P.

09 CARBOHYDRATES OF PHYSIOLOGIC o reflects the change in blood glucose after ingestion of a

SIGNIFICANCE (PART 3) test food compared to the reference food (e.g. white
Dr. Salango| February 06, 2018 bread, glucose, table sugar)
o Reference food: table sugar (50 g)
GI of table sugar: 100
OUTLINE
I. Glycemic Index vs. Glycemic Load
2. GLYCEMIC LOAD (GL)
A. Definition of terms
1. Glycemic Index (GI)
o measures the blood sugar raising power per serving of
2. Glycemic Load (GL) food(total amount of sugarcontent of a certain food)
B. Fiber Content and Glycemic Index
C. Food Preparation and Glycemic Index
D. Glycemic Index: Natural Sweeteners
II. Mannatech’s Rules of Low-Glycemic Eating
III. Major Biological and Physiological Effects of
Glycemic Products
IV. Formation of Monosaccharides via Hydrolysis
V. Absorption of Monosaccharides
A. Simple Diffusion
B. Facilitated Diffusion
C. Active Transport (Cotransport)
VI. Storage of Monosaccharides

I. GLYCEMIC INDEX VS GLYCEMIC LOAD

A. DEFINITION OF TERMS Worst Type- High GI, High GI (Situational) – good preparation
for strenuous activities
Anything made of salts (Na, Potassium or positively charged
cations) when found in a certain substance, can have a tendency Low GI is Better, go for load and not index.
to be salty.
A two-hour blood glucose response of
Sweet Taste- Hydroxyl group, Negative Charge
a high GI food vs. a low GI food:
Amino group tends to be bitter

1. GLYCEMIC INDEX (GI)

o pertains to how fast a carbohydrate causes blood sugar
to elevate
o ranks specific carbohydrates from 0 to 100 based on the
rate it affects blood sugar index

B. FIBER CONTENT AND GLYCEMIC INDEX

o GENERAL RULE: the more fiber content, the more likely

the food is to be low glycemic.

o It is the ability of the food that we eat to be converted

Comparing cassava and sweet potato:
into a monosaccharide that goes to the bloodstream in
the shortest time.
Ø the faster it goes to the blood, the higher the GI o GI: sweet potato < cassava
Ø the slower it goes to the blood, the lower the GI o Sweet potatoes have very fine fibers which
protect the starch within (protect us from alpha-
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 glucosidases). This promotes delayed starch
digestion and absorption (prevents further
increase in blood sugar).
o Cassava has largeand thick fibers close to baked
potato, gabi and ube, which cannot be digested.
The large fibers give limited protection to the
starch content.
o Thus, sweet potato is better for diabetic patient.

C. FOOD PREPARATION AND GLYCEMIC INDEX

o The manner by which the food is prepared also modifies
the availability of the nutrients.
o Example: if you look at the apple, it has a glycemic index
of 39; that probably is the raw apple. Once it is
osteorized, then the glycemic index becomes much
higher compared to the raw apple.
o Example: Corn
o chewed very well: it becomes medium to high
glycemic
o NOT chewed very well: it is not (or a little bit D. GLYCEMIC INDEX: NATURAL SWEETENERS
only) absorbed by the body making it low
glycemic
o Thus, we can say that the type of preparation a food
undergoes dictates the GI of its carbohydrate contents.
o Determining the GI and GL is not very exact, they must
specify how the food was prepared.

Glycemic Index Glycemic Load

Low ≤55 ≤10

Medium 56-69 11-19

High ≥70 ≥20

It is important to remember that there is a GI classification for

Glycemic Index.
o Stevia
Example of a high GI/low GL: Ø derived from the “miracle fruit” (originally from and
naturally grow in the Philippines but patented by Japan)
o Watermelon Ø a natural sweetener that does not elevate blood sugar (0
o One serving: 120 g GI); unstable when cooked
o GI of watermelon: 72
o CHO per serving: 6 g Anything made of salts (Na, Potassium or positively charged
o GL: [(72 x 6) / 100] = 4.3 cations) when found in a certain substance, can have a tendency
Example of a low GI/high GL: to be salty. Sweet Taste is a characteristic of Hydroxyl group
(Negative Charge)
o Spaghetti
o One serving: 180 g
o Fructose
o GI of spaghetti: 37
Ø up to 10x sweeter than sugar
o CHO per serving: [42 g CHO – approx 6 g fiber
Ø discovered as the sweetest sugar
conten] = 36 g
Ø problem: as compared to glucose
o GL: [(37 x 36) / 100] = 13
o glucose: when taken and becomes higher than
the normal blood level, stimulates insulin
release
o fructose: when taken and becomes higher than
the normal, does not stimulate insulin release

