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HNSC 2170 > Unit 2: Carbohydrates > Flashcards

Unit 2: Carbohydrates Flashcards

1
Q

what are monosaccharides

A
  • simple sugars
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2
Q

list 3 types of monosaccharides

A
  1. glucose
  2. fructose
  3. galactose
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3
Q

what is the purpose of glucose in the body (2)

A
  • fuel for cells

- exclusive energy source for the brain & nervous system

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4
Q

list some examples of where fructose is found (3)

A
  • fruit, honey, and table sugar
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5
Q

what is galactose? when is it freed?

A
  • part of the 2 sugar structure of lactose

- freed during digestion

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6
Q

list 3 types of disaccharides (3)

A
  1. sucrose
  2. lactose
  3. maltose
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7
Q

what is sucrose? what is it made of?

A
  • table sugar

- glucose + fructose

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8
Q

what is lactose?

A
  • principal carb found in milk
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9
Q

what is lactose made of?

A
  • glucose + galactose
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10
Q

what is maltose? what is it made of?

A
  • product of starch breakdown

- glucose + glucose

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11
Q

what type of dissacharide do many people lose the ability to break down?

A
  • lactose
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12
Q

why are carbohydrates important? (4)

A
  • ideal to meet our body’s energy needs
  • fuels the brain & NS
  • keeps our digestive tract fat & in ideal working order
  • keeps our body lean
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13
Q

what do carbohydrates contain

A
  • carbon, hydrogen & oxygen (CHO)
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14
Q

where do CHO rich foods exclusively come from?

A
  • plants
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15
Q

what is the only animal derived food that contains significant amounts of CHO?

A
  • milk
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16
Q

what are 3 types of carbs?

A
  1. monosaccharides
  2. disaccharides
  3. polysaccharides
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17
Q

what are polysaccharides

A
  • complex carbs

- long chains of mostly glucose linked together

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18
Q

what are 3 types of polysaccharides

A
  1. glycogen
  2. starch
  3. fibres
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19
Q

what is glycogen

A
  • most highly branched glucose chains

- storage form of glucose

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20
Q

what is starch?

A
  • long, straight, or branched glucose chain

- energy storage for plants

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21
Q

what are the 3 highest sources of starch

A
  1. grains
  2. legumes
  3. root veggies (such as potatoes)
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22
Q

what are resistant starches

A
  • these are considered to be fibre bc they are not broken down by humans
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23
Q

why are resistant starches important?

A
  • support a healthy colon
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24
Q

describe how fibres are passed thru the human body

A
  • human digestive enzymes cannot break their chemical bonds

= they pass thru the body without providing energy

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25
Q

what are the 2 groups of fibres

A
  1. soluble fibres

2. insoluble fibres

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26
Q

what are soluble fibres

A
  • fibers that dissolve in water
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27
Q

what are 2 benefits of soluble fibers

A
  1. can form a gel in the intestine & be fermented to provide some nutritional benefit in the form of energy
  2. associated with lower risk of chronic disease
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28
Q

what are some examples of soluble fibres (5)

A
  • barley
  • legumes
  • fruits
  • veggies
  • oats
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29
Q

what are insoluble fibers

A
  • fibers that do not dissolve in water
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30
Q

what are 2 benefits of insoluble fibers

A
  1. provide dietary roughage

2. ease elimination

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31
Q

what are examples of insoluble fibers (4)

A
  • bran
  • celery
  • seed hulls
  • corn kernel skins
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32
Q

list 3 poly/disaccharides fiber contains

A
  • hemicellulose
  • pectin
  • gums & mucilages
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33
Q

where is hemicellulose found

A
  • in cereal fibers
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34
Q

where is pectin found

A
  • found in fruits & veggies
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35
Q

where are gums & mucilages found

A
  • used as additives & stabilizers in food industry
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36
Q

what causes lactose intolerance

A
  • when people lose their ability to produce lactase & therefore their ability to digest lactose
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37
Q

as we age, approximately ___% of the world’s population lose their ability to produce lactase

A

75

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38
Q

which population has the lowest rates of lactose intolerance?

