Carbohydrates

Types of Carbohydrates

Monosaccharides (1 sugar) Directly absorbed

Glucose most common form used for energy also called blood sugar Fructose fruit sugar, very sweet Galactose does not occur free in nature, found as part of lactose

Types of Carbohydrates

Disaccharides (Mono + Mono) require some digestion Sucrose (Glucose + Fructose) table sugar Maltose (Glucose + Glucose) Lactose (Glucose + Galactose) milk sugar Complex Carbohydrates

Polysaccharides: Starch & Glycogen Dietary fiber cannot be digested

Glycogen Storage form of carbohydrate for animals and humans Not a significant food source of carbohydrate We store glycogen in the liver and muscles limited storage capacityabout a days worth is stored Dietary Fiber Undigested starch Body cannot break the bonds (provides 0 calories) Insoluble fiber Whole grain bread = 2g per slice Fresh fruit=2-3 g

Soluble fiber Sources: Fruits, vegetables, whole grains, oatmeal, beans Beans cup=89 fiber All bran cereal cup=10g fiber

Dietary Fiber and Health Weight Control and Fiber

While providing little calories Satisfied after eating Foods high in fiber are typically also low in caloriesfruit, vegetables beans, whole grains Promotes bowel regularity/health by keeping fecal mass moist, moving and easy to eliminate Prevents constipation, hemorrhoids and diverticulosis Parches in the large intestine, that can become infected and blocked. Glucose Absorption and Fiber

Promotes feeling of fullness

Soluble fiber slows glucose absorptions Better blood glucose regulation Helpful for diabetics- help slow glucose absorption into the blood system

Cholesterol and (Soluble) Fiber Absorption of cholesterol inhibited Bile acid (bile is made from cholesterol and needed to absorb fat) absorption reduced Bile is excreted ( body needs to make more and uses cholesterol to do this) Blood cholesterol lowered Risk for cardiovascular disease reduced

Recommended Dietary Fiber Intake AI is 25 grams/day for women AI is 38 grams/day for men Average U.S. intake: too low due to poor intake of fruits, vegetables and whole grains 14 grams/day for women 17 grams/day for men Too Much Fiber

>60 grams/day (typically from fiber supplements) Extra fluid needed Fiber absorbs water May decrease availability of some minerals (iron, zinc and calcium) Children need less fiber than adults (5 grams + age/day)

example 12 year child needs 17 grams/day Too much fiber can fill a child up without providing sufficient calories needed for growth

Digestion of Carbohydrates

After Absorption Monosaccharides travel via portal vein to the liver Liver can: Transform monosaccharide into glucose Release glucose back into the bloodstream Store as glycogen (or fat) Function of Carbohydrates

Brain requires a constant supply of glucose Source of Glucose Blood we always have glucose in the blood system

4 kcal/g-complex and simple carbohydrates Glucose sugar energy source for the body

Glycogen Body can use for energy-brain and muscle cells use for energy Extra glucose can be stored as glycogen (limited storage)

store glucose as fat when we take in excessive amounts and have limited physical activity

Glucose can be stored as fat (fat stores are unlimited) we only

Carbohydrates

Blood Glucose

Maintained in narrow range 70-110 mg/dl

High or low blood glucose levels are dangerous High: hyperglycemia think of insulin as the key that let glucose out of the blood system and into the cells Low: hypoglycemia Blood Glucose Regulation Insulin Hormone made in pancreas Produced when glucose levels are high (after a meal) Assist cells in drawing glucose out of blood End result lowers blood glucose levels Glucagon Hormone made in pancreas Produced when glucose levels are low (fasting) Stimulates liver to release glucose from glycogen End result increase blood glucose levels Diabetes

Inability to control blood glucose levels Hyperglycemia High blood glucose level

Typically see hyperglycemia with untreated diabetes. Hyperglycemia can cause long term complications. Hypoglycemia Diabetes Common Symptoms (caused by high blood glucose levels) Extreme hunger Weight loss Extreme thirst Excessive urination Frequent infections Blurred vision Slow healing

Possible Complications

Diabetes

Blindness Heart disease Kidney failure Amputation (due to poor wound healing and loss of feeling) Can be treatable if properly treated Types of Diabetes

Insulin Dependent (Type I) Non-Insulin Dependent (Type II) Gestational Type I Diabetes 10% of cases < 40 years of age Begins abruptly Pancreas does not make insulin Viral infection or allergic reaction damages pancreas

Results in hyperglycemia-without insulin glucose is trapped in the blood

Type I Diabetes

Treatment Individual cannot survive without insulin Insulin shots Insulin pump Exercise Diet Type II Diabetes

90% of cases Over 16 million in US Pancreas makes insulin Poor use of insulin (resistant) insulin does not work properly--results in high blood glucose levels

Insulin resistant

Type II Diabetes

This type of diabetes is very common in overweight individuals

Used to be more common in elderly, today common in children and young adults, adults, especially those that are obese.

Type II Diabetes

Insulin injectionssome cases may eventually require insulin injections

Diabetes

Treatment Weight loss if overweight Exercise Medicationincrease body ability to use insulin

Dietary Management Low fat lowers risk for cardiovascular disease Consistent mealseating mealseating similar amounts and at similar times each day Avoid skipping mealscan mealscan cause low blood glucose Portion control Consistent Carbohydrates helps maintain normal blood glucose levels Can have sugar at meals limited amounts Gestational Diabetes

Diabetes during pregnancy Occurs more frequently in obese mother, over > 35 years of age Usually disappears after birth Increased risk of developing Type II Diabetes Treatment consists of exercise, medication and diet. Weight loss never recommended while pregnant. Simple Sugars

Low nutrient density (high in calories, limited in nutrients) Lead to dental cavities Added to many food and beverages

Displaces healthy beverages

Recommendation: Recommendation: < 10% of total kcals/day (12 tsp or 50 grams/day) grams/day)

Us avg. intake 82 grams/day A 20 oz soda contains about 12 tsp sugar

Sugar

Empty calorie foods High in cal. Low in nutrients Soda cake cookies These are the carbohydrates we should limit

Nutrient dense foods Low in cal. High in nutrients

Vegetables and fruits, whole grains These are the healthy carbohydrates
Limit empty calorie foods Soda, cake, cookies, Koolaid, high sugar cereal, etc.

Encourage Nutrient Dense Foods Brown rice, whole wheat bread, oatmeal, high fiber cereal, beans, fruit, vegetables, etc.

Sugar

Diabetes

Sugar does not cause diabetes Diabetes can have limited amounts of sugar in diet

Behavior

Sugar not linked to behavior Excessive caffeine intake in children linked to behavior

Tooth decay

High intakes of sugar increases risk of cavities

Helpful Tips Eat whole grain, bran or oatmeal breads and cereals. Use brown rice Use whole wheat pasta Snack on fresh fruit and vegetables Start your day with a fruit Add beans to soup or salads