Chapter 4 – The Carbohydrates: Sugars, Starches, and Fibers

Learning Objectives
After completing Chapter 4, the student will be able to:
4.1 Identify the monosaccharides, disaccharides, and polysaccharides common in nutrition by their chemical
structures and major food sources.
a. Classify carbohydrates as mono-, di-, or polysaccharides.
b. Explain the two major types of dietary fibers and their uses in the body.
4.2 Summarize carbohydrate digestion and absorption.
a. Trace the digestion and absorption of carbohydrates.
b. List the enzymes used in the digestion of carbohydrates.
c. Describe lactose intolerance symptoms, prevalence, and treatment.
4.3 Explain how the body maintains its blood glucose concentration and what happens when blood glucose
rises too high or falls too low.
a. List the major uses of glucose in the body.
b. Discuss the hormones used by the body to maintain normal blood glucose concentration.
c. List the major types of diabetes.
d. Explain glycemic load and the pros and cons of its use in meal planning.
4.4 Describe how added sugars can contribute to health problems.
a. Identify the major sources of added sugars in the diet.
b. Describe the effect of added sugars on dental health.
c. List the common alternatives to sugar in the diet.
4.5 Identify the health benefits of, and recommendations for, starches and fibers.
a. Identify the health benefits of a diet rich in starch and fiber.
b. Identify the Daily Value and DRI for fiber and methods to increase fiber in the diet.
c. Identify quality carbohydrate food sources and foods high in fiber.
H4 Summarize the key scientific evidence behind some of the current controversies surrounding carbohydrates
and their kcalories.
a. Discuss the role of carbohydrates in weight gain and in weight-loss diets.

Assignments and Other Instructional Materials

The following ready-to-use assignments are available in this chapter of the instructor’s manual:
 New! Case Study 4-1: Sweeteners and kCalorie Control
 Updated! Case Study 4-2: Increasing Dietary Fiber
 Updated! Worksheet 4-1: Carbohydrate Basics (Internet Exercise) 1
 Worksheet 4-2: Glycemic Index and Glycemic Load
 Worksheet 4-3: Hidden Sugars—What Is Your Sugar IQ?
 Worksheet 4-4: Check Your Carbohydrate Choices2
 Worksheet 4-5: Chapter 4 Crossword Puzzle3
 Critical thinking questions with answers
 New! Key Terms and Definitions
Other instructional materials in this chapter of the instructor’s manual include:
 Answer key for How To activity and study card questions
 Classroom activities, featuring meal comparison activity (4-4)
 Worksheet answer keys (as appropriate)
 Handout 4-1: Glycemic Index of Selected Foods
 Handout 4-2: Alternatives to Sugar

1 Worksheets 4-1, 4-2, and 4-3 contributed by Daryle Wane.

2 Worksheet 4-4 and Handouts 4-1, 4-2, 4-4, and 4-5 contributed by Sharon Rady Rolfes
3 Contributed by Carrie King.
Visit the book’s instructor companion website to download:
 Handout 4-3: Characteristics of Fiber
 Handout 4-4: How to Use the Exchange System to Estimate Carbohydrate
 Handout 4-5: Fibers

