4/4/2019

The Carbohydrates:
Sugars, Starches and Fibers

Emmy Hainida Khairul Ikram

Centre of Nutrition and Dietetics
Faculty of Health Sciences
UiTM Puncak Alam

LEARNING OUTCOMES
1. Identify the monosaccharides, disaccharides, and
polysaccharides common in nutrition by their
chemical structures and major food sources.

1. Explain how the body maintains its blood glucose

concentration and what happens when blood
glucose rises too high or falls too low.

2. Identify the health benefits of, and recommendations

for, starches and fibers.

Have you ever encountered a

person who excludes
carbohydrates in the diet?

Do you agree that

CHO can lead to
overweight /
obesity?

1
 4/4/2019

Not all carbohydrates are

created equal

Introduction
▪ Carbohydrates (CHO) supplying half or more of total
calorie intake.
▪ It is the major source of energy fuel.
• Brain and Muscles
▪ Roughly half of dietary CHO is in the form of
polysaccharides (starches & dextrins)
▪ The remaining half is supplied as simple sugars.

Introduction
▪ CHO: compounds composed of carbon (C), oxygen
(O) and hydrogen (H).
▪ Carbo = carbon, hydrate = with water (H2O)
▪ Dietary carbohydrate can be found from:
i. Naturally occurring carbohydrates
ii. Synthetic carbohydrates
▪ Example of CHO food: Rice, noodles, kuey-teow,
spaghetti, bread, bun, flour, biscuits, sweetened
beverages.

2
 4/4/2019

MALAYSIAN FOOD PYRAMID

Carbohydrates
Naturally occurring
carbohydrates

Simple Complex

Monosaccharides Oligosaccharides
(1 sugar unit) (3-10 sugar units)

Disaccharides Polysaccharides
(2 sugar units) (>10 sugar units)

Glucose
Condensation –
Links two monosaccharides
Monosaccharides together
Fructose Hydrolysis –
Breaks a disaccharide in two

Galactose

+
Lactose Glucose Galactose

+
Sucrose Glucose Fructose
Disaccharides

+
Maltose Glucose Glucose

3
 4/4/2019

Starch
Glucose
Polysaccharides Glycogen

Dietary fiber

Carbohydrate: Monosaccharides
▪ Normally present as free molecules in nature.
▪ Glucose
▪ Most widely distributed sugar in nature.
▪ ‘Blood sugar’ is referred to glucose.
▪ Fructose
▪ Sometimes known as levulose or fruit sugar.
▪ The sweetest of all monosaccharides.
▪ Galactose
▪ Produced from lactose (milk sugar) by
hydrolysis.

Carbohydrate: Disaccharides
▪ These sugars are formed from monosaccharides joined
by a glycosidic linkage.
▪ Sucrose
▪ Honey is made up of glucose and fructose produced by the
action of honeybee sucrase and amylase enzymes on
sucrose in nectar.
▪ Lactose
▪ Also known as milk sugar.
▪ Made almost exclusively in the mammary glands of lactating
animals.
▪ Maltose
▪ Seldom found naturally in food.

4
 4/4/2019

Carbohydrate: Oligosaccharides
▪ Can be found in beans, peas, bran and whole
grains.
▪ Human digestive enzymes do not hydrolyze
them, but the bacteria within the intestine can digest
them.
▪ This is the basis for flatulence that occurs after
eating these foods.

Carbohydrate: Polysaccharides
▪ Starch
▪ Storage form of carbohydrates in plant.
▪ Plants make two types of starch: Amylose and
Amylopectin.

Carbohydrate: Polysaccharides
▪ Glycogen
▪ The major form of stored carbohydrate in animal
tissue which is localized primarily in liver and skeletal
muscle.

5
 4/4/2019

Carbohydrate: Dietary fiber

▪ Dietary fibers are not digestible by gastrointestinal
enzymes.
▪ Resistant starches does not digested in small
intestines and resist to digestion. Common in raw
potatoes, whole legumes and unripe bananas.

Carbohydrate: Dietary fiber

▪ Total fiber is the sum of dietary fibers and functional
fibers.
▪ Insoluble fiber – Does not dissolve in water. Also
known as less soluble fiber.
▪ Soluble fiber – Dissolve in water.

*Phytic acid is a non-nutrient component commonly

found in fibrous food. It binds and prevents mineral
absorption but until now researchers have been unable to
determine whether it is the dietary fiber, phytic acid or
both.

Carbohydrate: Dietary fiber

Soluble Insoluble
Functions Slows digestion and assist the Increase the movement of
body in absorbing vital waste through the intestinal
nutrients from foods tract

Properties Dissolve in water, forms gels Do not dissolve in water, do

(viscous), and are easily not form gels. And are less
digested by bacteria in colon readily fermented.
(fermentable)
Health Most often associated with Alleviate constipation and
impact protecting against heart may reduce the risk of colon
disease and diabetes cancer.

