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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
• All varieties

MyPlate: Sources of Carbohydrates

• All varieties

• All varieties

• Milk • Yogurt 12 grams per serving

• 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


Carbohydrates = CHO

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

Monosaccharides = Simple CHO
• Glucose • Fructose • Galactose

• • • • • 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


• 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

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

• 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


• 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


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)


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


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 taste…wean 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 products—sugar is often used to make the product taste good

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


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