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Chapter 2
Carbohydrates, Proteins, and Fats:
The Energy Macronutrients of
Balanced Meals
Learning Objectives
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Describe the macronutrient content of
various foods and meal items.
Describe the function and general
recommendations for carbohydrate,
protein, and fat in health prevention and
disease management.
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Macronutrients
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Macronutrients provide kilocalories (kcal),
a measure of energy
Carbohydrate (CHO) and protein (PRO) =
4 kcal/g
Fat = 9 kcal/g
Alcohol (EtOH) = 7 kcal/g; alcohol is not
considered macronutrient
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Macronutrients (continued)
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Macronutrients are organic—they all
contain carbon
Fats contain more carbon, thus being
higher in kilocalories
Being organic, all three macronutrients are
digestible—they can break down into
component molecules
All three macronutrients contain carbon,
hydrogen, and oxygen
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Foods Generally Contain a
Combination of Macronutrients
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Carbohydrates
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Made up of glucose molecules: C6H12O6
Three basic forms:
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Two sources:
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Sugar: monosaccharides and disaccharides
Starch: polysaccharides
Fiber: indigestible polysaccharide
Plants (from photosynthesis)
Milk
Chief energy source for the body cells
(sugar and/or starch)
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Examples
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Sugar is noted with suffix “ose”: glucose = blood sugar;
sucrose = table sugar; fructose = fruit sugar; lactose =
milk sugar
Glucose and fructose = monosaccharides
Starch = polysaccharide; found in bread, peas, corn,
pasta, and potatoes (digested similarly to sugar)
Fiber = indigestible polysaccharide found in plants;
insoluble = skin and seeds and “crunchy” components;
soluble = pulp and “gummy” components
High-fiber foods have a relatively low glycemic index
Glycemic load: a meal with a high content of CHO with
sources that are high in glycemic index (quickly enter
the bloodstream)
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Whole Grains Contain the Entire Kernel
(Bran, Germ, and Endosperm)
Make at least half
your grains whole
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Food Label Guidelines
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60% kcal as CHO (300 g per 2000 kcal)
Total CHO = sum of sugar, starch, and
fiber
Fiber goal = 25 g per 2000 kcal
Net CHO = total CHO minus fiber and 1/2
sugar alcohols
*RDA for CHO: 130 g
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Estimating CHO Content
of Plant-Based Foods
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Assess 3 aspects of sensory experience of food:
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Level of sweetness
Level of water
Density
• ½ cup fruit (sweet): 15 g CHO
• ½ cup dry grains and dry (potato, legumes) or “sweet”
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vegetables (sweet corn, sweet peas): 15 g CHO
3 cups popcorn (low density): 15 g CHO
½ cup cooked or 1 cup raw low-CHO vegetables: 5 g CHO,
(most low CHO vegetables sound odd to say, “sweet _____”)
½ cup flour (very dry): about 45 g CHO
½ cup sugar (very dry and very sweet): about 100 g CHO
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Carbohydrate Counting
http://coursewareobjects.elsevier.com/object
s/elr/Peckenpaugh/essentials11e/video/CHO
.html
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Sugar Guidelines
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American Heart Association Guideline
• Less than 25g of sugar/day (100kcal) for women
• Less than 37g of sugar/day (150kcal) for men
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Protein Attributes and Functions
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Protein is unique among nutrients because it
contains nitrogen
Because of its nitrogen content, protein is
used as a building source for new body cells
Protein is found in all body cells and
constituents such as the immune system,
hormones, and digestive enzymes
Dietary intake digested into amino acids; the
liver reassembles these into protein
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Protein Sources
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Found in muscle (i.e., red and white meats and fish),
eggs, nuts, legumes, milk, and milk products
Limited amounts in grains and vegetables
Only fats and sugars do not contain protein; fruit contains
only trace amounts of protein and is generally considered
to have none
Essential amino acids (EAA)—eight required for adults,
nine for children with need for histidine; certain quantity
needed in the diet within a 24-hour period to make
protein
Complete protein source: a food containing adequate
amounts of all eight EAAs (animal products)
High-biologic value diet: emphasizes foods with all EAAs
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Protein Needs
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Minimum of 50 g daily
Individualized needs based on age and
other factors
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Infants: 2.24 g/kg body weight (BW)
Children: 1.5 g/kg BW
Adults: 0.8 g/kg BW
Older adults 1.0 to 1.2 g/kg BW
Athletes: 1.0 to 2.0 g maximum per kg BW
Increased needs also based on health
parameters (e.g., protein status or states of
increased demand, such as with burns)
Generally 15-25% of calories from protein
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Protein Deficiency Conditions
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Reduced albumin (<3.5 mg/dL) related to
impaired body processes; (<2.8 mg/dL
related to poor surgical outcomes with
impaired wound healing and compromised
immune system)
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Albumin is also affected by inflammation, certain
drugs, liver disease, fluid status, kidney disease,
etc…& is NOT a reliable marker of malnutrition!
Kwashiorkor: condition of protein deficiency
Marasmus, or protein-calorie malnutrition
(PCM)
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Kwashiorkor and Marasmus/PCM
(Right) Infant with “sugar baby” kwashiorkor, attributed to a highsugar, low-protein diet. The infant has stunted growth, edema of
the feet and hands, fatty liver, moon face, and dyspigmentation
of the skin and hair. (Left) Normal infant.
(From Jellife DB: Hypochromotrichia and malnutrition in
Jamaican infants, J Trop Pediatr 1:25, 1995; by permission of
Oxford University Press.)
Marasmus.
(From Zitelli BJ, Davis HW: Atlas of pediatric physical diagnosis,
ed 4, Philadelphia, 2002, Mosby.)
