Module 4: Carbohydrates & Fats 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 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

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 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. 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 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

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 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)

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

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: 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:  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

Questions? Any questions?

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.