Lecture 7: Chapter 4 Carbohydrates (continued)

Artificial sweeteners
Splenda (sucralose)
Youre eating chlorine (not much, but there is)
Splenda isnt metabolized by the body b/c of the presence of chlorine.
Has no use, just satisfies craving of sweet taste
Aspartame (a dipeptied [2 amino acids linked] of aspartate and phenylalanine
methyl ester) is an artificial sweetener (Equa, NutraSweet) about 200x sweeter
than table sugra. Aspartame is found in lots of foods/drinks. Theres
phenylalanine, so you dont want it (bladder cancer).
Saccharin (Benzoic sulfimide) is used 3rd after splenda and aspartame in terms of
quantities used for artificial sweetening. Unlike sucrose, this has a bitter
aftertaste. No risk of bladder cancer
Digestion and Absorption of Carbohydrates
CARBOHYDRATE DIGESTION
Figure 4-10: Carbohydrate digestion in the GI tract
o In the mouth: Salivary amylases begin starch digestion.
o In the stomach: Stomach acid and stomach proteases inactivate the salivary
amylases, halting starch digestion.
o In the small intestine: Here is where most carbohydrate digestion takes place, via
the action of pancreatic amylase and disaccharidases: maltase, sucrase, and lactase
(Note: maltase and sucrase are -glycosidases, but lactase is a -glycosidase).
o Fibers delay the absorption of carbohydrates and fats in the small intestine. Within 1-
4 hours, all the sugars and most of the starches have been digested.
o In the large intestine: The small amount of undigested starch that gets to the large
intestine is called resistant starch. Usually, this is starch that somehow avoided
interaction w/ the enzymes of the small intestine b/c of the physical nature of the food
(we could call it hard-to-get-at starch). The resistant starch and indigestible fiber
attract water, which softens the stools. Some bacteria can ferment ( metabolize
without the requirement for oxygen) these materials.
o Absorption into the bloodstream: Except for a small amount of glucose absorbed
by the tissues of the mouth, carbohydrate absorption takes place solely in the small
intestine via active transport and are carried away in the blood to the liver, via the
portal vein. See Figure 4-11.
The liver can convert galactose and fructose to glucose
Summary: Digestion of carbohydrates by the body converts starches into disaccharides and
then monosaccharides (principally glucose, fructose, and galactose). Glucose is the
prominent monosaccharide, since the others (fructose and galactose) are readily converted
into glucose.
Lactose Intolerance: Lactose = "milk sugar" = a disaccharide of glucose joined to galactose,
via a -glycosidic bond.
o Lactase is the enzyme that hydrolyzes this -glycosidic bond, converting lactose to
glucose + galactose:
o lactose + H2O glucose + galactose
o Lactase is produced in abundance immediately after birth, but it declines in amount
 during childhood and adolescence. Only 30% of the world's adult population
produces enough lactase to digest lactose efficiently.
Lactose Intolerance
o Symptoms
Undigested lactose attracts water, causing bloating, abdominal discomfort,
and diarrhea. Undigested lactose is metabolized by bacteria in the large
intestine, causing gas
o Causes
Age & attendant lactase decline; also disease, some medications, prolonged
diarrhea, malnutrition. Or, rarely, a genetic deficiency at birth
o Prevalence
Highest in Asians and African Americans, lowest in Northern Europeans
o Managing lactose intolerance
Lactaid
Controlling amt of lactose in the diet, through less consumption of milk &
milk products.
Glucose in the body:
o Glucose plays a central role in carbohydrate metabolism. It is the major energy
source for many tissues and is the preferred energy source for the brain.
A preview of carbohydrate metabolism: metabolism "change": Metabolism is defined as
the chemical changes as nutrients are broken down to release energy or to provide building
blocks, and the chemical changes as building blocks are assembled into larger molecules
needed to form new cells and tissues.
o Typical carbohydrate reserves in a 70-kg (154-lb) person:
Glucose (blood and other bodily fluids))
Glycogen (muscle)
Glycogen (liver)
o Total carbohydrate reserves = 840 kcal
o Storing glucose as glycogen: 1/3rd in the liver, 2/3rds in the muscles.
Liver glycogen serves as a reservoir of glucose that can be used to maintain
the proper levels of glucose in the blood ("blood glucose").
Muscle stores glucose in the form of glycogen in order to have a ready supply
of glucose as the energy source for muscle contraction.
o Using glucose for energy: Glucose fuels the work of many of the cells in the body.
Overall, the process is the same as burning wood (cellulose) in a fireplace:
glucose + oxygen carbon dioxide + water + energy
C6H12O6 + 6 O2 6 CO2 + 6 H2O + energy
o Making glucose from protein: If no carbohydrate is available in the diet (as occurs
during starvation), protein is broken down to form organic molecules that can be
transformed into glucose to provide fuel for the brain and other tissues via
gluconeogenesis.
o Fat molecules cannot be rearranged to form glucose molecules.