A
  • northern european
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39
Q

how much milk can a person w lactose intolerance tolerate without symptoms?

A
  • 2 cups of milk daily
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40
Q

what does regular consumption of milk by someone with lactose intolerance result in?

A

regular consumption of milk products =

- increased metabolism by intestinal bacteria = improved tolerance

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41
Q

what should nurses encourage people w lactose intolerance to do? what are 2 tips we can give people who do this?

A
  • gradually increase their tolerance
    1. aged cheese is a good choice bc there is less lactose
    2. may take with food to ease discomfort
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42
Q

what should patients do if lactose intolerance follows illness

A
  • should temporarily restrict milk products
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43
Q

list 4 ingredients that do not contain lactose

A
  • lactic acid
  • lactalbumin
  • lactate
  • casein
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44
Q

list 3 treatments of lactose intolerance

A
  • lactase enzyme drops to milk
  • tablets ???
  • probiotics (shown to improve lactose intolerance)
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45
Q

what should you do if you are reducing foods containing lactose

A
  • supplement foods with foods high in vitamin D and calcium
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46
Q

list 3 examples of lactose free sources of calcium

A
  • canned salmon & sardines
  • fortified plant-based beverages
  • calcium-fortified 100% fruit juices
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47
Q

what are 4 examples of fortified plant-based beverages

A

calcium fortified:

  • almond
  • coconut
  • rice
  • soy beverages
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48
Q

list 5 examples of lactose free sources of vitamin D

A
  • fish
  • liver
  • egg yolks
  • non-hydrogenated margine
  • some plant-based beverages like soy & rice
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49
Q

list 5 health conditions which fiber rich foods plays a role in helping manage & prevent

A
  • cardiovascular disease
  • diabetes
  • GI conditions (diverticular disease & constipation)
  • colon cancer
  • obesity
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50
Q

how does fiber help protect against heart disease & stroke? (3)

A
  • lowers BP
  • improves blood lipids
  • reduces inflammation
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51
Q

describe the role of fiber in the prevention of type 2 diabetes

A
  • regulates BG by trapping nutrients & delaying their absorption
  • prevents glucose surge & rebound
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52
Q

describe the role of fiber in GI health

A
  • enhances large intestinal health

- fermentable soluble fibers helps sustain colonic bacteria

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53
Q

describe fiber’s role in weight management

A
  • prevents weight gain
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54
Q

what is a harmful effect of excessive fiber intake

A
  • if too much fibre is consumed, some minerals may bind to it & be excreted with it without becoming available for the body to use
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55
Q

what is diverticular disease

A
  • presence of pebble sized herniations (outpockets) in the colon’s mucosa
  • basically little bumps all over the large intestine
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56
Q

what is diverticulitis

A
  • when the pouches or sacs in the colon become inflamed or infected
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57
Q

what are symptoms of diverticulitis (4)

A
  • pain or tenderness, typically in the left lower abdomen
  • constipation
  • NVD
  • fever
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58
Q

how does fibre intake related to diverticular disease

A
  • low fiber diet increases the risk of developing this condition
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59
Q

what is constipation

A
  • difficult passage of stool
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60
Q

what are common causes of constipation (6)

A
  • low fibre
  • not enough fluids
  • limited daily activity
  • not going to the washroom when you feel the urge
  • change in your daily routine such as travelling
  • side effects from iron or calcium supplements & meds
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61
Q

list 5 diseases & health conditions that can cause constipation

A
  • underactive thyroid
  • diabetes
  • celiac disease
  • irritable bowel syndrome
  • hemorrhoids
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62
Q

what is nutritional treatment for constipation (4)

