1. Module 4: Carbohydrates & Fats
Unit 4 Seminar NS 220
Module 4: Carbohydrates & Fats

2. 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.

3. Exchange Examples 1 slice bread 1 6-in tortilla ½ English Muffin
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 6-in tortilla
½ English Muffin
½ cup hot cereal
3 cups popcorn
½ cup corn
½ cup sweet potato
1 small banana
1 small apple
½ cup canned fruit or fresh fruit
½ cup fruit juice
¼ cup dried fruit

4. 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

5. Carbohydrates Which food groups contain carbohydrate?
Provide 4 calories/gram
Simple carbs
Complex carbs
Fiber helps control diverticulosis, glucose, cholesterol, weight, appetite

6. Carbohydrate Requirements
RDA= 130 grams/day for adults (minimum supply needed for brain)
Avg. intake=~ grams
Recommendations vary
FNB: 45%-65% of total Calories
Nutrition Facts panel:
60%= 300 grams for 2000 Calories
Focus on fruits, vegetables, whole grains, and beans

7. 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

8. 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)

9. Carb Counting for Diabetes
Meal plan method for diabetes by counting carb grams or servings in meals and snacks.
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)

10. 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

11. Sports Nutrition
Do athletes require low-carbohydrate or moderate-high carbohydrate diets? Why?

12. 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

13. High-Carbohydrate Training Diet
Snack:
Dry cereal mixed with raisins and peanuts
Peach
Dinner:
Pasta with meat sauce
Italian bread
Salad with veggies/lowfat dressing
Steamed broccoli and cauliflower
Frozen yogurt/strawberries
Breakfast: Oatmeal with skim milk + Banana Orange juice Endurance workout: 8 ounces of Gatorade® for every 10 –20 minutes 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

14. 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

15. 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

16. Saturated & Trans Fats Saturated Fats Saturated Fats Trans Fats
Mainly from animals:
Beef, lamb, pork, poultry with skin, beef fat
Lard, cream, butter
Cheese, other whole or reduced- fat dairy products
Some from plants:
Palm, palm kernel & coconut oils
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
Raise bad chol level (LDL);
Increase risk of heart disease;
Trans may lower good chol (HDL)

17. Unsaturated Fats Monounsaturated Fats Polyunsaturated Fats
Vegetable oils:
Olive, canola, peanut & sesame
Fruits:
Avocados & olives
Many nuts and seeds:
Almonds & peanuts/peanut butter
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

18. 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

19. AHA Recommendations: Omega-3
Benefit the heart of healthy people & those at high risk of or who have cardiovascular disease. 
Omega-3 fatty acids:
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.

20. AHA Recommendations: Omega-3
Patients without CHD:
Eat a variety of (preferably fatty) 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: 
2 to 4 grams of EPA+DHA per day provided as capsules under a physician’s care. 

21. Resources American Diabetes Association: www.diabetes.org
Carbohydrate Counting: CarbCounting.pdf
American Heart Association:
Gatorade Sports Science Institute:

22. Questions?
Any questions?

23. You have completed Seminar 4
Congratulations!
You have completed Seminar 4
Have a Good Night!
Congratulations! You have completed Seminar 4. With a head start on studying for the final exam.