MACRONUTRIENTS:

CARBOHYDRATES
BASIC NUTRITION & DIET THERAPY
BSN 2
OBJECTIVES:
Carbohydrates and Health
Upon completion of this lecture the student should be able to do the following:

1. Identify the types of carbohydrates, their fuel value, and storage methods.
2. Summarize the major functions and food sources of carbohydrates.
3. Discuss nutritive and nonnutritive sweeteners.
4. Evaluate blood glucose level as an indicator of certain body conditions.
5. Define fiber and list its functions and food sources.
ENERGY
What is Carbohydrates?
• Carbohydrates are the most abundant organic substances on
Earth, comprising approximately 70% of plant structure.
• The main or chief source of the body’s energy.
THE NATURE OF CARBOHYDRATE

Basic Fuels: Sugars and Starch

Two forms of digestible carbohydrate occur

naturally in plant foods: (1) sugars and (2) starch.
Energy on planet Earth comes ultimately from the
sun and its action on plants. Using their internal
process of photosynthesis, plants transform the sun’s
energy into the stored fuel of carbohydrate. Plants
use carbon dioxide (CO2) from the air and water
from the soil—with the plant pigment chlorophyll as
a chemical catalyst—to manufacture sugars and
starch. The carbohydrates that plants store for their
own energy needs become a source of fuel for
humans who eat those plants. Because our bodies
can rapidly break down starch and sugars, Photosynthesis: In the presence of sunlight and the green leaf pigment
chlorophyll, plants use water and carbon dioxide (CO2) to produce
carbohydrates are often referred to as quick energy glucose and starch by capturing the sun’s energy and trans- forming it
foods. They are our primary source of energy. into chemical energy in the food products stored in their roots, stems,
and leaves; through this process oxygen is returned to the atmosphere.
CLASSIFICATION OF CARBOHYDRATES

• The term carbohydrate comes from its chemical nature. Carbohydrates contain
the elements carbon, hydrogen, and oxygen, with the hydrogen/oxygen ratio
usually that of water (CH2O).
• Carbohydrates are classified according to the number of basic sugar or
saccharide units that make up their structure.
• The monosaccharides and disaccharides are referred to as simple carbohydrates
because of their relatively small size and structure.
• The polysaccharides, including starch and certain fibers, are called complex
carbohydrates based on their larger size and more complicated structure.
Dietary Importance

• Carbohydrates make up a major portion of the food of people all over the world.
• Fruits, vegetables, cereals, grains, and dairy foods supply carbohydrate; in some
countries fruits, vegetables, and grains make up 85% of the diet.
• Rice is one of the world’s most important sources of carbohydrate, feeding 3 billion
people in the developing world.
• Carbohydrate foods are readily available, relatively low in cost, and easily stored.
Compared with food items that require refrigeration or have a short shelf life, many
carbohydrate foods can be held in dry storage for fairly long periods without spoiling.
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1. Monosaccharides

• The simplest form of carbohydrate is the

monosaccharide, or single sugar.
• The three monosaccharides important
in human nutrition are (1) glucose, (2)
fructose, and (3) galactose.
Glucose
• Glucose is a moderately sweet sugar found naturally in only a few foods, one being corn
syrup.

• Glucose is the common body fuel oxidized by cells.

• It is supplied to the body directly from the digestion of starch but is also obtained through
conversion of other simple sugars.

• Glucose (referred to by its older name dextrose in hospital intravenous solutions) is the form
in which carbohydrates circulate in the blood.
Fructose
• The sweetest of the simple sugars, is found naturally in fruits and honey.

• Fructose intake has escalated dramatically since high-fructose corn syrup (HFCS)
was introduced for use in processed food.

• HFCS is the sweetener in many soft drinks, fruit drinks, commercial baked products,
and dessert mixes.

• In humans, fructose is converted to glucose and burned for energy. Fructose is

absorbed less efficiently than glucose, and amounts of 25 g to 50 g or more can
cause gastrointestinal distress.
Galactose
• The simple sugar galactose is never found free in foods but is released in the digestion of lactose
(milk sugar) and then converted to glucose in the liver.