Sources Oats, barley, legumes, citrus Whole grains (bran), and

fruits vegetables and fruits with
skin

6
 4/4/2019

Carbohydrate: Glycemic Response

▪ Glycemic response – Measure of the speed of glucose
absorption, level of blood glucose, and return to normal
glucose levels

Regulating Blood Glucose:

 Glycemic Response: The rate, magnitude, and duration

of the rise in blood glucose that occurs after a food or
meal is consumed. – how quickly and how high blood
glucose rises after carbohydrate is consumed.
 Refined sugars and starches generally causes a great
glycemic response compared to unrefined foods.
 The presence of fats and protein also slows stomach
emptying and therefore, foods high in these
macronutrients generally cause less glycemic response.
 Glycemic response can be quantified by its glycemic
index.

Glycemic Index
 Glycemic index: a ranking of how a food
affects blood glucose compared to the
response of a reference food such as bread
or pure glucose.
 A method of classifying foods according to
their potential for raising blood glucose.
 Food that have glycemic index 70 or more
compared to glucose are considered high
glycemic index foods, those with glycemic
index 55 are considered low glycemic index
foods.

7
 4/4/2019

Carbohydrate and health

Carbohydrate: Recommendation
▪ World Health Organization (WHO) suggested the
intake of total carbohydrate should be from 55% to 75%
of total energy.
▪ This suggestion is for prevention of diet-related chronic
disease.
▪ The same recommendation has been made by the joint
FAO/WHO expert consultation.

Carbohydrate: Recommendation
▪ For Malaysian, the RNI recommended CHO should
comprise 55-70% of total energy.
▪ Sugar intake is recommended not more than 15% o
total energy.
▪ RNI also recommended fiber intake should be 20-30g
per day for all age groups.

8
 4/4/2019

Carbohydrate: Malaysian Food Pyramid

Carbohydrate: Serving size

4-8 servings daily

Carbohydrate: Food labels

Food labels Sugar and fiber on food labels

Sugar-free • Product contains no amount, or a trivial amount

of sugars (<0.5g per serving). Synonym for
‘free’ include ‘without’, ‘no’, ‘zero’.
Reduced sugar • Nutritionally altered product contains 25% less
sugar than the reference food. ‘Fewer’ may be
used as well.
No added • No sugar or sugar-containing ingredient is
sugars or added during processing
without added
sugars

9
 4/4/2019

Carbohydrate: Food labels

Food labels Sugar and fiber on food labels

High fiber • Food contains 20% or more of the daily value

for fiber per serving. Synonyms for ‘high’
include ‘rich in’ and ‘excellent source of’.
Good source of • Food contains 10% to 19% of the daily value
fiber for fiber per serving. Synonyms for ‘good
source of’ include ‘contains’ and ‘provides’
More fiber • Food contains 10% or more of the daily value
for fiber preserving than an appropriate
reference food. Synonyms for ‘more’ include
‘added’ (or ‘fortified’ and ‘enriched’), extra, or
‘plus’.

Carbohydrate: Alternative sweeteners

1. Saccharin
▪ 200-700 times sweeter than sugar
▪ No warning labels required since May 2000
2. Aspartame
▪ Made of aspartic acid and phenylalanine
▪ Can be dangerous to people with Phenylketonuria
3. Sucralose
▪ Sold under the name ‘Splenda’
▪ Derived from sugar

Carbohydrate: Alternative sweeteners

4. Acesulfame K
▪ 200 times as sweet as sugar
▪ Heat stable
5. Neotame
▪ Similar to aspartame, with stronger chemical bond
(cannot be broken down easily)
▪ 7000-13,000 times sweeter than sugar
6. Sugar alcohols
▪ Chemical derivatives of sugar
▪ Low-calorie: 0-2-3 kcalories/ gram
▪ Can be described as ‘sugar free’ on food labels.

10
 4/4/2019

ENERGY YIELDING NUTRIENTS

Thank You

11
 4/4/2019

Energy Balance and

Body Composition

PRINCIPLES OF ENERGY BALANCE

• Standard energy unit : Joule/kilojoules

• 1 kCal or cal= 4.184 kJ, sometimes written as Calorie.
• Energy cannot ‘disappear’, food energy eaten has to
be excreted in the faeces, or absorb by the body
• Once absorb
= small amount excreted in the urine
= stored in the tissue in the form of glycogen

Energy In: Food Composition

• Direct measure of
food’s energy value
(Direct calorimetry)
• Bomb calorimetry
• measures the amount
of heat release.
• Indirect calorimetry
• Measure oxygen
consumed

12
 4/4/2019

Energy Balance

• Excess energy is stored as fat

• Energy balance: energy in = energy out
• A shift in balance causes weight changes
• Not simply fat changes

Nutrient Balance: Rate of macronutrient intake = rate of

oxidation

Energy Balance

•Type of energy •Metabolism

•Amount at •Daily Activity
one time •Exercise-type
•Timing of meals and intensity
•Energy stored •Thermal effect
in body of meals

Energy INTAKE Energy Expenditure

Energy In: Food Intake

• Food Intake; Regulated by

• Appetite initiates eating through the sight, smell, thought or
taste of food.
• Hunger is the feeling that motivates us to eat and is
controlled by the hypothalamus.
• Satiation is the feeling of satisfaction and fullness that
causes us to stop eating.
• Satiety reminds us not to eat again until the body needs
food.

