Victor Tambunan

Erwin Christianto
Department of Nutrition
Faculty of Medicine
Universitas Indonesia

References
Bowman BA, Russell RM. Present Knowledge in
Nutrition 9th ed., 2006
Mahan LK, Escott-Stump S. Food & Nutrition Therapy
12th ed., 2008
Wahlqvist ML. Food and Nutrition: Australasia, Asia and
the Pacific, 1997
Gropper SS, et al. Advanced Nutrition and Human
Metabolism 4th ed., 2005
3

Found primarily in plant tissues

Small amount in animal tissues
Carbohydrate (CHO) in foods traditionally
classified as:

Simple CHO (sugars): mono & disaccharide

Complex CHO: polysaccharides
4

Classification
Classification according to degree of
polymerization (number of
monomeric
units)

(Food and Agriculture Organization/World Hea

Organization Expert Consultation of
Carbohydrates in Human Nutrition, 1998)

The major dietary carbohydrates

Class (degree of
polymerization*)
Sugars (12)

Subgroup

Components

Monosaccharides
Disaccharides
Polyols (sugar alcohols)

Glucose, galactose, fructose

Sucrose, lactose, maltose
Sorbitol, mannitol

Oligosaccharides Maltooligosaccharides
(39)
Other oligosaccharides
Polysaccharides
(>9)

Starch
Non-starch
polysaccharides (NSP)

Maltodextrins
Raffinose, stachyose,
fructooligosaccharides (FOS)
Amylose, amylopectin, modified
starches
Cellulose, hemicellulose,
pectins, hydrocolloids

*Number of monomeric units

6

Roles of Carbohydrate
1. Source of Energy
1 gram CHO ~ 4 kcal
Glucose is the major source of energy
for:
- Nerve tissue
- Red blood cells
Under normal circumstances, glucose is the
sole source of energy for the brain

2. Protein-Sparing Action
Sufficient CHO to meet energy demands
prevents the protein breakdown for this
purpose
7

Food Source of Carbohydrate

CHO
- Starch &
dextrins
- Glycogen
- Sucrose
- Lactose
- Glucose

Food Sources
Grains, vegetables (esp.
tubers & legumes)
Meat products, seafood
Cane & beet sugars,
molasses, maple syrup
Milk & milk products
Fruits, honey
Fruits, honey, corn syrup

- Fructose
8

Definition

Physiological definition:
the remnants of plant cells after
hydrolysis by the enzymes of human digestives syst
Chemical definition:
plant non-starch polysaccharides plus
lignin
A great deal of the plant material that resists digestion in
human diets originates from the cell walls of the tissues
of fruits, vegetables, & cereal grains
9

Classification of Fibre
Insoluble fibre
Soluble fibre
Fibre-like substances

10

Sources of Fibre Components

Soluble
Gum
Oat
Legumes
Guar
Barley

Pectin
Apple
Citrus fruits
Strawberry
Carrot

-glucan

Psyllium

Oat

Plantago ovata

Insoluble
Cellulose

Hemicellulose

White-wheat flour Bran

Bran
Whole grains
Vegetables

Lignin
Mature vegetables
Wheat
Fruits with edible seeds,
such as strawberry
11

Sources of
(cont.)
Fibre-like Substances

Inulin
Fructooligosaccharides (FOS)
Chitosan

12

Sources of (cont.)
Inulin & FOS
Food Sources:
Chicory root
Onion
Wheat

Garlic
Banana

Inulin & FOS are prebiotics

stimulate the growth and/or activity of good
bacteria
in the colon i. e. bifidobacteria (probiotic)

Chitosan

Animal-derived materials that resist

digestion
Food source: Crustacea (shrimp, crab,

13

Physical and Chemical Properties

of
Fibre & Fibre-like substances
Insoluble
fibre
Water insoluble
Non-fermentable or
partly fermentable
Non-viscous
Hold water

Soluble fibre
Water soluble
Fermentable:
fermentation yields
short chain fatty acids
(acetate, propionate,
butyrate)
Viscous/gelling
Inulin & FOS
Water soluble
Fermentable
Non-viscous
14

Physiological Benefits of Fibre

Insoluble fibre
Reduce constipation, faecal mass, softness &
frequency, and accelerate intestinal transit
Promote growth of ileal & colonic mucosa (?)
Enhance protection from bacterial infection (?)

