1 00:00:00,012 --> 00:00:02,747 This week, you will learn about carbohydrates. 2 00:00:02,747 --> 00:00:06,247 There are general dietary requirements, whether in foods, 3 00:00:06,247 --> 00:00:09,732 how our bodies process them, and how are they're utilized. 4 00:00:09,732 --> 00:00:14,502 Whole grains, fruits and vegetables are important parts of the nutritious diet 5 00:00:14,502 --> 00:00:19,402 and are healthy sources of carbohydrates. Added sugars may not provide nutrition, 6 00:00:19,402 --> 00:00:23,992 but that does not mean we can never have a slice of pie or sweeten our tea. 7 00:00:23,992 --> 00:00:30,163 Relatively, recently, carbohydrates of a whole have gotten a bad-rap and that was 8 00:00:30,163 --> 00:00:35,755 true, excess sugar intake is associated with disease risks and increases in 9 00:00:35,755 --> 00:00:41,506 morbidity. We cannot simply say that all sugars, all carbohydrates are bad. 10 00:00:41,506 --> 00:00:47,587 It's not just about the simple sugar. Whole grains, fruits, vegetables, these 11 00:00:47,587 --> 00:00:52,344 are all carbohydrates. Fruits contain sugar and in moderation, 12 00:00:52,344 --> 00:00:58,156 sugar can be a part of a healthy diet. So carbohydrates as a whole, have been 13 00:00:58,156 --> 00:01:02,573 framed for crimes they did not commit, at least not alone. 14 00:01:02,573 --> 00:01:05,892 Sugar has been accused of causing diabetes, 15 00:01:05,892 --> 00:01:12,364 cavities, hyperactivity, and weight gain. And though sugar may be playing a roll in 16 00:01:12,364 --> 00:01:16,775 all these conditions, sugar itself does not cause any of them. 17 00:01:16,775 --> 00:01:22,576 So let's consider the evidence behind each accusation. Can sugar cause 18 00:01:22,576 --> 00:01:26,586 diabetes? Type 1 diabetes is an autoimmune disorder, 19 00:01:26,586 --> 00:01:32,273 regardless of what a person with type diabetes eats, they will always have it. 20 00:01:32,273 --> 00:01:37,769 Proper nutrition is part of managing type 1 diabetes, but it's not cause for 21 00:01:37,769 --> 00:01:41,152 malnutrition. Type 2 diabetes has many causes. 22 00:01:41,152 --> 00:01:47,002 It's a multifactorial disease progressing from insulin insufficiency or resistance. 23 00:01:47,002 --> 00:01:52,252 Once someone has diabetes, a good diet with regulated carbohydrate intake will 24 00:01:52,252 --> 00:01:56,352 be part of the treatment playing. First factors for developing insulin 25 00:01:56,352 --> 00:02:01,272 resistance include obesity, high blood pressure, high cholesterol, 26 00:02:01,272 --> 00:02:07,392 sedentary lifestyle, genetics, polycystic ovary syndrome, and aging. 27 00:02:07,392 --> 00:02:11,910 It's a much more complex than sugar causes diabetes. 28 00:02:11,910 --> 00:02:17,839 And we see, as life goes along, we roll around and our bodies deteriorates 29 00:02:17,839 --> 00:02:22,452 depending on how well we do or do not take care of them. 30 00:02:22,452 --> 00:02:26,269 We cannot isolate any one of these as causing diabetes. 31 00:02:26,269 --> 00:02:31,930 They are certainly part of a process, and then, once someone is diabetic, these are 32 00:02:31,930 --> 00:02:37,310 all conditions one would want to manage and one would also want to manage their 33 00:02:37,310 --> 00:02:43,002 carbohydrate intake, but again, we cannot say sugar makes you become diabetic. 34 00:02:43,002 --> 00:02:48,723 Is sugar rotting your teeth or a little sugar monster is chipping away at your 35 00:02:48,723 --> 00:02:54,550 teeth with every bite? Well, just like diabetes, the development of dental care 36 00:02:54,550 --> 00:02:57,959 is, is also a multi, multifactorial phenomenon. 37 00:02:57,959 --> 00:03:03,312 While sugar fuels the organism responsible for dental demineralization, 38 00:03:03,312 --> 00:03:07,776 sugar at own does not break down tooth enamel. 39 00:03:07,776 --> 00:03:12,718 The bacteria responsible for this process is s mutans. 40 00:03:12,718 --> 00:03:20,183 Caries its caries formation will begin with a demineralization of tooth enamel 41 00:03:20,183 --> 00:03:25,570 from the acids in the mouth. The activity of this s mutans actually 42 00:03:25,570 --> 00:03:31,571 will cause this acid production, as well as any acid that you consume like orange 43 00:03:31,571 --> 00:03:36,242 juice is an acidic food that will add to the acidic environment. 