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09 L E C Nutrition and Diet Therapy 02 Marieta Hilario...

09 L E C Nutrition and Diet Therapy 02 Marieta Hilario 21 O4 CARBOHYDRATES AND HEALTH 4 calories per gram OUTLINE I. Carbohydrates Go food = keep us moving & supply a lot of II. Classifications of Carbohydrates energy Monosaccharides Food sources: rice, bread, cereal, root crops 1. Glucose The preferred source of energy for many of the 2. Fructose body’s functions 3. Galactose Glucose is the simplest form of carbohydrates; Disaccharides carbohydrates will be converted first into 1. Sucrose 2. Lactose glucose before the brain can use it 3. Maltose The cheapest source of energy for Filipino Polysaccharides since we are an agricultural country and PH has 1. Starch an abundant supply of carbohydrates 2. Glycogen Carbs are a preferable source of energy since it 3. Dietary Fibers has the least amount of detrimental effects to III. Health Effects of Sugars our health compared to fats and protein IV. Some Harmful Effects of Excessive Fiber Intake Deprivation of carbohydrates leads to ketosis V. Sugar Alcohol (more acid in the body which is not good for VI. Alternative Sweetener DNA) VII. Digestion Review CLASSIFICATIONS OF CARBOHYDRATES CARBOHYDRATES MONOSACCHARIDE (single sugar) - Preferred source of energy for many of the - Simple CHO: natural content of fruits and body's functions. vegetable o Cheapest food in our country; - Body digest it readily except for agriculture maldigestion disease o Least amount of detrimental effects on our health compared to fats and 3 MONOSACCHARIDES proteins 1. Glucose (common in nature) Share its fuel responsibility with FATS and - brain cells and nervous system depend CHON almost exclusively on glucose for their it's a CHON sparer: source of energy ▪ Spare protein in converted to energy - Other names: dextrose (glucose is the ▪ CHON: body-building food not body sugar inside dextrose), the only sugar energy giving (RBC, antibodies, and circulating in the blood aka physiologic chemical enzymes for digestion sugar (all sugar needs to convert into dependent on protein) glucose before body can use it as energy) ▪ CHO should be enough supply - Two hormones that regulate blood Side Notes: glucose homeostasis are: Hydrated carbons 1. Insulin – hormone that helps in the Products of nature regulation of the deposits and 3 natural resources: air, water, and sunlight storage of excess glucose from the thru photosynthesis BSN-2B TRANSCRIBED BY: GROUP 4 1 blood to the muscle and liver in a - the final digestive product is 2 molecules of form of GLYCOGEN glucose hence the body can convert again fructose Io glucose 2. Glucagon - if there is very low - important in oral glucose test for the level glucose of the blood, this will of glucose in the blood regulate the release of glycogen - to get glucose test: let the patient drink % (storage form) from the muscle of sugar and water. and liver to convert as glucose - after 1hr they will compare the results of (energy) the level of glucose in the blood in the Indication of deprivation before and after drinking the mixture CHO/energy: muscle wasting 2. Lactose 2. Fructose (common in nature) - principal CHO of milk - sweetest of all sugars - most human infants are born with - occurs normally in fruits and honey digestive enzymes necessary to split - kind of CHO present in fruits and young lactose into glucose and galactose vegetables, grains, rice (whole grain) - breastmilk has simple, easily digested CHO - After digestion, it will yield GLUCOSE and 3. Galactose GALACTOSE - occur mostly as part of lactose - Kind of sugar in milk - free as a single sugar during digestion - 12 g of CHO (lactose) = 1 exchange of milk - Not free in nature because it is dependent on the digestive product of lactose. 