Transcript Vitamins
Carbohydrates
Presented by
Janice Hermann, PhD, RD/LD
OCES Adult and Older Adult Nutrition Specialist
Chemistry of Carbohydrates
Carbohydrates Are Made Of:
Carbon (4 Bonds)
Oxygen (2 Bonds)
Hydrogen (1 Bond)
Carbohydrates
Monosaccharides
Disaccharides
Simple Carbohydrates (Sugars)
Polysaccharides
Complex Carbohydrates (Glycogen, Starch, Fiber)
Monosaccharides
One Sugar Molecule
Glucose
Fructose
Galactose
Same Chemical Formula
Different Structure
Effects Sweetness And Absorption
Disaccharides
Two Sugar Molecules
Maltose = Glucose + Glucose
Sucrose = Glucose + Fructose
Lactose = Glucose + Galactose
Polysaccharides
Many Sugar Molecules
Glycogen
Liver
Muscle
Starch
Fiber
Digestion
Mouth (salivary amylase)
Stomach (HCl and pepsin)
Small Intestine (pancreatic amylase)
Intestinal Wall (disaccharidases)
Maltase (maltose to glucose + glucose)
Sucrase (sucrose to glucose + fructose)
Lactase (lactose to glucose + galactose)
Lactose Intolerance
Lactase activity declines with age and for
certain racial groups. Lactose remains
undigested and is not absorbed.
Undigested lactose moves into the large
intestine where it absorbs water causing
bloating, abdominal discomfort and diarrhea.
Undigested lactose becomes food for
intestinal bacteria which produce irritating
acid and gas, further contributing to
discomfort and diarrhea.
Absorption
Lining Of The Mouth
Small Intestine
Some Fructose Converted To Glucose
Fructose Absorbed Slower
Liver
Fructose and Galactose Converted To Glucose
Metabolism
Storage Of Glucose As Glycogen
Storage Form Of Glucose In Animals
Liver Glycogen
Brain, Nerve Cells, Developing Red Blood Cells
Muscle Glycogen
Glycogen Storage For Hours Not Days
Lose Water When Breakdown Glycogen
Metabolism
Using Glucose For Energy
Primary Role Of Glucose
38 ATP/glucose
Brain, Nerve Cells
and Developing RBCs
Metabolism
Making Glucose From Protein
Protein Converted To Glucose
Fat Can’t Be Converted To Glucose
If Carbohydrate Inadequate, Converts Protein To
Glucose For Brain, Nerve Cells And Developing
RBCs
Adequate Carbohydrate Spares Protein
Metabolism
Using Fat for Energy
Inadequate Carbohydrate, Fat Used For Energy For
Other Cells
Fat Broken Into 2-C Fragments And Converted to
Acetyl CoA
Overloads TCA Cycle
2-C Fragments Combine Forming Ketone Bodies,
Can Lead To Ketoacidosis
Metabolism
Converting Glucose To Fat
More Glucose Than Needed For Energy Or
Glycogen Converted To Fat And Stored
Maintaining Blood Glucose
Important To Maintain Blood Glucose
Too Low (Weak/Dizzy)
Too High (Confused/Difficulty Breathing)
Extremes Either Way Can Be Fatal
Regulating Hormones
Glucose Too High - Insulin
Stimulate Body Cells To Take
Up Glucose
Stimulates Glycogen
Synthesis
Stimulates Triglyceride
Synthesis
Glucose Too Low -
Glucagon
Stimulates Liver To
Breakdown Glycogen
Falling Out Of Range
If Blood Glucose Regulation Fails
Diabetes
Hypoglycemia
Glucose May Be Modified As Part Of
Treatment, But Hormonal Regulation Or
Obesity (For Type 2 Diabetes) Is The Cause
Not Glucose
Glycemic Index
Usefulness of glycemic index controverseal
Controversy on health impact
Practical utility limited
Few foods have glycemic index determined
Those that have based on wide variations
Glycemic index may be unnecessary
Current guidelines already suggest many low glycemic
index choices; whole grains, legumes, vegetables, fruits
and milk products.
Eating frequent, small meals spreads glucose absorption
across the day and thus offers similar metabolic
advantages to eating foods with a low glycemic response
Glycemic Index
Effect Of Food On Blood Glucose
Glycemic Index Differs
Amount of carbohydrate consumed
Nature of starch
Type of sugar
Preparation methods
Fat content
Fiber content
Most foods are eaten in combination in a meal
Fasting and pre-meal blood glucose
Types Of Sweeteners
Caloric Sweeteners
Sugars
Sugar Alcohol
Non-Caloric Sweeteners
Sugars (provide cal
Includes Many Caloric Sweeteners
Refined Sugars
Lactose
Corn Sweeteners
Glucose
Invert Sugars
Dextrose
Maltose
Honey
High Fructose Corn Syrup
Syrups
Concentrated Fruit Juices
Health Effects of Sugars
Nutritional Deficiencies
Sugar Can Only Contribute To Deficiencies By
Displacing Nutrients
Sugars Are Not “Bad” But Nutrient Dense Foods
Must Come First
Amount Of Sugar Depends On Calories Available
Beyond Those Needed For Nutrients
Health Effects of Sugars
Tooth Decay
Sugars And Starches Contribute To Decay
Bacteria In Mouth Ferment Sugars And Produce
Acid That Dissolves Enamel
Sugar Only One Of Many Factors
How Long Food On Teeth
How Often Food Eaten
Dental Hygiene
Health Effects of Sugars
Diabetes
Hormonal regulation or obesity (in case of type 2
diabetes) causes diabetes - not sugar
Carbohydrate intake, including sugar, may be
modified as part of the treatment for diabetes but
it is not a cause
For people with diabetes, attention is first given to
total amount of carbohydrate in the diet rather
than the source
Health Effects of Sugars
Hyperactivity/Misbehavior In Children
Controlled Studies Failed To Show An Adverse
Relationship Between Sugar And Hyperactivity Or
Misbehavior In Children
Carbohydrates, Including Sugars, Stimulate
Production Of Serotonin, Makes A Person Sleepy
And Sluggish
Health Effects of Sugars
Heart Disease
Normal Sugar Intakes Do Not Raise Triglycerides, If
Calories In Balance
Very High Intakes Of Sucrose And Fructose Can
Increase Triglycerides
Glucose Causes Insulin Release
Some People Over Produce Insulin In Response To
High Glucose Or Carbohydrate
Other dietary factors such as total fat, saturated
fat, and obesity have a much stronger association
with heart disease than sugar intake.
