unit 4: carbohydrates & fats. exchange system review: weekly project the exchange system groups...

UNIT 4: CARBOHYDRATES & FATS

Exchange System Review: Weekly Project

The exchange system groups similar kinds of foods into various exchange lists: Fruit, vegetable, starch, sweets/desserts/other carbs, meat & meat subs, milk, fat, fast

foods, combo foods, free foods, alcohol.

Portion sizes are specified for each food. You should be able to "exchange" any food on a list for another food on the same list, because they are similar in nutrient content (calories, carbs, fat, protein).

Example: Starch list includes bread, tortillas, pasta, rice, cereal and starchy vegetables like potatoes. Each serving provides approximately the same nutrients, and they are all interchangeable in your meal plan.

1 Starch Exchange=

15 g carb, 3 g pro, 0-1 g fat, 80 kcals

1 Fruit Exchange=

15 g carb, 0 g pro, 0 g fat, 60 kcals

1 slice bread 1 6-in tortilla ½ English Muffin ½ cup hot cereal 3 cups popcorn ½ cup corn ½ cup sweet potato

1 small banana 1 small apple ½ cup canned fruit or

fresh fruit ½ cup fruit juice ¼ cup dried fruit

Exchange Examples

Carbohydrates

Carbohydrates

Provide 4 calories/gram Simple carbohydrates

Monosaccharides: glucose, fructose (sugar in fruit), galactose

Disaccharides: maltose (sugar in syrup), sucrose (table sugar), lactose (sugar in milk)

Complex carbohydrates Polysaccharides: glycogen (storage of

glucose in muscle and liver), starch, fiber

Carbohydrates

What are the functions of carbohydrates?

Functions of Carbohydrate

Supplies energy/calories for use by body Main fuel source for brain, nervous system, RBC, &

muscles in forms of blood glucose & glycogen Brain gets energy ONLY from glucose

Imparts sweetness to our foods When carbohydrates are not consumed, fat and

protein are used as sources of energy. Ketosis – production of ketone bodies Ketoacidosis – lowering of blood pH

Carbohydrate Requirements

RDA: 130 grams/day for adults (minimum supply needed for brain)

Avg. intake ~ 180-330 grams/day Recommendations vary

FNB: 45%-65% of total calories Nutrition Facts panel: 60% or 300 grams per 2000 Calories

Focus on fruits, vegetables, whole grains, and beans

Blood Glucose Control

Pancreas regulates blood glucose When blood glucose is high, insulin is secreted. When blood glucose is low, glucagon is secreted.

Pancreas

Blood Glucose Control

Insulin Active after a meal Stimulates the uptake of glucose from the blood by

muscle, adipose, other cells. Net effect: insulin lowers blood glucose

Glucagon Active during a fast Stimulates the formation of glucose from non-

carbohydrate compounds (e.g., amino acids, lactic acid, glycerol) (process “gluconeogenesis”)

Net effect: glucagon increases blood glucose

Diabetes & Blood Glucose

Diabetes Type 1: no or limited production of insulin Type 2: resistance to the produced insulin Gestational diabetes: affects some pregnant women

Hyperglycemia (high blood glucose) Fasting glucose > 126 mg glucose/dL blood Symptoms: excessive urination, thirst, hunger, blurred

vision, fatigue, weight loss, poor wound healing, dry mouth, tingling in feet, cardiac arrhythmia, coma, seizures.

Carbohydrate Counting during diabetes

Count carbohydrates consumed. By evenly spacing carbohydrate-rich foods through the day & by

consuming approximate the same amount you get better glucose control.

Aim for small meals/snacks with mix of complex carbohydrates, protein, & fat.

Carbohydrates can be counted by either carbohydrate servings or carbohydrates grams. One carbohydrate serving= 15g of carb.

Sample Menu: Carbohydrate Counting

Breakfast:

1/2 cup orange juice = 15 g

2 slices (2 oz.) whole-wheat toast = 30 g

1 soft-cooked egg = 0 g

2 tsp. Margarine = 0 g

Total carbohydrates= 45 g

Lunch:

2 slices (2 oz.) rye bread = 30 g

2 oz. sliced turkey = 0 g

2 lettuce leaves < 1 g

1 tsp. mayonnaise = 0 g

1 small bag (3/4 oz.) pretzels = 15 g

1 small (4 oz.) apple = 15 g

Total carbohydrates = 60 g

Dinner:

3oz. baked chicken breast = 0 g

1/2 c. mashed potato = 15 g

1/2 c. cooked carrots = 5 g

1 small (1 oz.) dinner roll = 15 g

2” brownie square = 15 g

Total carbohydrates = 50 g

Snack:

1/2 c. juice-packed fruit cocktail = 15 g

10 peanuts = 0 g

Total carbohydrates = 15 g

Sports Nutrition

Do athletes require low-carbohydrate or moderate-

high carbohydrate diets?Why?

