Digestion of carbohydrates

By: Amanuel Tobe (MSc in Clinical Biochemistry)

09/16/2023 By Amanuel Tobe 1

 Learning objectives

 At the end of the sessions you will able to:

• Define intermediary metabolism
• Describe digestion process of carbohydrates
• Identify absorption mechanism of monosacharides
• Identify carbohydrate metabolism disorders

09/16/2023 By Amanuel Tobe 2

09/16/2023 Figure: Three stagesBy Amanuel
of catabolism
Tobe 3
3
 Catabolic vs anabolic reactions

Catabolic reactions (blue arrows) and anabolic ones (green)

09/16/2023 AMU By Amanuel Tobe 4

 Digestion of carbohydrates

• In the diet, carbohydrates are present as complex

polysaccharides (starch, glycogen), and to a minor extent, as
disaccharides (sucrose and lactose). They are hydrolyzed to
monosaccharide units in the gastrointestinal tract. Cooking
makes the digestion process easier.
• The process of digestion starts in mouth by the salivary
alpha-amylase.

09/16/2023 By Amanuel Tobe 5

 Cont.

• However, the time available for digestion in the mouth is

limited, because the gastric hydrochloric acid will inhibit the
action of salivary amylase.
• During mastication, salivary α-amylase acts briefly on dietary
starch and glycogen, hydrolyzing random α(1→4) bonds.
• There are both α(1→4)- and β(1→4)-endoglucosidases in
nature, but humans do not produce the latter. Therefore, we are
unable to digest cellulose, a carbohydrate of plant origin
containing β(1→4) glycosidic bonds between glucose
residues.

09/16/2023 By Amanuel Tobe 6

 Cont.

• Because branched amylopectin and glycogen also contain

α(1→6) bonds, which α-amylase cannot hydrolyze, the digest
resulting from its action contains a mixture of short, branched
and unbranched oligosaccharides known as dextrins.
• When the acidic stomach contents reach the small intestine,
they are neutralized by bicarbonate secreted by the pancreas,
and pancreatic α-amylase continues the process of starch
digestion.

09/16/2023 By Amanuel Tobe 7

 Cont.

• In the pancreatic juice another alpha-amylase is available

which will hydrolyse the alpha-1,4 glycosidic linkages
randomly, so as to produce smaller subunits like maltose,
isomaltose, dextrins and branched or unbranched
oligosaccharides.
• The cells of brush border of intestine contain the enzymes,
sucrase, maltase, isomaltose and lactase. They hydrolyse the
corresponding disaccharides into component monosaccharides
which are then absorbed.

09/16/2023 By Amanuel Tobe 8

 Cellulose

Fig. Overview of
carbohydrate digestion

09/16/2023 By Amanuel Tobe 9

Figure: Overview of carbohydrateBydigestion
09/16/2023 Amanuel Tobe 10
 Cont.

09/16/2023 By Amanuel Tobe 11

 Cont.

09/16/2023 By Amanuel Tobe 12

The dietary carbohydrates are present in three forms:

A. Ready-to-absorb carbohydrates: The carbohydrate molecules,

which do not require digestion and are absorbed as such, e.g.,
monosaccharides: glucose, mannose, galactose, fructose and
pentoses.
B. Digestible carbohydrates: They are completely digested into their
respective monosaccharides. These include starch (constitutes
more than 50%), glycogen, maltose, sucrose, and lactose
(oligosaccharides and polysaccharides).
C. Non-digestible carbohydrates: There are carbohydrate molecules
(dietary fibers) that cannot be digested in human gastrointestinal
tract primarily due to the absence of specific digestive enzymes.

09/16/2023 By Amanuel Tobe 13

 Cont.

• Glycosidases are usually specific for the structure and

configuration of the glycosyl residue to be removed as well as
for the type of bond to be broken. The final products of
carbohydrate digestion are the monosaccharides, glucose,
galactose, and fructose that are absorbed by cells of the small
intestine.

