1. Chapter 4 Carbohydrates: Sugar Starch and Fiber

2. Carbohydrates Chemically, carbohydrates are compound that contain: carbon (carbo), Hydrogen, Oxygen In the same proportion as in water (hydrate). CH 2 O

3. Glucose is Produced by Plants through Photosynthesis

4. Carbohydrate Basics CH2O – Rich foods are obtained almost exclusively from plants Milk in the only animals – derived food that contains significant amounts of CH20 ____________________

5. Facts about Carbohydrates The primary role of carbohydrates is to provide the body with energy (calories). Carbohydrates are the preferred fuel for the body. Carbohydrates are the cleanest and ideal fuel compared to other alternatives: Fat Protein

6. Certain body systems use CARBOHYDRATE, almost, exclusively, such are: Brain Nervous system RBC Retina

7. Carbohydrate in our Food Our Forefathers used to eat “unrefined foods” Today most of our foods are refined and processed

8. Carbohydrates in Our Diet Carbohydrates make up most of the energy in a healthy diet. Grains are sources of carbohydrates. Refined carbohydrates lack fiber and many rich nutrients. Unrefined carbohydrates are healthier to eat.

9. Unrefined and Refined Foods

10. The Wheat Kernel: A Whole Grain Germ : the nutrient-rich and fat-dense inner part of a whole grain. Endosperm: provides energy; contains starch grains embedded in a protein matrix. Bran: the fibrous protective covering of a whole grain and source of fiber, B vitamins, and trace minerals. Husk: (chaff) the outer, inedible covering of a grain

11. Types of Carbohydrates

12. Carbohydrates are divided into two categories: Simple carbohydrates Complex carbohydrates ________

13. Simple Carbohydrates Further divided onto Two Groups: Monosaccharides Disaccharides

14. Monosaccharides

15. Most Common Monosaccharides Glucose Fructose Galactose

16. Monosaccharide

17. -Glucose is the most common Monosaccharide inside the body -Liver convert Fructose and Galactose into Glucose or convert into fat -Glucose rarely occurs as a Monosaccharide in food’

18. DIFFERENCE BETWEEN FRUIT SUGAR AND CANDY SUGAR Sugars from fruits and vegetables are not the same as from candies or cola beverages Vegetables and fruits have higher nutrient density— vitamins and minerals Sugar are diluted in large volume of water and packaged with fiber

19. Disaccharides

20. Most Common Disaccharides Sucrose (Table Sugar)- Glucose + Fructose Lactose (Milk Sugar)- Glucose + Galactose Maltose (Malt Sugar)- Glucose + Glucose

21. Disaccharides'

22. Lactose Intolerance

23. Lactose Intolerant 75% of the worlds people lost most of the ability to produce enough of the enzyme LACTASE as they age. Cause nausea, pain, diarrhea, and excessive gas Yogurt or aged cheese may be acceptable The failure of digest lactose affect people to different degree Infants produce abundant LACTASE Few suffer inborn lactose intolerance

24. Milk is almost indispensible source of calcium In case of Lactose intolerance · Must need alternative sources such as: Yogurt Aged cheese Canned sardines or salmon with bones Calcium fortified orange juice Calcium and vitamins fortified soy drinks

26. Complex Carbohydrates

27. Also known as Polysaccharides Those Include: Starch – mainly found in grains and some vegetables Glycogen- Storage in animals Fiber- CHO2 that cannot be digested by Human, found in plants specially in the outer portions of: Cereal grains, fruits, legumes, most vegetables.

28. Complex Carbohydrates Complex carbohydrates contain many molecules of glucose. Starch and glycogen are synthesized by a chain of glucose molecules joined by alpha 1–4 and 1–6 bonds they also have branched chain attached. Fiber (cellulose) is a chain of glucose molecules joined by beta 1–4 bond that human intestine does not produce the enzyme to digest it.

29. Complex Carbohydrates

30. Complex Carbohydrate Starch has two component: Amylose Amylopectin Glycogen rapidly break down upon the slaughter of the animal

31. Polysaccharides

32. FIBER

33. Complex Carbohydrates Fiber In plants form supporting structure of leaves, stems and seeds Pass through body – provide no energy Best known fibers are : Cellulose Hemi Cellulose Pectin

34. Fiber is Divided in to Two Groups Insoluble Fiber Soluble Fiber

35. FIBER A study of almost 520,000 people conclude that doubling the naturally occurring fiber in diets populations with low fiber intakes could reduce the risks of colon and rectal cancers by 40% They studied only fiber in food, not supplements.