Glossary
Chapter Key Terms
 Acceptable Daily Intake (ADI): the estimated amount of a sweetener that individuals can safely consume
each day over the course of a lifetime without adverse effect.
 acid-base balance: the equilibrium in the body between acid and base concentrations (see Chapter 12).
 amylase (AM-ih-lace): an enzyme that hydrolyzes amylose (a form of starch). Amylase is a carbohydrase,
an enzyme that breaks down carbohydrates.
 artificial sweeteners: sugar substitutes that provide negligible, if any, energy; sometimes called
nonnutritive sweeteners.
 carbohydrates: compounds composed of carbon, oxygen, and hydrogen arranged as monosaccharides or
multiples of monosaccharides. Most, but not all, carbohydrates have a ratio of one carbon molecule to one
water molecule: (CH2O)n.
o carbo = carbon (C)
o hydrate = with water (H2O) disaccharides, or both.
 condensation: a chemical reaction in which water is released as two molecules combine to form one larger
product.
 dental caries: decay of teeth.
o caries = rottenness
 dental plaque: a gummy mass of bacteria that grows on teeth and can lead to dental caries and gum
disease.
 diabetes (DYE-ah-BEE-teez): metabolic disorders, metabolism characterized by elevated blood glucose
resulting from insufficient or ineffective insulin; the complete medical term is diabetes mellitus (meh-LIE-
tus). When blood glucose levels are higher than normal, but below the diagnosis of diabetes, the condition
is called prediabetes.
 dietary fibers: in plant foods, the nonstarch polysaccharides that are not digested by human digestive
enzymes, although some are digested by GI tract bacteria.
 disaccharides (dye-SACK-uh-rides): pairs of monosaccharides linked together. See Appendix C for the
 chemical structures of the disaccharides.
o di = two
 epinephrine (EP-ih-NEFF-rin): a hormone of the adrenal gland that modulates the stress response;
formerly called adrenaline. When administered by injection, epinephrine counteracts anaphylactic shock by
opening the airways and maintaining heartbeat and blood pressure.
 fermentable: the extent to which bacteria in the GI tract can break down fibers to fragments that the body
can use.
 fructose (FRUK-tose or FROOK-tose): a monosaccharide; sometimes known as fruit sugar or levulose.
Fructose is found abundantly in fruits, honey, and saps.
o fruct = fruit
 galactose (ga-LAK-tose): a monosaccharide; part of the disaccharide lactose.
 glucagon (GLOO-ka-gon): a hormone secreted by special cells in the pancreas in response to low blood
glucose concentration. Glucagon elicits release of glucose from liver glycogen stores.
 gluconeogenesis (gloo-ko-nee-oh-JEN-ih-sis): the making of glucose from a noncarbohydrate source such
as amino acids or glycerol (described in more detail in Chapter 7).
o gluco = glucose
o neo = new
o genesis = making
 glucose (GLOO-kose): a monosaccharide; sometimes known as blood sugar in the body or dextrose in
foods.
 ose = carbohydrate
 glycemic index: a method of classifying foods according to their potential for raising blood glucose.
 glycemic (gly-SEEM-ic) response: the extent to which a food raises the blood glucose concentration and
elicits an insulin response.
 glycogen (GLY-ko-jen): an animal polysaccharide composed of glucose; a storage form of glucose
manufactured and stored in the liver and muscles. Glycogen is not a significant food source of carbohydrate
and is not counted as a dietary carbohydrate in foods.
o glyco = glucose
o gen = gives rise to
 hydrolysis (high-DROL-ih-sis): a chemical reaction in which one molecule is split into two molecules,
with hydrogen (H) added to one and a hydroxyl group (OH) to the other (from water, H2O). (The noun is
