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DASAR ILMU GIZI Sub Topik

• Struktur Kimia
• Jenis
KARBOHIDRAT • Sumber
• Pencernaan, Absorpsi dan Metabolisme
Triska Susila Nindya, SKM., MPH (Nutr)
• Glukosa dalam tubuh
Dept Gizi Kesehatan • Efek Kekurangan dan Kelebihan Bagi Tubuh
FKM UNAIR

Excellence with Morality

UNIVERSITAS AIRLANGGA

Struktur Kimia Karbohidrat

• Terdiri atas atom Carbon (C), Hidrogen (H) dan
Oksigen (O)
• Atom tersebut terikat mengikuti aturan =
Cn(H2O)n dengan molar rasio 1:2:1

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Jenis The Simple Carbohydrates

Karbohidrat (CH2O)n
• Monosakarida: most are hexoses (C6H12O6)
• Karbohidrat Sederhana (Simple – Glukosa: sebagai sumber energi utama, dikenal
juga dengan gula darah atau dextrosa
carbohydrates)
– Fructosa: memiliki rasa paling manis, secara alami
–Hexosa Monosaccharides terdapat pada madu dan buah, dan juga
–Disaccharides ditambahkan pada makanan dalam bentuk high-
fructose corn syrup.
• Karbohidrat Kompleks (Complex – Galactosa: sebagai “single sugar” yang hanya ada
carbohydrates) pada beberapa jenis pangan

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The Simple Carbohydrates

• Disakarida: terdiri dari dua macam single sugar, salah
satu diantaranya selalu dalam bentuk glukosa
– Kondensasi: menggabungkan 2 macam monosakarida.
– Hidrolisis: memecah ikatan molekul disakarida menjadi monosakarida.
Terjadi apada saat pencernaan
– Maltosa: terdiri dari 2 glukosa. Diproduksi saat terjadi pemecahan pati
pada pencerncaan karbohidrat. Juga diproduksi pada saat proses
fermentasi.
– Sucrosa: terdiri dari fructose dan glucose. Terdapat pada gula tebu,
buah, rasa manis.
– Lactosa: terdiri dari Galactose dan Glucose. Terdapat pada susu dan
produknya

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KARBOHIDRAT KOMPLEKS KARBOHIDRAT KOMPLEKS

• Terdiri dari banyak ikatan glukosa dalam • Glycogen
bentuk rantai lurus atau bercabang – Bentuk simpanan glukosa dalam tubuh
- ≤ 10 ikatan: oligosaccharides – Memberi energi yang cepat pada saat diperlukan
tubuh
- Triosa, Tetrosa, Pentosa (penyusun asam
nukleat) • Pati (Starches)
- > 10 ikatan: polysaccharides – Bentuk simpanan glukosa pada tumbuhan
– Terdapat pada biji-bijian (grain), umbi (tubers) dan
- starch, glycogen, pectin, cellulosa kacang-kacangan (legumes)

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Glycogen
A glycogen molecule contains
hundreds of glucose units in
highly branched chains. Each
new glycogen molecule needs
a special protein for the
attachment of the first
glucose (shown here in red).
KARBOHIDRAT KOMPLEKS
• Serat pangan (Dietary fibers): memberi struktur pada
tanaman dan tidak dapat dipecah oleh enzim tubuh
manusia, sehingga disebut juga nonstarch
polysaccharides
– Soluble fibers: membentuk gel (viscous) dan dapat dicerna
oleh bakteri usus ( fermentasi). Protecting against heart
Starch (amylopectin) Starch (amylose)
disease and diabetes. Terdapat pada buah, kacang2an, oat
A starch molecule contains hundreds of
glucose molecules in either occasionally – Insoluble fibers: tidak membentuk gel (nonviscous) dan
branched chains (amylopectin) or tidak dapat dicerna oleh bakteri usus. Mencegah
unbranched chains (amylose). konstipasi. Terdapat pada whole grain dan sayur.
Stepped Art
© 2008 Thomson - Wadsworth
Fig. 4-8, p. 106

KARBOHIDRAT KOMPLEKS
• Fiber Sources
– Dietary fibers are found in plant foods.
– Functional fibers are health-benefiting fibers that are
added to foods or supplements.
– Total fiber considers both dietary and functional fibers.
• Resistant starches (RS) escape digestion and are found in
legumes, raw potatoes and unripe bananas. RS stimulate
bacterial growth in colon
• Phytic acid or phytate: has a close association with fiber
and binds some minerals.