o Fat fragments can be used to make ketone bodies: During prolonged starvation,
fat is broken down to form ketone bodies, a class of molecules that can replace
glucose as a source of energy for the brain.
 o Build-up of ketone bodies (a condition known as ketosis)
o To spare body protein and to prevent the build-up of ketone bodies (ketosis) requires
50-100 grams of carbs per day
o Actually, dietary recommendations for carbs are set much higher than this minimum
o Converting glucose to fat: Excess carbohydrates in the diet will be converted to fat
for storage in fatty tissues (adipose tissues).
Usually, however, if excess calories are consumed, the dietary fat is
preferentially stored in adipose tissue, rather than converting the carb to fat,
since its easier for the body to store fat directly than toconvert carb to fat for
storage purposes
Clicker Question: Whats the primary storage form of carbohydrate in the body? Glycogen
The Constancy of Blood Glucose: Normal blood glucose levels = 80 to 120 mg per
deciliter
o Maintaining glucose homeostasis: Since most cells require some glucose, the body
must keep the blood glucose levels within limits that the cells can use.
Low blood glucose levels person becomes weak and dizzy.
High blood glucose levels person becomes confused and has breathing
difficulties.
o Extremes in either direction can be fatal.
The hormones of glucose homeostasis: Figure 4-12
o The two principal hormones of glucose homeostasis are insulin and glucagon.
Insulin: pancreatic hormone that stimulates cells to absorb glucose from the
blood.
Insulin is produced in the -cells of the pancreas.
Glucagon: another pancreatic hormone, but it works oppositely to insulin -
glucagon stimulates the movement of glucose from storage depots into the
blood.
Glucagon is produced in the -cells of the pancreas.
o A third hormone (produced in the adrenal medulla) called adrenaline (also called
epinephrine) is the "fight-or-flight" hormone: In a stressful situation, adrenaline
stimulates muscle cells to convert glycogen to glucose for use as a fuel for muscle
contractions needed for fight or flight.
o Failures in blood glucose regulation: diabetes (high blood glucose) and
hypoglycemia (low blood glucose).
o Diabetes (diabetes mellitus) is now the 6th leading cause of death in the United
States.
Type 1 Diabetes (also known as insulin-dependent diabetes mellitus
(IDDM) or juvenile-onset diabetes mellitus: The pancreas fails to make
insulin. Treated by daily insulin injections.

Type 2 Diabetes (also known as noninsulin-dependent diabetes mellitus

(NDDM) or adult-onset diabetes mellitus: Cells stop responding to insulin
 (cells have fewer insulin receptors on their membranes). Type 2 diabetes
tends to occur because of chronic obesity. Type 2 diabetes can often be
controlled by maintaining a healthy weight, or, in a less desirable way, by
injection of additional insulin so that the message gets through via the few
insulin receptors remaining.

Glycemic Response, Glycemic Index and Glycemic Load:

The glycemic response: a measure of the extent to which a food raises the blood glucose
concentration and elicits an insulin response

o Desirable glycemic response =

o Undesirable glycemic response =

The glycemic index is a method of classifying foods according to the potential to raise blood
glucose. The glycemic effects of foods are particularly important to diabetics.

GLYCEMIC INDEX vs. GLYCEMIC LOAD

Glycemic Index (GI) = how fast a carbohydrate triggers a rise in circulating blood sugar.

Glycemic Load (GL) gives a more complete picture. GI doesn't tell you how much
carbohydrate is in a serving of a particular food, but GL does.

GL = (GI)(available carbohydrate content)/100, where available carbohydrate content

(total carbohydrates minus fiber) in grams.

High-glycemic load foods are detrimental to long-term health

How high-glycemic load foods lead to elevated insulin levels

One important note, under Accusations against sugars:

o Contrary to popular belief, scientific studies show that sugar consumption does not
contribute to hyperactivity in children.
o Further, sugar intake does not contribute to criminal behavior in adults (the "Twinkie"
defense notwithstanding!).

o For an account of the Twinkle defense, see http://ask.yahoo.com/ask/20010829.html

 Read over the section entitled Health Effects and Recommended Intakes of Starch and
Fibers

Note that foods rich in soluble fibers (oat bran, barley, legumes) lower blood cholesterol by
binding with bile acids, leading to their excretion. Bile acid loss causes the liver to replenish
the bile acids through synthesis from cholesterol, and blood cholesterol levels drop

Another important note, GI health is improved by fiber in the diet. Taken with adequate
fluid, dietary fiber lessens the likelihood of hemorrhoids (swellings in rectal veins),
appendicitis (caused by compaction of the stools that lead to appendix obstruction and
bacterial infection), and diverticulitis (the formation of bulge-like pouches in the colon wall
due to weak intestinal muscles).

Summary:

o Recommended intake of sugar: no more than 10% of the daily caloric intake should
be in the form of sugar.

o Recommended intake of starch: 55-60% of the total caloric intake should come from
carbohydrates (1,100 to 1,200 kcal of carbohydrates [275 to 300 grams] for a person
consuming 2,000 kcal per day).

o Recommended intake of fiber: 12.5 grams per 1,000 kcal consumed (25 grams per
day for a person on a 2,000-kcal/day diet) is recommended by the FDA. The
American Dietetic Association recommends 20 to 35 grams per day.