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UNIT 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 Starch Exchange=
1 Fruit Exchange=
15 g carb, 3 g pro, 0-1 g fat, 80 kcals
15 g carb, 0 g pro, 0 g fat, 60 kcals
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1 slice bread
1 6-in tortilla
½ English Muffin
½ cup hot cereal
3 cups popcorn
½ cup corn
½ cup sweet potato
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1 small banana
1 small apple
½ cup canned fruit or
fresh fruit
½ cup fruit juice
¼ cup dried fruit
Carbohydrates
Carbohydrates


Provide 4 calories/gram
Simple carbohydrates
 Monosaccharides:
glucose, fructose
(sugar in fruit), galactose
 Disaccharides: maltose (sugar in syrup),
sucrose (table sugar), lactose (sugar in
milk)

Complex carbohydrates
 Polysaccharides:
glycogen (storage of
glucose in muscle and liver), starch,
fiber
Carbohydrates
What are the functions of
carbohydrates?
Functions of Carbohydrate

Supplies energy/calories for use by body
Main fuel source for brain, nervous system, RBC, & muscles
in forms of blood glucose & glycogen
 Brain gets energy ONLY from glucose

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
Imparts sweetness to our foods
When carbohydrates are not consumed, fat and
protein are used as sources of energy.
 Ketosis
– production of ketone bodies
 Ketoacidosis – lowering of blood pH
Carbohydrate Requirements
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RDA: 130 grams/day for adults (minimum supply
needed for brain)
Avg. intake ~ 180-330 grams/day
Recommendations vary
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FNB: 45%-65% of total calories
Nutrition Facts panel: 60% or 300 grams per 2000 Calories
Focus on fruits, vegetables, whole grains, and beans
Blood Glucose Control

Pancreas regulates blood glucose
When blood glucose is high, insulin is secreted.
 When blood glucose is low, glucagon is secreted.

Pancreas
Blood Glucose Control

Insulin
Active after a meal
 Stimulates the uptake of glucose from the blood by
muscle, adipose, other cells.

 Net

effect: insulin lowers blood glucose
Glucagon
 Active

during a fast
Stimulates the formation of glucose from noncarbohydrate compounds (e.g., amino acids, lactic acid,
glycerol) (process “gluconeogenesis”)
 Net
effect: glucagon increases blood glucose
Diabetes & Blood Glucose

Diabetes
 Type
1: no or limited production of insulin
 Type 2: resistance to the produced insulin
 Gestational diabetes: affects some pregnant
women
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Hyperglycemia (high blood glucose)
Fasting glucose > 126 mg glucose/dL blood
 Symptoms: excessive urination, thirst, hunger, blurred
vision, fatigue, weight loss, poor wound healing, dry
mouth, tingling in feet, cardiac arrhythmia, coma,
seizures.
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Carbohydrate Counting during
diabetes
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Count carbohydrates consumed.
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By evenly spacing carbohydrate-rich foods through the day & by
consuming approximate the same amount you get better
glucose control.
Aim for small meals/snacks with mix of complex carbohydrates,
protein, & fat.
Carbohydrates can be counted by either carbohydrate
servings or carbohydrates grams.

One carbohydrate serving= 15g of carb.
Sample Menu: Carbohydrate Counting
Breakfast:
Dinner:
1/2 cup orange juice = 15 g
3oz. baked chicken breast = 0 g
2 slices (2 oz.) whole-wheat toast = 30 g
1/2 c. mashed potato = 15 g
1 soft-cooked egg = 0 g
1/2 c. cooked carrots = 5 g
2 tsp. Margarine = 0 g
1 small (1 oz.) dinner roll = 15 g
Total carbohydrates= 45 g
2” brownie square = 15 g
Total carbohydrates = 50 g
Lunch:
2 slices (2 oz.) rye bread = 30 g
Snack:
2 oz. sliced turkey = 0 g
1/2 c. juice-packed fruit cocktail = 15 g
2 lettuce leaves < 1 g
10 peanuts = 0 g
1 tsp. mayonnaise = 0 g
Total carbohydrates = 15 g
1 small bag (3/4 oz.) pretzels = 15 g
1 small (4 oz.) apple = 15 g
Total carbohydrates = 60 g
Sports Nutrition
Do athletes require
low-carbohydrate or moderatehigh carbohydrate diets?
Why?
Carbohydrates for Athletes
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To provide energy to working muscles.
Essential to building glycogen stores
During exercise, glycogen is converted back to glucose
and is used for energy.
Consume:
50-60% of daily calories from carbohydrates
 15-20% of daily calories from proteins
 30-35% of daily calories from fats

High-Carbohydrate Training Diet
Breakfast:
Snack:
Oatmeal with skim milk + banana,
Dry cereal mixed with raisins and peanuts
orange juice
Peach
Endurance workout: 8 ounces of
Dinner:
Gatorade® for every 10 – 20 minutes of
Pasta with meat sauce, Italian bread, salad
exercise
with veggies/low-fat dressing, steamed
broccoli and cauliflower, frozen
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
yogurt/strawberries
Fats