A
  • high fibre foods
  • increased fluid intake
  • increased physical activity
  • foods with laxative effect
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63
Q

what are 3 examples of foods with a laxative effect that can help ease constipation

A
  • prunes
  • pears
  • apples
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64
Q

what structures play a role in sugar & starch digestion/absorption (4)

A
  • mouth & salivary glands
  • stomach
  • small intestine & pancreas

see chart in notes for details

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65
Q

what is the mouth’s and salivary gland’s role in sugar & starch digestion

A
  • salivary glands secrete salivia into the mouth which moistens the food
  • the salivary enzyme amylase begins digestion
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66
Q

what is the role of the stomach in sugar & starch digestion

A
  • stomach acid inactivates salivary enzymes = halts starch digestion
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67
Q

what is the role of the small intestine & pancreas in sugar & starch digestion/absorption (3 steps)

A
  • pancreas produces an amylase that is released thru the pancreatic duct into the small intestine
  • enzymes on the surface of the small intestine break down disachharides into mono
  • intestinal cells absorb the monosaccharides
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68
Q

what structures are involved in the digestion/absorption of fibre

A
  • mouth
  • stomch
  • small intestine
  • large intestine
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69
Q

what is the role of the mouth in fiber digestion/absorption

A
  • mechanical action of the mouth crushes fiber in food

- salivia mixes with the food to moisten it for swallowing

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70
Q

what is the role of the stomach in fiber digestion/absorption

A
  • fiber is not digested

- delays gastric emptying

71
Q

what is the role of the small intestin in fiber digestion/absorption

A
  • fiber is not digested
  • passes thru intact to the large intestine
  • delays absorption of some nutrients
72
Q

what is the role of the large intestine in fiber digestion/absorption

A
  • bacterial enzymes digest soluble fibers which are immediately absorbed by the large intestine
  • insoluble fibers remain intact, retain water & bind to substances to carry them out of the body
73
Q

what 2 hormones play a role in regulation of BG? where are they released from?

A
  • released from the pancreas
    1. insulin
    2. glucagon
74
Q

how does insulin regulate BG (2)

A

overall, lowers BG by:

  • promotes glucose uptake from blood into muscle & adipose tissue
  • muscle & liver cells respond by coverting glucose into glycogen
75
Q

how does glucagon regulate BG(1)

A

overall, raises BG by:

- stimulating breakdown of glycogen in the liver to glucose

76
Q

what is our normal fasting BG

A

4-6 mmol/L

77
Q

what is hypoglycemia? what BG level is it?

A
  • low BG

<4 mmol/L

78
Q

what are symptoms of a dropped blood sugar (<3.5, not severe)

A
  • shakiness
  • nervous, anxious
  • tachycardia
  • sweaty
  • weakness
  • nausea
  • hungry
  • irritable
  • numbness or tingling on tongue or lips
79
Q

what are signs of a very low blood sugar (<2.8)

A

these are more severe

  • confusion
  • disorientation
  • seizure
  • loss of consciousness
  • coma
  • light headedness
80
Q

what is hyperglycemia? what BG level is it?

A
  • high blood glucose

>11 mmol/L

81
Q

what are some symptoms of hyperglycemia

A
  • extreme thirst
  • hunger
  • frequent urination & bedwetting
  • exhaustion
  • confusion
  • headache
82
Q

list 4 things that may cause hypoglycemia

A
  • increased physical activity
  • NPO
  • too much meds (ex, insulin)
  • excessive alcohol intake
83
Q

what is treatment for hypoglycemia?