hydrolysis; the verb is hydrolyze.)
o hydro = water
o lysis = breaking
 hypoglycemia (HIGH-po-gly-SEE-me-ah): an abnormally low blood glucose concentration.
 insoluble fibers: nonstarch polysaccharides that do not dissolve in water. Examples include the tough,
fibrous structures found in the strings of celery and the skins of corn kernels.
 insulin (IN-suh-lin): a hormone secreted by special cells in the pancreas in response to (among other
things) elevated blood glucose concentration. Insulin controls the transport of glucose from the bloodstream
into the muscle and fat cells.
 kefir (keh-FUR): a fermented milk created by adding Lactobacillus acidophilus and other bacteria that
break down lactose to glucose and galactose, producing a sweet, lactose-free product.
 ketone (KEE-tone) bodies: acidic compounds produced by the liver during the breakdown of fat when
carbohydrate is not available.
 ketosis (kee-TOE-sis): an undesirably high concentration of ketone bodies in the blood and urine.
 lactase: an enzyme that hydrolyzes lactose.
 lactose (LAK-tose): a disaccharide composed of glucose and galactose; commonly known as milk sugar.
 lac = milk
 lactase deficiency: a lack of the enzyme required to digest the disaccharide lactose into its component
monosaccharides (glucose and galactose).
 lactose intolerance: a condition that results from the inability to digest the milk sugar lactose;
characterized by bloating, gas, abdominal discomfort, and diarrhea. Lactose intolerance differs from milk
allergy, which is caused by an immune reaction to the protein in milk.
 maltase: an enzyme that hydrolyzes maltose.
 maltose (MAWL-tose): a disaccharide composed of two glucose units; sometimes known as malt sugar.
 monosaccharides (mon-oh-SACK-uh-rides): carbohydrates of the general formula CnH2nOn that typically
 form a single ring. The monosaccharides important in nutrition are hexoses, sugars with six atoms of
carbon and the formula C6H12O6. See Appendix C for the chemical structures of the monosaccharides.
o mono = one
o saccharide = sugar
o hex = six
 nonnutritive sweeteners: sweeteners that yield no energy (or insignificant energy in the case of
aspartame).
 nutritive sweeteners: sweeteners that yield energy, including both sugars and sugar alcohols.
 phytic (FYE-tick) acid: a nonnutrient component of plant seeds; also called phytate (FYE-tate). Phytic acid
occurs in the husks of grains, legumes, and seeds and is capable of binding minerals such as zinc, iron,
calcium, magnesium, and copper in insoluble complexes in the intestine, which the body excretes unused.
 polysaccharides: compounds composed of many monosaccharides linked together. An intermediate string
of 3 to 10 monosaccharides is an oligosaccharide.
o poly = many
o oligo = few
 protein-sparing action: the action of carbohydrate (and fat) in providing energy that allows protein to be
used for other purposes.
 resistant starches: starches that escape digestion and absorption in the small intestine of healthy people.
 satiety (sah-TIE-eh-tee): the feeling of fullness and satisfaction that occurs after a meal and inhibits eating
until the next meal. Satiety determines how much time passes between meals.
o sate = to fill
o sucrase: an enzyme that hydrolyzes sucrose.
  sucrose (SUE-krose): a disaccharide composed of glucose and fructose; commonly known as table sugar,
beet sugar, or cane sugar. Sucrose also occurs in many fruits and some vegetables and grains.
 sucro = sugar
 soluble fibers: nonstarch polysaccharides that dissolve in water to form a gel. An example is pectin from
fruit, which is used to thicken jellies.
 starches: plant polysaccharides composed of many glucose molecules.
