Dietary recommendations carbohydrates

The most important biological function of carbohydrates is to provide energy. Most current dietary recommendations suggest that about 55% of total caloric requirements be provided by carbohydrates. 

HPI DK is a 62-year-old woman with type 2 diabetes for 5 years. She has been treated with giyburide for 4 years. She follows dietary recommendations (low fat distributes carbohydrates throughout her three meals a day) to the best of her ability and walks 30 minutes three times weekly. At a routine veit with her primary care provider, her FBG is 180 mg/dL. She does not monitor her blood glucose at home and does not have a glucose meter. She is a nonsmoker and her father has type 2 diabetes. Her only long-term diabetes complication is background diabetic retinopathy. 

Dietary consumption should be balanced in carbohydrates, protein, and fat. Several diet plans exist that promote weight loss through strict limitation or overabundance of only one macronutrient (e.g., low-fat, low-carbohydrate, or high-protein diets) however, overall energy consumption and expenditure will determine the amount of weight alteration. Consultation with a dietician is recommended when... 

Every patient with diabetes requires some form of dietary assessment, and often therapy. This is important to allocate the relative amounts of energy derived from carbohydrate, protein and fat of total recommended daily calories in proportion to the patient s body weight and height and daily requirements, while avoiding atherogenic diets. Diets with high carbohydrate content (50-60%), low fat (30-35%) and adequate protein (10-15%) is recommended. Fibre-rich foods are preferable. The use of non-nutritive sweeteners (saccharin, aspartame, ace-sulfame K and sucralose) are acceptable. Alcohol intake should be assessed since excess consumption... 

LDL-cholesterol ("bad cholesterol") is reduced when saturated fats are replaced with FUFAs or w ith carbohydrates. Howev er, HDLsaturated fats arc replaced with FUFAs or with carbohydrates. These responses indicate that dietary monounsaturates may be of more value than FUFAs or carbohydrates. However, this statement should be vici cd with caution because it has not been established that an elevated HDLhumans prevents formation of atherosclerotic lesions and cardiovascular disease. High levels of saturated fatty acids in dietary fats are a risk factor for cardiovascular disease. The percentage of energy derived from fat is recommended to be reduced to 30%, but not much below this level. 

IV.A), this ion is currently officially recognized as an essential micronutrient for humans (577, 578). The recently published values of Dietary Reference Intakes of Crflll) in the United States and Canada (ranging from 0.2 to 5.5 pg day for infants or from 20 to 45 pg day for adults) (578) are significantly lower than the previously accepted values of Recommended Dietary Allowances (RDA) (from 10 pg day for infants to 200 pg day for adults) (577). Measurements of Cr(III) contents in food sources suggested that up to 90% of the population in industrialized countries receive less than adequate amounts of dietary Cr(III). These amounts can be further decreased by carbohydrate- and fat-based diets, which promote Cr(III) excretion (3). As the biological activity of Cr(III) has been related to improvements in glucose and fat metabolism (579), the use of... 

Postprandial hyperglycemia strongly depends on the amount of absorbed monosaccharides and the velocity of absorption in the small intestine. Carbohydrates are recommended to account for -50% of the daily supply of calories in type 2 diabetes. Monosaccharides play only a minor role as dietary carbohydrates. They consist mainly of complex carbohydrates, such as starch (-60%), and disaccharides, such as sucrose (-30%). Complex carbohydrates and disaccharides must be hydrolyzed by intestinal and pancreatic enzymes before they can be tfansported through the mucosa of the bowel. Thus, any medication that delays breakdown of complex carbohydrates should decrease postprandial hyperglycemia and improve insulin sensitivity, as well as protecting the beta cells of the pancreas. 

It is my hope and belief that this publication will help in the expansion and utilization of fiber sources in foods, as well as in pharmaceutical and medical preparations. After all, we should recognize that the chance to accomplish this is quite favorable because complex carbohydrates, which are the main constituents of dietary fiber, represent the only group of major food components for which increased daily intake is repeatedly being recommended. 

Nnmerous nutritional studies include recommendations abont dietary carbohydrates in their reports. One conclusion common to most of these smdies is that a typical American diet does not include enough complex carbohydrates. These studies recommend that about 58% of daily calories should come from carbohydrate food. Currently, only about 46% of... 

That the analysis and labelling of dietary carbohydrates, for whatever purpose, be based on the chemical divisions recommended. Additional groupings such as polyols, resistant starch, non-digestible ohgosaccharides and dietary fibre can be used, provided the included components are clearly defined. 

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