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Module 3.4 Carbohydrate Storage & Disorders By Jennifer Turley and Joan Thompson © 2013 Cengage Presentation Overview Storage 1. 2. 3. 4. Blood Sugar (glucose) Starch vs. glycogen Glycogen (in detail) Blood sugar regulation Insulin & Glucagon Disorders 1. 2. 3. Lactose intolerance & mal-digestion Hypoglycemia Diabetes What is glucose used for? Immediate carbohydrate energy &/or glycogen storage (Liver & Muscle) Brain, central nervous system (CNS), & red blood cell (RBC) function Requires a minimum of 100-150g carbohydrate day (continuous) Muscle Fat functioning (muscle glycogen) synthesis (excess energy intake) Glycogen The storage form of glucose Made All from dietary carbohydrate sources carbohydrates are converted to glucose then 1) used immediately or 2) stored as glycogen Glycogen The storage form of glucose Made from dietary carbohydrate sources All carbohydrates are converted to glucose then 1) used immediately or 2) stored as glycogen Diets should be planned to meet the 45-65% of Calories AMDR & the minimum DRI for carbohydrate (130g/day for adults). Glycogen Storage The Liver (100 grams; 400 Calories) Is used for blood sugar (glucose) regulation The Muscle (1-4 grams/100 grams of muscle) The level increases with high carbohydrate diets & exercise Is used for the working muscle Blood Sugar (glucose) Regulation By hormones that are produced in the pancreas The hormones effect the liver & muscle cells Insulin: decreases blood sugar levels Glucagon: increases blood sugar level Blood Sugar (glucose) Regulation Insulin Blood Sugar (glucose) Regulation Glucagon Carb Related Disorders Lactose Intolerance & Lactose Mal-digestion Hypoglycemia Diabetes Lactose Intolerance NOT a food allergy Caused by lactase deficiency Enzyme to break down lactose is missing strongly tied to evolution with several gene mutations identified Symptoms: Gas, bloating, cramps, diarrhea Lactose Intolerance Dairy Products & Lactose Intolerance Use a product like lactaid Consume yogurt with live cultures Consume aged cheese -OR Avoid dairy products Food Allergy vs. Intolerance An allergy elicits an immune reaction & involves antigens & antibodies Antibody: Protein structures produced by immune cells that inactivate antigens (allergens) Antigen (allergen): Foreign protein substances that elicit an immune reaction Allergic responses cause the formation of mucous in the respiratory tract, GI distress &/or hives Hypoglycemia (low blood sugar) Reactive: Blood sugar levels drop after eating sugar Drug-induced: Improper insulin or oral hypoglycemic drug use with diabetes. Too much insulin is secreted in response to sugar consumption. Hyperinsulinemia Low blood sugar from a drug reaction Anti-inflammatory and thyroid medications are known to cause hypoglycemia Spontaneous: Liver stores of glycogen are depleted, the ability to maintain blood sugar is diminished Happens to everyone in between meals or when food has not been consumed. 4-6 hours during the day, 10-12 hours with sleep Diabetes (a chronic disease) Is characterized by hyperglycemia (high blood sugar) Affects >20 million Americans, many unaware Increases risk of heart disease, stroke, kidney disease, retinopathy, and neuropathy Decreases Exists life expectancy as Type I or Type II Type I Diabetes (less common) 5% of cases Juvenile More onset difficult to control (without treatment) Insulin administration is essential in the control of blood sugar Auto-immune factors disorder caused by genetic or viral Immune system attacks pancreatic beta cells and disrupts ability to produce insulin Type I Diabetes (less common) Blood Stream 1. Antibodies attack the insulin producing cells of the pancreas. 2. No insulin is made. 3. Blood glucose/sugar levels are high. 4. Liver & muscle cells cannot take up glucose because there is no insulin to bind the cell receptor. Type II Diabetes (very common) ~95% of cases Typically adult onset May be controlled with lifestyle changes & oral hypoglycemic agents Is caused by insulin resistance (decreased insulin receptor response) Can have a genetic pre-disposition or can develop with obesity Type II Diabetes (very common) Blood Stream 1. The pancreas produces insulin. 2. Blood glucose/sugar levels are high. 3. The insulin receptor on the liver and muscle cells are insensitive to the insulin. Diagnosis of Diabetes Normal blood glucose <100 mg/dL Pre-diabetic Fasting 2 levels are between 100-125 mg/dL glucose level ≥ 126 mg/dL hour post prandial (fed) blood glucose level ≥ 200 mg/dl. Diagnosis of Diabetes Diagnosis of Diabetes Glucose Tolerance Test Normal diet for 3 days prior to test Baseline fasting blood sugar level Glucose load. 1g carbohydrate /Kg body weight or a max of 100g for adults Monitor blood sugar every half hour for six hours. How Overweight Hyperglycemia Case Studies: Dick & Jane Case Studies: Dick & Jane Food Composition: The glycemic response/ index Simple sugars & foods with a high glycemic index burn up fast & elicit an insulin response Complex carbohydrates sustain energy better. Glycemic Response/ Index The rise in blood sugar in response to food (as compared to glucose) Glucose The is assigned 100 Glycemic Index of a food can be useful to anyone concerned with blood sugar control. Glycemic Response of Foods Those with diabetes should eat foods that have a lower glycemic response (for slower entrance of glucose into the blood stream) Foods with high protein, fat, & fiber lower the glycemic response Diabetics careful can still eat carbs… but need to be Glycemic Response of Foods Summary Glucose is required by the brain, RBCs & CNS for energy Carbohydrate is the preferred energy source of the body All carbohydrate is converted to glucose for energy Excess carbohydrates are stored as glycogen (liver & muscle) If glycogen stores are full, excess carbohydrates are stored as fat (ATP) References for this presentation are the same as those for this topic found in module 3 of the textbook Summary Liver glycogen maintains blood sugar for brain, RBCs & CNS function Muscle glycogen maintains the working muscle in high intensity exercise The hormones insulin & glucagon regulate blood sugar levels Insulin decreases & glucagon increases blood sugar References for this presentation are the same as those for this topic found in module 3 of the textbook Summary Lactose intolerance occurs when the enzyme lactase is missing Milk allergy involves immunity Hypoglycemia is low blood sugar. Can be reactive, spontaneous, or drug induced Hyperglycemia is a sign of diabetes References for this presentation are the same as those for this topic found in module 3 of the textbook Summary Diabetes occurs as type 1 & type 2 Unmanaged diabetes has health implications Individuals with diabetes should consider the glycemic response of foods for diet planning Selecting low glycemic index foods is useful in controlling blood sugar rises References for this presentation are the same as those for this topic found in module 3 of the textbook