ‡ Dietary carbohydrates gives an energy value of 4 kcal/g (17 kJ/g). the value of 3. satiety and food intake by altering the type of carbohydrate in food. ‡ A better approach to controlling hunger and increasing satiety is associated with changes in the composition of the total diet.7 kJ/g) is used. . ‡ Maintenance of energy balance is important in order to avoid obesity and its associated co-morbidities such as diabetes and cardiovascular disease.75 kcal/g (15. Satiety ‡ The possibility of controlling hunger. although where carbohydrates are expressed as monosaccharides.

Protein glycosylation ‡ Proteins glycation is dependent on the concentration of glucose and fructose in blood and the half-life of the protein. ‡ The extent of glycation of specific proteins. to form a Shiff base which undergoes rearrangement and formation of Amadori products. usually lysine. ‡ As the reaction progresses. such as Haemoglobin in diabetics serves as an indication of medium term control of blood glucose. ‡ The reaction is between the monosaccharide and the amino group of an amino acid. increasingly complex Maillard products are formed with the eventual production of Advanced Glycation End-products or AGEs which are associated with irreversible loss of protein function. .

‡ The gases are either absorbed and excreted in breath. and stimulates bacterial growth (biomass). ‡ This process involves gut microflora and is unique to the colon of humans because it occurs without the availability of oxygen. ‡ Propionate is a major glucose precursor in ruminant animals such as the cow and sheep. but this is not an important pathway in humans. muscle and other tissues. ‡ Butyrate is metabolized primarily by colonocytes and regulate cell growth. ‡ Acetate passes primarily into the blood and is taken up by liver. ‡ SCFA which are rapidly absorbed and metabolized by the body. propionate and butyrate).Fermentation ‡ Fermentation is the colonic phase of the digestive process and breakdown of carbohydrates in the large intestine. and to induce differentiation . ‡ It results in the formation of the gases hydrogen. or passed out via the rectum. as well as short chain fatty acids (SCFA) (acetate. methane and carbon dioxide. .

Bowel habit ‡ Non-starch polysaccharides are the principal dietary component affecting laxation through increases in bowel content bulk and a speeding up of intestinal transit time. ‡ Fermentable polysaccharides stimulate increases in microbial biomass in the colon. ‡ The efficiency of conversion of carbohydrate to biomass is determined by:  the type of substrate. Microflora ‡ Carbohydrate which is fermented stimulates the growth of bacteria in the large gut. ‡ More transit time . . ‡ The extent of the effect depends on the chemical and physical nature of the polysaccharides and the extent to which they are fermented in the colon.less feacal weight and vice-versa.  the rate of breakdown and  the transit time through the large intestine . resulting in some increase in fecal weight.

reduce the obesity and its co-morbid conditions. ‡ carbohydrate provides the majority of energy in the diets of most people. ‡ Diets high in carbohydrate as compared to those high in fat. ‡ Dietary carbohydrate is important to maintain glycemic homeostasis and for gastrointestinal integrity and function.The role of carbohydrates in maintenance of health Carbohydrates in the diet ‡ Amount of carbohydrate required to avoid ketosis is very small (about 50 g/day). ‡ A diet should consist of at least 55% of total energy coming from carbohydrate. ‡ carbohydrate-containing foods are vehicles for important micronutrients and phytochemicals. .

‡ The combination of a high carbohydrate diet and regular physical activity is the optimal arrangement to avoid positive energy balance and obesity. ‡ The importance of carbohydrate in the diet becomes more critical as the amount and intensity of physical activity increases. . Carbohydrate and behaviour ‡ It has been suggested that providing breakfast to children who do not typically eat breakfast can increase cognitive performance. ‡ The increased energy needs of physical activity can be supplied by carbohydrate or fat. ‡ It has been suggested that sugar consumption leads to hyperactivity in children.Physical activity ‡ Maintenance of energy balance is dependent both on energy intake and energy expenditure.

by displacing other nutrients or facilitating increased intakes of a wide range of other substances frequently found in carbohydrate-containing foods. ‡ Carbohydrates may also have indirect effects on diseases. for example.Beneficial effect of carbohydrate in disorders/diseases ‡ Carbohydrates may directly influence human diseases by affecting physiological and metabolic processes by reducing risk factors for the disease. . ‡ Thus the nutrient-disease or food-disease associations discussed below must be considered in terms of the strength of evidence from a range of observational studies and clinical experiments and the existence of plausible hypotheses.

coronary heart disease and other chronic diseases of lifestyle.Obesity ‡ The frequency of obesity has increased in many developed and developing countries. ‡ As fat is stored more efficiently than excess carbohydrate. ‡ This is public health importance because of negative effect of obesity in relation to diabetes. ‡ Excess energy in any form will promote body fat accumulation. use of high carbohydrate foods is likely to reduce the risk of obesity in the long term. ‡ Genetic .environmental factorsand lack of physical activity is believed to contribute to the increasing rates of obesity. .

