Victor Tambunan

Erwin Christianto
Department of Nutrition
Faculty of Medicine
Universitas Indonesia
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References

Bowman BA, Russell RM. Present Knowledge in

Nutrition 9th ed., 2006

Mahan LK, Escott-Stump S. Food & Nutrition Therapy

12th ed., 2008
Wahlqvist ML. Food and Nutrition: Australasia, Asia and
the Pacific, 1997
Gropper SS, et al. Advanced Nutrition and Human
Metabolism 4th ed., 2005

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Found primarily in plant tissues
Small amount in animal tissues

Carbohydrate (CHO) in foods traditionally

classified as:
• Simple CHO (sugars): mono & disaccharides
• Complex CHO: polysaccharides

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Classification

Classification according to degree of

polymerization (number of monomeric
units)
(Food and Agriculture Organization/World Health
Organization Expert Consultation of
Carbohydrates in Human Nutrition, 1998)

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 The major dietary carbohydrates
Class (degree of
Subgroup Components
polymerization*)
Sugars (1–2) Monosaccharides Glucose, galactose, fructose
Disaccharides Sucrose, lactose, maltose
Polyols (sugar alcohols) Sorbitol, mannitol

Oligosaccharides Maltooligosaccharides Maltodextrins

(3–9) Other oligosaccharides Raffinose, stachyose,
fructooligosaccharides (FOS)

Polysaccharides Starch Amylose, amylopectin, modified

starches
(>9)
Non-starch Cellulose, hemicellulose,
polysaccharides (NSP) pectins, hydrocolloids

*Number of monomeric units

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Roles of Carbohydrate
1. Source of Energy
1 gram CHO ~ 4 kcal
Glucose is the major source of energy for:
- Nerve tissue
- Red blood cells
Under normal circumstances, glucose is the sole
source of energy for the brain

2. Protein-Sparing Action
Sufficient CHO to meet energy demands
prevents the protein breakdown for this purpose

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Food Source of Carbohydrate

CHO Food Sources

- Starch & dextrins Grains, vegetables (esp. tubers &
legumes)
- Glycogen Meat products, seafood
- Sucrose Cane & beet sugars, molasses,
maple syrup
- Lactose Milk & milk products
- Glucose Fruits, honey
- Fructose Fruits, honey, corn syrup

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Definition
Physiological definition:
the remnants of plant cells after
hydrolysis by the enzymes of human digestives system
Chemical definition:
plant non-starch polysaccharides plus lignin

A great deal of the plant material that resists digestion in

human diets originates from the cell walls of the tissues
of fruits, vegetables, & cereal grains
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Classification of Fibre

Insoluble fibre

Soluble fibre

Fibre-like substances

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Sources of Fibre Components
Soluble
Gum Pectin b-glucan Psyllium
Oat Apple Oat Plantago ovata
Legumes Citrus fruits
Guar Strawberry
Barley Carrot

Insoluble
Cellulose Hemicellulose Lignin
White-wheat flour Bran Mature vegetables
Bran Whole grains Wheat
Vegetables Fruits with edible seeds,
such as strawberry

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Sources of ………………………… (cont.)

Fibre-like Substances

Inulin
Fructooligosaccharides (FOS)
Chitosan

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Sources of ………………………… (cont.)
Inulin & FOS
Food Sources:
 Chicory root  Garlic
 Onion  Banana
 Wheat
Inulin & FOS are prebiotics

stimulate the growth and/or activity of “good” bacteria

in the colon i. e. bifidobacteria (probiotic)
Chitosan
Animal-derived materials that resist digestion
Food source: Crustacea (shrimp, crab, lobster)
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 Physical and Chemical Properties of
Fibre & Fibre-like substances
Insoluble fibre Soluble fibre
 Water insoluble  Water soluble
 Non-fermentable or  Fermentable: fermentation
partly fermentable yields short chain fatty
 Non-viscous acids (acetate, propionate,
 Hold water
butyrate)
 Viscous/gelling
Inulin & FOS
• Water soluble
• Fermentable
• Non-viscous
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Physiological Benefits of Fibre

Insoluble fibre

 Reduce constipation,  faecal mass, softness &

frequency, and accelerate intestinal transit
 Promote growth of ileal & colonic mucosa (?)
 Enhance protection from bacterial infection (?)

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Physiological Benefits ………………………… (cont.)
Soluble fibre
Delay gastric emptying and small intestine transit
Modulate GI motility
 Faecal mass, volume & softness (mild effects)
Reduce diarrhoea ( water absorption)
Promote growth of ileal & colonic mucosa
Provides energy to the intestinal mucosa
 Colonic pH
 Protection from infection (barrier function, immunity)
 Glucose tolerance
increases
 High total & LDL cholesterol levels with viscosity

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Physiological Benefits ………………………… (cont.)

