CARBOHYDRATES

Carbohydrates
Carbohydrates

a
nutrient that
provide the
major source of
energy.
*chemical
elements are
composed with
carbon, hydrogen
and oxygen.

Carbohydrates- Food Sources

Principal

source of carbohydrates are plant foods

cereal grains
fruits

vegetables
sugars
The only substantial animal source of
carbohydrates is

MILK
Rice is the basic foods among Filipinos
Cereals also contains vitamins, minerals and some
protein
Carbohydrates with added B vitamins as thiamine,
riboflavin and niacin and mineral oil to the final
product is called
ENRICHED
When a nutrient that has never been a part of a
grain is
said to ne FORTIFIED
Fiber is indigestible carbohydrates.

An example of fortification is the addition of

the folic acid to cereal grains to prevent
neural tube defect.
Vegetables : potatoes, peas, corns provides
substantial amount of carbohydrates in the form
of starch
Green leafy vegetables provide dietary fibers
the provide vitamins and mineral
Fruits provide sugar, fiber, vitamins and mineral
Sugar such as table sugar, syrup and honey

Sugar rich foods

such as desserts and
candy provide
carbohydrates in the
form of sugar.

Carbohydrates in health
promotion

FIBER

Classification of fiber
1. Insoluble
dietary fiber
A feature of
insoluble fiber is
the long, rough,
threadlike
filaments found
in ripe
vegetables and
other foods.

Insoluble fiber-rich
foods:

grains,
vegetables,
and legumes,
insoluble fiber
is also found
in the shells
of shrimp and
crabs.

Insoluble

fiber
is found in foods such as wheat bran,
vegetables, and whole grains.
It

adds bulk to the stool and appears

to help food pass more quickly
through the stomach and intestines
(preventing constipation)

2. Soluble fiber
Soluble

fiberattracts water and turns

to gel during digestion.
This slows digestion.
Can help lower glucose levels as well
as help lower blood cholesterol(lower
risk of heart disease
Sources:

oat bran, barley, nuts, seeds, beans, peas, and

some fruits and vegetables.
Psyllium a commonfiber a common

fiber supplement.

Role of fiber in health

Promotion
1.

High intake of dietary fiber

has been linked to a lower risk
of heart disease
2. Linked to a lower risk of
metabolic syndrome (heart
disease and diabetes)
3.lower risk of diverticular
disease (inflammation of the
intestine)
4. preventing constipation
5. higher fiber intake reduces
breast cancerrisk intakeshould start at adolescence

Summary:

Sources of fiber

Dietary Source of
fiber
A. CELLULOSE
- a primary source of dietary fiber,
found in the skins of fruits,
leaves and stems of legumes
and vegetable
- has no energy value, but useful
because itprovides bulk of stool

B. HEMICELLULOSE
- dietary fiber found
in whole grains
C. LIGNINS
- dietary fiber found
in the woody parts of
vegetables like carrots,
asparagus, small
seeds of strawberries

SUGAR

Recommended daily sugar

intake

Example:

Sugar
substitutes

Sugar

substitute
s
are

substances
used to sweeten
foods and
beverages instead
of sucrose (sugar)

Benefits of
sugar
substitutes:
.Have few or
no
calories
.Do not cause
blood
sugar to go
up as much
as
regular
sugar does
.Do not cause
tooth
decay or
cavities

Artificial sweeteners
are

chemicals that are generally much

sweeter than sugar, so a smaller
amount of them is needed to have
the same sweetness as sugar.
They typically provide very little to no
calories and have no nutrients in
them.
Examples of artificial sweeteners include:

Saccharin (SweetN Low, SugarTwin)

Acesulfame K (Sunett, Sweet One)

Sucralose (Splenda)

Aspartame (NutraSweet, Equal)

Products

containing
aspartame have a warning
label because they are NOT
safe for use by people that
have the hereditary
disease and
Phenylketonuria (PKU).

Pregnant

women may be
advised by their health
care provider to avoid
saccharin due to the
unknown long-term effects.

Sugar

alcohols

are

carbohydrates
found in plant products.

In

order to use sugar

alcohols as a sweetener,
they are altered in a
laboratory environment
to make them usable in
sugar-free and reducedsugar foods.