A
  • eat or drink a fast-acting carb

- sugar, honey, soft drinks

84
Q

when should you recheck your BG after hypoglycemia

A
  • in 15 min
85
Q

list 4 things that may cause hyperglycemia

A
  • increased food intake
  • decreased activity
  • meds
  • sick or stress
86
Q

what is treatment for hyperglycemia

A
  • adjust your meal plan
  • adjust your exercise routine
  • adjust your meds
87
Q

what is diabetes characterized by (2)

A
  • elevated BG levels

- problems with insulin metabolism

88
Q

what are 2 common forms of diabetes

A

type 1 & 2

89
Q

is type 1 or type 2 more common

A

type 2

90
Q

what is the age of onset for type 1 vs type 2

A
  • type 1 = <30 yrs

- type 2 = >40 years (but increasing in adolescents)

91
Q

what are associated conditions/risk factors with type 1 vs type 2

A
  • type 1 = autoimmune diseases, viral infection, inheritied factors
  • type 2 = obesity, aging, inherited factors
92
Q

what is the major defect in type 1 vs type 2

A
  • type 1 = destruction of beta cells –> insulin deficiency

- type 2 = insulin resistance, insulin deficiency relative to needs

93
Q

describe insulin secretion in type 1 vs type 2

A
  • type 1 = little or non

- type 2 = variable

94
Q

describe requirement for insulin therapy in type 1 vs type 2

A
  • type 1 = all cases

- type 2 = some cases

95
Q

what are 2 former names of type 1 diabetes

A
  • juvenille diabetes

- insulin dependent

96
Q

what are 2 former names of type 2 diabetes

A
  • adult-onset diabetes

- noninsulin-dependent diabetes

97
Q

what is prediabetes

A
  • elevated BG levels below the threshold for diagnosis
98
Q

prediabetes can increase a person’s risk of developing ______ and _____ later in life

A
  • type 2 diabetes

- heart disease

99
Q

how can an individual with prediabetes reduce their future risk of developing type 2 diabetes & heart disease (3)

A

lifestyle changes:

  • weight reduction (5-10% of body weight)
  • increased physical activity
  • dietary modification
100
Q

what dietary modifications should someone with prediabetes make (3)

A
  • increased intake of fiber & whole grains

- reduced intake of fat

101
Q

what is insulin resistance

A
  • when insulin is present but is not effectively moving the glucose into the cells
102
Q

what are 2 consequences of insulin resistance

A
  • hyperglycemia

- insulinemia

103
Q

insulin resistance is thought to be a metabolic consequence of________? why?

A
  • obesity

- bc obese individuals require more insulin to maintain normal BG

104
Q

insulin resistance is characteristic of ___??

A
  • type 2 diabetes
105
Q

describe the relation between nutrition therapy & diabetes (2)

A

can assist in:

  • improving blood sugar control
  • slow the progression of complications associated with diabetes
106
Q

what must be considered when making nutrition recommendations for people with diabetes (4)

A 
must be modified to accomodate the patient's:
- lifestyle habits
- age
- personal preferences
- other health conditions
etc.
107
Q

describe carb intake recommendations for someone w diabetes (3)

A
  • day-to-day consistency in carb intake recommended
  • carb intake should be tailored to the type of diabetes, metabolic need, etc.
  • should be all be sources from whole food if possible
108
Q

describe fat recommendations for someone w diabetes

A
  • should be largely unsaturated
109
Q

describe whole grains & fibre recommendations for someone w diabetes

A
  • normal DRI of whole grains & fibre
110
Q

what is glycemic index

A
  • a ranking of carbs based on their effect on BG levels after digestion compared to a standard
  • includes how fast & how much the food causes a rise in BG
111
Q

what does lower GI mean

A
  • less glycemic effect = causes a lower & slower rise in BG
112
Q

what factors influence a food’s glycemic index (3)

A
  • fibre content
  • prep method
  • what the carb is combined with
113
Q

foods with what glycemic index should people aim to select

A
  • low glycemic index (high fibre, minimal processing)
114
Q

does sugar or starch have a lower glycemic index

A
  • sugar
115
Q

what are sugar intake recommendations for someone w diabetes

A
  • sugar intake recommendations similar to normal population
116
Q

what are alcohol guidelines for someone with diabetes? what about when on insulin?

