Carbohydrates

Prof. Dwi Prijatmoko, DDS, PhD

Empirical Formula Cn ( H2O)n n > 4

Summary of principle dietary CarbohydratesSourceMaize, Rice, PotatoSugarcane Beet SugarPoly-SachStarch

Oligo-SachGlucose Syrup

Di-SachMaltoseSucrose

Mono-SachGlucose Fructose + Glucose

AlcoholSorbitolMalitol Mannitol Sorbitol

Summary of principle dietary CarbohydratesSourceMilk

Poly-Sach

Oligo-Sach

Di-SachLactose

Mono-SachGalactose + Glucose

AlcoholGalactitol SorbitolLactitol

PolysaccharidesLittle Metabolic roleStarchCelluloseInulin(Renal Function Test)

DisacharidesSucrose: Fructose + GlucoseLactose : Galactose + Glucose Only in MilkMaltose: Glucose+ Glucose

Mono SacharidesGlucose : Main carbohydrate in the body.Fructose: Same formula as Glucose (beda rotasi)Pentose: 5 Carbon Essential component Nucleic Acids

AlcoholSorbitol: Had a therapeutic value as a replacement carbohydrate in the diet of DM & Parenteral feeding.Xylose & Xylitol: Alcohol of Pentose Less Cariogenic Less insulinogenic

Main Function of dietary CarbohydrateProvide EnergyTexture of foodAs sweeting agents

Carbohydrate as Energy SourceIntake of energy as carbohydrate Carbohydrate X Heat of combustion

CarbohydrateKcal/gKJ/gStarch4.1517.36Sucrose3.9616.57Fructose3.7615.73Glucose3.7515.69

DigestionAll carbohydrates have to be hydrolyzed into monosaccharide.- Can be absorbed- Crossed intestinal wall

After absorption- Portal Circulation- Liver

Take Home assignmentExplain how Cn(H2O)n is hydrolyzed through the Alimentary Tract, which commences in the mouthExplain how Monosaccharide is absorbed through the brush border

IntoleranceInability to hydrolyzed carbohydrate and absorb especially LaktoseOral Tolerance TestIs used in the diagnosis of Carbohydrate intolerance3. SymptomsAbdominal discomfortBorborygmiFlatulenceDiarrhea

Enzyme/ Carrier DeficiencyPrimer : Enzyme/Carrier defectLactase deficiency in adults2. Secondary : Arise due to disease/ disorder of the intestinal tract- Intestinal infection- Celiac disease

Relatives sweetness of various carbohydratesSugarSweetnessSucrose100Maltose40Lactose20Glucose70Fructose(Sweeter in cooler)115-170Sorbitol70Mannitol70Xylitol90

MetabolismGlucose : Common source of Energy to cellsCO2 + H2O+ ATPEnergy : Converted to Glycogen and fat Essential to brain and red cellsBrain140g glucose/dayRed cells 40g glucose/dayPregnancyRequires more glucose

GluconeogenesisIn Absence Carbohydrate130 g/day (Not enough)Ketone bodys oxidation !

Carbohydrate and Adipose tissueExcess energy intake is converted to fat.Adipose tissue : Over weightLiver : Fatty LiverPlasma : Free Fatty Acid Etherification

Carbohydrate Tolerance TestIs used to assess the ability to metabolize or absorb carbohydrateGlucose is given orally then :Blood Glucose is measured at various intervalAny values above normal : Inadequate handling of glucose

Short Home workWhat is the normal value of glucose concentration in venous blood and capillary blood during fasting and 2 hours post prandial (2JPP)How about those with DM?What is by mean of Glycemic Index (GI) of Food?What is the knowledge of GI to DM patient?

Carbohydrate and serum lipidDietary CarbohydrateEffect level of serum lipidFructose is more lipogenic GlucoseAll dietary Carbohydrates reduce High Density Lipoprotein Cholesterol (HDL Cholesterol)

Carbohydrate and diseaseCarries : No Correlation between Sucrose and dental caries, but interaction between carbohydrate + time + mycobacterium.Obesity: Excess energy is stored as FM. Sucrose, Fructose provide more weight gain than that of glucose

3. Diabetes MellitusThe relationship between DM and Carbohydrate consumption is conflicting.Sucrose consumption = Blood glucose(Am Diabetes mellitus Assoc Report : Diabetes 20:633-634. 1971) draw consensus regarding Carbohydrate diet and DM.Fructose & Sorbitol produce minimal insulin level response

4. Cardiovascular disease.Dietary carbohydrate may have role in ischemic HDType IV hyperlipidemia is associated with coronary artery disease due to the level of TG is dependent on level of carbohydrate consumedEffect of sucrose is greater over starchHowever, if P.U.F is added, the effect on TG level is reduced.

5 CataractsGalactose and glucose play significant role in the development of cataract. This mono sacharide is further metabolized in the lens. (Osmotic effects!)Glucose cataract is seen in DM patientGalactose cataract I seen in galactosemia

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