Non-insulin dependent diabetes mellitus (NIDDM) ‡ High rates of NIDDM in all population groups are associated with rapid cultural changes in populations consuming traditional diets. ‡ Foods rich in non-starch polysaccharides and carbohydrate-containing foods with a low glycemic index appear to protect against diabetes. and also with increasing obesity. ‡ Some epidemiological evidence suggests particular benefit of appropriately processed cereal foods. ‡ Avoid obesity and increase intakes of foods rich in non-starch polysaccharide and carbohydrate-containing foods with a low glycemic index offers the best means of reducing the rapidly increasing rates of NIDDM. while other epidemiological and clinical studies suggest benefits of non-starch polysaccharide from legumes and pectin-rich foods. .

There has been concern that a substantial increase in carbohydrate-containing food at the expense of fat. Plant foods are good sources of potassium and reducing the sodium to potassium ratio may help to reduce the risk of hypertension as well as cerebrovascular disease. Non-starch polysaccharides (NSP) have an appreciable effect in lowering serum cholesterol when consumed in naturally occurring foods and it may be used in the management hypercholesterolemia. Among those who are overweight or obese it is more important to reduce total fat intake and to encourage the consumption of the carbohydrate-containing foods. ‡ ‡ ‡ ‡ ‡ . On the other hand.Cardiovascular disease ‡ Genetic . lifestyle factors . might result in a decrease in high-density lipoprotein and an increase in very low-density lipoprotein and triglycerides in the blood. dietary factors . there is strong protective effect by a range of antioxidant nutrients found in fruits and vegetables .obesity and high intakes of saturated fatty acids are involved in the etiology of coronary heart disease and influence both the atherosclerotic and thrombotic processes.increasing carbohydrate intake can assist in the reduction of saturated fat.

‡ ‡      ‡ . the reduction of products of protein fermentation through stimulation of bacterial growth. maintenance of the gut mucosal barrier. pH effects. Gene defects in somatic cells is thought to be through DNA damage and failure of the DNA repair system ( apoptosis). Dietary carbohydrate is thought to be protective through mechanisms involving arrest of cell growth. differentiation and selection of damaged cells for cell death (apoptosis).Cancer ‡ ‡ ‡ Cancer is a disease associated with well-recognized genetic abnormalities. effects on bile acid degradation. and.. Butyric acid which is formed in the colon from fermentation of carbohydrates fight against the abnormalities. The process of fermentation may protect the colorectal area against the genetic damage that leads to colorectal cancer through other mechanisms which include: the dilution of potential carcinogens. Carbohydrate staple foods are a source of phytoestrogens which may be protective for breast cancer.

increasing consumption of foods rich in these carbohydrates like bran and cereals are very effective means of preventing and treating constipation.Gastrointestinal diseases ‡ Intakes of non-starch polysaccharides(NSP) and resistant starch (RS)are the most important contributors to stool weight. diverticular disease as well as haemorrhoids and anal fissures. ‡ Therefore. .

.35% or less from fats and the remainder from proteins. ‡ Diet for athletes and active people should include more carbohydratecontaining foods.30% or less from fat and 10 to 15 % from proteins. ‡ Their diets should be such that about 60% of their daily energy intake is obtained from carbohydrates. ‡ The common message is that we should move from high fat meat-based diets to those that are made up of more carbohydrates and fresh fruits and vegetables.The Role of Carbohydrates in Exercise and Physical Performance Some general dietary considerations ‡ Health professionals argue that a healthy diet is one which provides us with at least 50% of our daily energy intake in the form of carbohydrates.

‡ In contrast. . endurance capacity on a cycle ergometer doubled in comparison with the exercise times achieved after consuming a normal mixed diet. ‡ This clearly showed the benefits of eating a high-carbohydrate diet before prolonged exercise have been shown mainly during cycling and establish importance of the carbohydrate content in the diets of athletes preparing for competition. a fat and protein diet reduced exercise capacity to almost half that achieved after normal mixed diets. ‡ The importance of muscle glycogen during prolonged exercise was confirmed in studies which showed that fatigue occurs when muscle glycogen concentrations are reduced to low values.Carbohydrate diets and endurance capacity :Studies ‡ A study exploring the link between diet and exercise capacity found that after a period on a high carbohydrate diet.

