1. Chapter 4 Carbohydrates: Sugar, Starches and Fiber

2. Carbohydrates in Our Diet
Carbohydrates make up most of the energy in a healthy diet.
Grains are sources of carbohydrates.
Refined carbohydrates lack fiber and many rich nutrients.
Unrefined carbohydrates are healthier to eat.

3. Unrefined and Refined Foods

4. Whole Grains Whole grains are made up of
bran: containing fiber and vitamins
germ: mainly protein and vitamins
endosperm: starch, protein, vitamins, and minerals

6. Empty Calories
Many processed/ready to eat foods contain added sugar that reduces nutrient density (empty calories)

7. Types of Carbohydrates
Glucose, fructose and galactose are simple carbohydrates.
Glucose is the blood sugar and found in cells.
Sucrose is made up of a molecules of glucose and a molecule of fructose is a disaccharide.
Maltose is made up of two glucose molecules.
Lactose contains one glucose and one galactose.

8. Monosaccharides

9. Dissaccharides
Simple carbohydrates have one or two molecules of single sugars.
maltose, sucrose and lactose are simple carbohydrates.
Glucose, galactose and fructose are single carbohydrates.
Glucose is the blood sugar and source of energy from carbohydrates.
Galactose is milk sugar important in producing milk in lactating women and animals.

10. Dissaccharides

11. Complex Carbohydrates
Complex carbohydrates contain many molecules of glucose.
Starch, glycogen and cellulose are complex carbohydrates.
Starch and glycogen are synthesized by a chain of glucose molecules joined by alpha 1–4 and 1–6 bonds they also have branched chain attached.
Fiber (cellulose) is a chain of glucose molecules joined by beta 1–4 bond that human intestine does not produce the enzyme to digest it.

12. Complex Carbohydrates

13. Glucose is Produced by Plants through Photosynthesis

14. Chemistry of Carbohydrates
Starch is stored in the grains, stems and root of the plant.
Fiber is found in the bran of the grains, stem, leaf, and other structures of the plants.
There are two types of fiber in the plant varieties:
Soluble fiber in fruits, oats and legumes
Insoluble fiber mostly in grains and vegetables

15. Soluble and Insoluble Fiber
Pectin
Beans

16. Fiber
Humans do not produce enzyme to digest fiber—therefore, no calories from fiber.
Fiber provides many health benefits to humans:
Insoluble fiber:
provides bulk in the intestine to ease elimination.
prevents constipation, diverticulitis, appendicitis, and may prevent colon cancer.
Soluble fiber:
combines with bile, eliminate it,
preventing elevated blood cholesterol

17. Carbohydrate Digestion & Absorption
Mouth
Small intestine
Digestive enzymes from pancreas
Absorption through the small intestinal villi
Active absorption
Passive diffusion
Large intestine
Elimination of undigested starch and fiber
Modification of intestinal microflora
Role of the pancreas

18. Carbohydrate Digestion

19. Glycemic Index
Different carbohydrate containing foods are absorbed at different rate.
Simple carbohydrates and potato starch are absorbed fast and make a large spike in the blood sugar (a high glycemic index) causing a high insulin response.
Beans, legumes and some mixed foods are absorbed slower and have lower glycemic index.

20. Glycemic Index

21. Carbohydrate Functions
Getting glucose to the cells, role of insulin.
Problems of glucose metabolism
Type 1 diabetes, pancreases loss of insulin producing ability. Autoimmune problem
Type 2 diabetes
increased body fat cells causing resistance to insulin delivery of glucose to the cells
Role of insulin in regulating blood glucose levels

22. Functions of Monosaccharide
Absorbed monosaccharids enter liver where galactose and fructose are converted to glucose.
Glucose enters the blood and circulates.
Insulin helps glucose enter the cells for energy.
Glucagon helps excess blood glucose return to liver and muscles to form storage and form
glycogen
Glucose also is a part of genetic DNA, RNA, ATP and other functional molecules in the body.

23. Blood Glucose Regulation

24. Cellular Carbohydrate Metabolism
In cells, glucose is metabolized to produce energy.
There are two pathways for producing energy:
Anaerobic pathway (incomplete metabolism) with production of lactate.
Happens in absence of oxygen. Resulting in lower energy production
Aerobic pathway (complete metabolism) with end products of CO2 and H2O.
Happens when oxygen is present. Produces lot more energy.

