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metabolisme
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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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