• This reaction is reversible; in lactation, glucose is reconverted to galactose for use in milk
production.
 PHYSIOLOGIC AND NUTRITIONAL SIGNIFICANCE OF MONOSACCHARIDES
MONOSACCHARIDE
D-Glucose* D-Fructose D-Galactose

SOURCE
Fruit juices; hydrolysis of starch, cane sugar, maltose, and lactose
Fruit and fruit juices; honey; hydrolysis of sucrose from cane sugar
Hydrolysis of lactose (milk sugar)

SIGNIFICANCE
Form of sugar used by the body for fuel; found in blood and tissue fluids
Converted to glucose in the liver and intestine to serve as body fuel
Converted to glucose in the liver to be used as body fuel; synthesized in the mammary gland to form lactose for milk; constituent of glycolipids and
glycoproteins
*Monosaccharides can exist in or forms depending on the position of the hydroxyl group on the right ( ) or left ( ) side of a specific carbon. Digestive enzymes are
D L D L

stereospecific and act only on sugars.

D
2. Disaccharides

• The disaccharides are double sugars made up of two monosaccharides linked together.
• The three disaccharides of physiologic importance are sucrose, lactose, and maltose.
• Their monosaccharide components are as follows:

Sucrose = one glucose + one fructose

Lactose = one glucose + one galactose
Maltose = one glucose + one glucose
Sucrose
• Sucrose is common “table sugar” and is made commercially from sugar cane and
sugar beets.

• It is found naturally in molasses and certain fruits and vegetables (e.g., peaches and
carrots) and is added to many processed foods.
Lactose
• Lactose is the sugar found in milk and is the least sweet of the disaccharides, only about
one sixth as sweet as sucrose.

• Although milk is relatively high in lactose, cheese, one of milk’s products, may contain little
or no lactose depending on how the cheese is made.

• When milk sours in the initial stage of cheese making, the liquid whey separates from the
solid curd.

• The lactose from the milk dissolves into the whey, which is drained away and discarded.
The remaining curd is processed into cheese, making it possible for many lactose intolerant
individuals to digest cheese, although particular cheeses vary in lactose content.
Maltose Sugar Alcohols
• Sugar alcohols (sometimes referred to as polyols)
• Maltose occurs naturally in relatively
are other forms of carbohydrate with sweetening
few foods but is formed in the body
power. Sugar alcohols, such as sorbitol, mannitol,
as an intermediate product in
and xylitol, are found in nature but are also used in
starch digestion.
food processing.
• Under current labeling laws, processed foods in
• It is found in commercial malt
which sugar alcohols replace sugar can be
products and germinating cereal
labeled as sugar free. Sugar alcohols are poorly
grains.
absorbed in the small intestine and, if absorbed,
are poorly metabolized.
• Sugar alcohols commonly used as sugar replacers
add only 0.2 to 3.0 kcal/g when compared with
other sugars, which add 4 kcal/g.1
PHYSIOLOGIC AND NUTRITIONAL SIGNIFICANCE OF DISACCHARIDES
DISACCHARIDE
Sucrose, Lactose, Maltose

SOURCE
Cane and beet sugar, sorghum cane, carrots, pineapple
Milk
Starch digestion by amylase or commercial hydrolysis; malt and germinating cereals

SIGNIFICANCE
Hydrolyzed to glucose and fructose; fuel for cells
Hydrolyzed to glucose and galactose; fuel for cells; milk production in lactation
Hydrolyzed to yield two molecules of glucose; fuel for cells; can be fermented
3. Polysaccharides
• Complex carbohydrates are called polysaccharides because they are made up of many (poly)
single glucose (saccharide) units.

• Starch is the most important digestible polysaccharide; others are glycogen and dextrin.
Nondigestible polysaccharides, such as cellulose, add important bulk to the diet and are
categorized as dietary fiber.
Starch Resistant Starch
• Starch consists of many coiled and • At one time it was thought that starch was
branching chains of single glucose units and completely digested and absorbed in the small
yields only glucose on complete digestion. intestine. Now we know that some starch in
particular foods, such as whole grains, potatoes,
• Cooking not only improves the flavor of bananas, and legumes, escapes digestion and
starch but also softens and ruptures the enters the colon generally intact.
starch cells, making digestion easier.
• This starch, called resistant starch, can make up as
• Starch mixtures thicken when cooked much as 8% by weight of a food high in starch.
because the substance encasing the starch
granules has a gel-like quality that thickens
mixtures in the same way as pectin causes
jelly to set.
Glycogen Dextrin
• Glycogen is the storage form of carbohydrate in • Dextrins are polysaccharide
animals, whereas starch is the storage form of compounds formed as intermediate
carbohydrate in plants. products in the breakdown of starch

• Glycogen is synthesized in liver cells and stored in

small amounts in liver and muscle.

