Unit 2: Carbohydrates Flashcards
1
Q
what are monosaccharides
A
- simple sugars
2
Q
list 3 types of monosaccharides
A
- glucose
- fructose
- galactose
3
Q
what is the purpose of glucose in the body (2)
A
- fuel for cells
- exclusive energy source for the brain & nervous system
4
Q
list some examples of where fructose is found (3)
A
- fruit, honey, and table sugar
5
Q
what is galactose? when is it freed?
A
- part of the 2 sugar structure of lactose
- freed during digestion
6
Q
list 3 types of disaccharides (3)
A
- sucrose
- lactose
- maltose
7
Q
what is sucrose? what is it made of?
A
- table sugar
- glucose + fructose
8
Q
what is lactose?
A
- principal carb found in milk
9
Q
what is lactose made of?
A
- glucose + galactose
10
Q
what is maltose? what is it made of?
A
- product of starch breakdown
- glucose + glucose
11
Q
what type of dissacharide do many people lose the ability to break down?
A
- lactose
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
13
Q
what do carbohydrates contain
A
- carbon, hydrogen & oxygen (CHO)
14
Q
where do CHO rich foods exclusively come from?
A
- plants
15
Q
what is the only animal derived food that contains significant amounts of CHO?
A
- milk
16
Q
what are 3 types of carbs?
A
- monosaccharides
- disaccharides
- polysaccharides
17
Q
what are polysaccharides
A
- complex carbs
- long chains of mostly glucose linked together
18
Q
what are 3 types of polysaccharides
A
- glycogen
- starch
- fibres
19
Q
what is glycogen
A
- most highly branched glucose chains
- storage form of glucose
20
Q
what is starch?
A
- long, straight, or branched glucose chain
- energy storage for plants
21
Q
what are the 3 highest sources of starch
A
- grains
- legumes
- root veggies (such as potatoes)
22
Q
what are resistant starches
A
- these are considered to be fibre bc they are not broken down by humans
23
Q
why are resistant starches important?
A
- support a healthy colon
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
25
what are the 2 groups of fibres
1. soluble fibres
| 2. insoluble fibres
26
what are soluble fibres
- fibers that dissolve in water
27
what are 2 benefits of soluble fibers
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
28
what are some examples of soluble fibres (5)
- barley
- legumes
- fruits
- veggies
- oats
29
what are insoluble fibers
- fibers that do not dissolve in water
30
what are 2 benefits of insoluble fibers
1. provide dietary roughage
| 2. ease elimination
31
what are examples of insoluble fibers (4)
- bran
- celery
- seed hulls
- corn kernel skins
32
list 3 poly/disaccharides fiber contains
- hemicellulose
- pectin
- gums & mucilages
33
where is hemicellulose found
- in cereal fibers
34
where is pectin found
- found in fruits & veggies
35
where are gums & mucilages found
- used as additives & stabilizers in food industry
36
what causes lactose intolerance
- when people lose their ability to produce lactase & therefore their ability to digest lactose
37
as we age, approximately ___% of the world's population lose their ability to produce lactase
75
38
which population has the lowest rates of lactose intolerance?
- northern european
39
how much milk can a person w lactose intolerance tolerate without symptoms?
- 2 cups of milk daily
40
what does regular consumption of milk by someone with lactose intolerance result in?
regular consumption of milk products =
| - increased metabolism by intestinal bacteria = improved tolerance
41
what should nurses encourage people w lactose intolerance to do? what are 2 tips we can give people who do this?
- gradually increase their tolerance
1. aged cheese is a good choice bc there is less lactose
2. may take with food to ease discomfort
42
what should patients do if lactose intolerance follows illness
- should temporarily restrict milk products
43
list 4 ingredients that do not contain lactose
- lactic acid
- lactalbumin
- lactate
- casein
44
list 3 treatments of lactose intolerance
- lactase enzyme drops to milk
- tablets ???