25. Cellular Respiration

26. Breakdown of Fat and Protein
In the absence of carbohydrates body breaks down protein to form glucose to feed the brain.
About ½ of amino acids skeletons can produce glucose
Other amino acids produce ketone
acidic molecules that changes the pH of body environment to acid.
Body also breaks down the stored fat to provide energy for body needs
Fat breakdown in the absence of carbohydrates results in ketone production.
Ketone bodies are harmful to the body and are excreted through the urine.
Severe ketosis can occur with untreated diabetes and can cause coma and even death.

27. Ketone Formation

28. Carbohydrates and Health
Are carbohydrates good or bad for you?
What kind of carbohydrates are beneficial to health?
Whole grains, complex carbohydrates foods are healthy carbohydrates.
What kind are not healthy carbohydrates to consume?
Refined carbohydrates and food with added sugar are not healthy and may cause risk of chronic diseases.

29. Diabetes
Carbohydrates are generally blamed for diabetes. The interesting fact is again which kind of carbohydrates are to be blamed.
Whole grain and complex carbohydrates prevent type 2 diabetes by preventing fat cells accumulation in the body.
Refined carbohydrates increase empty calories in the diet may cause weight gain, increase resistance to insulin causing type 2 diabetes.

30. Diabetes
Type 1 diabetes is due to lack of production of insulin from pancreas causing blood glucose to elevate.
It can be controlled by a diet very low on fast absorbing starches (potato) and refined sugars.
A diet high in fiber and whole grains help slow absorption and prevent fast rise in blood sugar.
In sever cases insulin must be injected to regulate blood sugar levels.

31. Blood Glucose Levels in Diabetes

32. Diabetes Incidences of diabetes in the US is on the rise.
Certain racial groups are more susptible to diabetes than others.
Lifestyle, dietary habits physical activity and environment also play a role.
Managing diabetes with diet, exercise and medication.
Symptoms and complications of diabetes.

33. Incidence of Diabetes

34. Other Health Problems Hypoglycemia: Dental caries:
Reactive hypoglycemia
Fasting hypoglycemia
Dental caries:
Dental hygiene
Refined sugars
Carbohydrates and weight management:
Which kind to consume?

35. Carbohydrates and Weight Management

36. Carbohydrates & Body Weight
Carbohydrates and weight management.
Role of refined carbohydrates in storage of fat.
Role of insulin in body fat accumulation.
The consequence of low or no carbohydrate diets?
Ketosis and ketogenic diets
Role of ketones in weight loss
Benefits and harms of nonnutritive sweeteners.

37. Nonnutritive Sweeteners

38. Carbohydrates and Heart Disease
Diets with high sugar, added sugar glucose or any simple sugar raise blood sugar, cholesterol and the risk of heart disease.
High fiber containing diets with both soluble and insoluble fiber reduce the risk of heart disease.

39. Carbohydrates and Heart Disease
Consuming foods high in soluble fiber reduce cholesterol synthesis by liver.
Soluble fiber in legumes, fruits, oats, brown rice, etc. bind with bile in the intestine, removing it from the body preventing bile reabsorption, and cholesterol re-synthesis.
Soluble fiber may also reduce blood cholesterol by other means.

40. Cholesterol and Soluble Fiber

41. Carbohydrates and Heart Disease
Diets with high insoluble help reduce risk of heart disease by:
Reducing absorption of starch and sugars.
Keeping blood glucose normal
Reducing food intake by filling the stomach and reducing the appetite.
Preventing obesity
Reducing blood pressure.
Preventing formation of diverticula

42. Diverticula

43. Intestinal Health and Fiber
Insoluble fiber is not digested, absorbs water in the intestine and increase in volume conferring benefits:
Softens the stool, making elimination easy.
Preventing constipation, diverticulitis, appendicitis, hemorrhoids, and possibly colon cancer.
Speed up the movement of waste materials from the bowl.
Modify the bowl micro flora environment positively.

44. Meeting Carbohydrate Needs
Carbohydrates intake is to meet the needs of:
Adequate blood glucose levels to meet the brain, red blood cells and nerves energy requirements (about 300 grams/day).
Minimum carbohydrate intake to prevent ketosis
is 100 grams/day
Recommendations are:
45% – 65% of total daily calorie intake should come from complex carbohydrates.
In the US diet, the right percentage of calories consumed from carbohydrates, but it is mostly refined or added sugars.

45. Healthy Carbohydrate Choices

46. Choosing Carbohydrates Wisely

47. End of Chapter 4
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