Carbohydrate diets and endurance capacity :Studies ‡ One study examined the influence of different nutritional states on the resynthesis of glycogen during recovery from prolonged exhaustive exercise. . produced a delayed muscle glycogen resynthesis. accompanied by a decrease in training intensity. ‡ This dietary manipulation not only increased the pre-exercise muscle glycogen concentration but also resulted in a significant improvement in endurance capacity (Figure 2). ‡ It found that a diet low in carbohydrate. resulted in increased muscle glycogen concentrations. and high in fat and protein for 2 to 3 days after prolonged submaximal exercise. but when this was followed by a high carbohydrate diet for the same period of time. ‡ It was found that a carbohydrate-rich diet consumed for 3 days prior to competition. glycogen supercompensation occurred ( Figure 1).

. and the simple carbohydrate group improved by 23%. rice or pasta.  The 'complex' carbohydrate group supplemented their normal mixed diet with bread. complex carbohydrates or simple carbohydrates. ‡ The runner s normal mixed diets were modified by providing either additional protein.Carbohydrate diets and endurance capacity :Studies ‡ Studies on the influence of carbohydrate loading and endurance capacity during running. potatoes.  The 'simple' carbohydrate group ate their normal mixed diet but increased their carbohydrate intake with chocolates. ‡ There was no improvement in the performance times of the protein group. ‡ The complex carbohydrate group improved their running times by 26%.

Saltin.L. Hultman. 1 = Mixed diet for 3 days 2 = Low carbohydrate diet for 3 days 3 = High carbohydrate diet for 3 days .Hermansen. J. B..Fig.1Muscle glycogen concentrations before and after constant load cycling to exhaustion.. following three dietary conditions Source: Adapted from Bergstrom. E.

2Cycling time to exhaustion at constant load under three dietary conditions 1 = Mixed diet for 3 days 2 = Low carbohydrate diet for 3 days 3 = High carbohydrate for 3 days .Fig.

‡ Sports which demand that their participants perform a combination of submaximal running and brief periods of sprinting. . reduces muscle glycogen values. so carbohydrate loading would be necessary for participants in multiple-sprint sports.Carbohydrate diets and high intensity exercise ‡ Multiple-sprint sports involve a mixture of brief periods of exercise of maximum intensity followed by recovery periods of rest or light activity. such as soccer. ‡ There is rapid utilization of muscle glycogen during several brief periods of maximal exercise. the rate of glycogenolysis decreases as exercise continues. ‡ Performance is impaired when glycogen value lowered. and last up to 90 minutes.

and compared the responses to these after drinking a glucose solution or plain water. with potatoes and glucose as the high glycemic index foods. . ‡ A recent study has attempted to answer this question by comparing the endurance performances of subjects following isocaloric high fat or high carbohydrate meals. ‡ Eating a high fat meal before exercise is not recommended as a nutritional preparation for endurance competitions because these meals take a longer time to digest.Composition of pre-exercise meals ‡ The low glycemic index carbohydrate appeared to improve endurance capacity to a greater extent than the high glycemic index food . ‡ The pre-exercise meals contained approximately 280g of carbohydrate in the high carbohydrate meal and 84g in the high fat meal. four hours before submaximal exercise. ‡ If this glycogen sparing did occur following a high fat meal then it would be expected to delay the onset of fatigue in a similar manner to consuming carbohydrate-rich meals before exercise. ‡ Lentils as the low glycemic index food. ‡ From animal studies to suggest that increased fat intake will result in a lower oxidation of carbohydrate during exercise.

‡ Tissues undergo repair and reproduction. ‡ A high carbohydrate diet and adequate fluid intake to avoid dehydration are the two most important elements in the formula for successful participation in sport. fluid balance is restored and substrate stores are replaced. ‡ Carbohydrate replacement is one of the most important events during recovery. ‡ Increasing the carbohydrate intake to 8 g/kg BW per day may not be enough to prevent a significant reduction in muscle glycogen concentrations after 5 successive days of hard training. ‡ Several days participation in sport need a normal mixed diet containing about 4 to 5 g/kg body weight (BW) of carbohydrate to replace muscle glycogen stores.Recovery from exercise ‡ Recovery from exercise is not a passive process. .

The impact of these carbohydrates on caries is dependent on the type of food. Starches with a high glycemic index produce more pronounced changes in plaque than low glycemic index starch. frequency of consumption. and not on sucrose intake alone. Prevention programmes to control and eliminate dental caries should focus on fluoridation and adequate oral hygiene. salivary function. degree of oral hygiene performed.‡ ‡ ‡ ‡ Disorder of carbohydrate metabolism in health Dental caries Foods containing sugars may be easily broken down by amylase and bacteria in the mouth and can produce acid which increases the risk of caries. and genetic factors. . availability of fluoride.