Carbohydrates for Athletes

To provide energy to working muscles. Essential to building glycogen stores During exercise, glycogen is converted back to

glucose and is used for energy. Consume:

50-60% of daily calories from carbohydrates 15-20% of daily calories from proteins 30-35% of daily calories from fats

High-Carbohydrate Training Diet

Breakfast:

Oatmeal with skim milk + banana,

orange juice

Endurance workout: 8 ounces of

Gatorade® for every 10 – 20 minutes of

exercise

Post-workout: Bagel with peanut butter,

fruit yogurt and grape juice

Lunch: Chicken salad sandwich on whole

grain bread , carrot and pepper sticks +

apple, corn chips, skim milk

Snack:

Dry cereal mixed with raisins and peanuts

Peach

Dinner:

Pasta with meat sauce, Italian bread, salad

with veggies/low-fat dressing, steamed

broccoli and cauliflower, frozen

yogurt/strawberries

Fats

Fats are comprised of: Fatty acids (simplest type of fat) Triglycerides (made of 3 fatty acids attached to one glycerol

molecule) Phospholipids (made of 1 phosphate group + 2 fatty acids

attached to one glycerol molecule) Cholesterol (found only in animal foods; precursor for bile

acids, hormones, & vitamin D) Fatty acids can either be:

Saturated Unsaturated – monounsaturated & polyunsaturated

Fat

High intakes of saturated fat, trans fat, & cholesterol can lead to high blood cholesterol and heart disease. Functions of fats:

Provide omega 3 and omega 6 fatty acids (essential fatty acids)

Impart flavor and mouth-feel to our foods Cholesterol – important for bile production, vitamin D,

certain hormones Phospholipids – component of cell membranes

Recommendations: Fat Intake

Dietary Guidelines 20-35% of total calories (= 44-78 total grams/day for 2000

calories) <10% total calories from saturated fat

Food Labels: 2000 calories <65 grams total fat <20 grams saturated fat/day

To reduce risk of heart disease: <7% total calories from saturated fat (= 15 grams for 2,000

calories) <200 mg cholesterol daily

Saturated & Trans Fats

Mainly from animals: Beef, lamb, pork, poultry with skin,

beef fat Lard, cream, butter Cheese, other whole or reduced-fat

dairy products

Some from plants: Palm, palm kernel & coconut oils

Baked goods: Pastries, biscuits, muffins, cakes,

pie crusts, doughnuts, & cookies

Fried foods: French fries, fried & breaded

chicken & fish

Snack foods: Popcorn, crackers.

Traditional: Stick margarine & vegetable

shortening

Saturated Fats Trans FatsSaturated Fats

Raise bad LDL levels

Increase risk of heart disease

Trans fats lower HDL levels

Unsaturated Fats

Vegetable oils: Olive, canola, peanut & sesame

Fruits: Avocados & olives

Many nuts and seeds: Almonds & peanuts/peanut

butter

High in Omega-6 & Omega-3

(ALA) Vegetable oils – soybean, corn and

safflower Many nuts and seeds – walnuts &

sunflower seeds

High in Omega-3 (EPA and DHA) Fatty fish – salmon, tuna, mackerel,

herring and trout

Monounsaturated Fats Polyunsaturated Fats

Reduce LDL levels

May lower risk of heart disease

Heart Healthy Meal Plan

Breakfast:

1 c bran cereal with raisins

3/4 c skim milk

1 med. banana

1/4 c egg substitute

Lunch:

1 ½ c tossed green salad w/raw veggies

2 T olive oil vinaigrette salad dressing

1 serving frozen lean cuisine beef and

broccoli

Snack:

1 medium apple

1 T peanut butter

Dinner :

1 c pasta + 1 T olive oil

1/4 c marinara sauce

3 oz skinless chicken breast

Snack:

1/2 c low-fat frozen yogurt

Calories= 1,600 kCal

6% Calories from Saturated Fat

30% Calories from Total Fat

AHA Recommendations: Omega-3

Beneficial to the heart and for proper cardiovascular health.

Omega-3 fatty acids: decrease risk of arrhythmias, which can lead to

sudden cardiac death decrease triglyceride levels decrease growth rate of atherosclerotic plaque lower blood pressure (slightly)

Food Serving omega-3 fatty acids % DV Density Quality

Flax seeds 0.25 cups 7.0 g 156.4 17.6 Excellent

Walnuts C 0.25 cup 2.3 g 50.4 6.3 Very good

Chinook salmon, baked/broiled 4.0 oz-wt 2.1 g 46.4 3.6 Very good

Scallops, baked/broiled 4.0 oz-wt 1.1 g 24.4 3.3 Good

Soybeans, cooked 1 cup 1.0 g 22.9 1.6 Good

Halibut, baked/broiled 4.0 oz-wt 0.6 g 13.8 1.8 Good

Shrimp, steamed, boiled 4.0 oz-wt 0.4 g 8.2 1.5 Good

Snapper, baked 4.0 oz-wt 0.4 g 8.0 1.1 Good

Tofu, raw 4.0 oz-wt 0.4 g 8.0 1.9 Good

Winter squash 1 cup 0.3 g 7.6 1.9 Good

Tuna, yellowfin 4.0 oz-wt 0.3 g 7.3 0.9 -

Cod, baked 4.0 oz-wt 0.3 g 7.1 1.2 -

Kidney beans 1 cup 0.3 g 6.7 0.6 -

http://www.whfoods.com/genpage.php?tname=george&dbid=75

AHA Recommendations: Omega-3

Patients without CHD: Eat a variety of (preferably fatty) fish @ least 2x/week Include oils & foods rich in ALA (flaxseed, canola,

soybean oils, flaxseed and walnuts). Patients with CHD:

Consume ~1 g of EPA+DHA per day, preferably fatty fish. Patients who need to lower triglycerides:

2 to 4 grams of EPA+DHA per day provided as capsules under a physician’s care.

Resources

American Diabetes Association: www.diabetes.org Carbohydrate Counting:

http://www.diabetes.org/uedocuments/10-CarbCounting.pdf

American Heart Association: www.americanheart.org

Gatorade Sports Science Institute:www.gssiweb.com