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Diet and nutrition > Carbohydrate > Flashcards

Carbohydrate Flashcards

1
Q

Types of carbohydrate: MONOSACCHARIDES?

A

Pentoses
(5 carbon atoms):
Ribose
Deoxyribose

Hexoses
(6 carbon atoms):
Fructose
Glucose
Galactose
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2
Q

Types of carbohydrate: DISACCHARIDES?

A

Maltose:
Glucose
Glucose

Sucrose:
Glucose
Fructose

Lactose:
Glucose
Galactose

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3
Q

Types of carbohydrate: OLIGOSACCHARIDES?

A

Maltodextrin

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4
Q

Types of carbohydrate: POLYSACCHARIDES?

A

Amylose (starch)

Amylopectin (starch)

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5
Q

Dietary Carbohydrate Intake

A

• All sugars (mono, disaccharides) and starches

Starches:

• Typically associated in food items containing other nutrients.  For example:
– Vitamins
– Minerals
– Protein
– Fibre

Free Sugars:

• Include mono and disaccharides added to food and drink by the manufacturer, cook or consumer AND sugars naturally present in honey, syrups and fruit juices.
– This does not include 1) lactose in milk and milk products and sugars contained within the cellular structure of food.

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6
Q

Carbohydrate Digestion:

A

Dietary Starch–>
(Salivary α-amylase- Stomach pH
Pancreatic α-amylase + Bicarbonate)
α-Dextrins–>(Isomaltase/Glucoamylase) Lactose, Maltose, Sucrose–>
Galactose, Glucose, Fructose–>
(SGL T1, 2Na+, Water + GLUT5) Galactose/Glucose + Fructose–>
(GLUT2+Na+, -K+, ATPase) Glucose, Galactose, Fructose–>
Liver

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7
Q

Total Carbohydrate Intake & Health: Total Carbohydrate & CVD?

A

• RR = 1.00 (0.89 to 1.12) per 8% EI ↑

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8
Q

Total Carbohydrate Intake & Health: Total Carbohydrate & CHD (per 8% EI ↑)

A

• No association (limited evidence)

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9
Q

Total Carbohydrate Intake & Health: Total Carbohydrate & BP?

A
  • SBP = 0.71mmHg (-0.71 to 2.14)

* DBP = 0.02mmHg (-0.81 to 0.86)

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10
Q

Total Carbohydrate Intake & Health: Total Carbohydrate & Blood Lipids *

A
  • [Total-C]= -0.16mmol/L (-0.28 to -0.04)
  • [LDL-C] = No effect (adequate evidence)
  • [HDL-C] = 0.03mmol/L (-0.06 to 0.01)
  • Total-C:HDL-C = -0.03 (-0.12 to 0.05)
  • LDL:HDL = 0.04 (-0.36 to 0.44)
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11
Q

Total Carbohydrate Intake & Health: Total Carbohydrate & Type II Diabetes?

A

• RR=0.96 (0.86 to 1.08) per 70g/d ↑

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12
Q

Total Carbohydrate Intake & Health: Total Carbohydrate & Blood Glucose?

A
  • [Glucose] = -0.01mmol/L (-0.06 to 0.04)

* [Insulin] = No effect (adequate evidence)

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13
Q

Total Carbohydrate Intake & Health: Total Carbohydrate & Fat-Free Mass?

A
  • FFM = 0.03kg (-0.77 to 0.83)
  • Fat Mass = 0.30kg (-0.01 to 0.62)
  • BM = -0.93kg (-1.87 to 0.01)

• BMI = Energy restricted HCHO-LFAT
may be better

• Waist Circumference = 0.04 (-1.26 to 1.34)

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14
Q

Total Carbohydrate Intake & Health: Total Carbohydrate & Colorectal Cancer?

A
  • RR = 1.00 (0.87 to 1.14) per 70g/d ↑
  • RR (colon) = 0.99 (0.89 to 1.08) per 70g/d ↑
  • RR (rectal) = 0.99 (0.86, 1.14) per 70g/d ↑
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15
Q

Total Carbohydrate Intake & Health Summary?

A

Total carbohydrate intake appears to be neither detrimental nor beneficial to cardio-metabolic health, colo-rectal health or oral health.

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16
Q

Total Carbohydrate Intake: DRV

A 
DRV drivers:
• No association between total CHO 
Intake and..
– CVD
– Type 2 diabetes
– Colo-rectal cancer

DRV:
• Men = ~50% of total EI
• Women = ~50% of total EI

Current Intake:
• M (19-64y) = 251g/d (47.8%)
• W (19-64y) = 197g/d (48.2%)

17
Q

Total Sugar Intake - Oral Health?

A

Carbohydrate–> (Bacteria)

Lactic acid/acetic acid–>

↓ Dental Plaque pH–>

Dental Enamel Dissolves–>

Dental Caries

• A 1% increase in % energy intake from “total sugar” is
associated with a 1.2%, 0.9% and 0.9% increase in the probability of DMFS, approximal DMFS, and pit and fissures.

18
Q

Confectionary Intake - Oral Health?

