Carbohydrates

Prof. Dwi Prijatmoko, DDS, PhD

Empirical Formula

Cn ( H2O)n
n>4

Summary of principle dietary Carbohydrates

Source Poly-Sach Maize, Rice, Potato Starch Sugarcane Beet Sugar

Oligo-Sach
Di-Sach Mono-Sach Alcohol

Glucose Syrup
Maltose Glucose Sorbitol Malitol Sucrose Fructose + Glucose Mannitol Sorbitol

Summary of principle dietary Carbohydrates

Source Poly-Sach Milk

Oligo-Sach
Di-Sach Mono-Sach Alcohol Lactose Galactose + Glucose Galactitol Sorbitol Lactitol

Polysaccharides
Little Metabolic role Starch Cellulose Inulin(Renal Function Test)

Disacharides
Sucrose Lactose Maltose : Fructose + Glucose : Galactose + Glucose Only in Milk : Glucose + Glucose

Mono Sacharides
Glucose Fructose Pentose : Main carbohydrate in the body. : Same formula as Glucose (beda rotasi) : 5 Carbon Essential component Nucleic Acids

Alcohol
Sorbitol : Had a therapeutic value as a replacement carbohydrate in the diet of DM & Parenteral feeding. Xylose & Xylitol : Alcohol of Pentose Less Cariogenic Less insulinogenic

Main Function of dietary Carbohydrate

1. Provide Energy 2. Texture of food 3. As sweeting agents

Carbohydrate as Energy Source

Intake of energy as carbohydrate Carbohydrate X Heat of combustion

Carbohydrate Starch Sucrose Fructose Glucose

Kcal/g 4.15 3.96 3.76 3.75

KJ/g 17.36 16.57 15.73 15.69

Digestion
All carbohydrates have to be hydrolyzed into monosaccharide. - Can be absorbed - Crossed intestinal wall After absorption - Portal Circulation - Liver

Take Home assignment

1. Explain how Cn(H2O)n is hydrolyzed through the Alimentary Tract, which commences in the mouth 2. Explain how Monosaccharide is absorbed through the brush border

Intolerance
1. Inability to hydrolyzed carbohydrate and absorb especially Laktose 2. Oral Tolerance Test Is used in the diagnosis of Carbohydrate intolerance 3. Symptoms
Abdominal discomfort Borborygmi Flatulence Diarrhea

Enzyme/ Carrier Deficiency

1. Primer : Enzyme/Carrier defect Lactase deficiency in adults

2. Secondary : Arise due to disease/ disorder of the intestinal tract - Intestinal infection - Celiac disease

Relatives sweetness of various carbohydrates

Sugar Sweetness Sucrose 100 Maltose 40 Lactose 20 Glucose 70 Fructose (Sweeter in cooler)115-170 Sorbitol 70 Mannitol 70 Xylitol 90

Metabolism
Glucose : Common source of Energy to cells CO2 + H2O+ ATP Energy : Converted to Glycogen and fat Essential to brain and red cells Brain 140g glucose/day Red cells 40g glucose/day Pregnancy Requires more glucose

Gluconeogenesis
1. In Absence Carbohydrate 2. 130 g/day (Not enough) 3. Ketone bodys oxidation !

Carbohydrate and Adipose tissue

Excess energy intake is converted to fat. Adipose tissue : Over weight Liver : Fatty Liver Plasma : Free Fatty Acid Etherification

Carbohydrate Tolerance Test

Is used to assess the ability to metabolize or absorb carbohydrate Glucose is given orally then : Blood Glucose is measured at various interval Any values above normal : Inadequate handling of glucose

Short Home work

What is the normal value of glucose concentration in venous blood and capillary blood during fasting and 2 hours post prandial (2JPP) How about those with DM? What is by mean of Glycemic Index (GI) of Food? What is the knowledge of GI to DM patient?

Carbohydrate and serum lipid

Dietary Carbohydrate Effect level of serum lipid Fructose is more lipogenic Glucose All dietary Carbohydrates reduce High Density Lipoprotein Cholesterol (HDL Cholesterol)

Carbohydrate and disease

1. Carries : No Correlation between Sucrose and dental caries, but interaction between carbohydrate + time + mycobacterium. 2. Obesity: Excess energy is stored as FM. Sucrose, Fructose provide more weight gain than that of glucose

3. Diabetes Mellitus The relationship between DM and Carbohydrate consumption is conflicting. Sucrose consumption = Blood glucose (Am Diabetes mellitus Assoc Report : Diabetes 20:633-634. 1971) draw consensus regarding Carbohydrate diet and DM. Fructose & Sorbitol produce minimal insulin level response

4. Cardiovascular disease. Dietary carbohydrate may have role in ischemic HD Type IV hyperlipidemia is associated with coronary artery disease due to the level of TG is dependent on level of carbohydrate consumed Effect of sucrose is greater over starch However, if P.U.F is added, the effect on TG level is reduced.

5 Cataracts Galactose and glucose play significant role in the development of cataract. This mono sacharide is further metabolized in the lens. (Osmotic effects!) Glucose cataract is seen in DM patient Galactose cataract I seen in galactosemia

END OF LECTURE