CARBOHYDRATE DIGESTION AND

ABSOPTION

Th.S NGUYN NG M DUYN

BM CNTP

The Chemists review

Carbohydrates are made of carbon,
hydrogen and oxygen atoms.
These atoms form chemical bonds that
follow the laws of nature.

The Simple Carbohydrates

Mono saccharides are single sugars
Glucose serves as the essential energy
source, and is commonly known as
blood sugar or dextrose.
Fructose is the
sweetest, occurs
naturally in honey and fruits, and is
added to many foods in the form of
high-fructose corn syrup.
Galactose rarely occurs naturally as a
single sugar.

Mono saccharides

The Simple Carbohydrates

Disaccharides are pairs of monosaccharides, one of

which is always glucose
Condensation reactions link monosaccharides
together.
Hydrolysis
reactions split molecules and
commonly occur during digestion.
Maltose consists of two glucose units. It is
produced during the germination of seeds and
fermentation.
Sucrose is fructose and glucose combined. It is
refined from sugarcane and sugar beets, tastes
sweet, and is readily available.
Lactose is galactose and glucose combined. It is
found in milk and milk products.

 2008 Thomson Wadsworth

The Complex Carbohydrates

Glycogen
Storage form of glucose in the body
Provides a rapid release of energy when
needed

Starches
Storage form of glucose in plants
Found in grains, tubers, and legumes

The Complex Carbohydrates

The Complex Carbohydrates

Dietary fibers provide structure in plants, are very

diverse, and cannot be broken down by human
enzymes.
Soluble

fibers are viscous and can be

digested by intestinal bacteria (this property is
also known as fermentability). These fibers
are found in fruits and vegetables.
Insoluble fibers are nonviscous and are not
digested by intestinal bacteria. These fibers
are found in grains and vegetables.

Carbohydrate digestion
MOUTH - amylase
STOMACH
SMALL INTESTINE pancreatic
amylase, disaccharidases,
maltase, sucrase, lactase

Carbohydrate digestion
In the mouth, the salivary enzyme
amylase begins to hydrolyze starch into
short polysaccharides and maltose.
In
the stomach, acid continues to
hydrolyze starch while fiber delays gastric
emptying and provides a feeling of
fullness (satiety).

Carbohydrate digestion

In the small intestine, pancreatic amylase

among other enzymes (maltase, sucrase, and
lactase) hydrolyzes starches to disaccharides
and monosaccharides.
In the large intestine, fibers remain and attract
water, soften stools and ferment.

Carbohydrate digestion
Khu
vc
Ming
D dy

Rut
non

Dch tit

Enzyme

C cht

Nc bt

Amy nc
bt

Dch d
dy

Amy d dy Amy yu

Dch ty

Amy ty

Sn phm cui

Polysaccharides Disaccharides, dextrin,

v tinh bt chn maltose
Hot ng ko ng k

Polysaccharides Disaccharides, dextrin,

maltose, maltriose

Dch rut Sucrase

(Succus
Maltase
entericus)

Sucrose

Glucose, fructose

Maltose and
maltrios

Glucose

Lactase

Lactose

Glucose and galactose

Dextrinase

Dextrin, maltose Glucose

v maltrios

Trehalase

Trehalose

Glucose

(Amy: amylase); (source: K.Sembulingam, Esentials of Medical Physiology, 2012)

Nutrient Absorption
Primarily takes place in the small
intestine
Glucose
and
galactose
are
absorbed by active transport.
Fructose is absorbed by facilitated
diffusion.

Nutrient Absorption
Khuch tn
th ng n
gin

Mt s cht dinh dng (nc, cc lipid nh) c

hp thu bng cch khuch tn n gin. Chng i vo
cc t bo mt cch t do.

Nutrient Absorption
Khuch tn
th ng c
cht mang v
mng lc

Mt s cht dinh dng (cc vitamin tan trong nc,fructose)

c hp thu bng cch vn chuyn th ng, khuch tn c
cht mang v mng lc. Chng cn mt cht mang c hiu
vn chuyn t t bn ngoi vo bn trong t bo.
Khuch tn ch ng c th xy ra khi cht mang lm thay i
mng t bo cht dinh dng c th i qua.

