Lesson 2 - Carbohydrates

OBJECTIVES :
1. Review what are Carbohydrates.

2. Learn the classifications of carbohydrates.
3. Know the ways in which carbohydrates are
digested, absorbed and metabolized
4. Enumerate food sources of carbohydrates.
5. Describe the functions and general
recommendations for carbohydrates, health
promotion, prevention and disease
management.
6. Describe the role of the nurse in promoting an
appropriate intake of carbohydrates in a meal.
Carbohydrates
• Provide the major source of energy for all
people all over the world.
• organic compounds of Carbon,
Hydrogen and Oxygen ( CHO )
• One of three energy nutrients
(the others are fats and protein)
• CHO yield’s 4 g/1 kcal
Carbohydrates
• Manufactured by green plants in a
process known as photosynthesis
• Two major groups: sugars and
starches
• All CHO are not equal in terms of
health benefits from eating
• Storage of CHO is cheaper and
simpler than other foods
Classification of CHO:
1. Monosaccharides
2. Disaccharides
3. Polysaccharides
• Mono = one
• Di = two
• Poly = complex
• C6H12O6 chemical formula

Monosaccharides
• Building blocks of all other CHO
• Glucose is known as the blood sugar
– The body converts all forms of sugar
consumed to glucose
– Normal FBS is 70-100mg/100 ml of serum
– Also known as dextrose
• Fructose – Found in honey; very sweet
- the body converts to glucose after
consumption
• Galactose – Comes mainly from the
breakdown of milk,
- least sweet of all monosaccharides
Sugar Alcohols
• Sugar replacers- Polyols, nutritive
sweeteners, bulk sweeteners
• Lactitol, maltitol, isomalt, sorbitol,
xylitol, and mannitol are sugar
replacers approved for use in US
It adds sweetness and bulk to recipes

Intense Sweeteners
– Sugar substitutes like artificial
sweeteners
– Saccharine
– Do not add bulk or volume, only
sweetness
– 150 to 500 times as sweet as sugar
– Ex. Nonnutritive sweeteners:
aspartame, saccharin and sucralose
Disaccharides:
• Formed When Two Monosaccharides Are Joined
• Sucrose = glucose + fructose (table sugar)
• Also found in molasses, maple syrup and fruits
• Lactose = glucose + galactose (milk)
• Lactose intolerance: abdominal cramping, pain, loose
stools, flatulence after eating or drinking milk products
• Maltose = glucose + glucose
(produced mainly when other starches are broken down)
– Found in a few sources naturally (malt),
malt products, some infant formulas
Complex Carbohydrates:
Polysaccharides or Many Units of C6H12O6
Joined
• Starch – Major source of CHO in diet
• Glycogen – “The animal starch”; form
animals, including human storage; found
in liver and muscle tissues
– Storage form of glucose
– Continually broken down and built up to
provide energy for the body
Dietary Fiber (mainly from
plants):
CHO
Food the Body
and Nutrition Cannot
Board Break
recommends:
• Men 50 years orDown
younger:
38 grams per day
• Women 50 years or younger:
25 grams per day
• Men over 50:
30 grams per day
• Women over 50:
21 grams per day
Fiber Intake
 Average fiber intake in U.S. is only 15
grams per day
• Range of fiber intake 20-35 g/day
• Eating too much fiber is not
recommended
– can interfere with mineral absorption
– Don’t add fiber concentrates
– Eat fruits, vegetables, legumes, and whole-
grain cereals, also contain other nutrients
Insoluble Fiber :
• Insoluble fiber does not dissolve in water
– Consists of the woody or structural parts of plants-
fruit and vegetables skins
• Wheat bran, corn bran, vegetables, nuts, fruit
skins, and some dry beans contain soluble
fiber
• Health benefits:
promotes regularity;
may reduce risk of some forms of cancer;
may reduce risk of diverticular disease
Soluble Fiber :
• Dissolves in water
• Oatmeal, oat bran, barley, apples, oranges,
broccoli, and some dry beans
• Health benefits:
may help lower cholesterol;
may assist in lowering blood sugar levels;
may promote satiety
• Everyone needs both kinds of fiber in the
diet
Functions of Carbohydrates
• Provide fuel
– Along with fats and proteins
• Spare body protein