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Estimating Protein Content of Foods
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1 oz meat (equals ¼ cup volume) = 7 g PRO
1 egg (¼ cup volume) = 7 g PRO
½ cup legumes, ¼ cup nuts, ¼ cup cheese
(1 oz) and 1 tbsp peanut butter are counted
as alternative to 1 oz meat
1 cup milk = 8 g PRO
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Protein and Fat
http://coursewareobjects.elsevier.com/object
s/elr/Peckenpaugh/essentials11e/video/PRO
.html
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Fat (Lipids)
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Constituent of body cell membranes:
phospholipids
Essential fatty acids needed for hormonal
production (e.g., linoleic acid, an omega-6
fatty acid; alpha linolenic acid, an omega-3
fatty acid)
Solid = saturated fats; liquid = unsaturated
fats (monounsaturated and polyunsaturated)
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Foods Contain All Three Kinds of Fats:
The Proportion Dictates the Texture
Degree of saturation in common foods (in percentages). Percentages are based on the total amount of saturated,
monounsaturated, and polyunsaturated fats. Purple, Saturated fat; green, monounsaturated fat; orange, polyunsaturated fat.
(Reference for fat content modified from U.S. Department of Agriculture, Agricultural Research Service, 2005. USDA National
Nutrient Database for Standard Reference, Release 18.)
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Degree of Saturation Can Be Determined
by Texture at Cold Temperature
General amounts of saturated fats, monounsaturated fats, and polyunsaturated fats can be determined by
appearance when fats are chilled. Note that solids are on the bottom of avocado and olive oils.
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Food Label Guidelines
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Fat based on 30% kcal (65 g/2000 kcal)
Saturated fat based on 10% kcal
(20 g/2000 kcal)
Trans fatty acids now listed; goal to have
intake as minimal as possible
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Made from the addition of hydrogen to liquid
oils; first commercial use of margarines and
shortenings in the 1940s
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Food Sources of Fat
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Found in germ portion of grains, some fruits
(e.g., coconut, avocado, olives), and in whole
milk (including butter), meats (including lard),
nuts and seeds, egg yolks
Omega-3 fatty acids (found in cold-water fish)
essential for brain development; plant forms
include flax, walnuts, canola oil
Monounsaturated fats are preferred source for
health (olive, canola oil and peanut oil, olives
and most nuts, avocado)
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Putting it into Perspective
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How much fat is in your food?
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Biscuit with egg and sausage: 39g=8 tsp
 Large french fries: 29g=6 tsp
 Tuna salad 6 inch sub: 29g=6 tsp
 Chicken filet sandwich: 29g=6 tsp
 8 oz prime rib: 39g=8 tsp
 1 cup vanilla ice cream: 24g=5 tsp
 ½ cup cheese dip: 24g=5 tsp
 1 cup pasta with alfredo sauce: 17g:3.5 tsp
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Cholesterol
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A fatlike substance produced in the liver
Found only in animal fat
Not a kilocalorie source
Necessary for normal body functioning
Saturated fats can encourage excess
production of cholesterol by the liver;
unsaturated fats suppress the liver’s
production of cholesterol; these processes
are reflected in blood cholesterol levels
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To be discussed with review of Chapter 7
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The Food Exchange System
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A food guide originally developed by the
American Diabetes Association and the
American Dietetic Association for diabetes
management
Generally no longer advised for diabetes
management but useful to recognize the
macronutrient content of foods
(carbohydrate, protein, and fat)
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Macronutrient Content of Food
Exchanges (Per 1 Serving on Average)
Food
Serv
CHO g
GRAIN
OR
STARCH
1 oz
15
FRUIT
½c
15
MILK
1c
VEG
½c
MEAT
1 oz
FAT
1 tsp
SUG
1 tsp
PRO g
FAT g
2
0
15
8
5 avg
5
2
7
LUNCH
PM
DINNER
H/S
5
4
54
19
15
Kcal
216
76
135
50%
18%
32%
@427
AM
5 avg
Total
% kcal
BKFST
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Basal Metabolic Rate
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Amount of energy (kcal) required for basic
processes of life
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Approximately 1200-1400 kcal for women
Approximately 1600-1800 kcal for men
Harris Benedict equation for BMR:
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Women: BMR = 655 + ( 4.35 x weight in pounds ) + ( 4.7 x
height in inches ) - ( 4.7 x age in years )
 Men: BMR = 66 + ( 6.23 x weight in pounds ) + ( 12.7 x height
in inches ) - ( 6.8 x age in year )
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Menu Planning Using
Food Exchanges
Example: Goal 2000 kcal at 55% CHO, 15% PRO,
30% fat
2000 kcal × 0.55 = 1100 kcal/4 = 275 g CHO
2000 kcal × 0.15 = 300 kcal/4 = 75 g PRO
2000 kcal × 0.30 = 600 kcal/9 = 66 g fat
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Study Guide
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Vocabulary
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Macronutrient
Sugar
Starch
Fiber
Glycemic index
Glycemic load
Complete protein
High biologic value diet
Soluble fiber
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Albumin
Kwashikor
Marasmus
Saturated fat
Unsaturated fat
Trans fat
Essential amino acid
Omega 3 fatty acid
Insoluble fiber
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Study Guide (continued)
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How many calories per gram of protein, fat, carbohydrates and
alcohol?
Why are fats higher in calories?
Basics of carbohydrates (slide 6)
Approximately what % of grains should be whole grains? Why are
they important? Are multigrain breads whole grain?
Name the 3 parts of a whole grain
How many grams of fiber is recommended? Why is fiber important?
How many grams of CHO per serving?
Food sources of carbohydrates
What makes protein unique compared with CHO and fat?
Is albumin a good nutritional marker? Why?
Why is fat important?
Food sources of cholesterol (plant or animal based?)
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