Sugar
alcohols
are used
in
anything
from
candy to
gum to
bakery
goods
and ice
cream.

Examples

of
sugar alcohols
include:

Sorbitol
Mannitol
Zylitol
Isomalt
Lactitol
Maltitol
Erythritol

Are

sugar substitutes safe?

The

U.S. Food and Drug Administration

(FDA) consider sugar substitutes to be
safe food additives.

The

FDA has also set an acceptable

daily intake (ADI) for each sweetener
which is an amount they feel is safe to
have each day.

Sugar

substitutes can be used as a safe

alternative to sugar. Its important to use
them in moderation and eat mostly foods
without added sugar or sugar substitutes.

CLASSIFICATION OF CARBOHYDRATES

A. MONOSACCHARIDES
(simple sugar)
the simplest form of
carbohydrates
they are sweet, require
no digestion, absorbed
directly into the blood
stream from the small
intestine.
Examples : glucose,
fructose
and galactose

KINDS OF
MONOSSACHARIDES
1. GLUCOSE
*is the simple sugar to which
carbohydrates must be broken
down for absorption known as
DEXTROSE
-principal form in which
carbohydrate is used by the body:
blood sugar
-abundant in : fruits, sweet corn,
corn syrup
FUELS work of the BODY CELLS

2.FRUCTOSE (Levulose)
*a simple
sugar(monosaccharide)found
fruits and honey

in

sweetest of simple sugars

found: most fruits ,some
vegetables
converted to glucose in the body

3.GALACTOSE
not found in free foods
It is produced from lactose (milk
sugar) during digestion converted
to glucose in the body
INABILITY to metabolize galactose
(infants) GALACTOSEMIA

B. DISACCHARIDES
are

double sugars

that are reduced by

hydrolysis to monosaccharide before they can
be absorb
EXAMPLES:

1.SUCROSE-(ordinary table sugar)

examples :
granulated, powdered and brown sugar
its source are sugar cane or snap from maple
tree.
CONVERTED TO GLUCOSE AND GALACTOSE UPON
DIGESTION
Composed of glucose and fructose

2. MALTOSE
not found in free foods
- a double sugar
occurring as a result of
the digestion of
grain/starch converted
to glucose in digestion

3. LACTOSE
- the sugar in the milk;
found in milk and milk products
-less sweet than sucrose
-stays longer in the intestine
than other sugars encourages
the growth of certain useful
bacteria

LACTOSE INTOLERANCE
- inability to digest lactose
because of a lack of the
enzymes lactase causes
abdominal cramps and
diarrhea.

WHEY- liquid part of

the milk that
separates from the
curds (solid part)
during the making of
hard cheese.

C.POLYSACCHARIDES

composed of
many molecules of
simple sugar
KNOWN as
COMPLEX sugar

a. STARCH
most significant polysaccharide in human
nutrition
Food sources: cereal grains ; potatoes, root
vegetables, legumes
converted to glucose
requires a longer time to digest
SUPPLY ENERGY FOR A LONGER PERIOD OF TIME

b. GLYCOGEN (ANIMAL STARCH)

glucose as stored in the liver and muscle TISSUE
Food sources: meat and sea foods
converted entirely to glucose thru the help of
hormone GLUCAGON

c. FIBER (CELLULOSE)
is called roughage , is
indigestible because it
cannot be broken down
by digestive enzymes
provides important
bulk in the diet which
helps move digestive
food and stimulate
peristalsis

D. Dextrins are not

found in free foods
Formed as
intermediate
products in the
breakdown of starch

E. Pectins

non
digestible; having a gel
quality
Sources: mostly fruits used
as a base for jellies
Function:
a. Used as a treatment for
diarrhea absorb toxins and
bacteria in the intestines
b. Bind cholesterol reducing
absorption in blood

DIGESTION AND ABSORPTION

MONOSSACHARIDES
*glucose, fructose, galactose are simple
sugar absorbed from the intestine
bloodstream carried to the LIVER
where
fructose and galactose are change to
glucose
Blood carries glucose to the cells.
DISSACHARIDES
*sucrose, maltose, lactose must be
converted
into simple sugar glucose absorbed
into the blood stream.