Health Effects of Sugars
Obesity
Obesity Due To Energy Imbalance
No Direct Connection Between Sugar And Obesity,
Unless Excess Sugar Containing Foods Leads To
Energy Imbalance
Foods High In Sugar Often High In Fat
Increase In Calorie Intake Has Come From
Carbohydrates, And Primarily Soft Drinks
Sugar Alcohols
Provide Calories, But Fewer Than Sugars
Because Not Completely Absorbed
Products With Sugar Alcohols Can Be Labeled
“Sugar Free” or “Reduced Calorie”
Incomplete Absorption Can Cause Gas,
Abdominal Discomfort and Diarrhea
Real benefit of using sugar alcohols is that
they do not contribute to dental caries
Non-Caloric Sweeteners
FDA Approved Non-Caloric Sweeteners
Name
Sweetness ADI
Saccharin
Sweet & Low 450x
5 mg/kg
Aspartame NutraSweet 200x
50 mg/kg
Equal
Acesulfame K Sunette
200x
15 mg/kg
Sucralose
Splenda
600x
5 mg/kg
Neotame
8,000x
18 mg/day
Non-Caloric Sweeteners
FDA Petitioned Non-Caloric Sweeteners
Cyclamate
Alitame
Accepted Daily Intake (ADI)
Amount a Person Can Safely Consume
Everyday Over A Lifetime Without Risk
Conservative Level with a wide margin of
safety
Safety Of Non-Caloric Sweeteners
All Compounds Toxic At Some Dose
Question Is Whether Non-Caloric
Sweeteners Are Safe In Quantities People
Normally Consume And Potentially Abuse
Saccharine Safety
Used Over 100 Years In US
Not Metabolized By Body, Rapidly Excreted,
Does Not Accumulate In Body
Originally on GRAS List
Safety Questions Arose In 1977
Rat Study Suggested Large Doses Increased
Risk Of Bladder Cancer
Saccharine Safety
Large Human Studies Do Not Support An
Association Between Saccharine And Cancer
For Population As A Whole
Subgroup May Have Increased Risk
Aspartame Safety
Composed Of:
Phenylalanine
Aspartic Acid
Methyl Group
Extensive Studies Document Safety, Except
For People With PKU
Phenylketonuria (PKU)
Inherited Disease Were Can’t Handle Excess
Phenylalanine (1:10-15,000)
Accumulation Of Excess Phenylalanine and
By-Products Can Cause Irreversible Brain
Damage
Newborns Screened For PKU
Phenylketonuria (PKU)
Strict Diet Providing Phenylalanine For
Growth But Not Damage
Aspartame Products Carry A Warning
Someone With PKU Can Handle Aspartame In
A Diet Soda, But Children With PKU Need
Phenylalanine From Nutrient Rich Foods
Methyl Group
During Metabolism:
Methyl Group ⃗ Methanol ⃗ Formaldehyde ⃗ Carbon Dioxide
Amount Produced Fall Below Levels That
Would Cause Harm
Many Juices Produce More Methanol Than
Aspartame In A Diet Soda
Other Accusations
No Credible Evidence Links Aspartame To:
Multiple Sclerosis
Lupus
Seizures
Brain Tumors
Birth Defects
Other Accusations
Some People Claim They Have Unusual
Sensitivity To Aspartame
Double Blind Studies Have Failed To
Reproduce Reactions
In Conclusion, Except For People With PKU,
Aspartame is Safe.
Acesulfame K Safety
FDA Approved Acesulfame K In 1988 After
Reviewing 90 Safety Studies
Some Groups Believe Acesulfame K Caused
Tumors In Rats
FDA Concluded Tumors Were Not Caused By
Sweetener
Sucralose Safety
FDA Approved Sucralose In 1998 After
Reviewing 110 Safety Studies
Neotame Safety
FDA approved neotame in 2002 after
reviewing 110 safety studies
Neotame also contains phenylalanine,
aspartic acid , a methyl group and an
additional side group which blocks digestive
enzymes from separating phenylalanine and
aspartic acid
As a result, the amino acids are not absorbed
Neotame does not have to carry a warning
for people with PKU