15

Physiological Benefits
(cont.)
Soluble fibre
Delay gastric emptying and small intestine
transit
Modulate GI motility
Faecal mass, volume & softness (mild effects)
Reduce diarrhoea ( water absorption)
Promote growth of ileal & colonic mucosa
Provides energy to the intestinal mucosa
Colonic pH
Protection from infection (barrier function,
increases
immunity)
with
viscosity
Glucose tolerance
High total & LDL cholesterol levels
16

Physiological Benefits
(cont.)
Inulin & FOS
Promote healthy gut microflora
(prebiotic/bifidogenic effect)
Colonic pH (lactic acid production)
Protection from infection (barrier function,
immunity)
Reduce diarrhoea and constipation (?)
High blood glucose levels & improve blood lipids
(?)
17

Dietary soluble fibre

Gel formation in the stomach
Delayed gastric emptying
Uniform levels of CHO to the small intestine
Flattened blood glucose curve
Insulin surge

Possible mechanism by which soluble fibre lowers serum glucose

18

Soluble Fibre
Delayed gastric Interference with
emptying
digestive enzymes

May sequester
May contain
lipase inhibitors lipid + CHO from
digestive enzymes

Flattened glucose
curve

Insulin secretion

Interference with
micelle formation

Inhibition of
cholesterol biosynthesis

May bind Bacterial fermentation

bile acids produces propionate

Impaired absorption Cholesterol

Bile
Propionate inhibits
of lipid & CHO cant be absorbed reabsorption HMG-CoA reductase

Stimulation of
HMG-CoA reductase
by insulin

Substrate for
hepatic lipid
synthesis

Exogenous
cholesterol available
for cholesterol synthesis

Cholesterol pulled
out of blood to
make new bile

Cholesterol
biosynthesis

LOWER SERUM CHOLESTEROL

Possible mechanisms by which dietary fibre lowers serum cholesterol

Dietary starch that resists digestive enzyme

action
and reaches the colon; a starch encased in a
nondigestible plant seed coat or modified by
Western diets:
cooking or
resistant starch may be as much as 10% of
processing can be resistant
daily starch intake (840 g/day)
Starch-rich diets:
resistant starch
>>>

Recommended Intakes
FAO/WHO expert consultation (1998):
optimal diet should consist at least 55% of
total energy from CHO obtained from a variety
of food sources.

A wide range of intakes is regarded as acceptab

---- up to 75% of total energy

Pedoman Umum Gizi Seimbang (PUGS) Indones

Sugar not more than 5% of total energy
21

Recommended
(cont.)
Fibre:
Adequate dietary fibre intake for adult
(Institute of Medicine, Food, and Nutrition
Board, 2002):
14 g per 1000 kcal
Ratio of insoluble to soluble fibre:
3:1
can be obtained with 5 servings of fruits
&
vegetables and 6 servings daily of wholegrain breads, cereals, and legumes
22

Dietary Lipids
Triglycerides (triacylglycerols)
Cholesterol
Phospholipids

23

Triglycerides
Combinations of fatty acids with glycerol
Fats: solids
Oils: liquids

24

Common Fatty Acids

Biochemical
Trivial name

Food sources
abbreviatio
n

SATURATED
Short-chain
Butyric
Caproic
Caprylic

C4:0
C6:0
C8:0

Butter
Butter
Coconut oil

C10:0
C12:0
C14:0

Palm oil
Coconut oil
Butterfat, coconut oil

C16:0

Palm oil, animal fat

Medium-chain
Capric
Lauric
Myristic

Long-chain
Palmitic

25

Common Fatty (cont.)

Trivial name

Biochemical
abbreviatio Food sources
n

MONO-UNSATURATED
(MUFA)
Oleic
Erucic

C18:1 n-9
C22:1 n-9

Olive, canola, peanut oil

Canola oil

C18:2
C18:3
C20:4
C20:5
C22:6

Seeds fats--corn,
cottonseed
Soybean oil
Lard, meats
Some fish oil, shellfish
Some fish oil, shellfish

POLY-UNSATURATED
(PUFA)
Linoleic
-linolenic
Arachidonic
Eicosapentaenoic (EPA)
Docosahexaenoic
(DHA)

n-6
n-3
n-6
n-3
n-3

26

Classification and Food Sources of Omega Fatty

Acids
Class

Fatty acid

Omega3

-linolenic
acid
EPA
DHA

Omega6

Linoleic acid
Arachidonic
acid

Biochemica
l
Food Sources
abbreviatio
n
C18:3 n-3
C20:5 n-3
C22:6 n-3
C18:2 n-6
C20:4 n-6

Soybean oil
Some fish oil,
shellfish
Some fish oil,
shellfish
Corn, cottonseed oil
Lard, meats

C18:1 n-9
Omega-

Oleic acid

Olive, canola,

27

Role of Fat
In the Diet
In the Body

28

Role of Fat
In the Diet
1. Source of energy (9 kcal/g
2.

3.
4.
5.

fat)
Satiety value tends to
leave the stomach
relatively slow
Carrier of fat-soluble
vitamins (A, D, E, and K)
Essential fatty acids supply
Palatability responsible for
much of the texture &
flavor of food

In the Body
1. Constituent of cell
2.
3.