Inulin & FOS

Promote healthy gut microflora (prebiotic/bifidogenic

effect)
 Colonic pH (lactic acid production)
 Protection from infection (barrier function, immunity)
Reduce diarrhoea and constipation (?)
 High blood glucose levels & improve blood lipids (?)

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 Dietary soluble fibre

Gel formation in the stomach

Delayed gastric emptying

Uniform levels of CHO to the small intestine

Flattened blood glucose curve

Insulin surge

Possible mechanism by which soluble fibre lowers serum glucose

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 Soluble Fibre

Delayed gastric Interference with Interference with Inhibition of

emptying digestive enzymes micelle formation cholesterol biosynthesis

Flattened glucose May contain May sequester May bind Bacterial fermentation
curve lipase inhibitors lipid + CHO from bile acids produces propionate
digestive enzymes

Impaired absorption Cholesterol  Bile Propionate inhibits

 Insulin secretion
of lipid & CHO can’t be absorbed reabsorption HMG-CoA reductase

 Stimulation of  Substrate for  Exogenous Cholesterol pulled  Cholesterol

HMG-CoA reductase hepatic lipid cholesterol available out of blood to biosynthesis
by insulin synthesis for cholesterol synthesis make new bile

LOWER SERUM CHOLESTEROL

Possible mechanisms by which dietary fibre lowers serum cholesterol

Dietary starch that resists digestive enzyme action
and reaches the colon; a starch encased in a non-
digestible plant seed coat or modified by cooking or
processing can be resistant
Western diets:
resistant starch may be as much as 10% of
daily starch intake (8–40 g/day)
Starch-rich diets:
resistant starch >>>
Recommended Intakes
FAO/WHO expert consultation (1998):
optimal diet should consist at least 55% of
total energy from CHO obtained from a variety
of food sources.

A wide range of intakes is regarded as acceptable

---- up to 75% of total energy

Pedoman Umum Gizi Seimbang (PUGS) Indonesia:

Sugar  not more than 5% of total energy

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Recommended ……………………… (cont.)
Fibre:
Adequate dietary fibre intake for adult
(Institute of Medicine, Food, and Nutrition
Board, 2002):
14 g per 1000 kcal
Ratio of insoluble to soluble fibre:
3:1
can be obtained with ≥5 servings of fruits &
vegetables and 6 servings daily of whole-grain
breads, cereals, and legumes
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Dietary Lipids
Triglycerides (triacylglycerols)

Cholesterol

Phospholipids

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Triglycerides

Combinations of fatty acids with glycerol

Fats: solids

Oils: liquids

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 Common Fatty Acids
Biochemical
Trivial name Food sources
abbreviation
SATURATED
Short-chain
Butyric C4:0 Butter
Caproic C6:0 Butter
Caprylic C8:0 Coconut oil
Medium-chain
Capric C10:0 Palm oil
Lauric C12:0 Coconut oil
Myristic C14:0 Butterfat, coconut oil
Long-chain
Palmitic C16:0 Palm oil, animal fat
Stearic C18:0 Cocoa butter, animal fat

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Common Fatty ………………………… (cont.)
Biochemical
Trivial name Food sources
abbreviation
MONO-UNSATURATED
(MUFA)
Oleic C18:1 n-9 Olive, canola, peanut oil
Erucic C22:1 n-9 Canola oil
POLY-UNSATURATED
(PUFA)
Linoleic C18:2 n-6 Seeds fats--corn, cottonseed
a-linolenic C18:3 n-3 Soybean oil
Arachidonic C20:4 n-6 Lard, meats
Eicosapentaenoic (EPA) C20:5 n-3 Some fish oil, shellfish
Docosahexaenoic (DHA) C22:6 n-3 Some fish oil, shellfish

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Classification and Food Sources of Omega Fatty Acids
Biochemical
Class Fatty acid Food Sources
abbreviation

Omega-3 a-linolenic acid C18:3 n-3 Soybean oil

EPA C20:5 n-3 Some fish oil, shellfish
DHA C22:6 n-3 Some fish oil, shellfish

Omega-6 Linoleic acid C18:2 n-6 Corn, cottonseed oil

Arachidonic C20:4 n-6 Lard, meats
acid

Omega-9 Oleic acid C18:1 n-9 Olive, canola, peanut

oil

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Role of Fat

In the Diet

In the Body

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 Role of Fat

In the Diet In the Body

1. Source of energy (9 kcal/g fat) 1. Constituent of cell membranes

2. Satiety value  tends to leave 2. Energy reserve → as triglycerides
the stomach relatively slow 3. Regulator of body functions
3. Carrier of fat-soluble vitamins  arachidonic acid (n-6 PUFA)
(A, D, E, and K)  a-linolenic acids (n-3 PUFA)

4. Essential fatty acids supply  precursors of eicosanoids

5. Palatability  responsible for (prostaglandin, thromboxane)
much of the texture & flavor of 4. Insulator  prevent heat loss
food 5. Protector  protect vital organs