3. Maltose ▪ Lactose upon hydrolysis and - a plant sugar that consists of 2 digestion, it will release 1 molecule of glucose (product) galactose and 1 mol of glucose - best for infant feeding for il will not spoil - Abundant in pregnancy and lactation easily ▪ Mammary gland will release galactose with the help of - Recommended for infant feeding esp. milk progesterone formula - Could only be found in milk in a form of ▪ Instead using distilled water, mother lactose is advise to use lanot (rice water/ - Preformed galactose (prepared; synthetically) thoroughly cooked porridge) because it contains maltose and DISACCHARIDES (double sugar) - simple CHO contains kcal 3 DISACCHARIDES ▪ Milk and kcal content of lanot will add the weight of the milk 1. Sucrose - Not expensive - sugar present in our brown and white sugar; GRANULATED NOT REFINED - table sugar or white sugar POLYSACCHARIDE (starch & fibers) - complex - usually obtained by refining the juice from CHO sugar beets or sugar canes - Not easily digested, it may take 3 to 5 hours - it provides the brown, while and powdered - Hunger sensation extended sugars available in the market - Dietary fibers not digested in SI, bacteria - occurs naturally in many fruits and ferments it in the colon then producing vegetables calories - the partial digestive products of the - Not easily digested, it may take 3 to 5 hours chemical digestion of sucrose in the - Hunger sensation extended digestive tract are glucose and fructose BSN-2B TRANSCRIBED BY: GROUP 4 2 - Dietary fibers not digested in SI, bacteria - not a significant source of CHO but it does ferments it in the colon then producing play an important role in the body's PA. calories - not free: it is a storage form of excess glucose in the liver and muscles 3 POLYSACCHARIDES - The liver will convert glycogen stores to 1. STARCH glucose, to provide emergency glucose - long, straight or branched chain of reserves, to fuel the brain an hour or two hundreds of glucose units linked together in severe glucose deprivation - abundant in rice grain and potato roots - useful if there is starvation of CHO and - Storage form of CHO in plants source of energy a) Staple grains 3. DIETARY FIBERS 1. rice in Asia - Are structural parts of the plant, in plant- 2. wheat in Canada, US and Europe derived foods 3. Corn in central and south America. 1. vegetables o Prevalence of pellagra: 2. fruits deficiency in tryptophan 3. whole grains o Corn is deficient in tryptophan - Sugar units that are held together by bonds and niacin that human digestive enzymes cannot o Pellagra 4 characteristics: break dermatitis, diarrhea, dementia, - fiber includes: delirium: death a. cellulose – the main constituent of plant 4. millet, rye, barley and oats elsewhere cell walls found in: 1. vegetables b) Legumes (beans and peas) 2. fruits - also rich in CHO, substitute of meats 3. legumes for vegetarian diet b. hemicellulose – main constituent of cereal 1. peanuts fibers 2. dry beans (butter beans, kidney beans) c. pectin – are abundant in vegetables and 3. baked beans (garbanzos and soybeans) fruits especially citrus fruits and apples. c) Root vegetables (fibers) d. Gums and mucilages - have similar 1. potatoes structures and are used as additives 2. yams or stabilizers by the food industry ▪ Cassava, ube, sweet potatoes, gabbi e. lignin - are the tough, woody parts of ▪ Grains, legumes and tubers are not plants rich only in starch but also has abundant fiber, CHON and other STARCHES THAT ARE CLASSIFIED AS FIBER nutrients o Abundant in fiber Resistant starches - escape digestion and absorption in the SI. Grains, Legumes and tubers - are not only rich 1. whole milled grains in starch but also has abundant fiber, CHON 2. legumes and other nutrients 3. unripe bananas 4. raw potatoes 2. GLYCOGEN - human enzymes do not break down cellulose - found in meats, only in limited amounts and other dietary fiber and not all in plants - but bacteria in the human digestive tract can digest some fibers BSN-2B TRANSCRIBED BY: GROUP 4 3 - food fibers can only generate energy supply if because added sugar (refined sugar added to bacterial fermentation occurs in the colon; foods) has a high calorie content but almost this is the only time fibers produce calories empty in nutrient content (empty foods) - Fiber are the foods of colon foods