- probiotics (shown to improve lactose intolerance)
45
what should you do if you are reducing foods containing lactose
- supplement foods with foods high in vitamin D and calcium
46
list 3 examples of lactose free sources of calcium
- canned salmon & sardines
- fortified plant-based beverages
- calcium-fortified 100% fruit juices
47
what are 4 examples of fortified plant-based beverages
calcium fortified:
- almond
- coconut
- rice
- soy beverages
48
list 5 examples of lactose free sources of vitamin D
- fish
- liver
- egg yolks
- non-hydrogenated margine
- some plant-based beverages like soy & rice
49
list 5 health conditions which fiber rich foods plays a role in helping manage & prevent
- cardiovascular disease
- diabetes
- GI conditions (diverticular disease & constipation)
- colon cancer
- obesity
50
how does fiber help protect against heart disease & stroke? (3)
- lowers BP
- improves blood lipids
- reduces inflammation
51
describe the role of fiber in the prevention of type 2 diabetes
- regulates BG by trapping nutrients & delaying their absorption
- prevents glucose surge & rebound
52
describe the role of fiber in GI health
- enhances large intestinal health
| - fermentable soluble fibers helps sustain colonic bacteria
53
describe fiber's role in weight management
- prevents weight gain
54
what is a harmful effect of excessive fiber intake
- if too much fibre is consumed, some minerals may bind to it & be excreted with it without becoming available for the body to use
55
what is diverticular disease
- presence of pebble sized herniations (outpockets) in the colon's mucosa
- basically little bumps all over the large intestine
56
what is diverticulitis
- when the pouches or sacs in the colon become inflamed or infected
57
what are symptoms of diverticulitis (4)
- pain or tenderness, typically in the left lower abdomen
- constipation
- NVD
- fever
58
how does fibre intake related to diverticular disease
- low fiber diet increases the risk of developing this condition
59
what is constipation
- difficult passage of stool
60
what are common causes of constipation (6)
- 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
61
list 5 diseases & health conditions that can cause constipation
- underactive thyroid
- diabetes
- celiac disease
- irritable bowel syndrome
- hemorrhoids
62
what is nutritional treatment for constipation (4)
- high fibre foods
- increased fluid intake
- increased physical activity
- foods with laxative effect
63
what are 3 examples of foods with a laxative effect that can help ease constipation
- prunes
- pears
- apples
64
what structures play a role in sugar & starch digestion/absorption (4)
- mouth & salivary glands
- stomach
- small intestine & pancreas
see chart in notes for details
65
what is the mouth's and salivary gland's role in sugar & starch digestion
- salivary glands secrete salivia into the mouth which moistens the food
- the salivary enzyme amylase begins digestion
66
what is the role of the stomach in sugar & starch digestion
- stomach acid inactivates salivary enzymes = halts starch digestion
67
what is the role of the small intestine & pancreas in sugar & starch digestion/absorption (3 steps)
- 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
68
what structures are involved in the digestion/absorption of fibre
- mouth
- stomch
- small intestine
- large intestine
69
what is the role of the mouth in fiber digestion/absorption
- mechanical action of the mouth crushes fiber in food
| - salivia mixes with the food to moisten it for swallowing
70
what is the role of the stomach in fiber digestion/absorption
- fiber is not digested
| - delays gastric emptying
71
what is the role of the small intestin in fiber digestion/absorption
- fiber is not digested
- passes thru intact to the large intestine
- delays absorption of some nutrients
72
what is the role of the large intestine in fiber digestion/absorption
- 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
what 2 hormones play a role in regulation of BG? where are they released from?
- released from the pancreas
1. insulin
2. glucagon
74
how does insulin regulate BG (2)
overall, lowers BG by:
- promotes glucose uptake from blood into muscle & adipose tissue
- muscle & liver cells respond by coverting glucose into glycogen
75
how does glucagon regulate BG(1)
overall, raises BG by:
| - stimulating breakdown of glycogen in the liver to glucose
76
what is our normal fasting BG
4-6 mmol/L
77
what is hypoglycemia? what BG level is it?
- low BG
| <4 mmol/L
78
what are symptoms of a dropped blood sugar (<3.5, not severe)
- shakiness
- nervous, anxious
- tachycardia
- sweaty
- weakness
- nausea
- hungry
- irritable
- numbness or tingling on tongue or lips
79
what are signs of a very low blood sugar (<2.8)
these are more severe
- confusion
- disorientation
- seizure
- loss of consciousness
- coma
- light headedness
80
what is hyperglycemia? what BG level is it?
- high blood glucose
| >11 mmol/L
81
what are some symptoms of hyperglycemia
- extreme thirst
- hunger
- frequent urination & bedwetting
- exhaustion
- confusion
- headache
82
list 4 things that may cause hypoglycemia
- increased physical activity
- NPO
- too much meds (ex, insulin)
- excessive alcohol intake
83
what is treatment for hypoglycemia?