A

• A child who consumes sweets daily/couple of times a week is 5.5 times more likely to have poor dental
health than those who eat sweets < once/wk

19
Q

Sugar Sweetened soft drinks – BMI?

A

• Sugar-containing drinks result in weight gain, fat accumulation and increases in BMI in normal-weight children.

20
Q

Free Sugar Intake?

A

DRV drivers:
• Insufficient evidence for individual sugars

• Sugar intake/sugar sweetened products 
related to..
– ↑Dental caries (children, adolescents)
– ↑ Energy Intake (obesity)
– ↑Type 2 diabetes

DRV (adult):
• M&W = ≤5% of EI from free sugar

• M&W = Sugar sweetened beverages should
be minimised.

Current Intake:
Intrinsic Sugar
• M = 37.2g/d
• W = 35.3g/d

Non-Milk Extrinsic Sugar
• M = 68.4g (11.9%)
• W = 49.2g/d (11.1%)

21
Q

Guidance on design suitable advice:

A

In individuals who are a healthy BMI and in energy balance, free sugar intake should be replaced by:

  • Starches, sugars contained within the cellular structure of foods and
  • lactose naturally present in milk and milk products (for those who consume dairy products)

In individuals who are overweight, the reduction of free sugars would be part of a strategy to decrease energy intake.

22
Q

Glycaemic Index:

A

• The GI of a single food item is calculated by comparing the blood glucose response over the 2h period following food ingestion to that of a reference food (usually glucose).

• Foods are categorised as low GI (<55), 
moderate GI (55-70) and high GI (>70)

DRV Considerations:
• High GI/GL associated with ↑
– Type 2 diabetes
– CVD

• BUT, confounded by other variables:
2 hour blood glucose AUC in response to test food (50g CHO)
divided by:
2 hour blood glucose AUC in response to 50g glucose

23
Q

Factors Influencing the GI?

A

• Particle size/Mastication (chewing)

• Cell wall structure (intact, ripening)
– Ripe = ↑GI

• Lipid/Protein/Fibre content

• Amylose: Amylopectin Content
– AP more rapidly digested

• Monosaccharide composition
– Fructose = ↓GI

• Molecular CHO composition
– Alternative bonds to α(1-4)and α(1-6) = ↓GI

• Gastric emptying

24
Q

Dietary Fibre Intake: Old definition vs New definition?

A

Old Definition:
• Non starch polysaccharides (NSP) where this refers to non alpha-glucans

• Englyst Method

New Definition:
• All carbohydrates that are neither digested nor absorbed in the small intestine and have a degree of polymerisation of three or more monomeric units, plus lignin.

• AOAC method

25
Q

Dietary Fibre Intake: Non-starch polysaccharides?

A

• Contain (β1-4 glycosidic bonds) and is not digestible.

• Physiological effects of dietary fibre are determined by the structure of fibre (laxation, blood glucose, blood cholesterol)
– Insoluble Fibre
– Soluble Fibre

26
Q

Dietary Fibre Intake: Resistant Starch?

A

Resistant Starch:
• Naturally occurring and via
food processing

• 5 Types:
– Barriers (eg plant cell wall) 
prevent breakdown
– Crystalline structure 
prevents breakdown
– Formed when cooking/cooling 
prevents breakdown
– Chemically modified starch 
prevents breakdown
– Amylose-lipid complex 
formation prevents 
breakdown
27
Q

Dietary Fibre Intake: Lignin and Oligosaccharides?

A 
Lignin
• Branched polymer (not a 
carbohydrate), but located 
in close proximity to 
fibrous polysaccharides.

Oligosaccharides:
• Raffinose, Stachyose,
Verbascose, Inulin,
Fructo-oligosaccharides

• Chemical bonds are not α1-
4 or α1-6 and therefore 
cannot be broken down by 
pancreatic amylase or 
disaccharidases.
28
Q

Dietary Fibre Intake & Health: results?

A

Total Fibre & CVD:
• RR=0.91 (0.88 to 0.94) per 7g/d ↑

Total Fibre & CHD:
• RR=0.91 (0.87 to 0.94) per 7g/d ↑

Total Fibre & Stroke:
• RR= 0.93 (0.88 to 0.98) per 7g/d ↑

Total Fibre & Type 2 Diabetes (per 7g/d↑)
• Risk Ratio = 0.94 (0.90 to 0.97)

Total Fibre & Faecal weight/transit time
• Positive association (1g=4g faecal weight)

Total Fibre & Colorectal Cancer
• RR = 0.92 (0.87 to 0.97) per 7g/d ↑

Total Fibre & Colon Cancer
• RR = 0.93 (0.89 to 0.98) per 7g/d ↑

Total Fibre & Rectal Cancer
• RR = 0.91 (0.86 to 0.97) per 7g/d ↑

29
Q

Dietary Fibre Intake: DRV?

A 
DRV drivers:
• Based upon reduced risk of
– Type II diabetes
– CVD risk, 
– Colo-rectal cancer

• AOAC method
(methodological issues)

DRV (adult):
• M&W = 30g/d

• (note: equivalent to 24g/d using old
method)

Current Intake:
• Men = 15g/d

  • Women = 13g/d
  • (old method DRV = 18g/d)

Diet and nutrition (8 decks)

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