• Liver glycogen helps sustain normal blood glucose

levels during fasting periods such as sleep hours,
and muscle glycogen provides immediate fuel for
muscle action.

• Athletes sometimes practice pregame “glycogen

loading” to add fuel stores for athletic competition
Oligosaccharides
• Oligosaccharides are small fragments of partially digested starch ranging in size from 3 to
10 glucose units. They are formed in digestion and produced commercially by acid
hydrolysis.

• These small starch molecules are used in special formulas for infants and others with
gastrointestinal problems because they are easy to digest.

• Oligosaccharides are also common in sports drinks in which they often contribute almost
half of the total glucose.

• Some naturally occurring oligosaccharides are formed with bonds that cannot be broken
by human enzymes and therefore remain undigested.

• Two of these—stachyose and raffinose—are found in legumes such as beans, peas, and
soybeans, and provide a feast for bacteria in the colon, producing large amounts of gas
that result in discomfort and embarrassment.
Glycemic Index
• Carbohydrate foods are digested and absorbed at different rates. Refined carbohydrates, such as
white bread or corn flakes, are broken down quickly and rapidly absorbed into the blood.

• Less refined carbohydrate foods, such as brown rice, beans, or apples, also contain fiber and are
digested and absorbed more slowly.

• A food with a high GI will raise blood glucose to a greater extent than a food with a low GI. The
effect of particular foods is compared with the effect of a glucose solution on blood glucose. In
clinical practice, GI was measured by studying blood glucose levels over a 2-hour period following
ingestion of 50 g of glucose and after consuming a 50-g carbohydrate portion of the test food. Based
on its major effect on blood glucose, the glucose dose was assigned the rating of 100, and individual
foods were rated accordingly.
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 FUNCTIONS OF CARBOHYDRATES

1. Energy 2. Glycogen–Carbohydrate Storage

• The primary function of starch and sugars
• Liver and muscle glycogen are in constant
is to supply energy to cells, especially brain
interchange with the body’s overall energy
cells that depend on glucose.
system. These energy reserves protect cells,
• When carbohydrate is lacking, fats can be
especially brain cells, from depressed
used as an energy source by most organ
metabolic function and injury and support
systems; however, body tissues require a
urgent muscle responses.
constant supply of glucose to function
most efficiently.
 FUNCTIONS OF CARBOHYDRATES

3. Protein-Sparing Action 4. Antiketogenic Effect

• Carbohydrates help regulate protein metabolism. • Carbohydrates influence fat metabolism. The
an adequate supply of carbohydrate to satisfy supply of carbohydrate determines how much
ongoing energy demands prevents the fat must be broken down to meet energy
channeling of protein for energy. This protein- needs, thereby controlling the formation of
sparing action of carbohydrate allows protein to ketones.
be reserved for tissue building and repair.
• Ketones are intermediate products of fat
metabolism that normally are produced in very
small amounts. However, when carbohydrate is
inadequate to meet cell energy needs, as in
starvation or uncontrolled diabetes or very low-
carbohydrate diets, fat is oxidized at extreme
rates. Sufficient amounts of dietary
carbohydrates prevent any damaging excess
of ketones.
 FUNCTIONS OF CARBOHYDRATES

3. Protein-Sparing Action 4. Antiketogenic Effect

• Carbohydrates help regulate protein metabolism. • Carbohydrates influence fat metabolism. The
an adequate supply of carbohydrate to satisfy supply of carbohydrate determines how much
ongoing energy demands prevents the fat must be broken down to meet energy
channeling of protein for energy. This protein- needs, thereby controlling the formation of
sparing action of carbohydrate allows protein to ketones.
be reserved for tissue building and repair.
• Ketones are intermediate products of fat
metabolism that normally are produced in very
small amounts. However, when carbohydrate is
inadequate to meet cell energy needs, as in
starvation or uncontrolled diabetes or very low-
carbohydrate diets, fat is oxidized at extreme
rates. Sufficient amounts of dietary
carbohydrates prevent any damaging excess
of ketones.
 FUNCTIONS OF CARBOHYDRATES

5. Heart Action 6. Central Nervous System

• Heart action is a life-sustaining muscle activity. • The brain and central nervous system (CNS)
Although fatty acids are the preferred fuel for the depend on carbohydrate for energy but have
heart, the glycogen stored in cardiac muscle is an very low carbohydrate reserves enough to last
important emergency source of contractile only 10 to 15 minutes.
energy. • This makes them especially dependent on a
minute-to-minute supply of glucose from the
blood.
• Sustained hypoglycemic shock causes irreversible
brain damage. Providing an adequate morning
supply of glucose for brain function may help to
explain why individuals who eat breakfast do
better in school than those who skip breakfast.