Fats are comprised of:
 Fatty
acids (simplest type of fat)
 Triglycerides (made of 3 fatty acids attached to one
glycerol molecule)
 Phospholipids (made of 1 phosphate group + 2 fatty
acids attached to one glycerol molecule)
 Cholesterol (found only in animal foods; precursor for
bile acids, hormones, & vitamin D)

Fatty acids can either be:
 Saturated
 Unsaturated –
monounsaturated & polyunsaturated
Fat

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High intakes of saturated fat, trans fat, & cholesterol can
lead to high blood cholesterol and heart disease.
Functions of fats:
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Provide omega 3 and omega 6 fatty acids (essential fatty
acids)
Impart flavor and mouth-feel to our foods
Cholesterol – important for bile production, vitamin D,
certain hormones
Phospholipids – component of cell membranes
Recommendations: Fat Intake
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Dietary Guidelines
20-35% of total calories (= 44-78 total grams/day for
2000 calories)
 <10% total calories from saturated fat

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Food Labels: 2000 calories
<65 grams total fat
 <20 grams saturated fat/day
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To reduce risk of heart disease:
<7% total calories from saturated fat (= 15 grams for
2,000 calories)
 <200 mg cholesterol daily
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Saturated & Trans Fats
Saturated
Fats
Saturated
Fats
Mainly from animals:
Trans Fats
Baked goods:
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Beef, lamb, pork, poultry with skin,
beef fat
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Lard, cream, butter
Fried foods:
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Cheese, other whole or reduced-fat
dairy products
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Some from plants:
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Palm, palm kernel & coconut oils
Raise bad LDL levels
Trans fats lower HDL levels
French fries, fried & breaded
chicken & fish
Snack foods:
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Popcorn, crackers.
Traditional:
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Increase risk of heart disease
Pastries, biscuits, muffins, cakes,
pie crusts, doughnuts, & cookies
Stick margarine & vegetable
shortening
Unsaturated Fats
Monounsaturated Fats
Polyunsaturated Fats
Vegetable oils:
High in Omega-6 & Omega-3
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Olive, canola, peanut & sesame
Fruits:
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Avocados & olives
(ALA)
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Vegetable oils – soybean, corn and
safflower
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Many nuts and seeds – walnuts &
sunflower seeds
Many nuts and seeds:
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Almonds & peanuts/peanut
butter
High in Omega-3 (EPA and DHA)
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Fatty fish – salmon, tuna, mackerel,
herring and trout
Reduce LDL levels
May lower risk of heart disease
Heart Healthy Meal Plan
Breakfast:
Dinner :
1 c bran cereal with raisins
1 c pasta + 1 T olive oil
3/4 c skim milk
1/4 c marinara sauce
1 med. banana
3 oz skinless chicken breast
1/4 c egg substitute
Snack:
Lunch:
1/2 c low-fat frozen yogurt
1 ½ c tossed green salad w/raw veggies
2 T olive oil vinaigrette salad dressing
Calories= 1,600 kCal
1 serving frozen lean cuisine beef and
6% Calories from Saturated Fat
broccoli
30% Calories from Total Fat
Snack:
1 medium apple
1 T peanut butter
AHA Recommendations: Omega-3
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Beneficial to the heart and for proper
cardiovascular health.
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)
Food
Serving
omega-3 fatty
% DV
acids
Density
Quality
Flax seeds
0.25 cups
7.0 g
156.4
17.6
Excellent
Walnuts C
0.25 cup
2.3 g
50.4
6.3
Very good
Chinook salmon,
baked/broiled
4.0 oz-wt
2.1 g
46.4
3.6
Very good
Scallops, baked/broiled 4.0 oz-wt
1.1 g
24.4
3.3
Good
Soybeans, cooked
1 cup
1.0 g
22.9
1.6
Good
Halibut, baked/broiled
4.0 oz-wt
0.6 g
13.8
1.8
Good
Shrimp, steamed, boiled 4.0 oz-wt
0.4 g
8.2
1.5
Good
Snapper, baked
4.0 oz-wt
0.4 g
8.0
1.1
Good
Tofu, raw
4.0 oz-wt
0.4 g
8.0
1.9
Good
Winter squash
1 cup
0.3 g
7.6
1.9
Good
Tuna, yellowfin
4.0 oz-wt
0.3 g
7.3
0.9
-
Cod, baked
4.0 oz-wt
0.3 g
7.1
1.2
-
Kidney beans
1 cup
0.3 g
6.7
0.6
-
http://www.whfoods.com/genpage.php?tname=george&dbid=75
AHA Recommendations: Omega-3
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Patients without CHD:
Eat a variety of (preferably fatty) fish @ least 2x/week
 Include oils & foods rich in ALA (flaxseed, canola,
soybean oils, flaxseed and walnuts).
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Patients with CHD:
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Consume ~1 g of EPA+DHA per day, preferably fatty fish.
Patients who need to lower triglycerides:
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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/10CarbCounting.pdf

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American Heart Association:
www.americanheart.org
Gatorade Sports Science Institute:
www.gssiweb.com