2. The Carbohydrates Sugars Starches Fiber

3. Objectives After reading Chapter 3 and class discussion, you will be able to: –Describe the functions of CHO –Identify the classification of CHO –Describe CHO digestion & absorption –Identify food sources of CHO –Calculate calories from CHO

4. Objectives Differentiate between soluble and insoluble fiber Identify foods that are a significant source of fiber Discuss health related effects of CHO in –Diabetes -Heart Disease –Obesity -GI -Cancer

5. 4 Photosynthesis Plants make their own carbohydrates from –carbon dioxide in air –water from the soil Photosynthesis converts energy from sunlight into energy stored in carbohydrates

6. 5 Categories of Carbohydrate Simple carbohydrates –Natural sugars –Added (Refined) sugars Complex carbohydrates (polysaccharides) –Starch –Fiber

7. Carbohydrates Simple carbohydrates –Monosacchares –Disaccharides Complex carbohydrates –Glycogen –Starches –Fibers

8. Glucose

9. Fructose & Galactose p. 84

10. 9 Monosaccharides and Disaccharides p. 84

11. Disaccharides Maltose –Glucose + glucose –Starch breakdown; fermentation –Barley Sucrose –Glucose + fructose –Table sugar from sugarcane, sugar beet Lactose –Gucose + galactose –Milk

12. Complex Carbohydrates Polysaccharides –Glycogen Storage form of glucose Stored in liver and muscles –Starches Long chains of glucose linked together Straight or branched chains –Fibers Soluble or viscous Insoluble or nonviscous

13. Complex Carbohydrates Chemical Structure p. 91 Fig 3-6

14. 13 Complex Carbohydrate: Starch Amylose - straight glucose chain Amylopectin – branched glucose chain Found only in plant foods: grains, legumes, vegetables, some fruits. Gelatinization – When starches are heated, they absorb water and swell in size.

15. Complex Carbohydrates Fibers –Cellulose –Hemicelluloses –Pectins –Legnin –Gums and muscilages –Resistant starches p. 92-98

16. Complex Carbohydrates Fibers –Soluble fibers-dissolve in water Viscous-form gels Fermentable-digested in colon by bacteria

17. Complex Carbohydrates Fibers –Insoluble fibers Nonviscous Fermented less readily Phytic acid-binds minerals

19. Carbohydrate Categories Sugars Starches Fibers OR Simple Complex

20. Carbohydrate Categories Monosaccharide –Glucose-Fructose-Galactose Disaccharide –Maltose-Sucrose-Lactose Polysaccharide –Glycogen-Starches-Fibers

21. 20 Functions of Carbohydrate Primary source of body’s energy –Central nervous system and red blood cells rely almost exclusively on glucose. –Glucose stored in liver & muscles as glycogen. Protein sparing –Prevents breakdown of protein for energy (gluconeogenesis) Prevents ketone bodies & ketosis –Breakdown of fat for energy

22. Digestion Mouth –Salivary amylase –Mechanical mixing; chewing Stomach –Continued mixing of bolus –Fibers and satiety Small intestine –Maltase, Sucrase, Lactase

23. Digestion Pancreas –Pancreatic amylase Large intestine – Colon –Fermentation of viscous fibers Water, gas, short-chain fatty-acid production

26. Absorption

27. Carbohydrates and Health Lactose Intolerance Diabetes Dental caries Constipation Hyperactivity Obesity Heart Disease

28. Lactose Intolerance Symptoms –Abdominal discomfort –Bloating; Intestinal gas formation –Diarrhea Causes –Primary: Lactase deficiency –Secondary: Mucosal damage p. 89-90

29. Lactose Intolerance Prevalence (p. 111) Ethnic 80% –<10% Northern Europeans (Scandinavians) –20% Caucasians –50% Hispanics –60% Inuits –70% Mediterranean peoples –75% African Americans –80% Native Americans –>80% Southeast Asians

30. Lactose Content of Food Whole wheat bread 1 slice 0.5gm Cheese 1 oz 0.5-0.8 –Cheddar/American –Parmesan/Cream Doughnut, cake type 1.2 Chocolate 1 oz 2.3 Sherbet 1 c 4.0 Cottage cheese 7.5 Ice Cream 1 c 9.0 Milk 1 c 12.0 Yogurt 1 c 15.0

31. Lactose Intolerance Dietary changes –May not require the elimination of milk/milk products –Acidophilus milk –Kefir, yogurt –Adequate calcium intake –Conservative vs liberal approach

33. Blood Glucose Regulating hormones –Insulin Controls transport of glucose –Glucagon Release glycogen from liver stores –Epinephrine Signals liver to release glucose p. 82, 89

34. How the body regulates blood glucose p. 96

35. Blood Glucose Hypoglycemia –Rare in healthy people Diabetes –Type 1 diabetes Failure of insulin production –Type 2 diabetes Obesity