Nutrient Absorption

Vn chuyn
tch cc

Mt s cht dinh dng (glucose, amino acid) phi c

hp thu ch ng. Cc cht dinh dng ny di chuyn
ngc vi chnh lch nng , v cn phi c nng lng.

Monosaccharides, the end products of carbohydrate

digestion, enter the capillaries of the intestinal villi.

In the liver,
galactose
and fructose
are converted
to glucose.

Small intestine
Monosaccharides travel to
the liver via the portal vein.

Stepped Art
Fig. 4-11, p. 110

Monosaccharide absorption

Rut non

(Source: Whitney-Rolfes, Understand nutrition, 11th Ed)

21

Monosaccharide absorption

Glucose v galactose c hp thu t lng rut vo t bo theo c ch vn

chuyn tch cc th pht (secondary active transport) cng vi ion natri
Fructose c hp thu t lng rut vo t bo v t t bo vo mch
mu u theo c ch khch tn c cht mang.

Monosaccharide absorption

Mu

T bo biu m

23

Lactose Intolerance
Symptoms include bloating, abdominal
discomfort, and diarrhea.
Causes include lactase deficiency due to a
natural decrease that occurs with aging or
damaged intestinal villi.
Prevalence
Lowest in Scandinavians and northern
Europeans
Highest in Southeast Asians and native
North Americans

Lactose Intolerance - Dietary Changes

Increase consumption of milk products

gradually.
Mix dairy with other foods.
Spread dairy intake throughout the day.
Use of acidophilus milk, yogurt, and
kefir (fermented products)
Use of enzymes
Individualization of diets
Must be careful that vitamin and mineral
deficiencies do not develop

Glucose metabolism
1. Glucose d tr dng glycogen
2. S dng glucose sinh nng lng
3. To ra protein
4. To ra keton bodies t glucose
5. To m t glucose

Glucose metabolism

The body stores glucose as glycogen in liver

and muscle cells.
The body uses glucose for energy if glycogen
stores are available.
If glycogen stores are depleted, the body
makes glucose from protein.
Gluconeogenesis is the conversion of protein
to glucose.
Protein-sparing action is having adequate
carbohydrate in the diet to prevent the
breakdown of protein for energy.

Glucose metabolism

Making ketone bodies from fat

fragments
The accumulation of ketone bodies in
the blood is called ketosis.
Ketosis upsets the acid-base balance in
the body.
The body can use glucose to make
body fat when carbohydrates are
consumed excessively.

The Constancy of Blood Glucose

Maintaining Glucose Homeostasis

Low blood glucose may cause
dizziness and weakness.
High blood glucose may cause
fatigue.
Extreme fluctuations can be fatal.

The Constancy of Blood Glucose

The

Regulating Hormones
Insulin moves glucose into the
cells and helps to lower blood
sugar levels.
Glucagon brings glucose out of
storage and raises blood sugar
levels.

The Constancy of Blood Glucose

The Constancy of Blood Glucose

Insulin binds to its receptor (1), which, in turn,

starts many protein activation cascades (2).
These include: translocation of Glut-4 transporter
to the plasma membrane and influx of glucose
(3), glycogen synthesis (4), glycolysis (5), and
fatty acid synthesis (6).

The Constancy of Blood Glucose

The Constancy of Blood Glucose

Balance

glucose within the normal range by eating

balanced meals regularly with adequate complex
carbohydrates.
Blood glucose can fall outside the normal range with
hypoglycemia or diabetes.

The Constancy of Blood Glucose

Phn gii
glycogen
Tng hp glucose
Phn gii cht bo
Thy phn ng

Tng hp glycogen
Tng hp acid bo
Tng hp triglyceride
Thy phn ng

(Whitney-Rolfes, Understand nutrition, 2008)

(Whitney-Rolfes, Understand nutrition, 2008)

The Constancy of Blood Glucose

Diabetes
Type 1 diabetes is the less common type
with no insulin produced by the body.
Type 2 diabetes is the more common
type where fat cells resist insulin.
Prediabetes is blood glucose that is
higher than normal but below the
diagnosis of diabetes.
Hypoglycemia is low blood glucose and
can often be controlled by dietary changes.