 sugar alcohols: sugarlike compounds that can be derived from fruits or commercially produced from
dextrose; also called polyols. Examples include erythritol, isomalt, lactitol, maltitol, mannitol, sorbitol, and
xylitol.
 type 1 diabetes: the less common type of diabetes in which the pancreas produces little or no insulin.
 type 2 diabetes: the more common type of diabetes in which the cells fail to respond to insulin. Type 2
diabetes usually accompanies obesity and results from insulin resistance coupled with insufficient insulin
secretion.
 viscous: a gel-like consistency.
Added Sugars
 brown sugar: refined white sugar crystals to which manufacturers have added molasses syrup with natural
flavor and color; 91 to 96 percent pure sucrose.
 confectioners’ sugar: finely powdered sucrose, 99.9 percent pure.
 corn sweeteners: corn syrup and sugars derived from corn.
 corn syrup: a syrup made from cornstarch that has been treated with acid, high temperatures, and enzymes
to produce glucose, maltose, and dextrins. It may be dried and used as corn syrup solids. See also high-
fructose corn syrup (HFCS).
 dextrose: the name food manufacturers use for the sugar that is chemically the same as glucose; anhydrous
dextrose is similar, differing primarily in the temperature of crystallization.
 high-fructose corn syrup (HFCS): a syrup made from cornstarch that has been treated with an enzyme
that converts some of the glucose to the sweeter fructose; made especially for use in processed foods and
beverages, where it is the predominant sweetener. With a chemical structure similar to sucrose, HFCS has a
fructose content of 42, 55, or 90 percent, with glucose making up the remainder.
 honey: sugar (mostly sucrose) formed from nectar gathered by bees. Composition and flavor vary, but
honey always contains a mixture of sucrose, fructose, and glucose.
 invert sugar: a mixture of glucose and fructose formed by the hydrolysis of sucrose in a chemical process;
sold only in liquid form and sweeter than sucrose. Invert sugar is used as a food additive to help preserve
freshness and prevent shrinkage.
 levulose: an older name for fructose.
 malt syrup: a sweetener made from sprouted barley and containing mostly maltose.
 maple sugar: a sugar (mostly sucrose) purified from the concentrated sap of the sugar maple tree.
 molasses: the thick brown syrup produced during sugar refining. Molasses retains residual sugar and other
by-products and a few minerals; blackstrap molasses contains significant amounts of calcium and iron.
 nectar: a sugary fluid secreted by plants to encourage pollination by insects.
 raw sugar: the first crop of crystals harvested during sugar processing. Raw sugar cannot be sold in the
United
 States because it contains too much filth (dirt, insect fragments, and the like). Sugar sold as “raw sugar”
domestically has actually gone through more than half of the refining steps.
 tagatose (TAG-ah-tose): poorly absorbed monosaccharide similar in structure to fructose; naturally
occurring or derived from lactose.
 turbinado (ter-bih-NOD-oh) sugar: sugar produced using the same refining process as white sugar, but
without the bleaching and anticaking treatment. Traces of molasses give turbinado its sandy color.
 white sugar: granulated sucrose or “table sugar,” produced by dissolving, concentrating, and
recrystallizing raw sugar.
Lecture Presentation Outline
Key to instructor resource annotations (shown to the right of or below outline topics):
Website = Available for download from book companion website: HN = student handout
IM = Included in this instructor’s manual: CS = case study, WS = worksheet, CA = classroom activity