A
  • same as normal pop

- on insulin, eat food with alcohol to prevent hypoglycemia

117
Q

what is the alcohol recommendation for men? women?

A
  • women = 1 drink daily

- men = 2

118
Q

how many drinks can exacerbate hyperglycemia

A
  • 3 or more
119
Q

what is 1 meal planning strategy for people w diabetes

A
  • carbohydrate counting
120
Q

why is carbohydrate counting so effective for people w diabetes (2)

A
  • research shows that it is the total amt of CHO that matters most for BG control
  • also very flexible
121
Q

what is 1 con to CHO counting

A
  • require math & portioning
122
Q

describe how carbohydrate counting works

A
  • pt meets with a dietitian to discuss usually intake
  • pt given a daily carb allowance, expressed in grams or carb portions
  • pt can select from any of the carb-containing food groups as long as they meet the carb goals
123
Q

what are carbohydrate portions/choices

A
  • portions expressed in terms of servings that contain about 15 g of carbs each
124
Q

what are 2 benefits of using the glycemic index

A
  • to achieve better BG control

- to lose weight

125
Q

what are the 3 GI categories and what GI range is each?

A
  • low = 55 or less
  • medium = 56-69
  • high = 70 or more
126
Q

what are 3 benefits of physical activity for someone w diabetes?

A
  1. increased insulin sensitivity
  2. muscle glucose uptake
  3. glycemic control
127
Q

what should people w diabetes be cautious about while exercising

A
  • should be careful to prevent hypoglycemia

- check BG levels before & after

128
Q

people w diabetes should be medically evaliated for exercises which may aggravate issues such as…. (3)

A
  • feet
  • kidneys
  • NS
129
Q

what are naturally occurring sugar?

A
  • sugars found in whole foods

- are acceptable as they come with many nutrients

130
Q

sugar has been blamed for causing or increasing the risk of health problems such as… (4)

A
  • obesity
  • heart disease
  • nutrient deficiencies
  • dental caries
131
Q

despite common belief, sugar has not been shown to cause ______ or _______ in children

A
  • hyperactivity

- worsen behavior

132
Q

describe the relation between sugar & heart disease (3)

A

high sugar intake is directly correlated to blood lipid levels:
- increases likelihood of developing hyperlipidemia by (1) decreasing HDL and (2) impeding clearing of fats in the liver

133
Q

describe the relation between sugar & type 2 diabetes

A
  • high sugar intake increases the incidence of high body fat, which is associated with DM2
134
Q

what causes links between high sugar intake & diabetes to be diminished

A
  • when overall calorie intake does not exceed normal ranges
135
Q

describe the relationship between sugar & nutritonal deficiencies

A
  • displaces important nutrients leading to deficiencies
136
Q

describe the relationship between obesity & fructose corn syrup? what is the recommendation?

A
  • high fructose corn syrup is largely attributed to obesity

- recommendation = 100/day for women & 150 for men

137
Q

describe the relationship between sugar & dental caries

A
  • all carbs promote dental caries

- but, total sugar intake is closely correlated to incidence of dental caries

138
Q

describe the role of saliva in the development of dental caries

A
  • saliva prevents the development
139
Q

list 3 things that promote saliva production

A
  • sugar free gum
  • cheese
  • veggies
140
Q

list 2 health conditions & 1 type of treatment that increases the risk of dental or oral diseases

A
  • DM
  • HIV
  • radiation treatment
141
Q

what are dental caries

A
  • tooth decay / cavities
142
Q

what causes dental caries

A
  • bacteria that reside in dental plaque metabolize dietary carbs & produces acids that attack tooth enamel
143
Q

describe different ways that carbs contribute to the development of dental caries (4)

A
  • the type of carb consumed
  • frequency of carb intake
  • stickiness of the foods that contain carb
  • the availability of saliva to rinse the teeth & neutralize acid
144
Q

what other factors contribute to the development / susceptibility to dental caries (3)

A
  • oral hygeine
  • fluoride intake
  • composition of tooth enamel
145
Q

what happens if dental caries (tooth decay) continue to progress?

