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Lecture Outline Chapter 5 Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Carbohydrates Chapter 5 Insert photo from 1st page of chapter Chapter Learning Outcomes 1. Identify the major carbohydrates in human diets and their major food sources. 2. Recognize chemical and common names of nutritive sweeteners and identify common alternative sweeteners. 3. List the functions of carbohydrates in the body and roles of carbohydrates in health. Chapter Learning Outcomes (continued) 4. Describe how the body digests carbohydrates and regulates blood glucose. 5. Discuss differences between type 1 and type 2 diabetes and list common signs and symptoms of each disorder. 6. Identify risk factors for type 2 diabetes and measures that may prevent the disease. 7. Explain the health benefits of soluble and insoluble fiber and identify rich food sources of these types of fiber. Chapter Learning Outcomes (continued) 8. Define lactose intolerance, explain why the condition occurs, and discuss dietary measures that will reduce signs and symptoms of the disorder. Quiz Yourself True or False 1. Compared to table sugar, honey is a natural and far more nutritious sweetener. T F 2. Ounce per ounce, sugar provides more energy than starch. T F 3. Eating a high-fiber diet can improve the functioning of your large intestine and reduce your blood cholesterol levels. T F 4. The average American consumes 40% to 50% of his/her energy intake as refined sugars. T F 5. The results of clinical studies indicate that eating too much sugar makes children hyperactive. T F How Did You Do? 1. False Compared to table sugar, honey is not a significantly more nutritious sweetener. 2. False Ounce per ounce, sugar provides the same amount of energy as starch. 3. True Eating a high-fiber diet can improve the functioning of your large intestine and reduce your blood cholesterol levels. 4. False The average American consumes about 50% of his/her energy intake from all carbohydrates. 5. False The results of clinical studies do not indicate that sugar makes children hyperactive. What are Carbohydrates? Carbohydrates are: - Major source of energy - Plants use CO2, H2O, and energy from the sun to make carbohydrates - Often identified by chemical name ending in “-ose” How Carbohydrates Are Made Insert Figure 5.1 Plants use the sun’s energy to combine carbon, oxygen, and hydrogen to form carbohydrates. Simple Carbohydrates: Sugars Monosaccharide mono= one saccharide= sugar Disaccharide di= two saccharide= sugar Monosaccharides Glucose - Primary energy source for cells - “dextrose” Fructose - “Fruit sugar” or “levulose” Galactose - Part of “milk sugar” (lactose) • Insert Figure 5.2 Disaccharides Maltose glucose + glucose Sucrose glucose + fructose Lactose glucose + galactose • Insert figure 5.3 Sucrose • Table sugar: – Almost 100% sucrose – Made from sugar cane or sugar beets – Refinement strips away small amounts of vitamins and minerals naturally in cane and beets • Occurs naturally in honey, maple syrup, carrots, and fruits such as pineapples Nutritional Comparison of Selected Sweeteners • Insert table 5.1 • Insert photos of sugar & honey from page 113. Names for Sugars Insert table 5.2 How Much Added Sugar Is In That Food? Insert table 5.3 Nutritive and Alternative Sweeteners Nutritive sweeteners – Contribute energy to foods • Provide 4 kcal/g – Added sugars • Nutritive sweeteners, such as sucrose and high fructose corn syrup, added during processing or preparation – Alternative Nutritive Sweeteners • Sorbitol, xylitol, mannitol – Sweeten without providing much kcal – Do not promote dental decay Non-nutritive “Artificial” Sweeteners • Intensely-sweet synthetic compounds that sweeten foods without providing kcal/serving • FDA approved: – Saccharin, aspartame, acesulfame-K, sucralose, and neotame • Saccharin used for >100 yrs – Most scientific evidence supports its safety • Cyclamates banned in the U.S. since 1970 – Despite being determined as safe by panel of experts from FDA and NAS Comparing Artificial Sweeteners Insert Table 5.4 Aspartame Brand names include Nutrasweet and Equal Consists of phenylalanine and aspartic acid People with phenylketonuria must avoid aspartame. Insert Figure 5.4 Stevia • Herbal extract from South American shrub – used to sweeten foods in Japan and South America • May be sold as dietary supplement in U.S. • Not FDA approved as a food additive Complex Carbohydrates Polysaccharides • Contain >10 monosaccharides bonded together • Storage form of carbohydrate in plants and animals • Structural component of plants in stems and leaves Starch and Glycogen Starch Storage form of carbohydrate in plants In seeds, roots, and tubers Modified starches (maltodextrin, dextrin, and glucose polymers) Glycogen - Storage form of carbohydrate in humans and other animals - Stored primarily in liver and muscles Insert Figure 5.5 Most forms of fiber are complex carbohydrates Fiber the human body cannot digest. • Soluble • Insoluble Insert Table 5.5 Dietary Fiber Content of Common Foods What’s a Whole Grain? Insert Figure 5.6 • The intact, ground, cracked, or flaked seeds of cereal grains • Must contain: – Fiber-rich bran – Starchy endosperm – Oily germ What Happens to Carbohydrates in Your Body? • Insert Table 5.6 Maintaining Blood Glucose Levels Insulin and Glucagon Key hormones that maintain normal blood glucose levels Insert Figure 5.9 Maintaining Blood Glucose Levels Hormone When Secreted Action on Glucose Insulin Blood glucose Uptake by cells Glucagon Blood glucose Glycogen breakdown Synthesis of glucose Insert Figure 5.9 Effects of Insulin • Enables glucose to enter cells • Enhances production/storage of: – Fat – Glycogen – Protein • Decreases hunger What Happens When You Don’t Eat Glucagon is released and stimulates: - Glycogenolysis Glycogen breakdown releasing