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Essential Fatty Acids
Essential:

The body cannot synthesise or cannot make in

sufficient amounts  must obtain from the diet
Absence leads to a defined deficiency state

Nutritionally essential fatty acids:

linoleic acid & a-linolenic acid

Arachidonic acid is not an essential fatty acid

 can be synthesised from linoleic acid

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Prostaglandin & Prostacyclin
Thromboxane
Leukotriene

Have many functions, including:

Regulation of blood pressure
Stimulation of pain & fever
Induction of blood clotting
Modify the processes of inflammation

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 Omega-6 series Omega-3 series
Linoleic acid a-Linolenic acid
18:2n-6 18:3n-3
Elongation
Desaturation

Arachidonic acid Eicosapentaenoic acid

20:4n-6 20:5n-3
in platelets

Thromboxane2 Thromboxane3

in blood vessels

Prostaglandin2 Prostaglandin3

in leukocytes

Leukotriene4 Leukotriene5

Production of eicosanoids from n-3 & n-6 fatty acids

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Cholesterol

Is a fat-related compound belonging to

sterols family
Not yield energy
Found only in animal foods
Component of cell membranes
Precursors of steroid hormones

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Cholesterol …………………………… (cont.)
Food Sources

Food high in cholesterol:

Brain
Egg yolks
Organ meats such as liver & kidney
Lobster

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Food Sources …………… (cont.)

Lesser amounts occur in other animal food

sources:
Meats, especially fatty meats

Whole milk

Cream, butter, cheese, ice cream, and other whole milk

dairy products

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Recommended Intakes
Pedoman Umum Gizi Seimbang (PUGS) Indonesia:

Lipids:
25% of total energy
(at least 10% of total energy)

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Proteins are made up of chains of amino
acids linked by bonds to form ribbon-like
peptide chains.
Over 300 different amino acids
occur in nature.
There are only 20 common amino acids
which make up most protein
Only L-a-amino acids occur in proteins
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Nutritional Classification of Amino Acids:

Essential (indispensable)

Non-essential (dispensable)

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Essential (indispensable) amino acids
Must be supplied in the diet because:
Cannot be synthesised in the body
Cannot be synthesised at a sufficient
rate to meet body requirements

Non-essential (dispensable) amino acids

can be synthesised within the body
9 Essential amino acids:
Phenylalanine, valine, threonine, methionine, tryptophan,
histidine, isoleucine, leucine, & lysine

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Functions
Major functions of proteins in the body
1. Part of cell membranes
2. Enzymes & some hormones
3. Special proteins of blood:
hemoglobin, albumin, transferrin
4. Nucleoproteins:
stabilise the structure of RNA & DNA
5. Antibodies
6. Contractile protein in muscle

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Complete proteins or proteins of high
biological value contain all of the
essential amino acids in proportions capable
of promoting growth when they are the sole
protein in the diet

All animal proteins, except gelatin,

are complete proteins
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Incomplete proteins or proteins of low
biological value lack or have limited
amounts of one or more of the essential
amino acids and so are incapable of
promoting growth when they are the sole
protein in the diet

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 Food Source
Most of the foods we eat contribute some protein to the diet

Protein is the major component of lean meat,

fish, and egg white (protein contributes
>20% of energy)

Cereals contribute intermediate amounts of

protein (7% to 18%)

Fruits & vegetables contribute much less

(0% to 5%)

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Protein in foods
Protein amount in food
Food (g/100 g)
High content (protein contributes >20% of energy)
Beef and lamb (lean meat, cooked) 28
Chicken 25
Fish (whiting, without batter) 18
Eggs 12
Milk 3.3
Peas (fresh or frozen) 5
Medium content (protein contributes 7 to 8% of energy)
Bread (white) 7.8
Corn (sweet) 4.1
Potatoes (cooked) 1.6
Rice (cooked) 2.2
Low content (protein contributes 0 to 5% of energy)
Cassava 0.7
Apples 0.3
Butter and margarines <0.4

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Dietary Reference Intakes (DRIs) for Protein
Life-Stage Group RDA/AI (g/kg/day)

Infants 1.5

1–3 years 1.1

4–13 years 0.95

14–18 years 0.85

Adults 0.8
Pregnant (using pre-pregnancy 1.1
weight) women

Lactating women 1.1

RDA: Recommended Dietary Allowances

AI : Adequate Intake
Washington DC, 2002. The National Academies Press
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Excess dietary protein

May adversely affect calcium (Ca) status

Ca absorption is enhanced by higher intakes

of protein, but urinary excretion of Ca is also 

Rate of Ca urinary loss is higher than Ca uptake

There may be a net loss of Ca

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World Health Organisation
(WHO), 2003

Contribution of Macronutrients
to Total Energy:

Carbohydrates 55–75%
Lipids 15–30%
Protein 10–15%

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