Professional Documents
Culture Documents
DAN SERAT
MUKHLIDAH HANUN SIREGAR, M.KM
Sub Bahasan
Konsep kecukupan KH dan serat
Metode kalkulasi kecukupan KH dan serat
Kalkulasi kecukupan KH dan serat
Dietary Carbohydrates
KARBOHIDRAT
Karbohidrat memegang
peranan penting karena
merupakan sumber energi
utama bagi kehidupan
manusia dan hewan.
Di negara sedang berkembang
kurang lebih 80 % energi
makanan berasal dari
karbohidrat.
Susunan kimia dari
karbohidrat terdiri atas unsurunsur karbon (C), hidrogen (H),
dan oksigen (O).
Formula umum karbohidrat
adalah CnHnOn.
KLASIFIKASI KARBOHIDRAT
KARBOHIDRAT
KH Sederhana
MONOSAKARIDA
DISAKARIDA
KH Kompleks
GULA ALKOHOL
OLIGOSAKARIDA
POLISAKARIDA
Almatsier, 2009
SERAT/
POLISAKARIDA
NON PATI
Classes of Carbohydrates
Class
DP
Example
Site of digestion
Monosaccharides
Glucose
Small bowel
Fructose
Small bowel
Sucrose
Small bowel
Lactose
Small bowel
Raffinose
Large bowel
3-9
Inulin
Large bowel
>9
Starches
Predominantly
Small bowel
>9
Nonstarch
polysaccharides
Large bowel
Oligosaccharides
Polysaccharides
Definition
Example
monosaccharide
glucose or fructose
(sugar alcohols, such
as sorbitol and
mannitol)
disaccharide
Oligosaccharides
raffinose and
stachyose
Polysaccharides
starch
and glycogen
IOM, 2005
Function of CH
The primary role of carbohydrates (sugars and
starches) is to provide energy to cells in the
body, particularly the brain, which is the only
carbohydrate-dependent organ in the body.
Metabolisme KH
Sumber dari Eksogen dan Endogen
1. GLIKOLISIS serangkaian reaksi biokimia di mana glukosa
dioksidasi menjadi molekul asam piruvat.
2. GLIKOGENESIS proses pembentukan glikogen
3. GLIKOGENOLISIS pemecahan glikogen menjadi bentuk
glukosa di dalam sel.
4. GLUKONEOGENESIS sintesis glukosa dari senyawa bukan
karbohidrat, misalnya asam laktat dan beberapa asam amino.
Evidence... (2)
In overnight fasted adults, glucose production : 2 to 2.5 mg/kg/min, or
2.8 to 3.6 g/kg/d. In a 70-kg man, this represents approximately 210 to
270 g/d.
In overnight fasted adults, approximately 50 percent of glucose
production comes from glycogenolysis in liver and 50 percent from
gluconeogenesis in the liver.
Evidence... (3)
The requirement for glucose has been reported to be approximately 110
to 140 g/d in adults (Cahill et al., 1968). Nevertheless, even the brain
can adapt to a carbohydrate-free, energy-sufficient diet, or to
starvation, by utilizing ketoacids for part of its fuel requirements.
In individuals fully adapted to starvation, ketoacid oxidation can
account for approximately 80 percent of the brains energy
requirements (Cahill et al., 1973). Thus, only 22 to 28 g/d of glucose
are required to fuel the brain.
Evidence... (4)
Glucose utilization by the brain has been determined either by measuring
arteriovenous gradients of glucose, oxygen, lactate, and ketones across the brain and
the respiratory quotient (Kety, 1957; Sokoloff, 1973), or with estimates of brain
blood flow determined by different methods. But, the problem is the limited
accuracy of the blood flow methods used (Settergren et al., 1976, 1980). indirect
method and has limitations.
Brain O2 consumption in association with the brain respiratory quotient also has been
used as an indirect estimate of glucose utilization (Kalhan and Kili, 1999).
Setting EAR Only data determined by direct measurement of glucose
arteriovenous difference across the brain in association with determination of brain
blood flow can be considered, indirect methods yield similar results.
The glucose consumption by the brain can be used along with information from
Dobbing and Sands (1973) and Dekaban and Sadowsky (1978), which correlated
weight of the brain with body weight to calculate glucose utilization.
AI for Infants
1. 06 months 60 g/d of carbohydrate
Average volume of ASI intake 0.78 L/d as reported from studies of fullterm
infants by test weighing (Butte et al., 1984; Chandra, 1984; Hofvander et al.,
1982; Neville et al., 1988) 0,78 L/d x 74 g/L
Evidence (1)
EAR for total carbohydrate is set at 100 g/d. RDA calculate with CV
15%.
This amount should be sufficient to fuel central nervous system cells
without having to rely on a partial replacement of glucose by ketoacids.