Introductory/whole chapter resources: Test Bank; IM WS 4-5, CA 4-5

I. The Chemist’s View of Carbohydrates (Figure 4-1) IM WS 4-1

A. Monosaccharides – Define and provide examples, including:
1. Glucose. (Figure 4-2)
2. Fructose
3. Galactose (Figure 4-3)
B. Disaccharides – Define, explain the processes of condensation and hydrolysis, and provide examples of
disaccharides
1. Condensation (Figure 4-4)
2. Hydrolysis (Figure 4-5)
3. Maltose
4. Sucrose
5. Lactose
C. Polysaccharides – Define and provide examples, including:
1. Glycogen (Figure 4-6)
a. Storage form of glucose in the body
b. Provides a rapid release of energy when needed
2. Starches (Figure 4-6)
a. Storage form of glucose in plants
b. Found in grains, tubers, and legumes
3. Fibers Website HN 4-3, 4-5
a. Soluble fibers
b. Insoluble fibers
c. Dietary fibers
d. Functional fibers, for example: Cellulose (Figure 4-7)
e. Resistant starches
f. Phytic acid
II. Digestion and Absorption of Carbohydrates
A. Carbohydrate Digestion – Describe the process of carbohydrate digestion in the following anatomical areas
(Figure 4-8):
1. In the Mouth – Amylase
2. In the Stomach – Satiety
3. In the Small Intestine
a. Pancreatic amylase
b. Other enzymes (maltase, sucrase, and lactase)
4. In the Large Intestine
B. Carbohydrate Absorption – Describe the process of carbohydrate absorption (Figure 4-9)
1. Active transport
2. Facilitated diffusion
C. Lactose Intolerance – Discuss the condition, including
1. Symptoms
2. Causes
3. Prevalence
4. Dietary Changes – Necessary; usually management rather than restriction of dairy consumption
III. Glucose in the Body
A. A Preview of Carbohydrate Metabolism
1. Storing Glucose as Glycogen – Explain how and where the body stores glucose as glycogen
2. Using Glucose for Energy – Explain that glucose is an important fuel for body cells
3. Making Glucose from Protein – Explain how glucose can be made from protein
4. Making Ketone Bodies from Fat Fragments – Discuss how the body can make ketone bodies from fat
fragments and the situations where this is likely to occur
5. Using Glucose to Make Fat – Explain how the body can use glucose to make body fat
B. The Constancy of Blood Glucose – Explain the regulation of blood glucose (Figure 4-10)
including:
1. Maintaining Glucose Homeostasis – Describe the symptoms of low and high blood glucose
2. The Regulating Hormones – Explain how insulin, glucagon, and epinephrine are involved in blood
glucose
3. Balancing within the Normal Range – Describe how food intake affects the maintenance of glucose
within the normal range IM CA 4-1
4. Falling outside the Normal Range – Name the 2 conditions diagnosed when blood glucose is out of the
normal range
5. Diabetes – Discuss diabetes
a. Type 1 diabetes
b. Type 2 diabetes
6. Hypoglycemia – Explain hypoglycemia
7. The Glycemic Response IM WS 4-2, HN 4-1
a. Describe the glycemic response
b. Glycemic index
IV. Health Effects and Recommended Intakes of Sugars IM CS 4-1
A. Health Effects of Sugars – Discuss the health effects of sugars, including their influence on:
1. Obesity and Chronic Diseases
2. Nutrient Deficiencies
3. Dental Caries
B. Recommended Intakes of Sugars – Explain the recommended intakes
including: IM WS 4-3, CA 4-2
1. Dietary Guidelines: reduce intakes of added sugars
2. DRI: added sugars no more than 25% of a day’s total energy intake
3. WHO & FAO: <10% of energy intake
C. Alternative Sweeteners – Discuss the use of these products, including: IM HN 4-2
1. Artificial Sweeteners
2. Stevia—An Herbal Sweetener
3. Sugar Alcohols
V. Health Effects and Recommended Intakes of Starch and Fibers
A. Health Effects of Starch and Fibers – Explain the role of fiber in
1. Heart Disease – Heart disease and stroke
2. Diabetes – Type 2 diabetes
3. GI Health – The health of the GI tract
4. Cancer
5. Weight Management – Weight control
6. Harmful Effects of Excessive Fiber Intake – Discuss the harmful effects of excessive fiber intake
B. Recommended Intakes of Starch and Fibers
1. RDA for carbohydrate is 130 g per day; AMDR is 45%-65% of energy intake
2. Daily Value for total carbohydrate is 300 grams per day
 3. Dietary Guidelines encourage a variety of whole grains, vegetables, fruits, and legumes daily
4. Fiber
a. FDA sets the Daily Value at 25 grams for a 2,000-kcalorie diet
b. DRI at 14 g per 1000 kcalorie intake (28 grams for a 2,000-kcalorie diet)
C. From Guidelines to Groceries – Explain how to make healthy choices in the following
categories:
1. Grains (Figure 4-13)
2. Vegetables
3. Fruits
4. Milks and Milk Products
5. Protein Foods
6. Read Food Labels – Food labels list grams of carbohydrate, fiber, and sugar; starch grams can be
calculated
VI. Highlight: Carbs, kCalories, and Controversies
A. Carbohydrates’ kCalorie Contributions (Figure H4-1)
1. Blamed for increases in obesity
2. As carbohydrate intake increases, body weight decreases (Figures H4-2, H4-3)
3. Weight loss is due to kcalorie restriction
B. Sugars’ Share in the Problem
1. Increase in the use of high-fructose corn syrup in manufactured food and soft drinks
2. Cravings and Addictions – Explain their role in carbohydrate consumption
3. Appetite Control – Fructose does not cause the release of insulin, preventing appetite suppression
C. Insulin’s Response
1. Insulin resistance is a major health concern
2. The Glycemic Index and Body Weight – Explain the role of the glycemic index in weight
3. The Individual’s Response to Foods
D. In Summary
1. Restricting all carbohydrates is not recommended
2. Carbohydrates contain disease-protective nutrients