The Constancy of Blood Glucose

Glycemic response is how quickly the

blood glucose rises and elicits an insulin
response.
Glycemic
index
classifies
foods
according to their potential for raising
blood glucose.
Glycemic load refers to a foods glycemic
index and the amount of carbohydrate
the food contains.
The benefit of the glycemic index is

Health Effects and Recommended Intakes of Sugars

Sugar poses no major health problem

except dental caries.
Excessive intakes may displace nutrients
and contribute to obesity.
Consuming foods with added sugars
should be limited.
Naturally occurring sugars from fruits,
vegetables and milk are acceptable
sources.

Health Effects and Recommended Intakes of Sugars

Foods with added sugars have sugars

listed as a first ingredient.
Nutrient deficiencies may develop from
the intake of empty kcalories.
Just because a substance is natural does
not mean it is nutritious. (Example: honey)
Dental caries may be caused by bacteria
residing in dental plaque and the length of
time sugars have contact with the teeth.

 2008 Thomson Wadsworth

Enamel
Caries
Dentin
Gum

Crown

Pulp
(blood
vessels,
nerves)

Bone
Root
canal

Nerve
Blood vessel

Stepped Art
Fig. 4-14, p. 119

Health Effects and Recommended Intakes of Sugars

Excessive sugar intake can contribute to

the development of body fat.
Sugar may be able to alter blood lipid
levels and contribute to heart disease in
some.
There is no scientific evidence that
sugar causes misbehavior in children
and criminal behavior in adults.
There is a theory that sugar increases
serotonin levels, which can lead to
cravings and addictions.

Health Effects and Recommended Intakes of Sugars

Recommended Intakes of Sugars

The USDA Food Guide states that added

sugars can be included in the diet as part of
discretionary kcalories.
Dietary Guidelines state to limit intake of
foods and beverages that are high in added
sugars.
DRI suggest added sugars should
contribute no more than 25% of a days total
energy intake.

Health Effects and Recommended Intakes of Starch and

Fibers

May be some protection from heart disease and

stroke
Soluble fibers bind with bile and thereby lower
blood cholesterol levels.
Fiber may also displace fat in the diet.
Reduce the risk of type 2 diabetes by decreasing
glucose absorption
Enhance the health of the GI tract which can then
block the absorption of unwanted particles
May protect against colon cancer by removing
potential cancer-causing agents from the body

Health Effects and Recommended Intakes of

Starch and Fibers

Promote weight control because

complex carbohydrates provide less
fat and added sugar.
Harmful effects of excessive fiber
intake
Displaces energy and nutrient-dense
foods
Abdominal discomfort and distention
May interfere with nutrient absorption

Recommended Intakes of Starch and Fibers

RDA for carbohydrate is 130 g per day,

or 45-65% of energy intake.
Daily Value is 300 grams per day.
Dietary Guidelines encourage a variety
of whole grains, vegetables, fruits and
legumes daily.

Recommended Intakes of Fiber

FDA recommends

25 grams for a 2,000-kcalorie diet.

DRI at 14 g per 1000 kcalorie intake (28 grams for a
2,000 kcalorie diet)
American Dietetic Association recommends 20-35 g
per day.
World Health Organization suggests no more than 40
g per day.

Health Effects and Recommended Intakes of

Starch and Fibers

From Guidelines to Groceries

Grains

encourage whole grains

Vegetables starchy and nonstarchy vegetables
differ in carbohydrate content
Fruits vary in water, fiber and sugar content
Milks and Milk Products contain carbohydrate;
cheese is low
Meat and Meat Alternates meats are low but nuts
and legumes have some carbohydrate
Food labels list grams of carbohydrate, fiber and
sugar; starch grams can be calculated.

Carbohydrate in foods
STT

Tn thc phm

Carbohydrate/100g thc
phm n c (g)

ng knh

99,3

Bt sn dy

84,3

Go t

76,2

Go np

74,9

Ng vng ht kh

69,4

u en (ht)

53,3

C sn

36,4

Ht iu

28,7

Khoai lang

28,5

10

Chui tiu

22,2
51

(Vin dinh dng, 2000, Bng thnh phn dinh dng)