- eat or drink a fast-acting carb
| - sugar, honey, soft drinks
84
when should you recheck your BG after hypoglycemia
- in 15 min
85
list 4 things that may cause hyperglycemia
- increased food intake
- decreased activity
- meds
- sick or stress
86
what is treatment for hyperglycemia
- adjust your meal plan
- adjust your exercise routine
- adjust your meds
87
what is diabetes characterized by (2)
- elevated BG levels
| - problems with insulin metabolism
88
what are 2 common forms of diabetes
type 1 & 2
89
is type 1 or type 2 more common
type 2
90
what is the age of onset for type 1 vs type 2
- type 1 = <30 yrs
| - type 2 = >40 years (but increasing in adolescents)
91
what are associated conditions/risk factors with type 1 vs type 2
- type 1 = autoimmune diseases, viral infection, inheritied factors
- type 2 = obesity, aging, inherited factors
92
what is the major defect in type 1 vs type 2
- type 1 = destruction of beta cells --> insulin deficiency
| - type 2 = insulin resistance, insulin deficiency relative to needs
93
describe insulin secretion in type 1 vs type 2
- type 1 = little or non
| - type 2 = variable
94
describe requirement for insulin therapy in type 1 vs type 2
- type 1 = all cases
| - type 2 = some cases
95
what are 2 former names of type 1 diabetes
- juvenille diabetes
| - insulin dependent
96
what are 2 former names of type 2 diabetes
- adult-onset diabetes
| - noninsulin-dependent diabetes
97
what is prediabetes
- elevated BG levels below the threshold for diagnosis
98
prediabetes can increase a person's risk of developing ______ and _____ later in life
- type 2 diabetes
| - heart disease
99
how can an individual with prediabetes reduce their future risk of developing type 2 diabetes & heart disease (3)
lifestyle changes:
- weight reduction (5-10% of body weight)
- increased physical activity
- dietary modification
100
what dietary modifications should someone with prediabetes make (3)
- increased intake of fiber & whole grains
| - reduced intake of fat
101
what is insulin resistance
- when insulin is present but is not effectively moving the glucose into the cells
102
what are 2 consequences of insulin resistance
- hyperglycemia
| - insulinemia
103
insulin resistance is thought to be a metabolic consequence of________? why?
- obesity
| - bc obese individuals require more insulin to maintain normal BG
104
insulin resistance is characteristic of ___??
- type 2 diabetes
105
describe the relation between nutrition therapy & diabetes (2)
can assist in:
- improving blood sugar control
- slow the progression of complications associated with diabetes
106
what must be considered when making nutrition recommendations for people with diabetes (4)
```
must be modified to accomodate the patient's:
- lifestyle habits
- age
- personal preferences
- other health conditions
etc.
```
107
describe carb intake recommendations for someone w diabetes (3)
- 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
describe fat recommendations for someone w diabetes
- should be largely unsaturated
109
describe whole grains & fibre recommendations for someone w diabetes
- normal DRI of whole grains & fibre
110
what is glycemic index
- 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
what does lower GI mean
- less glycemic effect = causes a lower & slower rise in BG
112
what factors influence a food's glycemic index (3)
- fibre content
- prep method
- what the carb is combined with
113
foods with what glycemic index should people aim to select
- low glycemic index (high fibre, minimal processing)
114
does sugar or starch have a lower glycemic index
- sugar
115
what are sugar intake recommendations for someone w diabetes
- sugar intake recommendations similar to normal population
116
what are alcohol guidelines for someone with diabetes? what about when on insulin?
- same as normal pop
| - on insulin, eat food with alcohol to prevent hypoglycemia
117
what is the alcohol recommendation for men? women?
- women = 1 drink daily
| - men = 2
118
how many drinks can exacerbate hyperglycemia
- 3 or more
119
what is 1 meal planning strategy for people w diabetes
- carbohydrate counting
120
why is carbohydrate counting so effective for people w diabetes (2)
- research shows that it is the total amt of CHO that matters most for BG control
- also very flexible
121
what is 1 con to CHO counting
- require math & portioning
122
describe how carbohydrate counting works
- 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
what are carbohydrate portions/choices
- portions expressed in terms of servings that contain about 15 g of carbs each
124
what are 2 benefits of using the glycemic index
- to achieve better BG control
| - to lose weight
125
what are the 3 GI categories and what GI range is each?
- low = 55 or less
- medium = 56-69
- high = 70 or more
126
what are 3 benefits of physical activity for someone w diabetes?
1. increased insulin sensitivity
2. muscle glucose uptake
3. glycemic control
127
what should people w diabetes be cautious about while exercising
- should be careful to prevent hypoglycemia
| - check BG levels before & after
128
people w diabetes should be medically evaliated for exercises which may aggravate issues such as.... (3)
- feet
- kidneys
- NS
129
what are naturally occurring sugar?