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 § it is not directly converted to glucose
(reason: it will only overload the
system with more glucose) → instead,
it gets stored in the liver → converted
to glycerol (triglyceride backbone)
→OBESITY
Ø High fructose containing foods: fruits, maple syrup, corn
syrup, and soft drinks among others
Ø High fructose corn syrup
o root of all medical problems (obesity, diabetes,
cancer, etc.)
o can be a “weapon of mass destruction”
o Recommendation: Eat fruits first before eating your
meal.
5. Avoid white foods (white bread, white potatoes, white rice,
etc.)
These are refined products which get digested faster. Take
note of how the product was produced. Ground rice (used in
bilo-bilo) has a higher GI than plain rice.
Which has a lower GI, fried rice or plain rice?
Fried rice, because fat delays digestion and gastric emptying.
The issue here is only on the carbohydrates but when we talk
about the total caloric content, fried rice will have more
because of the oil. The fried rice also has a lower GL because
the longer you cook food, the more its sugar contents get
destroyed. The more you reheat, the more the glycemic load
decreases.

6. Drink sufficient water.

Digestion is basically hydrolysis. You need water to break the
bonds. The more water you take with food, the faster the
digestion; the faster you also become full so the less you will
eat.

Therefore, the idea here is to fill up your stomach as much as

possible with water so that you will eat less, although the
drawback is it makes digestion faster.

Recommendation: Drink water before you eat.

7. Time your food intake.

There's no such thing as, “If I will skip this meal, I will develop
an ulcer”. We can actually skip some meals then when we are
really hungry, we can take in some food.

Recommendation: The less frequent you eat, the better.

III. MAJOR BIOCHEMICAL AND PHYSIOLOGICAL

II. MANNATECH’S RULES OF LOW-GLYCEMIC EATING EFFECTS OF GLYCEMIC PRODUCTS
1. Eat foods in their natural state whenever possible. Low Glycemic Products High Glycemic Products
The more processed it is, the higher the GI.
Do not stimulate fat
2. Eat foods that are hard to digest, citrus fruits, fruit skins, Stimulate fat storage
storage
cooked cabbages, tomatoes, onions, cucumbers, beans, and
nuts.
The harder to digest, the more difficult it is to be absorbed in Enhance athletic Reduce athletic
your system, the lower the GI. performance performance

3. Eat foods that are high in fiber. Improve muscle:fat ratio Deter fat breakdown
Not all fibers are created equal.
Allow you to eat more
4. Don't use artificial sweeteners. Increase abdominal fat
calories
This refers to high-fructose corn syrup which is predominant
in the market now. Other sweeteners such as stevia and
Normal, healthy GH release Stunt GH release
aspartame are essentially not being metabolized; they do not
contribute excess calories so they are safe to use.
IV. FORMATION OF MONOSACCHARIDES VIA
HYDROLYSIS
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 o Dietary polysaccharides and disaccharides can undergo
hydrolysis yielding monosaccharides.
o Chewing produces salivary amylase, making the
carbohydrates partially digested. After 1-2hours after
meals, it is already in the intestine.

C. ACTIVE TRANSPORT (COTRANSPORT)

o It needs energy derived from the hydrolysis of ATP;

o Dextrine + H2O → n D-glucose via Dextrinase
(dextrinase found in the intestinal mucosa)
o Maltose + H2O → 2 D-glucose via Maltase
o Lactose + H2O → D-galactose + D-glucose via Lactase
o Sucrose + H2O → D-fructose + D-glucose via Sucrase
o Trehalose + H2O → 2 D-glucose via trehalase
V. ABSORPTION OF MONOSACCHARIDES
There is sugar absorption of sugar in oral cavity.
energy dependent.
o Requires a cotransport system (Na+, K+, H+).
o Active when the concentration gradient is not favorable
(low concentration in the lumen)
o GLUCOSE and GALACTOSE are actively transported
against their concentration gradients by this mechanism
Fluid Replacement Therapy
Ø Oral Hydrating/Replacement Solution
(ORS or ORESOL)
• Sodium-glucose cotransport mechanism
• Glucose is better absorbed with sodium which is
applicable for dehydrated patients