that contain lots of added sugar such: - Promotes muscle tone and peristalsis 1. cakes /pastries 2. Candies 2 GROUPS OF FIBERS ACCORDING TO THEIR 3. soda /cola CHEMICAL AND PHYSICAL PROPERTIES o Dough of doughnut uses all purpose or first-class flour (refined – nutrients are 1. Soluble fiber lost; maltose are lost) - viscous (a gel like consistency) o Added sugar for doughnut – white - are easily digested and fermented by refined sugar, just a calorie content bacteria in the human colon o Toppings of the doughnut - examples are barley, legumes, fruits, oats naturally occurring sugars are acceptable and vegetables because they are accompanied by nutrients. - it will lower the risks of chronic diseases 1.vegetables 2. fruits 2. Insoluble fibers 3. whole grains - non-viscous, do not form gel, less 4. milk fermentable often tough, stringy or gritty 5. legumes foods sugar is not bad, but nutritious foods must - Ex. mag lata ng monggo beans, ang mag come first. dismantle lang is ang loob pero ang pulp is always seek balance vainly, moderation still present so pulp is insoluble fiber. - These fibers retain their structures and 2. DENTAL CARIES rough textures even after hrs of cooking the gradual decay and disintegration of a - Aid digestive system by easing elimination tooth. CHO foods that can support bacterial growth Cellulose and hemicellulose are found in: are o the outer layers of whole grains (bran) 1. bread o the strings of celery 2. banana o the hulls of seeds 3. milk o the skin of com kernels 4. sugar o these fibers retain their structures and Facts related to Dental Caries rough textures even after hours of A. Saliva rinse the mouth and protect the teeth cooking ▪ We are encouraged to use cheese instead o aid the digestive system by easing of sugar because it is healthier. Cheese elimination contains phosphorus and calcium – good for teeth. Cheese also stimulate saliva Dietary fibers - refers to naturally occurring fibers B. Raw vegetables do not stick to the teeth and Intact in foods because they require vigorous chewing they Functional fibers - refers to added fiber that have Stimulate saliva flow. health benefits; manufacturers add fibers C. Tiny particles of bananas can get lodged between teeth and decompose, risk of caries D. Tiny particles of breads crackers and chips can HEALTH EFFECTS OF SUGAR also become lodged in teeth promoting cares formation 1. NUTRIENT DEFICIENCY 3. HEART DISEASE BSN-2B TRANSCRIBED BY: GROUP 4 4 Prevented by fiber because fiber has the - Eat fiber to prevent constipation ability to trap and bind cholesterol - Fiber promotes peristalsis and muscle tone; containing foods like atherogenic foods easy elimination After tapping and binding, it would be - Prevents appendicitis because fiber cleanse excreted by the feces: lessen cholesterol preventing and inhibiting bacteria not to go in content in the blood appendix ▪ Bacteria are attracted to appendix Soluble fibers (oat, bran, barley, legumes) because antibodies are present in lower blood cholesterol by binding there cholesterol compounds and carry out of the 1. Cellulose enlarges and soften stools resulted body with the feces to ease in elimination for the rectal muscles, it also separates and excretes atherogenic so il prevents constipation and hemorrhoids. foods that leads to Atherosclerosis 2. Prevent obstruction of the appendix, thus Fiber lowers blood cholesterol by displacing prevents the invasion of bacteria that may fatty cholesterol-raising foods from the diet infect it 3. Stimulate the muscle of the Gl tract and 4. DIABETES helps the content of the intestinal tract to dietary fiber delays the passage of nutrients move easily so they retain their health and from the stomach to SI, this will slow glucose lone absorption, then will elicit a moderate 4. Preventing digestive tract from bulging out insulin response that will give a moderate of places rise in blood sugar resulting to a desirable glycemic response. 