POLYSSACHARIDES
*are more complex
cellulose wall is broken downchange
into
starch and product DEXTRIN
example :
bread toast turn to golden
brown change to DEXTRIN
Digestion of starch begins in the mouth
where enzymes, salivary amylase begin
to
change starch to DEXTRIN.

ABSORPTION,DIGESTION AND
ELIMINATION OF CARBOHYDRATES

MOUTH

Enzyme-salivary AMYLASE
( enzyme of the saliva secreted
by the parotid gland)
Acts on starch
begin the breakdown of
dextrin and maltose

STOMACH

Enzyme none for

carbohydrates
Action of ptyalin
continues in minor
degree

SMALL

INTESTINE

Pancreatic

enzyme
(AMYLOPSIN)

Converts starch to
dextrin's and maltose

Mixes with intestinal juices

(containing 3 disaccharides
sucrose,lactose,maltose)

Producing monosaccharides
(glucose ,galactose,fructose)
END PRODUCT

ABSORBED INTO
BLOODSTREAM

*the process of glucose

metabolism
controlled mainly by the hormone
INSULIN
which is secreted by the ISLETS OF
LANGERHANDS in the pancreas
(maintain the Blood Glucose )
secretion of the insulin is
impaired/absent
glucose level in the blood
become
excessively
high-

Carbohydrates-Function in the Body

1. Carbohydrates are the MAJOR source of
energy for the body.
2. Exert a protein sparing action- if
insufficient carbohydrate body will convert
protein to glucose to supply energy
3. Necessary for formal fat metabolism-if
insufficient carbohydrate, large amount
of fat are use for energy
KETONES- product of fat metabolism
KETOACIDOSIS (in cases of starvation and
uncontrolled diabetes)

4.

Cellulose and closely

related indigestible
carbohydrates aids in
normal elimination

5.

Supply significant
quantities of proteins,
minerals and B vitamins

CarbohydratesRequirements
Carbohydrates

should

come from:
2-4 servings of fruits.
3-5 servings of
vegetables.
6-11 servings of whole
grains.
Only a small amount
from refined sugars.

Medications/ Supplements

Dietary supplements- Ensure.

IV Fluids- D5W
TPN- Total Parental Nutrition.
D5W- 5% Dextrose
solution=5gramof glucose per
100ml. So a 1000ml bag of D5W =
50 grams of glucose.
50gramsx 3.4 calories/1 gram=
170 calories per bag.

Carbohydrate- Deficit
A

deficiency of carbohydrates in
the diet can lead to:
Weight loss.
Hypoglycemia:
Headache, confusion, tired,
irritability, hungry, muscle
wasting, ketoacidosis, and
ketones in the urine.

Carbohydrate-Excess
Too

many carbohydrates in the

diet can lead to:
Weight gain.
Hyperglycemia:
Increase thirst, hungry,
increase urination, dry skin,
fruity breathe.
Diabetes mellitus- increase
blood sugar due to problem
with insulin.

Carbohydrates Nursing
Interventions
Health

effects of starches and fibers

1.

weight control- fibers rich

in completes carbohydrates
low in fat and added
sugars promote weight loss

2.

Heart disease high

carbohydrate diet (rich in
whole grains)protect against
heart disease and stroke

3.

Cancer- high carbohydrate

diet protects against many
types of cancer

4.

Diabetes- High
carbohydrate, low fat diet
helps control weight

5.

Gastrointestinal healthdietary fibers enhance the

health of the large intestines

Laboratory:
Design

a whole day menu for

yourself making sure to include
sugars, starches and fibers.
Follow the format:
Meal
Breakfast
Morning Snack
Lunch
Afternoon snack
Dinner

Menu pattern

Sample menu

Case study
Managing

diabetes mellitus
Lorna has been diagnosed to have
diabetes. She is overweight and was put
on a 1200-calorie diet by her physician.
She finds it really hard to follow the
diet. She is often hungry.
1. What should she include in her daily
meals?
2. Write 2 goals for Lorna related to her
diet and blood sugar.
3. Write a nursing diagnosis for Lorna
4. What sources of carbohydrates would
Lorna lose weight and maintain her
blood sugar?