44 00:03:36,242 --> 00:03:42,168 So, this s mutans who metabolize specifically from minimal carbohydrates 45 00:03:42,168 --> 00:03:46,133 that you eat. So whether that be a cookie or a caramel 46 00:03:46,133 --> 00:03:50,226 bread orange juice, the bacteria will break it down, and 47 00:03:50,226 --> 00:03:54,269 there, metabolic processes produce acids in the mouth. 48 00:03:54,269 --> 00:04:00,089 Over time, these acids will continue to build up to a point where you can change 49 00:04:00,089 --> 00:04:04,532 the ph of your mouth. Once you change the ph of your mouth, 50 00:04:04,532 --> 00:04:09,754 demineralization will begin. In addition to this, the process of this 51 00:04:09,754 --> 00:04:15,499 bacteria also induces the formation of plaque and these pockets of plaque on 52 00:04:15,499 --> 00:04:21,161 your teeth enhance the environment and make it hospitable for the s mutans to 53 00:04:21,161 --> 00:04:25,727 continue with s production, acidifying the mouth, and causing 54 00:04:25,727 --> 00:04:32,049 demineralization of the tooth. A demineralization continues if it 55 00:04:32,049 --> 00:04:36,229 reaches the dentin as you continue to eat. 56 00:04:36,229 --> 00:04:41,664 Over time, we can break it down enough to cause a carie. 57 00:04:41,664 --> 00:04:49,317 Now, we think about what kind of foods are bad here or less healthful. 58 00:04:49,317 --> 00:04:54,708 The foods that are responsible are any fermentable carbohydrate. 59 00:04:54,708 --> 00:04:59,182 An apple, an orange, a caramel, a soda, a candy bar. 60 00:04:59,182 --> 00:05:02,971 Some foods are less cariogenic than others, 61 00:05:02,971 --> 00:05:09,288 that means they have less capacity to cause caries and also the ph of a food 62 00:05:09,288 --> 00:05:14,048 will have an impact here. Well, think about some of the foods maybe 63 00:05:14,048 --> 00:05:19,046 you could've chosen for oral health. Oral hygiene is always important keeping 64 00:05:19,046 --> 00:05:23,734 the mouth clean, keeping debris off the mouth. It's going to be very important. 65 00:05:23,734 --> 00:05:27,317 We're just going to focus a little bit on food component here. 66 00:05:27,317 --> 00:05:30,352 So, let's think of some foods you might choose. 67 00:05:30,352 --> 00:05:35,507 How about an apple and cheese? Well, the apple has sugar as a fruit. 68 00:05:35,507 --> 00:05:40,010 The cheese does have some sugar. It's, it is based of milk. 69 00:05:40,010 --> 00:05:43,700 So there is some amount of carbohydrate in both, 70 00:05:43,700 --> 00:05:49,224 but this is not a very sticky food. It's not going to stick to your teeth. 71 00:05:49,224 --> 00:05:53,627 The fresh apple, the uncooked, unprocessed apple is less 72 00:05:53,627 --> 00:05:57,095 cariogenic than a processed apple would be. 73 00:05:57,095 --> 00:06:00,067 But, especially, if you added sugar to the 74 00:06:00,067 --> 00:06:05,340 apple and made like a dessert and certainly apple acids sitting on your 75 00:06:05,340 --> 00:06:11,058 teeth long term might not be good, but that's not one we consider highly highly 76 00:06:11,058 --> 00:06:14,651 problematic. How about some soda and pasta? Well, 77 00:06:14,651 --> 00:06:19,816 there's sugar in the soda and in the pasta, and there's acids in the soda. 78 00:06:19,816 --> 00:06:23,405 So these are formidable plus acidic, so yesm they certainly would lend themselves 79 00:06:23,405 --> 00:06:26,295 more [INAUDIBLE] demineralization or to exasperating demineralization. 80 00:06:26,295 --> 00:06:29,651 Milk and carrots, okay again, both have sugar, 81 00:06:29,651 --> 00:06:34,978 but their forms are less cariogenic. How about orange juice and a breakfast 82 00:06:34,978 --> 00:06:38,521 muffin? While orange juice is certainly helpful, 83 00:06:38,521 --> 00:06:42,401 it's got vitamin C, it's a nice part of your breakfast. 84 00:06:42,401 --> 00:06:47,121 A breakfast muffin, well, you know, it certainly could be a choice. 