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Pencernaan dan Penyerapan Pencernaan dan Penyerapan

Karbohidrat Karbohidrat
• Pencernaan Karbohidrat: enzim menghidrolisa • Carbohydrate Digestion
rantai panjang menjadi lebih pendek – In the small intestine, pancreatic amylase among
• In the mouth, the salivary enzyme amylase other enzymes (maltase, sucrase, and lactase)
hydrolyzes starches to disaccharides and
begins to hydrolyze starch into short
monosaccharides.
polysaccharides and maltose.
– In the large intestine, fibers remain and attract
• In the stomach, acid continues to hydrolyze water, soften stools and ferment.
starch while fiber delays gastric emptying and
provides a feeling of fullness (satiety).

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Pencernaan dan Penyerapan

Karbohidrat
• Carbohydrate Absorption
– Primarily takes place in the small intestine
– Glucose and galactose are absorbed by active
transport.
– Fructose is absorbed by facilitated diffusion (slows
its entry and produce a smaller rise in blood
sugar)

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Monosaccharides, the end products of carbohydrate

Pencernaan Serat
digestion, enter the capillaries of the intestinal villi.

• Dalam waktu 1-4 jam setelah

makan, semua gula dan pati telah
selesai dicerna
In the liver, • Usus Besar: hanya serat yg masuk
galactose
and fructose
are converted
ke usus besar
to glucose.
Small intestine – Fermentation of viscous fibers
Monosaccharides travel to • Water, gas, short-chain fatty acid
the liver via the portal vein.
production
Stepped Art
Fig. 4-11, p. 110 Copyright 2005 Wadsworth Group, a division of Thomson Learning

Digestion and Absorption of

Carbohydrates
• Lactose Intolerance
– Symptoms include bloating, abdominal discomfort, and
diarrhea.
– Causes include lactase deficiency due to a natural decrease
that occurs with aging or damaged intestinal villi.
– Prevalence
• Lowest in Scandinavians and northern Europeans
• Highest in Southeast Asians and native North Americans

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Digestion and Absorption of

Glucose in the Body
Carbohydrates
• Lactose Intolerance - Dietary Changes • A Preview of Carbohydrate Metabolism
– Increase consumption of milk products gradually. – The body stores glucose as glycogen in liver (1/3) and
– Mix dairy with other foods. muscle cells (2/3).
– Spread dairy intake throughout the day. – Glikolisis: The body uses glucose for energy if glycogen
– Use of acidophilus milk, yogurt, and kefir (fermented stores are available.
products) – If glycogen stores are depleted, the body makes glucose
– Use of enzymes from protein.
• Glucose is preferred energy sourcee for brain cell, nerve cell, red
– Individualization of diets blood cells
– Must be careful that vitamin and mineral deficiencies do • Gluconeogenesis is the conversion of protein to glucose.
not develop • Protein-sparing action is having adequate carbohydrate in the diet
to prevent the breakdown of protein for energy.

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Glikolisis - Gluconeogenesis

Pyruvate-to-Lactic Acid (Anaerobic)

Glucose in the Body
• A Preview of Carbohydrate Metabolism
– Making ketone bodies from fat fragments
• The accumulation of ketone bodies in the blood is called ketosis.
• Ketosis disturbs the acid-base balance in the body.
– The body can use glucose to make body fat when
carbohydrates are consumed excessively. Fat travels to the
fatty tissues

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REMEMBER Glucose in the Body

• 1 Gram Karbohidrat = 4 kkal • The Constancy of Blood Glucose
• 1 gram Protein = 4 kkal – Maintaining Glucose Homeostasis
• Low blood glucose may cause dizziness and weakness.
• 1 gram Lemak = 9 kkal
• High blood glucose may cause fatigue.
• Extreme fluctuations can be fatal.

