1. Carbohydrates, Chapter 4
Patty Maloney MSN/Ed,RN

2. Key Concepts Carbohydrate foods provide energy (calories)
Carbohydrates are readily available and usually low cost
Carbohydrate structures vary from simple to complex to provide both quick and extended energy for the body.
What are some of the staple carbohydrates in a diet? Wheat, corn, rice

3. Key Concepts Carbohydrates = Primary fuel source,
Major source of ENERGY
Carbohydrates – break down rapidly
The term energy is used interchangeably with calorie, kilocalorie, kcal

4. Carbohydrates
Carbon
Hydrogen
Oxygen

5. Carbohydrates Are widely available and easily grown
Relatively low in cost
May be easily stored
Approximately ½ of total calories in American diet come from carbs.

6. Carbohydrates
To produce energy, the body: 1. Digests the carbohydrate (fuel) and changes it to glucose 2. Absorbs and carries this fuel to cells in need 3. Energy is burned and released
Share these facts with the students:
In the typical American diet, half of total caloric intake is in the form of carbohydrates.
Daily intake of sugars by Americans accounts for 20% to 40% of total caloric intake.
Ask the students what some of the major sources of sugars are in their own diets.

7. Carbohydrates
Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

8. Classes of Carbohydrates
Monosaccharides (one molecule C6H12O6)
Disaccharides (two molecules C6H12O6)
Polysaccharides

9. Classes of Carbohydrates
Monosaccharides – building block of all carbs
Simple, single sugar
Simple carbohydrate
Glucose (also known as dextrose)
supply comes from digestion of starch
All sugars convert to glucose in the blood
Fructose
Found in fruits, honey – very sweet
High fructose corn syrup – soda, canned goods, processed foods
Galactose
From digestion of milk sugar
CHO – CHEMICAL NATURE = CARBON, HYDROGEN, OXYGEN
MONOSACCHARIDES = BUILDING BLOCKS FOR ALL CARBOHYDRATES
ABSORBED FROM INTESTINE INTO THE BLOOD STREAM AND STORED IN LIVER AS GLYCOGEN (THIS STORAGE PROVIDES
CONSTANT BACKUP SUPPLY OF ENERGY
***GLUCOSE = PRIMARY FUEL FOR CELLS, SUPPLY OF GLUCOSE COMES FROM DIGESTION OF STARCH – NOT USUALLY FOUND
IN DIET, EXCEPT CORN SYRUP OR SOME PROCESSED FOODS
***FRUCTOSE = FOUND IN FRUITS AND HONEY
***HIGH FRUCTOSE CORN SYRUP = INEXPENSIVE, USED MORE OFTEN NOW IN SODAS, CANNED GOODS, PROCESSED FOODS
***GALACTOSE = COMES FROM DIGESTION OF MILK, SUGAR OR LACTOSE
Figure information:
From Mahan LK, Escott-Stump S: Krause’s food, nutrition, & diet therapy, ed 11, Philadelphia, 2004, Saunders.

10. Classes of Carbohydrates, cont’d
Disaccharides
Double sugar
Simple carbohydrate
Sucrose – table sugar
Powdered, granulated, brown sugar
Lactose
Sugar found in milk
Maltose
Not found in diet, results as a breakdown product of starch
Used as a sweetener
Found in beer, malt products, infant formula
Which one of these is commonly known as table sugar? SUCROSE – GRANULATED, POWDER, OR BROWN SUGAR
***MADE FROM SUGAR CANE OR SUGAR BEETS
LACTOSE = SUGAR IN MILK, FORMED IN MAMMARY GLANDS, LESS SWEET THAN SUCROSE
MALTOSE = NOT FOUND IN THE DIET, RESULTS AS A BREAKDOWN PRODUCT OF STARCH, SYNTHETICALLY PRODUCED AND
USED AS A SWEETENER
Explain that maltose can be found naturally in foods such as beer but that most often it is an intermediate disaccharide that results from the digestion of starch.
Figure information:
From Mahan LK, Escott-Stump S: Krause’s food, nutrition, & diet therapy, ed 11, Philadelphia, 2004, Saunders.

11. Classes of Carbohydrates, cont’d
Polysaccharides = complex carbs
Starch
Glycogen
Dietary fiber
POLYSACCHARIDES = COMPLEX CARBS, MADE UP OF MANY SINGLE-SUGAR UNITs
***STARCHES BREAK DOWN SLOWLY IN THE BODY – BROKEN DOWN SOONER THROUGH COOKING/HEATING PROCESS
Ask the students to name sources of starch. Grains (cereal, pasta, bread, crackers), legumes (beans, peas), potatoes, rice, corn
Does cooking the starch before eating it make it more digestible? YES

