Nursing 3709 Week 2: Carbohydrates and Fats - PDF

Nursing 3709 Nutrition Week 2- Carbohydrates and Fats Dr. Stephanie Henry NP (Adapted from Jamie Riley MN)  US versus Canada Guidelines Disregard everything on page 51 referring to MY PLATE US guidelines. Our course will follow Canada’s food guide https://food- guide.canada.ca/artif...

Nursing 3709 Nutrition Week 2- Carbohydrates and Fats Dr. Stephanie Henry NP (Adapted from Jamie Riley MN)  US versus Canada Guidelines Disregard everything on page 51 referring to MY PLATE US guidelines. Our course will follow Canada’s food guide https://food- guide.canada.ca/artifacts/CFG- snapshot-EN.pdf Carbohydrates Organic compounds composed of carbon, hydrogen, and oxygen Simple Carbohydrates Monosaccharides – single carbohydrate units (Glucose, fructose, galactose) Disaccharides- two single carbohydrate units bound together (Sucrose, maltose, and lactose) Complex Carbohydrates Polysaccharides- many units of monosaccharides joined together (starch and fiber) Hamilton Health Sciences (2014)  Structure of Carbohydrates  Monosaccharides Glucose Fructose Galactose Disaccharides Sucrose (glucose + Dietary fructose) Lactose (glucose + Carbohydrates galactose) Maltose (glucose + glucose) Polysaccharides Starches Fiber Function of Carbohydrates ENERGY! Most efficient form of energy for the body Fiber Naturally occurring sweeteners Brain and nerve tissue function best on glucose from carbohydrates Digestion and Absorption  Digestion in the small intestine Intestinal enzymes and specific pancreatic amylase continue the breakdown of starch to monosaccharides Enzymes in the small intestine’s brush border cells are specific for disaccharides (lactase for lactose, sucrase for sucrose, and maltase for maltose) These enzymes hydrolyze disaccharides into monosaccharides Glucose, fructose, and galactose are transported to the liver Liver then converts fructose and galactose to glucose  Glucose is converted into glycogen Storing via glycogenesis Carbohydrates Glycogen Metabolism Primary aspect of carbohydrate metabolism is blood glucose homeostasis Dietary starches and simple carbohydrates provide blood glucose after digestion and absorption Carbohydrate metabolites (lactic acid and pyrucis acid) are also used for energy Non carbohydrates can also provide blood glucose Gluconeogenesis – process of producing glucose from fat  Insulin lowers blood glucose levels by enhancing the conversion of excess glucose to glycogen through Blood glycogenesis Insulin eases the absorption of Glucose glucose into the cells allow for the use of glucose as energy Regulation Glucagon stimulates the conversion of liver glycogen to glucose Somatostatin inhibits the function of glucagon and insulin  Clinical Application What happens where there is no insulin present to transport glucose into the cell for energy use? Who is more likely to have diabetic ketoacidosis s Type I Diabetic or a Type II Diabetic ? Why? When would DKA occur with Type I Diabetes? https://i1.pickpik.com/photos/1021/179/636/diabetes-blood-finger- glucose-thumb.jpg Mehta, A. & Emmett, M., (2023) Fasting ketoacidosis and alcoholic ketoacidosis [Up to Date] Absorption Carbohydrates require active absorption Absorptive cells in the small intestine take up the monosaccharides Glucose, fructose, and galactose enter the villi into the portal blood circulatory system transporting them to the liver. The liver then takes the fructose and galactose and converts them into glucose Glucose can be used immediately for energy or stored as glycogen  Ranking of food to the level that it raises blood glucose Physical form Fat, protein and carbohydrate Glycemic content Ripeness of fruits and Index vegetables Fiber content (slow digestion) Botanic variety of food  Sugar is Sugar! Nutrient displacement Sugar! Dental caries Obesity  Plant foods Complex Carbohydrates: Starch  Strings of simple sugars Cannot be broken down by human digestive enzymes. Used for microbial fermentation resulting in the synthesis of Vitamins and short-chain fatty acids. Fiber Soluble dietary fiber- dissolve in fluids Insoluble dietary fibers- do not dissolve in fluids. Best source of fiber is whole grains, fruits and vegetables!  Improves physical function of the human Fiber body Health Prevents the development Benefits of obesity, constipation, hemorrhoids, diverticular disease, and colon cancer.  