Although the latter are used by the brain in a concentration-dependent
fashion (Sokoloff, 1973), their utilization only becomes quantitatively
significant when the supply of glucose is considerably reduced and
their circulating concentration has increased several-fold over that
present after an overnight fast.
Evidence (2)
Aging decreases with aging overall rate of energy
metabolism, total body glucose oxidation rate (10% less than 19-29
years)
Changes out of proportion to brain mass remains a controversial
issue.
There is no evidence to indicate that a certain amount of carbohydrate
should be provided as starch or sugars. sugar + 30% from total
energy
Pregnancy
EVIDENCE
Pregnancy increased metabolic rate and fuel
requirement Establishment of the placental
fetal unit and an increased energy supply for
growth and development of the fetus.
Adaptation to pregnancy, there is a decrease in
maternal blood glucose concentration, a
development of insulin resistance, and a
tendency to develop ketosis.
Some data indicate an increase in glucose
ulitization.
Evidence (1)
Fetus 56 kkal/kg/d, so if 3 kg 168 kkal/d.
Transfer form mother 17 26 g/d in late
gestation.
Assuming the glucose consumption rate is the
same for infants and adults (32.5 g/d) greater
than transfer from mother
Glucose oxidation can only account for 70% of
the brains estimated fuel requirement fetus. So
70% from 32,5 = 23 g/d it adequate from
mother.
Evidence (2)
In order to assure provision of glucose to the fetal brain additional
+ 35 g/d
EAR Non pregnant 100 g/d + 35 g/d = 135 g/d RDA calculating
by CV 15%
EAR for Pregnancy
1418 years 135 g/d of KH
1930 years 135 g/d of KH
3150 years 135 g/d of KH
Lactation
EVIDENCE
The requirement for carbohydrate is increased during lactation. The
lactose content of human milk is approximately 74 g/L.
Lactose is synthesized from glucose, and increased supply of glucose
must be obtained from ingested carbohydrate or from an increased
supply of amino acids.
Intake necessary to replace the carbohydrate secreted in human milk
(60 g/d)
Dietary Fiber
FIBER
Dietary Fiber consists of nondigestible
carbohydrates and lignin that are intrinsic and
intact in plants.
Functional Fiber consists of isolated,
nondigestible carbohydrates that have
beneficial physiological effects in humans.
Total Fiber is the sum of Dietary Fiber and
Functional Fiber.
Examples Of Fiber
Dietary Fiber includes plant nonstarch polysaccharides
(e.g., cellulose, pectin, gums, hemicellulose, -glucans,
and fibers contained in oat and wheat bran), plant
carbohydrates that are not recovered by alcohol
precipitation (e.g., inulin, oligosaccharides, and
fructans), lignin, and some resistant starch.
Potential Functional Fibers for food labeling include
isolated, nondigestible plant (e.g., resistant starch,
pectin, and gums), animal (e.g., chitin and chitosan), or
commercially produced (e.g., resistant starch,
polydextrose, inulin, and indigestible dextrins)
carbohydrates.
Limitedness
All but one of the studies (Bonithon-Kopp et al., 2000)
cited in this section examined the relationship of
Dietary Fiber to colon cancer. Information is lacking on
the role of Functional Fibers in the incidence of colon
cancer because of the lack of intake data on specific
Functional Fibers collected in epidemiological studies.
Most animal studies on fiber and colon cancer,
however, have used what could be termed Functional
Fibers (Jacobs, 1986). Because evidence available is
either too conflicting or inadequately understood, a
recommended intake level based on the prevention of
colon cancer cannot be set.
Estimating AI
Total Fiber requirements (the sum of Dietary Fiber and
Functional Fiber) may be expressed in a variety of different
ways, including age plus number of grams per day (Williams
et al., 1995), grams per kilogram of body weight (AAP,
1993), grams per day (Health and Welfare Canada, 1985;
LSRO, 1987), and grams per 1,000 kcal (LSRO, 1987).
Each of these methods has its advantages and
disadvantages. Because the available evidence suggests
that the beneficial effects of fiber in humans are most likely
related to the amount of food consumednot to the
individuals age or body weight the best approach is to
set an Adequate Intake (AI) based on grams per 1,000 kcal.
However, since many people do not know how many
kilocalories they consume in a day, the AI is based on the
usual daily intake of energy.
AI for Boys
913 years 31 g/d of Total Fiber
1418 years 38 g/d of Total Fiber
AI for Girls
913 years 26 g/d of Total Fiber
1418 years 26 g/d of Total Fiber
AI for Women
1930 years 25 g/d of
Total Fiber
3150 years 25 g/d of
Total Fiber
5170 years 21 g/d of
Total Fiber
> 70 years 21 g/d of
Total Fiber
TERIMA KASIH