A. SIMPLE DIFFUSION
o Sodium-glucose cotransporters (SGLT):
Ø SGLT 1 – located in the small intestine, brain, beta
o Depending on the concentration gradient of sugars
cells, and to some extent in the kidneys
between intestinal lumen and mucosal cells.
Ø SGLT 2 – located in the proximal kidney tubules;
o Diffusion will depend on the concentration gradient of
dominant in kidneys
sugars between intestinal lumen and mucosal cells.
o Types of Cotransport
o From area of higher concentration to area of lower
Ø Symport - molecules are transported to the same
concentration
direction
o Utilized when there is low sugar concentration
Ø Antiport - molecules are transported to different
o E.g. FRUCTOSEand PENTOSE
directions
o Transporters that can act as both:
B. FACILITATED DIFFUSION
Ø Sodium-Glucose cotransporter in the small intestine
(symport) but can act at the same time as Sodium-
o It requires a transporter
Potassium Co-transporter (antiport)
o Requires the presence of carrier proteins or transporters
that are located on the surface of the mucosal cells of the
ü FRUCTOSE: Simple diffusion and facilitated diffusion
small intestine
ü GLUCOSE AND GALACTOSE: Facilitated diffusion and
o GLUT 2 - glucose transporter
active transport
o GLUT 5 - fructose transporter
o Vesicles attach to the membrane and the proteins acts as
channels by which monosaccharides can enter
o Transporters vary in names depending on their location
or the substance they carried
o Utilized when there is high glucose load
o E.g. GLUCOSE, FRUCTOSE and GALACTOSE

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VI. STORAGE OF MONOSACCHARIDES
o After passing through the small intestines,
monosaccharides will then be transported towards the
capillaries or to the lacteals for transport into the blood
stream
o Once in the blood stream, monosaccharides will be
deposited into the skeletal muscle
Ø Skeletal muscle is the preferred destination of
glucose and stores glucose for itself alone
Ø Glucose will be transported to other sites such as the
liver, when skeletal muscles reach maximal storage
capacity
o There is entry of glycogen, starch, disaccharides, and
hexoses into the preparatory stage of glycolysis.
o Phosphorylation reaction traps them inside the cell
Ø Non-specific enzyme: Hexokinase (liver)
Ø Specific components (depend on cell type):
glucokinase (skeletal muscles), fructokinase,
galactokinase
Km VALUE
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o Concentration of the substrate in which half is bounded
to the enzyme
o Lower Km - more specific and has greater affinity to the
enzyme thus, faster phosphorylation
o Hexokinase is most specific for glucose since it has the
lowest Km value, and is even more specific for glucose
when compared to glucokinase.
o Glucokinase is found in the brain, it is specific for glucose
but has higher Km value.
Ø Higher Km value - brain does not grab glucose all the
time, it depends on the metabolism of glucose for a
neuron.
Ø Liver & skeletal muscles grab glucose immediately
o In skeletal muscles: If there is more activity, there would
be more space for carbohydrates to occupy in the
muscles.
Ø If you eat and eat à no storage for carbohydrates
in muscle à bad.
o Skeletal muscle – lowest Km value
o Hepatic cells – intermediate Km value
o Brain – highest Km in order to maintain the osmolarity
o Glucose Affinity Opposite (Inversely Proportional to Km)
o Skeletal Muscle> Liver> Brain
NABIONG, R|RAMOS, J|GARCIA, K.
 CHECKPOINT

A. 1>2
B.1<2
C.1=2

1. Glucose Affinity
1. Skeletal Muscles 2. Liver
2. Km Value
1. Brain 2. Skeletal Muscles
3. Glycemic Index
1. Stevia 2. Fructose
4. Glycemic Index
1. White Bread 2. Whole Wheat Bread
5. Glycemic Load
1. Banana 2. Watermelon

TRUE/FALSE:
1. SGLT 1 is located in the kidney tubules.
2. SGLT 2 is located in the small intestines
3. Dietary polysaccharides and disaccharides can
undergo hydrolysis yielding monosaccharides.
4. Facilitated diffusion requires a transporter.
5. The higher the fiber content, the more likely is the
food to be high glycemic.

ANSWERS:
1. A
2. B
3. B
4. C
5. A
TRUE/FALSE:
FFTTF

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