- sugars found in whole foods
| - are acceptable as they come with many nutrients
130
sugar has been blamed for causing or increasing the risk of health problems such as... (4)
- obesity
- heart disease
- nutrient deficiencies
- dental caries
131
despite common belief, sugar has not been shown to cause ______ or _______ in children
- hyperactivity
| - worsen behavior
132
describe the relation between sugar & heart disease (3)
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
describe the relation between sugar & type 2 diabetes
- high sugar intake increases the incidence of high body fat, which is associated with DM2
134
what causes links between high sugar intake & diabetes to be diminished
- when overall calorie intake does not exceed normal ranges
135
describe the relationship between sugar & nutritonal deficiencies
- displaces important nutrients leading to deficiencies
136
describe the relationship between obesity & fructose corn syrup? what is the recommendation?
- high fructose corn syrup is largely attributed to obesity
| - recommendation = 100/day for women & 150 for men
137
describe the relationship between sugar & dental caries
- all carbs promote dental caries
| - but, total sugar intake is closely correlated to incidence of dental caries
138
describe the role of saliva in the development of dental caries
- saliva prevents the development
139
list 3 things that promote saliva production
- sugar free gum
- cheese
- veggies
140
list 2 health conditions & 1 type of treatment that increases the risk of dental or oral diseases
- DM
- HIV
- radiation treatment
141
what are dental caries
- tooth decay / cavities
142
what causes dental caries
- bacteria that reside in dental plaque metabolize dietary carbs & produces acids that attack tooth enamel
143
describe different ways that carbs contribute to the development of dental caries (4)
- 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
what other factors contribute to the development / susceptibility to dental caries (3)
- oral hygeine
- fluoride intake
- composition of tooth enamel
145
what happens if dental caries (tooth decay) continue to progress?
- the decay can penetrate the dentin & destory other structure that support & maintain the tooth
- can lead to loss of the tooth
146
define cariogenic
- promote the development of dental caries
147
what are considered the most cariogenic foods (3)
carb containing foods that:
- remain in contact w the teeth for prolonged periods
- are difficult to clear from the mouth
- are consumed frequently
148
what are examples of cariogenic foods (4)
- hard candies or lozenges that dissolve slowly
- sticky or chewy foods like dried fruit
- starchy snack foods (chips)
- sweetened beverages
149
define dental plaque
- a film of bacteria & bacterial by products that accumulates on the tooth surface
150
define gingiva
- the gums
151
define gingivitis
- inflammation of the gums
152
what is gingivitis characterized by (3)
- redness
- swelling
- bleeding
153
define periodontal disease
- disease that involves the CT that support the teeth
154
define periodontitis
- inflammation or degeneration of th e tissues that support the the teeth
155
define periodontium
- tissues that support the teeth
| ex. gums, cementum, periodontal ligament, underlying bone
156
what types of food help prevent caries?
foods that:
- stimulate saliva flow
- neutralize mouth acidity
- induce the clearance of food particles from the teeth
157
what are 2 types of alternative sweeteners?
1. sugar alcohols
| 2. artifical sweeteners
158
what are sugar alcohols
- sugars that belong to the chemical family of alcohols based on their structure
159
do sugar alcohols contain ethanol?
- no
160
what do sugar alcohols do (2)? give 4 examples
- 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
what are 3 benefits of sugar alcohols
- lower glycemic response & yield less energy than sucrose
- lower calorie option
- do not contribute to dental caries
162
how are sugar alcohols made/where are they found
- found naturally in fruits & veggies
| - or artificially manufactured
163
artifical sweeteners are ____ times more sweeter than sucrose
200-600
164
describe calories in artifical sweeteners
- considered to be calorie-free bc so little is used
165
list 4 examples of artifical sweeteners
1. acesulfame potassium
2. aspartame
3. sucralose (splenda)
4. stevia
166
what is aspartame made of?
2 protein (amino acid) fragments
167
what are the 2 protein fragments in aspartame
1. phenylalanine
| 2. aspartic acid
168
products containing aspartame have a warning for people w ____
phenylketonuria (PKU)
169
what is phenylketonuria (PKU)?
- inborn error of metabolism
| - results in decreased metabolism of the amino acid phenylalanine hydroxylase
170
what does decreased metabolism of phenylalanine hydroxylase cause? (3)
- without this enzyme, phenylalanine accumulates in tissue - - causes severe damage to developing brain
- prevents synthesis of tyrosine, epi, melanin, thyroxine
171
what can untreated PKU lead to? (6)
- intellectual disability
- seizures
- behavioral problems
- mental disorders
- musty smell
- lighter skin
172
what is the DRI for carbs
- should contribute to about half (45-65%) of energy requirement
173
what is the DRI for fiber
- 14 grams per 1000 caloric intake
| - upper limit of 40 g