6. CANCER When you eat a lot of fiber, di sya maka 1. Fiber has the ability to dilute and speed produce ng glucose in the blood since glucose removal of potential cancer-causing agents will only be digested in the process of from the large intestine (colon): fiber helps fermentation w/ bactera in lage intestine prevent colon cancer because of bacterial (favorable glycemic effect) fermentation in the colon 2. Some fiber stimulate bacterial GLYCEMIC RESPONSE fermentation of the fiber in the colon, - refers to how quickly glucose - a process that produces small fatlike absorbed after a person eats molecules that lower the pH. - how high blood glucose rises - these small fatlike molecules and the - how quickly it returns to normal lowering of ph inhibit cancer growth - Different foods have different effects in the colon on blood glucose, it depends on the NOTE: A diet that emphasize whole grains, vegetables, glycemic index. legumes, fruits are moderate in energy dense GLYCEMIC INDEX but high in nutrient dense and low in fats that - is a method of classifying foods can harm health. according to their potential to raise It will help reduce the risk of the ff: blood glucose. 1. Obesity Ex. Potato boiled with skin – low glycemic 2. Cancer index 3. DM ▪ Chop and peel, deep fry, with salt – 4. GI Disorder high glycemic index 5. Dental caries Fiber is good at glycemic response 6. Malnutrition ▪ Watermelon has high glycemic index; 7. CVD prohibited to diabetic patients 5. GI DISTURBANCES BSN-2B TRANSCRIBED BY: GROUP 4 5 SOME HARMFUL EFFECTS OF EXCESSIVE FIBER - the more it promotes hunger because it INTAKE does not contain calories and nutrients - people need a balance diet and activity Note: Excessive fiber intake will lead to nutrient through the day to control weight deficiency because it digests slowly and the next 4. saccharin, acesulfame-K. aspartame, neotame. hunger moment is far which distracts the function of Sucralose ghrelin and leptin. Leptin is a hormone in our brain that ▪ Scientifically prepared tells the body that we need to eat while Gherlin is a ▪ therapeutic diet hormone-producing lining of the stomach that - Use for diabetic patients (not all) promotes hunger. DIGESTION REVIEW 1. Some minerals may bind to fiber and excreted within it without becoming available for body 1. CHO starts in mouth use – may lead to calcium deficiency 2. Salivary gland will produce salivary amylase ▪ Bile salt – very important in the 3. Mouth to stomach emulsification of fat soluble vitamins - Stomach’s pH is 3. right in the digestion of fats - Salivary amylase couldn’t contain the pH of stomach 2. Eating high fiber foods may not able to lake - Stomach will use hydrochloric acid and enough food to meet energy or nutrients enzyme amylase released by pancreatic gland need 4. In SI, polysaccharide will turn to disaccharide 3. Carry water out of the body that may cause - Epithelium of SI will release disaccharidases dehydration. Fiber should be compensated (enzymes of disacc) with high water intake ▪ Release of maltase, lactase and sucrase SUGAR ALCOHOLS o Maltase - glucose and glucose o Sucrase - glucose and fructose 1. Are CHO - will yield (2 to 3 kcal/ 1 gram) o Lactose - galactose and glucose ▪ Alcohol proof = 80; the more energy - Final digestive of CHO: glucose, fructose, and you’ll get galactose 2. Side effects are gas formation and abdominal ▪ Only glucose is used by the body as discomfort energy 3. Do not contribute to dental caries. ▪ Fructose and galactose should be - bacteria in the mouth metabolize sugar converted to glucose to use as energy alcohols slower than sucrose - so inhibits the production of acids that promote caries formation REFERENCES 4. mannitol and sorbitol “PROF’S PPT ON QUIPPER AND LECTURE” ARTIFICIAL SWEETENERS Misinterpret na di maka taba: wrong because artificial sweetener has no nutrient and walang calorie content = empty. The more you will become hungry and crave food 1. Non energy yielding, non-nutritive sweeteners, not a CHO 2. Make food taste sweet without promoting tooth decay 3. Will not automatically lower energy intake BSN-2B TRANSCRIBED BY: GROUP 4 6

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