36. Insoluble Fiber Possible health effects: 1. Maintain digestive tract health by preventing: a. Constipation b. Diverticula c. Hemorrhoids d. Appendicitis e. Colon cancer

37. Soluble Fiber: Possible health effects: -Lower blood cholesterol -Slow Glucose absorption -Slow transit of food through upper digestive tract -Hold moisture in stool -Partly fermentable

38. Cholesterol and Soluble Fiber

39. Complex Carbohydrates Wheat Bran- Composed mostly of insoluble fiber, is one of the most effective stool – softening effect. Oat Bran- Composed mostly of soluble fiber, is one of the most effective in lowering blood cholesterol

40. Fiber -Fiber should be obtained from Whole grains Vegetables Fruits etc. Adding purifying fiber to food can be harmful -Moderation is the key -Some fibers act as Chelating Agent & Chemically bind minerals such as Iron Zinc Calcium etc.

41. Carbohydrate Digestion

43. Glycemic Index

44. Different carbohydrate containing foods are absorbed at different rate. Simple carbohydrates and potato starch are absorbed fast and make a large spike in the blood sugar (a high glycemic index) causing a high insulin response. Beans, legumes and some mixed foods are absorbed slower and have lower glycemic index.

45. Glycemic Index

46. Other Functions of Carbohydrates

47. Carbohydrate Functions Galactose is needed by nerve tissue, and in breast-feeding woman, it is needed for milk sugar “lactose”. Ribose and Deoxyribose are the components of RNA and DNA, respectively. Ribose is also a components of the B Vitamin riboflavin. Oligosaccharides are associated with cell membranes Large polysaccharides found in connective tissues provide cushioning and lubrication

48. Blood Glucose Regulation

49. How the Body Handles Carbohydrates Glucose used for energy Excess glucose temporarily stored as Glycogen in Liver and Muscles Balance Glucose is converted into more permanent form of storage as Fat.

50. How the Body Handles Carbohydrates Insulin: a hormone secreted by the pancreas in response to high blood glucose levels; it assists cells in drawing glucose from the blood. Glucagon (glue-cuh-gon):a hormone released by the pancreas that signals the liver to release glucose into the bloodstream.

51. Blood Glucose Regulation

52. Glucose as a Source of Energy Glucose Metabolism

53. Cellular Carbohydrate Metabolism Cells use glucose to provide energy via cellular respiration or metabolism. Cellular respiration, uses oxygen to convert glucose to CO 2 and H 2 O and provide energy in the form of ATP There are two types of systems: Anaerobic aerobic

54. Anaerobic Metabolism The first step in cellular respiration is glycolysis Oxygen is not needed for this reaction so it is anaerobic metabolism. Glycolysis can rapidly produce two molecules of ATP from each glucose molecule. When oxygen is limited, no further metabolism of glucose and production of ATP occurs.

55. Aerobic Metabolism When oxygen is available, the complete breakdown of glucose can proceed. This aerobic metabolism produces about 36 molecules of ATP for each glucose molecule. 18 times more ATP than is generated by anaerobic glycolysis

56. Cellular Respiration

57. Carbohydrate & Protein Breakdown Glucose is an essential fuel for brain and RBCs. If adequate amounts are not available, glucose can be synthesized from 3-carbon molecules. Fatty acids cannot be used to make glucose Because the reaction that breaks them down produce 2- carbon molecules. Amino acids from protein break down can supply 3-carbon molecules.

58. Carbohydrate & Protein Breakdown Because protein is not stored in the body. This use of amino acids takes away functioning body proteins. Body proteins that are broken down to make glucose are no longer available to do their job. Sufficient dietary carbohydrate ensures that protein is not utilized in this way. Carbohydrate is therefore said to spare protein

59. Carbohydrate and Fat Breakdown Energy is stored in body as Fat To use energy from fatty acids, carbohydrate is required. If carbohydrate is not available ketones are formed. Small amounts of ketones can be used for energy by heart, kidney muscles etc. High levels of ketones build up in the blood, a condition known as ketosis.