4.
5.

membranes
Energy reserve as
triglycerides
Regulator of body functions
arachidonic acid (n-6 PUFA)
-linolenic acids (n-3 PUFA)
precursors of eicosanoids
(prostaglandin,
thromboxane)
Insulator prevent heat loss
Protector protect vital
organs
29

Essential Fatty Acids

Essential:
The body cannot synthesise or cannot
make in
sufficient amounts must obtain from
the diet
Absence leads
to a defined
deficiency
Nutritionally
essential
fatty
acids: state
linoleic acid & -linolenic acid
Arachidonic acid is not an essential fatty acid
can be synthesised from linoleic acid
30

Prostaglandin & Prostacyclin

Thromboxane
Leukotriene

Have many functions, including:

Regulation of blood pressure
Stimulation of pain & fever
Induction of blood clotting
Modify the processes of inflammation
31

Omega-6
Linoleic acid
series

Omega-3
-Linolenic acid
series

18:2n-6

Arachidonic acid

18:3n-3

Elongation
Desaturatio
n
Eicosapentaenoic acid

20:4n-6

20:5n-3
in platelets

Thromboxane
2

Thromboxane3

in blood
vessels
Prostaglandin

Prostaglandin2
in leukocytes
Leukotriene4

Leukotriene5

Production of eicosanoids from n-3 & n-6 fatty

acids
32

Cholesterol
Is a fat-related compound belonging to
sterols family
Not yield energy
Found only in animal foods
Component of cell membranes
Precursors of steroid hormones

33

Cholesterol
(cont.)
Food Sources
Food high in cholesterol:
Brain
Egg yolks
Organ meats such as liver &
kidney
Lobster

34

Food Sources (cont.)

Lesser amounts occur in other animal food
sources:
Meats, especially fatty meats
Whole milk

Cream, butter, cheese, ice cream, and other whole m

dairy products

35

Recommended Intakes

Pedoman Umum Gizi Seimbang (PUGS) Indones

Lipids:
25% of total energy
(at least 10% of total energy)

36

Proteins are made up of chains of

amino acids linked by bonds to form
ribbon-like peptide chains.
Over 300 different amino acids
occur in nature.

There are only 20 common amino acid

which make up most protein

Only L--amino acids occur in protei

37

Nutritional Classification of Amino Acid

Essential (indispensable)
Non-essential (dispensable)

38

Essential (indispensable) amino

acids
Must be supplied in the diet because:
Cannot be synthesised in the body
Cannot be synthesised at a sufficient
rate to meet body requirements

Non-essential (dispensable) amino

acids can be synthesised within the body
9 Essential amino acids:

Phenylalanine, valine, threonine, methionine, tryptop

histidine, isoleucine, leucine, & lysine
39

Functions
Major functions of proteins in the body
1. Part of cell membranes
2. Enzymes & some hormones
3. Special proteins of blood:
hemoglobin, albumin, transferrin

4. Nucleoproteins:
stabilise the structure of RNA & DNA

5. Antibodies
6. Contractile protein in muscle
40

Complete proteins or proteins of high

biological value contain all of the
essential amino acids in proportions
capable
of promoting growth when they are the
sole
protein in the diet
All animal proteins, except gelatin,
are complete proteins
41

Incomplete proteins or proteins of low

biological value lack or have limited
amounts of one or more of the essential
amino acids and so are incapable of
promoting growth when they are the sole
protein in the diet

42

Food Source
Most of the foods we eat contribute some protein to
the diet

Protein is the major component of lean meat

fish, and egg white (protein contributes
>20% of energy)
Cereals contribute intermediate amounts of
protein (7% to 18%)
Fruits & vegetables contribute much less
(0% to 5%)
43

Protein in foods
Protein amount in food

Food

(g/100 g)

High content (protein contributes >20% of energy)

Beef and lamb (lean meat, cooked)

28

Chicken

25

Fish (whiting, without batter)

18

Eggs

12

Milk

3.3

Peas (fresh or frozen)

Medium content (protein contributes 7 to 8% of energy)

Bread (white)

7.8

Corn (sweet)

4.1

Potatoes (cooked)

1.6

Rice (cooked)

2.2

44

Dietary Reference Intakes (DRIs) for

Protein
Life-Stage Group
RDA/AI (g/kg/day)
Infants

1.5

13 years

1.1

413 years

0.95

1418 years

0.85

Adults
Pregnant (using prepregnancy
weight) women

0.8
1.1
1.1

Lactating women
RDA: Recommended Dietary Allowances
AI : Adequate Intake
Washington DC, 2002. The National Academies Press
45

Excess dietary protein

May adversely affect calcium (Ca) status

Ca absorption is enhanced by higher intakes

of protein, but urinary excretion of Ca is also

Rate of Ca urinary loss is higher than Ca uptak

There may be a net loss of Ca
46

World Health Organisation (WHO),

2003
Contribution of Macronutrients
to Total Energy:
Carbohydrates
5575%
Lipids
1530%
Protein 1015%

47

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dr.erwin.christianto@gmail.com