36. Blood Glucose Glycemic response –How quickly and how high blood sugar rises after eating Glycemic index –Method of classifying foods according to their potential for raising blood glucose p. 118

37. Blood Glucose Glycemic Load –Refers to both the Glycemic Index and the total amount of carbohydrate contained in the food Factors Influencing Glycemic Index –Effect of mixed meal –Fat, fiber, protein content of food –Amount and type of CHO eaten CAUTION

38. Added Sugars Sugars added to a food for sweetening or other purposes –Do not include natural sugars Other purposes: –Prevent spoilage –Browning –Food for yeast –Hold moisture p. 88

39. 38 Examples of Added Sugars White sugar (sucrose) High-fructose corn syrup or corn syrup Invert sugar Brown sugar Molasses Honey Powdered sugar Raw sugar Demerara sugar

40. Sugars Nutrient density Overused in USA

43. Sugars Health effects of sugars –Dental caries Dental plaque p. 88

44. Oral Health and …… 20% increase in CVD risk Risk for stroke even stronger Release cytokines, CRP, TNF Endothelial damage Plaque attachment http://www.videomd.com/OralHealthandCardiovascularD isease-fv-4794.aspx

45. Controversies Of Sugar Sugar causes obesity Sugar causes heart disease What about HFCS? p. 88-89

46. Controversies Of Sugar Sugar causes misbehavior in children and criminal behavior in adults Sugar causes cravings and addictions –Serotonin- mood elevator p. 89

47. Recommended Intakes of Sugars DRI –No more than 25% of total daily energy intake Average U.S. Intake=105#/yr »30 teaspoons/day

48. Starch and Fiber Health effects –Heart disease –Diabetes –GI health –Cancer –Weight management

49. Viscous Fibers SOLUBLE and more fermentable Gums and mucilages Pectins Psyllium Some hemicelluloses

50. Viscous Fibers Sources –Whole- grains, fruits, legumes, seeds and husks, vegetables

51. Viscous Fibers Lower blood cholesterol Slow glucose absorption Slow transit of food through upper GI tract Holds moisture in stools, softening them

52. Viscous Fibers Yield small fat molecules that the colon can use for energy Lower risk of heart disease Lower risk of diabetes

53. Viscous Fibers

54. Nonviscous Fibers INSOLUBLE and less fermentable Cellulose Lignins Psyllium Resistant starch Many hemicelluloses

55. Nonviscous Fibers Sources –Brown rice, fruits, legumes, seeds, vegetables, wheat bran, whole grains

56. Nonviscous Fibers Increase fecal weight Speed fecal passage through colon Provide bulk and feelings of fullness

57. Nonviscous Fibers Alleviate constipation Lower risks of diverticulosis, hemorrhoids, appendicitis May help with weight management

58. Nonviscous Fibers

59. Starch and Fiber RDA for carbohydrate –130 g/day –45% - 65% total daily energy intake Daily Value: 300 g/day; 60% of 2000 kcal diet Fiber –Daily Value: 25 gm/day –AI: 14 gm/1000 kcal/day

60. Fiber Grains –Whole Wheat or –100% Wheat vs –Wheat Bread

61. More on Fiber Vegetables –½ c. dry beans, carrots=5-7 gms –½ c. corn=2 gm; 1c. tomatoes=2 gm –½ c. broccoli=3-6 gm Fruits –1 pear=4-6 gm; canned=4 gm/1c –1 apple=3-5 –1 banana, orange=3

62. Fiber and Food Processing How much fiber is there in each food? 1 apple1 c. applesauce 1 c. apple juice

64. Food ItemAmountDietary Fiber 100% Bran cereal or Miller’s Bran 1/2 cup or 2 Tablespoons 10-14 grams Whole Wheat Bread 2 slices 4 grams Fresh Fruit2 pieces 4 grams Vegetables2 servings 4 grams Total22-26 grams Robertson’s Rule of 2’s

67. Alternatives to Sugar Artificial sweeteners & sugar replacers (nutritive sweeteners) Stevia-natural, herbal alternative Guidelines for Use: –More sweet than sugar; use less –FDA approved (p.119 ) –Caution when used in cooking Hot Topic p. 119-121

68. Alternatives to Sugar Caution: Patients with PKU Acceptable Daily Intake (ADI) p. 119

71. Objectives After reading Chapter 3 and class discussion, you will be able to: –Describe the functions of CHO –Identify the classification of CHO –Describe CHO digestion & absorption –Identify food sources of CHO –Calculate calories from CHO

72. Objectives Differentiate between soluble and insoluble fiber Identify foods that are a significant source of fiber Discuss health related effects of CHO in –Diabetes -Heart Disease –Obesity -GI -Cancer