09/16/2023 By Amanuel Tobe 14

 Absorption of carbohydrates

• Only monosaccharides are absorbed by the intestine.

Absorption rate is maximum for galactose; moderate for
glucose; and minimum for fructose.

09/16/2023 By Amanuel Tobe 15

 Cont.

SGluT-1. Sodium and glucose co-

transport system at luminal side Glucose absorption (GluT2)

09/16/2023 By Amanuel Tobe 16

 Cont.

09/16/2023 By Amanuel Tobe 17

Mutation in SGLT1 leads to the potentially fatal neonatal glucose-galactose malabsorption,
correctable by dietary fructose as a main sugar.
09/16/2023 By Amanuel Tobe 18
 Glucose transporters in specific cells

09/16/2023 By Amanuel Tobe 19

 Absorption of other monosaccharides

• Glucose and galactose are absorbed by the same transporter,

SGluT1. It is an energy dependent process, against a
concentration gradient, and therefore absorption is almost
complete from the intestine.
• Other monosaccharides are absorbed by carrier mediated
facilitated transport. Therefore, absorption is not complete,
and the remaining molecules in the intestine will be fermented
by bacteria.

09/16/2023 By Amanuel Tobe 20

 Cont.

• The overall process of carbohydrate digestion and absorption

is so efficient in healthy individuals that ordinarily all
digestible dietary carbohydrate is absorbed by the time the
ingested material reaches the lower jejunum. However,
because only monosaccharides are absorbed, any deficiency
(genetic or acquired) in a specific disaccharidase activity of
the intestinal mucosa causes the passage of undigested
carbohydrate into the large intestine.

09/16/2023 By Amanuel Tobe 21

 Cont.

• As a consequence of the presence of this osmotically active

material, water is drawn from the mucosa into the large
intestine, causing osmotic diarrhea. This is reinforced by the
bacterial fermentation of the remaining carbohydrate to two-
and three-carbon compounds (which are also osmotically
active) plus large volumes of CO2 and H2 gas, causing
abdominal cramps, diarrhea, and flatulence.

09/16/2023 By Amanuel Tobe 22

 Digestive enzyme deficiencies

• Genetic deficiencies of the individual disaccharidases result in

disaccharide intolerance. Alterations in disaccharide
degradation can also be caused by a variety of intestinal
diseases, malnutrition, and drugs that injure the mucosa of
the small intestine. For example, brush border enzymes are
rapidly lost in normal individuals with severe diarrhea, causing
a temporary, acquired enzyme deficiency.

09/16/2023 By Amanuel Tobe 23

 Cont.

• Lactose intolerance: More than 70% of the world’s adults are

lactose intolerant. This is particularly manifested in certain
populations. For example, up to 90% of adults of African or
Asian descent are lactase-deficient and, therefore, are less able
to metabolize lactose than individuals of Northern European
origin. The age-dependent loss of lactase activity represents a
reduction in the amount of enzyme produced.

09/16/2023 By Amanuel Tobe 24

 Cont.

• Treatment for this disorder is to reduce consumption of milk

and eat yogurts and some cheeses (bacterial action and aging
process decrease lactose content) as well as green vegetables,
such as broccoli, to ensure adequate calcium intake; to use
lactase-treated products; or to take lactase in pill form prior to
eating.

09/16/2023 By Amanuel Tobe 25

 Clinical Importance of Glucose

1. Glucose is the preferred source of energy for most of

the body tissues. Brain cells derive the energy mainly
from glucose.
2. When the glucose metabolism is deranged, life-threatening
conditions may occur. A minimum amount of glucose is
always required for normal functioning.
3. Normal fasting plasma glucose level is 70 to 100
mg/dl. After a heavy carbohydrate meal, in a normal
person, this level is below 150 mg/dl.

09/16/2023 By Amanuel Tobe 26

09/16/2023 By Amanuel Tobe 27