13
 4/4/2019

Energy In: Food Intake

• Food Intake
• Overriding Hunger and Satiety
• Stress eating is eating in response to arousal.
• Cognitive influences such as perceptions, memories, intellect, and
social interactions.

• Sustaining Hunger and Satiety

• Protein is the most satiating.
• Complex carbohydrates are satiating.
• High Fiber foods.
• High-fat foods – strong satiety signals.
• High-fat foods stimulate and entice people to eat more.

QUESTIONS/DISCUSSIONS

• What are the cognitive influences that may affect our

food intake?
• Most satiating food comes from__________
• Energy Balance

14
 4/4/2019

Energy Expenditure

Metabolism: Age, gender, body composition,

diet, exercise, stress, disease, drugs

Daily Activity: Sedentary daily life activities

Physical Activity

vs busy or active life

Exercise: Aerobic vs Resistant training,

Duration and intensity

Thermal Effect of Meals: Type and Number

of Meals

Energy Out: Basal Metabolism

• About two-thirds of energy expended in a day

• Metabolic activities
• All basic processes of life
• Basal metabolic rate (BMR)

15
 4/4/2019

Nutrition NAD403

Energy Out: The kCalories the Body Expends

• Components of Energy Expenditure
• Thermic effect of food (TEF) is estimated at 10% of total
energy intake and involves digestion and absorption.
• Carbohydrate 5-10%
• Fat 0-5%
• Protein 20-30%
• Alcohol 15-20%
• Adaptive thermogenesis is the adjustment in energy
expenditure related to environmental changes.

Energy Out: Physical Activity

• Voluntary movement of skeletal muscles

• Most variable component of energy expenditure
• Amount of energy needed
• Frequency, intensity, and duration

16
 4/4/2019

Defining Healthy
Body Weight?

MOOC UITM

Defining Healthy Body Weight

• Ideal
• Not appearance based
• Perceived body image and actual body size
• Damaging behaviors
• Little in common with health

Defining Healthy Body Weight

• Body mass index

• Relative weight for height
• BMI = weight (kg)
height (m)2
• Health-related classifications
• Healthy weight: BMI = 18.5 to 24.9
• Other classifications
• Not a measure of body composition
• Variations

17
 4/4/2019

Classification of weight by BMI

Classification BMI BMI Risk of co-morbidities

(kg/m2) (kg/m2)
Caucasians Asians
Underweight <18.5 <18.5 Low

Normal range 18.5 – 24.9 18.5-22.9 Increased but acceptable

risk

Overweight 25.0 – 29.9 >23

Pre-Obese 23.0-27.4 Increased.

Obese I 30.0-34.9 27.5-34.9 High

Obese II 35.0-39.9 35.0-39.0 Very High

Obese III >40.0 >40 Extremely high

Body Weight, Body Composition, and Health

• Defining Healthy Body Weight

• The Criterion of Fashion
• Society values change over time.
• Perceived body images

• The Criterion of Health

• Good health supercedes appearance.
• Longevity is a criterion.

BMI and Body Shapes

18
 4/4/2019

Body Fat and Its Distribution

• Important information for disease risk

• How much of weight is fat?
• Where is fat located?
• Ideal amount of body fat depends on person

Energy Stores

• Adipocytes – contain
droplets of fat surrounded
by other cell components.
As body fat gained, the
size of the fat droplets
increases.

7-19

Body Fat and Its Distribution

• Needing less body fat

• Some athletes
• Needing more body fat
• Example groups

19
 4/4/2019

Body Weight, Body Composition, and Health

• Body Fat and Its Distribution

• Fat Distribution
• Intra-abdominal fat around abdominal organs may be
critical.
• Central obesity is excess fat around the trunk of the
body. It is also called abdominal fat or upper-body fat.
• Associated with increased risks

Visceral Abdominal Fat

• Fat mainly around the waist is more likely to develop health

problems than fat mainly in hips and thighs.

• This is true even if BMI falls within the normal range.

“Apple” and
“Pear” Body
Shapes

20
 4/4/2019

Body Fat and Its Distribution

• Waist circumference
• Indicator of fat distribution & central obesity
• Women: greater than 35 inches (>88 cm)
• Men: greater than 40 inches (>102 cm)
• Waist-to-hip ratio (men: 0.9; women:0.8)
• Other techniques for body composition

Health Risks Associated with Body

Weight & Body Fat

• Body weight and fat distribution correlate with disease risk and life
expectancy

Health Risks Associated with Body

Weight & Body Fat

• Inflammation & metabolic syndrome

• Change in body’s metabolism
• Cluster of symptoms
• Fat accumulation
• Inflammation
• Elevated blood lipids
• Promote inflammation

21
 4/4/2019

Underweight

• Risks associated with being underweight

• Fighting against wasting diseases
• Menstrual irregularities and infertility
• Osteoporosis and bone fractures

Thank You

22