12. Starch Legumes = beans, peas, lentils
Most important polysaccharide in the diet
- Sources (grains, legumes,potatoes,rice)
- Complex CHO
Legumes = beans, peas, lentils
Enriched grains are refined grains that have nutrients added back to them (ie: iron, riboflavin, vitamin A)
Whole grains – keep outer bran layer, high fiber
MOST IMPORTANT DIETARY CHO - WORLDWIDE
COMPLEX CHO - STARCHES BREAK DOWN SLOWLY IN THE BODY - BUT ARE BROKEN DOWN SOONER DURING COOKING/HEATING PROCESS
SOURCES OF STARCH – GRAINS (CEREAL, PASTA, BREAD, CRACKERS), LEGUMES (PEAS, BEAN), POTATOES, RICE, CORN
REMEMBER – 45-65% TOTAL CALS. SHOULD COME FROM CHO – MAJORITY FROM COMPLEX CHO’S – WHOLE GRAINS BEST !!
- WHOLE GRAIN – UNREFINED GRAINS – KEEP OUTER BRAN LAYER = FIBER NUTRIENTS
Name sources of whole grains and mention the marketing done by food manufacturers and stores to promote whole grain consumption.
What vitamins and minerals have been added to enriched grains that are normally not found in significant amounts? Iron, calcium, folate

13. Kernel of Wheat Figure information:
Kernel of wheat showing bran layers, endosperm, and germ.
Courtesy Eileen Draper.

14. Glycogen Not a significant CHO source in the diet
Storage form of carbohydrates in the body – for about 24 hours, stored in the liver and muscles.
Stored in liver & muscles – it is “recycled”
Storage form of quick energy
Helps to maintain normal blood sugar throughout day & night
GLYCOGEN IS FOUND IN LIVER/MUSCLE WHERE IT IS RECYCLED - IT IS BROKEN DOWN TO FORM GLUCOSE FOR IMMEDIATE ENERGY
GLYCOGEN HELPS TO MAINTAIN A NORMAL BLOOD SUGAR THROUGHOUT DAY & NIGHT (EVEN WHILE ASLEEP, FASTING)
WILL LEARN MORE RE: GLYCOGEN CH. 20

15. Fiber
Type of polysaccharide
Soluble (helps to lower cholesterol & weight)
Beans, oatmeal, barley, broccoli, citrus fruits
Insoluble (provides bulk in GI tract)
Stems/leaves of vegetables, bran, whole grains
Indigestible carbohydrate – humans lack enzyme needed to digest fiber
Important for digestion and health of GI tract (gastrointestinal)
Fiber is important for health promotion and disease prevention – especially GI, CV, and diabetes management
FIBER DOES NOT HAVE A DIRECT ENERGY VALUE, BUT OTHER DIETARY ASSETS ! (AS ABOVE)
SOLUBLE FIBER (WATER SOLUBLE) = BINDS BILE ACIDS AND LOWERS CHOLESTEROL – CERTAIN PLANTS, SEAWEED, FRUITS
INSOLUBLE FIBER = IMPORTANT FOR CONSTIPATION – PROVIDES BULK – STEMS/LEAVES OF VEGETABLES, BRAN, WHOLE GRAIN
NAME DIETARY SOURCES OF FIBER – bran cereals, whole wheat bread, air popped popcorn, black beans, asparagus, cauliflower, green peas,
Raisins, apples – see page 20 in book for list of dietary fiber

17. FIBER Recommended daily intake = Men – 38 grams Women – 25 grams
Reduced for people over 50 yrs. –
Men – 30 grams
Women – 21 grams

18. Sweeteners Nutritive sweeteners Nonnutritive sweeteners
Sugar alcohols (sorbitol, mannitol, xylitol)
Have caloric value
Nonnutritive sweeteners
Artificial sweeteners in food (aspartame, saccharin)
Have no caloric value
SWEETENERS = CHO – EITHER NUTRITIVE OR NON-NUTRITIVE
Do sugar alcohols provide the same amount of energy as other carbohydrates?
Because sugar alcohols are absorbed more slowly from the gut than are other carbohydrates, how would this affect blood glucose levels?
Nonnutritive sweeteners are hundreds of times sweeter than table sugar. Explain how adding a minute amount can sweeten a food.

19. Function of Carbohydrates
Basic fuel supply
Energy for physical activities and all work of body cells
Reserve fuel supply
Provided by glycogen
Maintains normal blood glucose level
Carbohydrates burn in the body at rate of 4 kcal/g.
RESERVE FUEL SUPPLY = FROM GLYCOGEN (LIVER,MUSCLE) – NEED TO REFUEL BY EATING CHO REGULARLY – THIS HELPS TO AVOID DRAMATIC CHANGES IN BLOOD GLUCOSE LEVELS
OTHERWISE, ENERGY COMES FROM BREAKDOWN OF PROTEIN IN THE MUSCLE
Explain this in terms of work: 30 minutes jogging burns approximately 200 calories. How many grams of carbohydrate would be needed to provide that energy? 50 g How many pieces of bread would a person need to eat to get 50 g? 3-4 pieces
Explain the process of blood glucose level variance and homeostasis. The body regulates blood glucose to keep all cells provided with energy at all times.