Glycogen Storage Diseases ‡ Glycogen storage diseases are caused by lack of an enzyme needed to change glucose into glycogen and break down glycogen into glucose. ‡ Treatment depends on the type of glycogen storage disease and usually involves regulating the intake of carbohydrates. confusion. sweating. ‡ Give carbohydrate solutions through a stomach tube all night to prevent low blood sugar levels from occurring at night. and stunted growth. kidney stones. ‡ The diagnosis is made by examining a piece of tissue under a microscope (biopsy). ‡ Give uncooked cornstarch every 4 to 6 hours around the clock. . ‡ Symptoms include weakness.

muscle damage. and abnormally high levels of acid. and inflammatory bowel disease All organs Enlarged liver and heart and muscle weakness Liver. and uric acid in blood Liver and white blood cells 1. muscle damage. very low blood sugar levels.Low white blood cell count.Same as in von Gierke's disease but may be less severe2. and weak bones in some people Liver. slowed growth. and most tissues Cirrhosis. and delayed growth and development Muscle Muscle cramps or weakness during physical activity Liver Enlarged liver-Episodes of low blood sugar during fastingOften no symptoms Skeletal muscle and red blood Muscle cramps during physical cells activity and red blood cell destruction (hemolysis) Von Gierke's disease (type IA) Type IB Pompe's disease (type II) Forbes' disease (type III) Andersen's disease (type IV) McArdle disease (type V) Hers' disease (type VI) Tarui's disease (type VII) . fats. and heart Enlarged liver or cirrhosis. heart damage. muscle. low blood sugar levels.Types and Characteristics of Glycogen Storage Diseases Name Type O Affected Organ. muscle. recurring infections.Tissues or Cells Symptoms Liver or muscle Episodes of low blood sugar levels (hypoglycemia) during fasting if the liver is affected Liver and kidney Enlarged liver and kidney.

and abnormal growth. jaundice. .some fruits and vegetables which contain galactose. ‡ Symptoms include vomiting. ‡ The diagnosis is based on a blood test. ‡ Most common and the most severe form is referred to as classic galactosemia.Galactosemia ‡ Galactosemia is caused by lack of one of the enzymes needed to metabolize the galactose sugar in milk. ‡ Avoid seaweed . diarrhoea. ‡ Treatment involves completely eliminating milk and milk products from the diet.

resulting in jaundice. . seizures and coma. mental deterioration. ‡ Symptoms includes sweating. ‡ Treatment involves excluding fructose .Hereditary Fructose Intolerance ‡ Hereditary fructose intolerance is caused by lack of the enzyme needed to metabolize fructose. ‡ A by-product of fructose accumulates in the body. confusion. ‡ Diagnosis is based on the chemical examination of liver tissue determines that the enzyme is missing. seizures.sucrose. and death. ‡ Children who continue to eat foods containing fructose develop kidney and liver damage. and sorbitol from the diet. vomiting. blocking the formation of glycogen and its conversion to glucose for use as energy.

‡ A bone marrow transplant may help. and coarseness of the face. hairiness. accompanied by intellectual disability. liver. ‡ The result is a characteristic facial appearance and abnormalities of the bones.Mucopolysaccharidoses ‡ Mucopolysaccharidoses are a group of hereditary disorders in which complex sugar molecules are not broken down normally and accumulate in harmful amounts in the body tissues. and spleen. . eyes. ‡ Excess mucopolysaccharides enter in the blood and are deposited in abnormal locations throughout the body. stiff finger joints. ‡ Symptoms include short stature. ‡ The diagnosis is based on symptoms and a physical examination.

‡ Problems with pyruvate metabolism can limit a cell's ability to produce energy and allow a buildup of lactic acid. a waste product. intellectual disability. . ‡ These disorders are diagnosed by measuring enzyme activity in cells from the liver or skin. ‡ Symptoms include seizures. ‡ These disorders cause a buildup of lactic acid and a variety of neurologic abnormalities.Disorders of Pyruvate Metabolism ‡ Pyruvate metabolism disorders are caused by lack of the pyruvate carboxilase and dehydrogenase which are involved in pyruvate metabolism. and coordination problems. ‡ Some children are helped by diets that are either high in fat and low in carbohydrates or high in carbohydrates and low in protein. muscle weakness.

You're Reading a Free Preview

/*********** DO NOT ALTER ANYTHING BELOW THIS LINE ! ************/ var s_code=s.t();if(s_code)document.write(s_code)//-->