Diet and Health Implications for Reducing Chronic Disease Risk (1989) / Chapter Skim
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9 Carbohydrates
9 Carbohydrates
Pages 273-290
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From page 273... ...
consists of ~ glucose and ~ galactose unit per molecule. Maltose consists of two glucose molecules and is present in sprouting grains, malted milk, malted cereals, and some corn syrups.
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From page 274... ...
1986~. EVIDENCE ASSOCIATING CARBOHYDRATE INTAKE WITH CHRONIC DISEASES Non~nsulin-Dependent Diabetes Mellitus Epiddem~olog~c Evidence Most epidemiologic studies were conducted at the time when distinction was still made between juvenile-onset and adult~onset diabetes rather than the most recently adopted more distinct cIassifica' tions of Type I, or insulin-dependent diabetes mellitus (IDDM)
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From page 275... ...
High-carbohydrate diets have been recommended for the management of diabetes, because they appear to improve glucose tolerance and insulin sensitivity, and with a change to such a diet, there is a concomitant reduction in the proportion of calories as fat, which reduces risk of atherosclerosis a major cause of death among diabetics (American Diabetes Association, 1987~. There have been no prospective studies on the influence of diet on the complications of diabetes, and the role of diet in the increased prevalence and severity of atherosclerosis among diabetics has not been documented.
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From page 276... ...
Nevertheless, although some diet-specific effects on the complications and severity of already diagnosed diabetes may continue to be suspected or remain controversial, Here is little evidence to implicate dietary carbohydrates, either complex or simple, in the etiology of diabetes. Animal Sautes Evaluation of the hypothesis that a high-carbohydrate diet is an independent risk factor in the development of glucose intolerance or diabetes is complicated by such factors as hyperphagia and meal patterns (ad libitum versus meal feeding)
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From page 277... ...
That study shows that hyperglycemia, hypertriglyceridemia, and hyperinsulinemia do not necessarily accompany sucrose feeding of rats. Insulin-Dependent Diabetes Mellitus Epidemiologic Evidence The role of carbohydrates has not been examined in epidemiologic studies, at least in recent years, because there is considerable consensus that the etiology of IDDM is not diet dependent.
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From page 278... ...
For example, diabetic Wistar rats had increased lipid levels, whereas genetically diabetic mice had no change (Gonnermann et al., 1982~. Caution needs to be exercised in extrapolating the results of these animal studies to humans because very high levels of sugars were used, species appeared to differ in their responses, chronic effects on glycemia and metabolic changes often were not monitored, metabolic responses were not tested for reversibility, and some of the reported changes may have been due to nutrient deficiencies that also produce glucose intolerance (Glinsman et al., 1986~.
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From page 279... ...
The prevalence of dental caries in Japanese children decreased precipitously during the 1940s in conjunction with the severe reduction in supply of sugars (Takeuchi, 1961~. Similar changes were noted in Europe (Sognnaes, 1948; Toverud, 1957~.
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caries in odlers (Rosen et al., 1984~. The rat is the most favored animal species in studies of dietary carbohydrates and dental caries.
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From page 281... ...
Obesity Epidemiologic and Clinical Studies An inverse association between caloric intake and body fatness has been found in some epidemiologic studies (Baeke et al., 1983; Johnson et al., 1956; Keen et al., 1979; Keys et al., 1967; Kromhout, 1983a,b; Lincoln, 1972; Maxfield and 281 Konishi, 1966; McCarthy, 1966; Stefanik et al., 1959; Wilkinson et al., 1977) but not in others (Morris et al., 1977~.
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From page 282... ...
body fat increased without a significant increase in total caloric intake in rats given a low-fat, highcarbohydrate diets and the sucrose solution. Body weight, body fat, and total caloric intake were all decreased, however, in rats given high-fat, low' carbohydrate diets and the sugar solution.
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From page 283... ...
These studies cast doubt on the hypothesized clinical significance of sugar intake in the etiology of behavioral disturbances (Prinz et al., 1980~. A similar experimental design was used in a study by WoIraich et al.
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From page 284... ...
Population studies suggesting a link between carbohydrate intake and colorectal cancer have been inconclusive. With the exception of dental caries, clinical studies of carbohydrate intake and chronic diseases DIET AND HEALTH have focused more on dietary management of chronic diseases than on the role of diet in causation.
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1982. Effects of different eating patterns on dental caries in the rat.
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1988. Comparison of a high-carbohydrate diet with a high-monounsaturated-fat diet in patients with non-insulin-dependent diabetes mellitus.
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1976. Non-linear relationship between dietary sucrose and dental caries.
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1977. Low sucrose levels promote extensive Streptococcus murans-induced dental caries.
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1982. Sugar availability, sugar consumption, and dental caries.
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1978. Dietary intake and risk of coronary heart disease in DIET AND HEALTH Japanese men living in Hawaii.
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