glucose to the blood - Lypolysis Breakdown of triglycerides (fat) for energy Glucose for Energy • Cells use oxygen to release energy stored in glucose’s chemical bonds. • Carbon dioxide and water are formed in the process. Insert Figure 5.10 Ketones and Ketosis Ketones • Form as a result of incomplete fat breakdown – Poorly controlled diabetes – Fasting or starving – Low-carbohydrate, high-protein diet (e.g., Atkins) • Used by certain cells for energy Ketosis • Condition that occurs with very high blood ketones • Unconsciousness and death may occur Carbohydrate Consumption Patterns • Average American ~16% kcal (~20 tsp) from added sugars • Dietary Guidelines recommend limiting added sugar intake to 4 tsp/day for 2000 kcal diet. • Insert Figure 5.11 Reducing Your Intake of Refined Carbohydrates • Sources of refined carbohydrates: – – – – Regular soft drinks Cookies Candy Chips • Most processed foods • Suggested substitutes: – – – – Plain water Whole grains and nuts Fresh fruits and vegetables Plain yogurt sweetened with fresh fruit, dried fruits Understanding Nutrition Labeling: Carbohydrate and Fiber Information about total carbohydrates, sugar, and fiber content in a serving of food • Insert Figure 5.12 Carbohydrates and Health Frequently Asked Questions: • • • • • • • • Are all high-carbohydrate foods fattening? What is diabetes? What causes hypoglycemia? Is belly fat linked to metabolic syndrome? How do carbohydrates contribute to tooth decay? Why do some people have lactose intolerance? Does sugar cause hyperactivity? Do we really need to eat more fiber? Are Carbohydrates Fattening? It may depend on the type of carbohydrate… Probably “fattening” : • Added sugars • Refined starches • High-fructose corn syrup Insert photo Of sweets from page 125 Healthier choices: • Fiber-rich foods (e.g., fruits, vegetables, and unrefined grains) What is Diabetes? Diabetes mellitus • Group of serious chronic diseases characterized by abnormal glucose, fat, and protein metabolism – Type 1 diabetes • Autoimmune disease • Beta cells stop making insulin – Type 2 diabetes • Most common type • Insulin resistant cells Insert Table 5.7 Signs and Symptoms of Diabetes Mellitus • Insert Table 5.8 Use the American Diabetes Association’s questionnaire to assess your risk of type 2 diabetes. www.diabetes.org/risk-test/text-version.jsp Controlling Diabetes 1. Maintenance of normal or near normal blood glucose levels - Daily self-testing of blood glucose - Periodic measurement of glycosylated hemoglobin (hemoglobin A1c) 2. Maintain healthy body weight 3. Follow special diet 4. Obtain regular physical activity What Is the Glycemic Index and Glycemic Load? • Glycemic index (GI) and Glycemic Load (GL) – Standard values that indicate the body’s insulin response to a carbohydratecontaining food • Low GI foods may promote satiety • High GI foods may contribute to hyperinsulinemia. Can Diabetes Be Prevented? • Type 1 probably cannot be prevented. • Risk for developing Type 2 can be reduced. How to reduce the risk? »Avoid excess body fat »Exercise daily »Follow a “prudent diet” Prudent Diet vs. Western Diet • Insert the image from page 129 What is Hypoglycemia? Hypoglycemia - Abnormally low blood glucose levels Fasting blood glucose < 70 mg/dl (healthy person) - Blood glucose level is too low to provide cells adequate energy. - Certain signs and symptoms occur - True hypoglycemia is rare in non-diabetics Reactive hypoglycemia - In some people, blood glucose drops after eating highly refined carbohydrates. - Pancreas responds by secreting excess insulin Metabolic Syndrome • Seen in ¼ of adult Americans • Characterized by having >3 of these signs: • Large waist circumference • Hypertension • blood triglycerides • blood cholesterol • fasting blood glucose Signs of Metabolic Syndrome Insert Table 5.9 Tooth Decay • Linked to high-carbohydrate diet, especially sticky simple sugars that remain on teeth (residue) • Bacteria in mouth • Use carbohydrate in residue for energy • Produce acid by-products of metabolism • Acid damages tooth enamel • Damaged enamel allows decay (cavity forms) Lactose Intolerance • Inability to digest lactose • Caused by inadequate lactase – Affects ~30 to 50 million Americans – Very common in people of African, Asian, or Eastern European descent • Bacteria in the large intestine break down lactose, resulting in: – intestinal cramps, bloating, gas, and diarrhea Low-Lactose Milk Products Insert yogurt cartons from page 131 In the process of making yogurt and hard cheeses, lactose is converted to lactic acid or removed. Insert Fig. 5.14 Lactase-treated milk does not contain lactose. The enzyme breaks down the disaccharide to glucose and galactose Does Sugar Cause Hyperactivity Results of scientific studies do not indicate that sugar Increases children’s physical activity level, causes ADHD, or negatively affects behavior. • Insert photo of girl with lollypop from page 132 Fiber and Health Fiber and the Digestive Tract • Low fiber intake is linked to constipation and straining to expel feces. • Pressure on large intestine (colon) may result in diverticula formation. • Diverticula — abnormal tiny sacks that form in wall of colon. • Insert figure 5.15 Chapter 5 Highlight Glycemic Index and Glycemic Load • Glycemic Index (GI) — method of classifying carbohydrate-rich food by comparing the rise in blood glucose after eating either 50 g of glucose or white bread • Glycemic Load (GL) — determined by grams of carbohydrate in a serving of food multiplied by the food’s glycemic index GI & GL of Selected CHORich Foods Criticism of GI & GL • Some nutrition scientists do not think GI and GL are useful for menu planning. • GI and GL values for a particular food may vary. – When food is grown – Degree of ripeness – Extent of processing – Other components in a meal can modify effects on blood glucose level