A
  • the decay can penetrate the dentin & destory other structure that support & maintain the tooth
  • can lead to loss of the tooth
146
Q

define cariogenic

A
  • promote the development of dental caries
147
Q

what are considered the most cariogenic foods (3)

A

carb containing foods that:

  • remain in contact w the teeth for prolonged periods
  • are difficult to clear from the mouth
  • are consumed frequently
148
Q

what are examples of cariogenic foods (4)

A
  • hard candies or lozenges that dissolve slowly
  • sticky or chewy foods like dried fruit
  • starchy snack foods (chips)
  • sweetened beverages
149
Q

define dental plaque

A
  • a film of bacteria & bacterial by products that accumulates on the tooth surface
150
Q

define gingiva

A
  • the gums
151
Q

define gingivitis

A
  • inflammation of the gums
152
Q

what is gingivitis characterized by (3)

A
  • redness
  • swelling
  • bleeding
153
Q

define periodontal disease

A
  • disease that involves the CT that support the teeth
154
Q

define periodontitis

A
  • inflammation or degeneration of th e tissues that support the the teeth
155
Q

define periodontium

A
  • tissues that support the teeth

ex. gums, cementum, periodontal ligament, underlying bone

156
Q

what types of food help prevent caries?

A

foods that:

  • stimulate saliva flow
  • neutralize mouth acidity
  • induce the clearance of food particles from the teeth
157
Q

what are 2 types of alternative sweeteners?

A
  1. sugar alcohols

2. artifical sweeteners

158
Q

what are sugar alcohols

A
  • sugars that belong to the chemical family of alcohols based on their structure
159
Q

do sugar alcohols contain ethanol?

A
  • no
160
Q

what do sugar alcohols do (2)? give 4 examples

A
  • provide sweetness & bulk to foods such as
  • used to sweeten foods labelled “sugar free” or “no added sugar”
    1. cookies
    2. sugarless gum
    3. hard candies
    4. jam/jellies
161
Q

what are 3 benefits of sugar alcohols

A
  • lower glycemic response & yield less energy than sucrose
  • lower calorie option
  • do not contribute to dental caries
162
Q

how are sugar alcohols made/where are they found

A
  • found naturally in fruits & veggies

- or artificially manufactured

163
Q

artifical sweeteners are ____ times more sweeter than sucrose

A

200-600

164
Q

describe calories in artifical sweeteners

A
  • considered to be calorie-free bc so little is used
165
Q

list 4 examples of artifical sweeteners

A
  1. acesulfame potassium
  2. aspartame
  3. sucralose (splenda)
  4. stevia
166
Q

what is aspartame made of?

A

2 protein (amino acid) fragments

167
Q

what are the 2 protein fragments in aspartame

A
  1. phenylalanine

2. aspartic acid

168
Q

products containing aspartame have a warning for people w ____

A

phenylketonuria (PKU)

169
Q

what is phenylketonuria (PKU)?

A
  • inborn error of metabolism

- results in decreased metabolism of the amino acid phenylalanine hydroxylase

170
Q

what does decreased metabolism of phenylalanine hydroxylase cause? (3)

A
  • without this enzyme, phenylalanine accumulates in tissue - - causes severe damage to developing brain
  • prevents synthesis of tyrosine, epi, melanin, thyroxine
171
Q

what can untreated PKU lead to? (6)

A
  • intellectual disability
  • seizures
  • behavioral problems
  • mental disorders
  • musty smell
  • lighter skin
172
Q

what is the DRI for carbs

A
  • should contribute to about half (45-65%) of energy requirement
173
Q

what is the DRI for fiber

A
  • 14 grams per 1000 caloric intake

- upper limit of 40 g

HNSC 2170 (9 decks)

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