• Glucose increases the synthesis of acetylcholine, a

neurotransmitter that acts on areas of the brain
responsible for memory and cognitive function
Nonnutritive Sweeteners
• Most of us have an inborn desire for foods that are sweet; however, we are faced with
the dilemma of moderating our energy intakes to maintain a healthy weight.

• Nonnutritive sweeteners (NNSs) allow us to indulge our taste for sweets while limiting
kilocalorie intake. Sweeteners are grouped as nutritive or nonnutritive depending on the
kilocalories they add to a food.

• Sucrose (table sugar) and other natural sugars yield 4 kcal/g. In contrast, NNSs,
sometimes referred to as noncaloric sweeteners, contribute no kilocalories or an
insignificant number of kilocalories.
 FIBER: THE NONDIGESTIBLE CARBOHYDRATE

• Fiber is the nondigestible material found in whole-grain cereals, fruits, vegetables, and legumes
that our grandmothers referred to as roughage.

• Because humans lack the enzymes necessary to break down these complex carbohydrates into
forms that can be absorbed, they travel the length of the gastrointestinal tract and are
eliminated in the feces.

• Fiber’s ability to promote regular bowel function has been recognized for generations.

• All types of fiber are beneficial to health, but different fibers have different physiologic effects;
therefore, we need a variety of foods that supply various types. Although most foods contain
more than one type of fiber, they likely have more of one than another.
Types of Fiber
• In the past, fibers were classified as soluble or insoluble, based on their chemical properties
in the laboratory.

• It was believed that these properties influenced their actions in the body as well. We have
since learned that health benefits of fiber are dependent on two characteristics: viscosity
and fermentability.

• Viscous fibers, formerly referred to as soluble fibers, influence blood glucose levels and
lower LDL-cholesterol levels.

• Fibers that are fermented by the microflora in the gastrointestinal tract and provide bulk to
the stool were referred to as insoluble fibers; however, not all viscous fibers are soluble, and
not all fibers that influence laxation are insoluble, so these terms are no longer used to
describe health benefits, although food labels still use them.
Dietary Fiber
Dietary fiber includes the nondigestible carbohydrates and lignin found intact in plant foods. Several
dietary fibers important in human nutrition are described below:

• Cellulose: Cellulose is the material in plant cell walls that

provides structure. We find it in the stems and leaves of vegetables, in the coverings of seeds and
grains, and in skins and hulls. Because humans are unable to break down cellulose, it remains in the
digestive tract and contributes bulk to the food mass.

• Hemicellulose: This polysaccharide is found in plant cell walls and often surrounds cellulose. Some
hemicelluloses help regulate colon pressure by providing bulk for normal muscle action, whereas
others are fermented by colonic bacteria.

• Lignin: Lignin is the only dietary fiber that is not a carbohydrate. It is a large molecule that forms the
woody part of plants and in the intestine combines with bile acids and prevents their reabsorption.
Lignin contributes the sandy texture to pears and lima beans.

• Pectin: This fiber is found in plant cell walls. It forms a viscous, sticky gel that binds cholesterol and
prevents its absorption. Pectin also helps to slow gastric emptying and extend feelings of satiety.
 Dietary Fiber
Dietary fiber includes the nondigestible carbohydrates and lignin found intact in plant foods. Several
dietary fibers important in human nutrition are described below:

• Gums: Plants secrete gums in response to plant injury. In the intestine gums bind cholesterol and
prevent its absorption. Bacteria in the colon ferment gums to form short- chain fatty acids that nourish
colonic cells (this action is also true of resistant starch).

• β-Glucans: These water-soluble fibers are found in oats and oat bran, foods that carry a health
claim on the label indicating they can reduce the risk of heart disease. (β-glucans interfere with the
absorption of cholesterol.)