60. Carbohydrate and Fat Breakdown High amount of ketones can increase the blood acidity. Severe ketosis can occur with untreated diabetes and can cause coma and even death. Fatty Acids break down in 2-carbon molecules If carbohydrate is not available 2-carbon molecule will convert in to ketones If Carbohydrate is available 2- carbon molecule with enter in kerb’s cycle

61. Ketone Formation

62. Carbohydrates intake is to meet the needs of: Adequate blood glucose levels to meet the brain, red blood cells and nerves energy requirements (about 300 grams/day). Minimum carbohydrate intake to prevent ketosis and Break down of protein is 130 grams/day Recommendations are: 45% – 65% of total daily calorie intake should come from complex carbohydrates. In the US diet, the right percentage of calories consumed from carbohydrates, but it is mostly refined or added sugars.

63. Carbohydrates in Health & Disease

64. Carbohydrates and Health What kind of carbohydrates are beneficial to health? Whole grains, complex carbohydrates foods are healthy carbohydrates. What kind are not healthy carbohydrates to consume? Refined carbohydrates and food with added sugar are not healthy and may cause risk of chronic diseases.

65. Carbohydrates in Health & Disease Carbohydrate play role in: Diabetes Hypoglycemia Dental Caries Weight Management Heart Disease Bowel Health

66. How the Body Handles Carbohydrates The first organs to detect the excess glucose is the pancreas releases hormones Insulin & Glucagon

67. What is Diabetes? Elevated blood glucose Is a chronic disease One of the top ten killers of adults Contributes to a number of other serious diseases In the us diabetes cause more blindness than any other cause Also major cause of: amputations heart disease kidney disease, etc

68. Diabetes People with diabetes are three times more likely to die of flu or pneumonia Each year, diabetes cost nearly $132 billion in health care in US Half of those suffering from diatheses are unaware of their condition

69. Prevalence of Diagnosed Diabetes by State

70. Types of Diabetes Diabetes mellitus, the most common type of diabetes, occurs in two main forms: Type 1: insulin dependent diabetes mellitus (IDDM) Type 2: Insulin Resistant Gestational Diabetes The American diabetes association is calling for regular test for diabetes for: Every one ever 45 years old Younger people with risk factors such as- overweight

71. Type 1 Diabetes Less common (10-20% cases) but leading chronic disease among children & young adults Person’s own immune system attacks the cells of pancreas that synthesize the hormone insulin Possible causes: Genetics Viral infection Toxins Allergens Disordered immune system All are probable culprits in provoking attacks In type 1 diabetes insulin must be supplied Insulin is a protein, therefore cannot be taken orally Insulin must be injected Insulin inhaler

72. Warning Signs of Diabetes Diabetes presents few or no warning signs 1)Excessive urination & thirst 2)Weight loss with nausea, tiring & weakness 3)Craving for food, especially sweets 4)Pain in the legs, feet and fingers 5) Slow healing of cuts and bruises 6) Itching 7) Drowsiness 8)Glucose in urine 9)Abnormal high blood glucose

73. Diabetes Carbohydrates are generally blamed for diabetes. The interesting fact is again which kind of carbohydrates are to be blamed. Whole grain and complex carbohydrates prevent type 2 diabetes by preventing fat cells accumulation in the body. Refined carbohydrates increase empty calories in the diet may cause weight gain, increase resistance to insulin causing type 2 diabetes

74. Diagnosing & Controlling Diabetes Blood test after a night of fasting. Fasting Blood Glucose Levels Normal < 110 mg/100ml Impaired fasting Blood Glucose 110-126 mg/100ml Diabetes > 126mg/100ml Although the symptoms of diabetes are controllable- it effects can be severe & may progress even when drugs control blood glucose

75. Blood Glucose Levels in Diabetes

76. Managing Diabetes Weight loss in overweight people helps in control diabetes type 2 Same diet that’s best controls diabetes can also help to control body weight & support physical activity. This diet should be: oAdequate in all nutrients oAdequate in fiber (whole grain, fruits, etc) oModerate in added sugar oControlled in total CH2O oLow in saturated Fat (thought to worsen insulin responses) oAdequate but not too high in protein o Regular physical activity

77. Diabetes Person with diabetes must constantly balance three life-style factors Diet Exercise & Medication

78. We are advised to increase our intakes of complex carbohydrates. Choose plenty of whole foods like this… …and fewer foods like these—foods that no longer resemble their original farm-grown products

