Transcript Document

Unit 4 Seminar NS 220
MODULE 4:
CARBOHYDRATES & FATS
Exchange System Review: Weekly Project
 The exchange system groups similar kinds of foods into various
exchange lists:

Fruit, vegetable, starch, sweets/desserts/other carbs, meat & meat subs,
milk, fat, fast foods, combo foods, free foods, alcohol.
 Portion sizes are specified for each food. You should be able to
"exchange" any food on a list for another food on the same list,
because they are similar in nutrient content (calories, carbs, fat,
protein).
 Example: Starch list includes bread, tortillas, pasta, rice, cereal
and starchy vegetables like potatoes. Each serving provides
approximately the same nutrients, and they are all
interchangeable in your meal plan.
Exchange Examples
1 Starch Exchange=
15 g carb, 3 g pro, 0-1 g fat, 80 kcals
1 Fruit Exchange=
15 g carb, 0 g pro, 0 g fat, 60 kcals
 1 slice bread
 1 small banana
 1 6-in tortilla
 1 small apple
 ½ English Muffin
 ½ cup canned fruit or
 ½ cup hot cereal
fresh fruit
 ½ cup fruit juice
 ¼ cup dried fruit
 3 cups popcorn
 ½ cup corn
 ½ cup sweet potato
Functions of Carbohydrate
 Supplies energy/calories for use by body
Main fuel source for brain, nervous system, RBC’s, &
muscles in forms of blood glucose & glycogen
 Brain gets energy ONLY from glucose

 Prevents ketosis
 Protein sparing
 Regulates glucose
 Sweetener
Carbohydrates
 Which food groups contain
carbohydrate?
 Provide 4 calories/gram
 Simple carbs
 Complex carbs

Fiber helps control diverticulosis,
glucose, cholesterol, weight,
appetite
Carbohydrate Requirements
 RDA= 130 grams/day for adults (minimum supply
needed for brain)
 Avg. intake=~180-330 grams
 Recommendations vary
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
FNB: 45%-65% of total Calories
Nutrition Facts panel:
60%= 300 grams for 2000 Calories
 Focus on fruits, vegetables, whole grains, and
beans
Blood Glucose Control
 Liver & pancreas work to regulate blood glucose
Pancreas releases insulin after meal
 Liver regulates glucose that enters bloodstream

 Insulin:
Directs muscle, adipose, other cells to remove
glucose from blood by taking into cell for energy
 Promotes glycogen synthesis in liver

 Net
effect: insulin lowers blood glucose or
keeps it from rising too high in blood
Diabetes & Blood Glucose
 Diabetes: underproduction of insulin (or none at
all)
 Hyperglycemia (high blood glucose)
Diagnosis: fasting glucose >126
 Type 1, Type 2, Gestational
 Symptoms of diabetes: excessive urination, thirst,
& hunger; blurred vision

 Hypoglycemia (low blood glucose)
Carb Counting for Diabetes
 Meal plan method for diabetes by counting carb grams
or servings in meals and snacks.
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By evenly spacing carb foods through the day & by eating
about the same amount at each meal/snack you get better
glucose control.
Aim for small meals/snacks with mix of complex carbs,
protein, & fat.
 Carbs can be counted by either carb servings or by
carb grams. One carb serving= 15g of carb.
 Meals= ~3 or 4 carb servings (45 to 60 g)
 Snacks= ~1 or 2 carb servings (15 to 30g)
Sample Menu: Carb Counting
Breakfast:
1/2 cup orange juice= 15
2 slices (2 oz.) whole-wheat toast= 30
1 soft-cooked egg= 0
2 tsp. Margarine= 0
Total grams carb= 45
Lunch:
2 slices (2 oz.) rye bread= 30
2 oz. sliced turkey= 0
2 lettuce leaves= <1
1 tsp. mayonnaise= 0
1 small bag (3/4 oz.) pretzels= 15
1 small (4 oz.) apple= 15
Total grams carb= 60
Dinner:
3oz. baked chicken breast= 0
1/2 c. mashed potato= 15
1/2 c. cooked carrots= 5
1 small (1 oz.) dinner roll= 15
2” brownie square= 15
Total grams carb= 50
Snack:
1/2 c. juice-packed fruit cocktail= 15
10 peanuts= 0
Total grams carb= 15
Sports Nutrition
Do athletes require
low-carbohydrate or
moderate-high carbohydrate
diets?
Why?
Carbohydrates for Athletes
 To provide energy to working muscles.
 Essential to building glycogen stores
 Providing the long-haul energy that
is so important in endurance events
 During exercise, glycogen is
converted back to glucose and is used for energy.
 50-60% of daily calories as carb; 15-20% from
protein; 30-35% fat
High-Carbohydrate Training Diet
Breakfast:
Oatmeal with skim milk + Banana
Orange juice
Snack:
Dry cereal mixed with raisins and peanuts
Peach
Endurance workout: 8 ounces of
Gatorade® for every 10 –20 minutes
Dinner:
Pasta with meat sauce
Italian bread
Salad with veggies/lowfat dressing
Steamed broccoli and cauliflower
Frozen yogurt/strawberries
Post-workout: Bagel with peanut butter
Fruit yogurt and Grape juice
Lunch: Chicken salad sandwich on whole
grain bread
Carrot and pepper sticks + apple
Corn chips
Skim milk
Recommendations: Fat Intake
 Dietary Guidelines=
20-35% of total calories (=44-78 total grams/day
for 2000 calories), <10% total calories from
saturated fat
 Food Labels: 2000 calorie= <65 grams total fat,
<20 grams saturated fat/day
 To reduce risk of heart dz, ATP III (TLC Diet):