– Body will convert protein to glucose if
glucose is absent
Functions of Carbohydrates
• Help prevent ketosis
– Low CHO intake results in breakdown of stored fat
and internal protein stores to meet fuel needs
– The result is the breakdown of partially broken-
down fats accumulating in the blood in the form of
ketones
– Ketosis is determined by testing the urine for
acetone or deacetic acid
– Minimum of 50-100 g of CHO/day will prevent
ketosis
• Enhance learning and memory

– Children score higher on tests when they eat
breakfast
Consumption Patterns :
• Most of the world’s population subsists on CHO
• Much research has shown that Americans and
Canadians are eating too much of everything
including CHO (except fiber)
• Of particular concern is the excessive intake of
sugar from sweetened carbonated beverages
• Six servings of whole grains are recommended
to increase fiber intake
• Whole fruit and vegetable intakes are also lower
than recommended levels
Relationship to Dental Health and CHO
Consumption
• Genetic susceptibility
• Other factors related to cavity formation:
– Length of time food is in the mouth
– Food texture
– Frequency of food intake
– Acidity of food
– Foods that help: aged cheeses and fibrous foods
(apples and celery) that stimulate saliva production
– Saliva clears the mouth of food and counteracts
acid production
Nursing Bottle Syndrome
• Caused by the frequent and prolonged
exposure of an infant or young child to
liquids containing sugar
• Rampant dental caries
Food Sources: Two Major
• Groups
Sugars (4 grams of CHO/teaspoon)
honey, jam, jelly, sweetened carbonated beverages
• Starches
– Complex CHO’s containing fiber and other nutrients
– Cereals, grains, rice, pasta, potatoes, starchy
vegetables, breads, beans
• Emphasis on whole grain: oatmeal, rye bread, graham
crackers
• Make half of your grains whole
• Enrichment
– Add nutrients that were present in food but removed
during processing or storage
– Fiber lost through milling is not replaced by enrichment
CHO Counting
– Teaches about the CHO content of foods and portion
sizes
Parts of the Grain
Exchange List Values
• Starch/Bread Exchange List
– One exchange contains 15 g/CHO
• **Vegetable Exchange List
– Contain 2-3 g of fiber/serving
– One exchange contains 5 g/CHO
• Fruit Exchange List
– One exchange contains 15 g/ CHO
• **Milk Exchange List
– One cup of milk contains 12 g/CHO
• Estimating the Fiber Content of
Foods
Uses of Exchange Lists
To learn and teach others:

• Portion sizes
– How much oatmeal would provide 15 grams
of CHO?
• How foods compare to each other within
a given list
– 1¼ cups strawberries = ⅓ cup grape juice
Dietary Recommendations
• Focus on fruits (whole fruits better than

juices) – Eat 2 cups of fresh fruit per day
• Vary your vegetables – Eat 2½ cups per
day
• Make half of your grains whole: whole-
grain cereals, whole-grain breads, corn,
whole-grain rice, and whole-grain pasta
• Milk contains CHO – Eat or drink three
servings a day from this group
Guidelines :
• Eat breakfast or take a couple of pieces of fruit
to eat early in the day
• Have whole-grain cereal and milk for breakfast
with fruit
• Snack on fresh fruits and vegetables
• Mix vegetables with pasta or stir-fries
• Eat whole-grain breads
• Vary fruit and vegetable intake
• Have both a salad and cooked vegetable at
most meals
•Any
QUESTION???
•Is it
true??

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OBJECTIVES :

1. Review what are Carbohydrates.

• C6H12O6 chemical formula

It adds sweetness and bulk to recipes

• Spare body protein

• Enhance learning and memory

To learn and teach others:

• Focus on fruits (whole fruits better than

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