79. Hypoglycemia Refer to abnormally low blood glucose

80. Hypoglycemia But when blood glucose level falls rapidly person may experience symptoms of glucose deprivation to the brain like: Irritability Weakness & Dizziness Muscle may become: Weak Shaky & Trembling and heart may race in an attempt to speed more fuel to the brain

81. Hypoglycemia Types of Hypoglycemia: Fasting hypoglycemia Due to medications Post-prandial hypoglycemia (True low blood glucose )

82. Healthy Carbohydrate Choices

83. Sweeteners

84. Sugar & Alternative Sweeteners In U.S we consume an average 32 teaspoon sugar/day =100lb/ year as Added sugar In addition to consuming more sugars consumption of artificial sweeteners is also increasing. Does all this sugar harm people’s health? Or Sugar substitutes a better choice?

85. World health organization recommends that total added sugar contribute No more than 10% of person’s total calorie intake To meet sugar intake recommendations, many people should reduce their intake Option may be to replace sugar’s sweetness by choosing from two alternative sweeteners Nutritive sweeteners Non- nutrititive sweeteners

86. Nonnutritive Sweeteners

87. Artificial Sweeteners All substances are toxic if high enough doses are consumed. Artificial sweeteners, their components and their by-products are not exceptions FDA has proposed “acceptable daily intake (ADI) levels for some of the Artificial Sweeteners

88. Sweetness of Sugar Substitutes Sugars: Relative Sweetness Sucrose1.0 Fructose1.7 Sugar Alcohols: Sorbitol0.5 Isomalt0.6 Mannitol0.7 Xylitol1.0 Non-Caloric Sweeteners: Acesulfame-K200.0 Aspartame200.0 Saccharin300.0 Sucralose600.0

89. Artificial Sweeteners Saccharin: -Till 2000 a warning label is carried by the products containing saccharin about “saccharin as a cancer hazard” -Acceptable daily intake= 5mg/kg body wt.

90. Artificial Sweeteners Major Synthetic sweeteners today are: -Saccharin -Aspartame -Acesulfame-K -Sucralose -Neotame

91. Artificial Sweeteners Aspartame: -One of the most thoroughly studied ever to be approved for use in foods -Commercial names NutraSweet & Equal- to sweeten oNot heat stable o1g provides 4 cal- as protein oFlavor identical to that of sugar oConsidered safe for children oAspartame is a simple chemical compound- two amino acids; Phenylalanine & Aspartic Acid joined together oOn of them tastes bitter oOther is tasteless oYet aspartame is 200 times sweeter than sucrose

92. Phenylalanine poses problem for people with an inherited metabolic disease known as phenylketonuria (PKU) - Unusual products made from phenylalanine build up & damage the tissue -PKU causes irreversible brain damage -Children with PKU allowed a limited amount of milk & meat Other concerns about aspartame safety are: Compounds i.e. methyl alcohol, formaldehyde, etc arise briefly during its metabolism One publication showed: Increasing rate of brain tumors since aspartame was approved in 1980’s Headaches

93. Artificial Sweeteners Aspartame ADI 50mg/kg body wt. For 132 lb. Person= 50mg= 80 packets Or 15 soft drinks - Acceptable Daily Value= 50mg/kg 70kg x 2.2= 154 lbs Can Consume: 19 12-oz diet soda cans 97 packets of equal 1 packet equal35mg 12 oz diet soda170mg 8 oz sugar free fruit yogurt125mg

94. Acesulfame-K: During 15 years of testing- no health problems reported Marketed as Sunette & Sweet One As sweet as aspartame Used in chewing gums, beverages, instant coffee & tea, gelatins & puddings, as well as for table use Heat resistant 200 times as sweet as sucrose but, to some, it leaves a slight aftertaste It is not recognized by the body as food, therefore, it is excreted unchanged by the kidneys oDRI 15mg/kg of body wt

95. Sucralose Made from sucrose Trade name Splenda 3 chlorine atoms substitute for 3 hydrogen & oxygen group 600 times sweeter than sucrose

96. Neotame: Approved by FDA in 2002 About 7000 to 13000 times sweeter than sugar Currently available to food manufacturers only Chemically similar to aspartame Phenylalanine & Aspartic Acid