<7% total calories from saturated fat (15 grams for
2,000 calories); <200 mg cholesterol daily
Fat in Foods
 Saturated FA’s
 Unsaturated FA’s
 Cholesterol: found only in animal foods;
precursor for bile acids, hormones, & vitamin D
 High intakes of saturated fat, trans fat, & cholesterol
can lead to high blood cholesterol and heart disease
 Need fat for energy, essential fatty acids, protecting
organs, & insulating body for temperature regulation
Saturated & Trans Fats
Saturated Fats
Mainly from animals:
 Beef, lamb, pork, poultry with
skin, beef fat
 Lard, cream, butter
 Cheese, other whole or reducedfat dairy products
Some from plants:
 Palm, palm kernel & coconut oils
Raise bad chol level (LDL);
Increase risk of heart disease;
Trans may lower good chol
(HDL)
Trans Fats
Baked goods:
 Pastries, biscuits, muffins, cakes,
pie crusts, doughnuts, & cookies
Fried foods:
 French fries, fried & breaded
chicken & fish
Snack foods:
 Popcorn, crackers.
Traditional:
 Stick margarine & vegetable
shortening
Unsaturated Fats
Monounsaturated Fats
Vegetable oils:
 Olive, canola, peanut &
sesame
Fruits:
 Avocados & olives
Many nuts and seeds:
 Almonds & peanuts/peanut
butter
Polyunsaturated Fats
High in Omega-6 & Omega-3
(ALA)
 Vegetable oils – soybean, corn and
safflower
 Many nuts and seeds – walnuts &
sunflower seeds
High in Omega-3 (EPA and DHA)
 Fatty fish – salmon, tuna,
mackerel, herring and trout
Reduce bad chol (LDL);
May lower risk of heart disease
Heart Healthy Meal Plan
Breakfast:
1 c bran cereal with raisins
3/4 c skim milk
1 med. banana
1/4 c egg substitute
Lunch:
1 ½ c tossed green salad w/raw veggies
2 T olive oil vinaigrette salad dressing
1 serving frozen lean cuisine beef and
broccoli
Snack:
1 medium apple
1 T peanut butter
Dinner :
1 c pasta + 1 T olive oil
1/4 c marinara sauce
3 oz skinless chicken breast
Snack:
1/2 c low-fat frozen yogurt
Calories= ~1,600
6.0% Calories from Saturated Fat
30% Calories from Total Fat
AHA Recommendations: Omega-3
 Benefit the heart of healthy people & those at high
risk of or who have cardiovascular disease.
 Omega-3 fatty acids:
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decrease risk of arrhythmias, which can lead to sudden cardiac
death
decrease triglyceride levels
decrease growth rate of atherosclerotic plaque
lower blood pressure (slightly)
 People at risk for CHD benefit from omega-3 fatty
acids from plants and marine sources.
AHA Recommendations: Omega-3
 Patients without CHD:
Eat a variety of (preferably fatty) fish @ least 2x/wk
 Include oils & foods rich in ALA (flaxseed, canola,
soybean oils; flaxseed and walnuts).

 Patients with CHD:

Consume ~1 g of EPA+DHA per day, preferably fatty
fish.
 Patients who need to lower triglycerides:
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2 to 4 grams of EPA+DHA per day provided as
capsules under a physician’s care.
Resources
 American Diabetes Association:
www.diabetes.org

Carbohydrate Counting:
http://www.diabetes.org/uedocuments/10-CarbCounting.pdf
 American Heart Association: www.americanheart.org
 Gatorade Sports Science Institute:
www.gssiweb.com