20. Special Tissue Functions of Carbohydrates
Liver
Stores glycogen - to protect cells from depressed metabolic function
Back up energy source
Protein and fat
Carbohydrates protect (regulate) proteins and fat – allows them to be used properly for tissue building
Spares body protein from being used for energy
The protein-sparing function of carbohydrates protects proteins, allowing them to be used for tissue growth and maintenance.
Carbohydrates prevent the rapid breakdown of fats that would produce excess amounts of ketones.
What would happen without reserve stores of glycogen? - breakdown of protein (muscle) and fat (tissues), altered blood glucose
Which is used first to maintain blood glucose levels, liver or muscle glycogen?

21. Special Tissue Functions of Carbohydrates, cont’d
Heart
Glycogen is vital emergency fuel for heart muscle
Central nervous system
Brain dependent on minute-to-minute supply of glucose
Enhances learning and memory
HEART MUSCLE SUSTAINS LIFE ! FATTY ACIDS ARE MAIN FUEL SUPPLY OF HEART – GLYCOGEN IS EMERGENCY FUEL
BRAIN HAS NO STORED SUPPLY OF GLUCOSE – NEEDS IT FROM BLOOD SUPPLY
Low blood sugar may cause brain damage and death.
What type of effects would be seen in someone who cannot regulate blood glucose normally and therefore has low levels for an extended amount of time (e.g., diabetics)?

22. Food Sources of Carbohydrates
Starches
Provide important complex carbohydrates, key to a good diet !
Important source of fiber
Sugars
High-sugar diets carry health risks
Average American eats 10 tablespoons per day
***REVIEW TABLE 2.5 RE: CHO FOODS !
EXAMPLES -----CHO CONTENT OF FOODS (GRAMS PER SERVING) – ½ MED. TOMATOE = 2.4 GM, 1/2C. CHEDDAR = .7GM, 1 CUP LETTUCE = 1 G.,
*****SUGARS INCLUDE: GLUCOSE, SUCROSE (TABLE), FRUCTOSE, LACTOSE (IN MILK), MALTOSE
TSP. SUGAR = 4.2 GM, HIGH FRUCTOSE CORN SYRUP = 14.5 GM, 1 C. SKIM MILK = 12 GM., 1 C. PASTA = 39 GM, 1 SLICE WHITE BREAD 12 GM
1 OZ. SQUARE BROWNIE = 18GM, SODA (COLA) = 35 GM, 1 PKG. SKITTLES 2OZ = 52 GM, 1 PACKAGE (5 OZ) DRIED FRUIT = 93 GM
AVERAGE AMERICAN EATS 10 TABLESPOONS OF ADDED SUGAR PER DAY
What risks are associated with high-sugar diets?
Explain that one of the easiest steps someone dieting can take is to cut sugared drinks from the diet.

23. Food Sources of Carbohydrates
1 slice white bread 12 grams
1 cup pasta grams
1 cup skim milk 12 grams
1 soda (cola) 35 grams
Skittles (2 oz.) 52 grams
Dried fruit (5 oz.) 93 grams
1 tsp. sugar grams
RDA = grams per day

24. High Fructose Corn Syrup
Sweetener – from corn
Average annual intake = 60 lb. per person
Increases triglycerides and body fat
Leads to increased cravings

25. SOURCES OF HIGH FRUCTOSE CORN SYRUP:
SOURCES OF HIGH FRUCTOSE CORN SYRUP: ***CHECK YOUR KITCHEN FOR 3 ITEMS W/ HCFS - ASSIGNMENT
SODA FRUIT FLAVORED DRINKS
FAST FOODS SPECIAL K AND MANY CEREALS
PROCESSED FOODS CALORIE SNACK PACKS
SALAD DRESSINGS ** USED AS SWEETENER AND PRESERVATIVE
YOPLAIT YOGURT

26. Body Needs for Carbohydrates
Dietary Reference Intakes
45% to 60% of adult’s total caloric intake should come from carbohydrate foods
Approximately gm per day
Limit sugar to no more than 25% of calories consumed
Dietary Guidelines for Americans, 2005
General guidelines: fiber rich foods, whole grains, reduced sugar or no-added sugar, non-caloric sweeteners, oral hygiene
GUIDELINES ENCOURAGE THE FOLLOWING:
CHOOSE FIBER RICH FRUITS, VEGETABLES AND WHOLE GRAINS
CHOOSE FOODS WITH LITTLE OR NO ADDED SUGAR – CHOOSE NON-CALORIC SWEETENERS
GOOD ORAL HYGIENE TO REDUCE DENTAL CARRIES – LESS SUGAR !!!
What does MyPyramid focus on concerning the grains group? Make half your grains whole.
What recommendations do the Dietary Guidelines for Americans, make?
What recommendations would the students provide to others?