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CARBOHYDRATES

NUTR 2050 Nutrition for Nursing Professionals

Mrs. Deborah A. Hutcheon, MS, RD, LD

Lesson ObjectivesAt the end of the lesson, the student will be able to:

1. Discuss the broad functions of carbohydrates within the body.

2. Calculate the recommended carbohydrate intake for health promotion.

3. List the classification systems for carbohydrates and give examples and food sources for each category.

4. Analyze the benefits and risks associated with sugar, sugar alcohols, and alternative sweetener consumption.

5. Discuss the effects of fiber on health and identify suggested intake guidelines.

6. Distinguish between lactose intolerance & a milk allergy.

7. Distinguish between a whole grain & a refined grain.

Carbohydrates ENERGY!

Building Blocks:

**Distinguish between natural (inherent) vs. added**

Food Sources:

Provide 4 kcal per 1 gram

Amount Needed: 45% to 65% of daily kcal needs

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Classifying CarbohydratesCarbohydrates

(CHO)

Simple CHO

Monosaccharides Disaccharides

Complex CHO

Polysaccharides

Glycogen Starch Cellulose (Fiber)

Soluble Insoluble

Oligosaccharides

Monosaccharides• Do not require digestion: already in simplest form.

• Three Main Forms

1. Glucose:

2. Fructose ( sugar):

3. Galactose ( sugar)

DisaccharidesThree Forms

1. Sucrose ( sugar):

Source: http://sugar.org/images/docs/sugar-refining-processing.pdf

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DisaccharidesThree Forms

1. Sucrose ( sugar):

Image Source: http://sugar.org/images/docs/test-your-label-iq.pdf

Disaccharides—Glucose + Fructose

Source: http://www.sweetsurprise.com/charts-and-media-about-hfcs#92

Disaccharides—Glucose + Fructose

Image Source: http://sugar.org/images/docs/about-sugar.pdf

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Guidelines on Added Sugar Intake

OrganizationIntake (tsp & TBSP) Intake (kcal)

Male Female Male Female

American Heart Association

(AHA)

9 tsp = 3 TBSP

6 tsp = 2 TBSP

150 kcal 100 kcal

World Health Organization

(WHO)

12 tsp = 4 TBSP(Current)

≤10% daily kcal intake, or 200 kcal*

6 tsp = 2 TBSP(Proposed)

≤5% daily kcal intake, or 100 kcal*

*Based on a 2000 kcal diet for an adult of health body weight.

Perspectives on Added Sugar Intake

Source: http://www.sugarstacks.com/beverages.htm

Perspectives on Added Sugar Intake

Source: http://www.sugarstacks.com/beverages.htm

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Perspectives on Added Sugar Intake

Source: http://www.sugarstacks.com/shakes.htm

Perspectives on Added Sugar Intake

Source: http://www.sugarstacks.com/shakes.htm

DisaccharidesThree Forms

1. Sucrose (table sugar): Glucose + Fructose

2. Lactose ( sugar):

**Lactose Intolerance vs. Milk Allergy**

Source: Webb D. Demystifying lactose intolerance. Today’s Dietitian. 2012;14(4):16.

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DisaccharidesThree Forms

1. Sucrose (table sugar): Glucose + Fructose

2. Lactose (milk sugar): Glucose + Galactose

3. Maltose:

Activity BreakMr. Williams is an African American who complains of severe abdominal pain and diarrhea after drinking milk and eating ice cream.

• What additional information should you find out?

• What condition might he have? Why?

• What dietary changes can you recommend for him?

Oligosaccharides

• Three to ten monosaccharide molecules.

• Raffinose (3) & Stachyose (4)

• Found in dried peas and beans.

• Not digested by human GI tract but broken down by intestinal bacteria → gas & bloating.

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Polysaccharides

1. Starch: digestible polysaccharide from sources.

a. Amylose:

b. Amylopectin:

Polysaccharides

1. Starch: digestible polysaccharide from plant sources.

a. Amylose: straight chain

b. Amylopectin: branched chain

2. Glycogen: digestible polysaccharide from sources.

Storage form of glucose in

Primary location:

Polysaccharides

1. Starch: digestible polysaccharide from plant sources.

a. Amylose: straight chain

b. Amylopectin: branched chain

2. Glycogen: digestible polysaccharide from animal sources.

Storage from of glucose in animals & humans.

Primary location: liver and muscles.

3. Cellulose: indigestible polysaccharide from cell wall.

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Polysaccharides

1. Starch: digestible polysaccharide from plant sources.

a. Amylose: straight chain

b. Amylopectin: branched chain

2. Glycogen: digestible polysaccharide from animal sources.

Storage from of glucose in animals & humans.

Primary location: liver and muscles.

3. Cellulose: indigestible polysaccharide from plant cell wall.

Fiber Classification

1. Soluble Fiber• Food Sources:

• Delays gastric emptying/increases transit time (satiety)

• Health Benefits:

1. CVD:

2. Diabetes:

3. Weight Management:

4. GI:

Fiber Classification

2. Insoluble Fiber• Food Sources:

• Decrease transit time/increase fecal bulk

• Health Benefits:

1. GI:

2. Cancer:

3. Weight Management:

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AI for Fiber = 14 g/1000 kcal/day

Whole Grains / Complex Grains

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Is this a Whole Grain or Refined Grain?

Is this a Whole Grain or Refined Grain?

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Is this a Whole Grain or Refined Grain?

Activity BreakMrs. Smith who is 75 yr old with heart disease is complaining of constipation. She consumes the

following for breakfast:

Orange JuiceEnglish Muffin with Butter & Jelly

Scrambled EggsCoffee

• What additional information should you find out?

• What dietary changes can you recommend for her?

Artificial Nonnutritive Sweeteners

Source: http://www.sugar.org/wp-content/uploads/2013/11/How-well-do-you-know-sugar.pdf

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“Natural” Nonnutritive Sweeteners

• Stevia (Rebiana A), sold as Truvia, PureVia, Stevia in the Raw

• Monk Fruit Extract, sold as Nectresse, Monk Fruit in the Raw

Sweetener Times Sweeter than Sugar

Acceptable Daily Intake

Stevia 200-300 4 mg/kg bw/day

Monk Fruit Extract 150-300 None Determined

Sugar Alcohols

Sugar Alcohol Counterpart Kcal/Gram

Sucrose Sorbitol 2.6

Mannose Mannitol 1.6

Maltose Maltitol 2.1

Xylose Xylitol 2.4

• CHO with a chemical structure similar to sugar & similar to alcohol but neither sugar nor alcohol.