High fiber foods help with weight control Obesity Fiber makes us feel more full Often replace high fat and kcal foods  Insoluble fiber (wheat bran and whole grains) lead to larger softer Constipation stools preventing constipation, hemorrhoids and diverticular disease  Large intestine Pockets develop on the outside Diverticular walls Disease Low bulk secondary to low fiber can weaken muscles leading to diverticula  Diets high in fiber reduce risks of Cancer colon cancer! Reducing the risk by decreasing fat consumption Heart Disease Lowers blood cholesterol and lipid levels Lowers the consumption of high fat foods Soluble fiber binds to lipids and cholesterol as they move through the intestinal tract and excretes them with the fiber  Help stabilize blood glucose levels Soluble fiber slows the absorption of glucose Diabetes Canadian Carbohydrate Information https://www.canada.ca/en/health- canada/services/nutrients/carbohydrates.html Fiber intake should be 25-38g a day Carbs 30-45g per meal NCLEX Style Questions Case Study Fats Fats Chemical group called lipids Fats (triglycerides) Solids or oils Fat related substances (phospholipids and sterols)  Source of Energy Palatability Food Functions Satiety and satiation Food Processing Functions Nutrient Source of lipids Stored Energy Organ Protection Physiologic Functions Temperature Regulation Insulation Phospholipids Two fatty acids and one phosphate group Nonessential nutrient Form part of the cell membrane and work as emulsifiers Emulsifier- a substance that works by being soluble in water and fat at the same time Lecithin is the main phospholipid Lipoprotein- carriers or transports lipids Found in egg yolks and soybeans Sterols Cholesterol Carbon rings intermeshed with sidechains of carbon, hydrogen, and oxygen Nonessential Provide basic material to form bile, vitamin D, sex hormones, and cells in the brain and nerve tissue Cholesterol in the skin is converted to Vitamin D with UV light exposure The liver synthesizes cholesterol to make bile Dietary cholesterol account for 25% of cholesterol in the body Rest made in the liver Trans fats Saturated Fats Unsaturated Fats Found naturally in some animal- Saturated fats are found in foods There are 2 types of unsaturated based foods or can be industrially such as: fats: produced meat polyunsaturated lard and shortening monounsaturated Industrially produced trans fats are tropical oils such as palm oil and formed during food processing. coconut oil Some liquid vegetable oils, such as dairy products, including butter, canola and soybean oil, contain cheese and whole milk small amounts of trans fats They occur naturally in foods such Unsaturated fats are found in: as: nuts beef seeds lamb avocado dairy products fatty fish vegetable oils soft margarine soybeans and soy products, such as tofu Saturated and unsaturated fat Replace foods with mainly saturated fat to foods with unsaturated fat to promote cardiovascular health The type of fat consumed is more important that the total amount of fat consumed. Replacing saturated fat with unsaturated fat decreases total and LDL-cholesterol. Elevated LDL- cholesterol is seen in 1 in 5 adult Canadians and is a well-known risk factor for cardiovascular disease Omega 3 is a great example of an unsaturated fat that possesses many benefits! In the past, the main source of industrially produced trans fats were partially hydrogenated oils (PHOs). Health Canada banned the use of PHOs. Food manufacturers now can’t add PHOs to foods sold in Canada. This includes Canadian and imported foods, as well as those prepared in all food service establishments (Government of Canada, 2022). Fat in the body  Absorption Bile salts help move fatty acids from the lumen to the villi for absorption Micelles aid diffusion through the membrane wall After passing through the membrane wall fatty acids and glycerol combine back into triglycerides This allows them to travel through the lymphatic system to the blood circulatory system then to the hepatic portal system and liver. Lipoprotein lipase then helps break the triglycerides back into fatty acids and glycerol at the cell membrane Fatty acids can either be used for fuel or reform them into triglycerides and store them for energy Metabolism If fat catabolizes too quickly because of a lack of carbohydrates the liver cells form products from the oxidation of fatty acids. Ketones Excessive ketones results in ketosis Cholesterol Found in meat, eggs, fish, and dairy products Dietary cholesterol does not significant raise blood cholesterol Diets high in saturated fats increase blood cholesterol levels  https://food- guide.canada.ca/en/healthy- Healthy eating-recommendations/make-it- a-habit-to-eat-vegetables-fruit- whole-grains-and-protein- Fats! foods/choosing-foods-with- healthy-fats/ Fats: Fats and your health - Canada.ca Government of Canada (2022)  Fat is more efficient at being stored Energy then carbohydrates and proteins leading to more body fat with fat Intake consumption Chocolate Chips vs Apple Case Study