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Glucose in the Body

• The Constancy of Blood Glucose
– The Regulating Hormones
• Insulin moves glucose into the cells and helps to lower blood sugar
levels.
• Glucagon brings glucose out of storage and raises blood sugar
levels.
• Epinephrine acts quickly to bring glucose out of storage during
times of stress.
– Balance glucose within the normal range by eating
balanced meals regularly with adequate complex
carbohydrates.
– Blood glucose can fall outside the normal range with
hypoglycemia or diabetes.

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Glucose in the Body Glucose in the Body

• The Constancy of Blood Glucose • The Constancy of Blood Glucose
– Diabetes – Glycemic response is how quickly the blood glucose rises
• Type 1 diabetes is the less common type with no insulin produced and elicits an insulin response.
by the body. • Glycemic index classifies foods according to their potential for
• Type 2 diabetes is the more common type where fat cells resist raising blood glucose.
insulin. • Glycemic load refers to a food’s glycemic index and the amount of
• Prediabetes is blood glucose that is higher than normal but below carbohydrate the food contains.
the diagnosis of diabetes. • The benefit of the glycemic index is controversial.
– Hypoglycemia is low blood glucose and can often be
controlled by dietary changes.

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Health Effects and Recommended Intakes of

Sugars
• Sugar poses no major health problem except
dental caries.
• Excessive intakes may displace nutrients and
contribute to obesity.
• Consuming foods with added sugars should be
limited.
• Naturally occurring sugars from fruits,
vegetables and milk are acceptable sources.

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Enamel
Health Effects and Recommended Intakes of Caries Crown
Sugars Dentin
Gum
• Health Effects of Sugars Pulp
– Foods with added sugars have sugars listed as a first (blood
vessels,
ingredient. nerves)
– Nutrient deficiencies may develop from the intake of
empty kcalories.
• Just because a substance is natural does not mean it is nutritious. Bone
(Example: honey)
– Dental caries may be caused by bacteria residing in dental Root
plaque and the length of time sugars have contact with the canal
teeth.

Nerve
Blood vessel Stepped Art
© 2008 Thomson - Wadsworth
Fig. 4-14, p. 119

Health Impact of Fructose Health Effects and Recommended Intakes of

Consumption
• High Fructose (HFCS)  more lipogenic than
glucose  readily converted in the liver to TG,
which can be exported as VLDL containing
apolipoprotein-B and stored in adipose tissue
• Long term effect: increase the risk of
atherosclerosis and other CVD
Sugars
• Recommended Intakes of Sugars
– Dietary Guidelines state to limit intake of foods
and beverages that are high in added sugars.
– DRI suggest added sugars should contribute no
more than 25% of a day’s total energy intake.

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Health Effects and Recommended Intakes of
Starch and Fibers
• Health Effects of Starch and Fibers
– May be some protection from heart disease and stroke
• Soluble fibers bind with bile and thereby lower blood cholesterol
levels.
• Fiber may also displace fat in the diet.
– Reduce the risk of type 2 diabetes by decreasing glucose
absorption
– Enhance the health of the GI tract which can then block
the absorption of unwanted particles
– May protect against colon cancer by removing potential
cancer-causing agents from the body
Health Effects and Recommended Intakes of
Starch and Fibers
• Health Effects of Starch and Fibers
– Promote weight control because complex
carbohydrates provide less fat and added sugar.
– Harmful effects of excessive fiber intake
• Displaces energy and nutrient-dense foods
• Abdominal discomfort and distention
• May interfere with nutrient absorption

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Health Effects and Recommended Intakes of

Starch and Fibers
• Recommended Intakes of Starch and Fibers
– RDA for carbohydrate is 130 g per day, or 45-65% of energy
intake.
– Daily Value is 300 grams per day.
– Dietary Guidelines encourage a variety of whole grains,
vegetables, fruits and legumes daily.
– Healthy People 2010 recommends six servings of grains
and five servings of fruits and vegetables.
Contoh soal
• Seorang mahasiswa selama sehari
mengkonsumsi energi 2000 kkal, sebanyak
1400 kkal sumbangan energi berasal dari
karbohidrat. Berapa persen energi yang
berasal dari karbohidrat? Berapa gram
karbohidrat yang dikonsumsi? Bagaimana jika
dibandingkan dengan RDA?

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Health Effects and Recommended Intakes of

Starch and Fibers
• Recommended Intakes of Fiber
– FDA recommends 25 grams for a 2,000-kcalorie diet.
– DRI at 14 g per 1000 kcalorie intake (28 grams for a 2,000
kcalorie diet)
– American Dietetic Association recommends 20-35 g per
day.
– World Health Organization suggests no more than 40 g per
day.

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Health Effects and Recommended Intakes of

Starch and Fibers Artificial Sweeteners
• From Guidelines to Groceries • Also called nonnutritive sweeteners
– Grains – encourage whole grains
– Saccharin
– Vegetables – starchy and nonstarchy vegetables differ in
carbohydrate content • Used primarily in soft drinks and as a tabletop
– Fruits – vary in water, fiber and sugar content sweetener
– Milks and Milk Products – contain carbohydrate; cheese is • Rapidly excreted in the urine
low • Does not accumulate in the body
– Meat and Meat Alternates – meats are low, but nuts and • Has been removed from list of cancer-causing
legumes have some carbohydrate substances
– Food labels list grams of carbohydrate, fiber and sugar;
starch grams can be calculated.

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Artificial Sweeteners
• Aspartame
– General purpose sweetener
– Warning about phenylalanine for those with PKU
– Controversial finding that aspartame may have
caused cancer in rats
– Excessive intake should be avoided by those with
epilepsy

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Aspartic Phenylalanine
acid Artificial Sweeteners
Methyl
group
hydrolyzed • Acesulfame-K (acesulfame potassium)
– Research confirms safety

Methanol

Oxidized

Formaldehyde

Oxidized

Stepped Art
© 2008 Thomson - Wadsworth
Carbon dioxide Fig. H4-2, p. 134

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Artificial Sweeteners Artificial Sweeteners

• Sucralose • Tagatose
– Made from sugar – Used for foods and beverages
– Passes through digestive tract – Provides less kcalories than sugar
• Neotame – High doses can cause flatulence and loose stools.
– Most recent on the market • Alitame and Cyclamate
– Very sweet – Pending FDA approval
– Phenylalanine not an issue – Approved in other countries

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Artificial Sweeteners Stevia – An Herbal Alternative

• Acceptable Daily Intake (ADI) is the level of consumption, • Lacks research
maintained every day and still safe by a wide margin.
– Moderation and variety are still recommended.
• Classified as a dietary supplement
• Artificial Sweeteners and Weight Control • Not required to have testing and FDA approval
– Much research still being done
– Using artificial sweeteners will not automatically reduce
energy intake.

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Sugar Replacers
• Also called nutritive sweeteners, sugar
alcohols, and polyols
• Maltitol, mannitol, sorbitol, xylitol, isomalt,
and lactitol
• Absorbed more slowly and metabolized
differently in the body
• Low glycemic response
• Side effects include GI discomfort
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Reference
Whitney, E., SR Rolfes. 2008. Understanding
Nutrition 11th ed. Thomson Wadsworth
Ross et al. 2014. Modern Nutrition in Health and
Disease 11th ed. Wolter Kluwers- Lipincott
Williams

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