85 00:06:47,121 --> 00:06:52,280 It might be less helpfu, but Combined with foods from animal carbohydrates, 86 00:06:52,280 --> 00:06:57,277 potentially that stickiness of that muffin and the actives in your juice are 87 00:06:57,277 --> 00:07:01,652 going to promote demineralization in carriage formation. 88 00:07:01,652 --> 00:07:07,462 How about veggies and the chicken? Well, these are also going to change some 89 00:07:07,462 --> 00:07:14,041 carbohydrates probably have certain half carbohydrates, but they are not going to 90 00:07:14,041 --> 00:07:19,895 be highly cariogenic and not highly suitable for eating and demineralization. 91 00:07:19,895 --> 00:07:25,197 So I've used some terminology and listed some different foods that might be 92 00:07:25,197 --> 00:07:28,873 increasing the risks of developing dental caries. 93 00:07:28,873 --> 00:07:34,595 Foods that are going to be inducing more demineralization because of what they do 94 00:07:34,595 --> 00:07:39,631 to the oral environment and these terms that I've used just to help you 95 00:07:39,631 --> 00:07:44,321 understand what they are. Acidic foods can be termed acidogenic, 96 00:07:44,321 --> 00:07:49,560 they do decrease the oral pH quickly. Cariogenic foods are the fermentable 97 00:07:49,560 --> 00:07:55,473 carbohydrates as I mentioned that will be metabolized by the bacteria in your mouth 98 00:07:55,473 --> 00:08:00,440 to also reduce the pH in the mouth. Cariostatic foods, now, they do contain 99 00:08:00,440 --> 00:08:05,405 some sugars, but they're really not metabolizing by the bacteria into a point 100 00:08:05,405 --> 00:08:09,113 where they're going to actually drop the pH of your mouth. 101 00:08:09,113 --> 00:08:13,936 And lastly, anticariogenic foods that I didn't mention, but which are very 102 00:08:13,936 --> 00:08:18,354 important, can actually prevent cariogenic activity and the two that 103 00:08:18,354 --> 00:08:22,362 really come to mind are xylitol in sugar free gums and cheese. 104 00:08:22,362 --> 00:08:26,920 So cheese is actually a really great healthy snack option, for example. 105 00:08:26,920 --> 00:08:30,165 We'll talk a little bit about this in future lectures. 106 00:08:30,165 --> 00:08:34,698 But in pregnancy, one might want to eat smaller, more frequent meals if one's 107 00:08:34,698 --> 00:08:39,536 feeling significant amounts of nausea and a healthy snack for keeping good oral 108 00:08:39,536 --> 00:08:42,936 health in pregnancy would be a low fat cheese stick. 109 00:08:42,936 --> 00:08:47,861 This will be much better than something that seems healthy like a granola bar. 110 00:08:47,861 --> 00:08:52,881 A granola bar is sticky, a fermentable carbohydrate and it would be more likely 111 00:08:52,881 --> 00:08:56,346 to induce demineralization and various development. 112 00:08:56,346 --> 00:09:01,447 Another thing that's very important is how often you eat and what type of foods 113 00:09:01,447 --> 00:09:05,932 are in your meals or snacks together. So if you eat, eat more often then 114 00:09:05,932 --> 00:09:10,357 there's more chances that you're bringing in fermentable carbohydrates, potentially 115 00:09:10,357 --> 00:09:15,873 acids and you are activating those bacteria, so each time you eat, that pH 116 00:09:15,873 --> 00:09:20,324 could drop, the more often the pH drops the more likely you are going to see 117 00:09:20,324 --> 00:09:24,072 demineralization occur. So, more often, eating more often would 118 00:09:24,072 --> 00:09:27,962 be a risk factor for higher chances of developing dental caries. 119 00:09:27,962 --> 00:09:32,918 Also, if we have snacks that are high in fermentable carbohydrates and that's all 120 00:09:32,918 --> 00:09:37,448 they're made of, so a snack, like I just said, a granola bar versus a cheese 121 00:09:37,448 --> 00:09:42,318 stick, that snack has nothing else in it. It's going to be more likely to induce 122 00:09:42,318 --> 00:09:47,067 the development of dental caries. If I have that granola bar in a meal 123 00:09:47,067 --> 00:09:51,762 where there's lots of other foods, so maybe it was part of my lunch. 124 00:09:51,762 --> 00:09:57,352 I had a granola bar with a cup of yogurt and a nice bottle, cup of water to go 125 00:09:57,352 --> 00:10:03,370 with that those foods would combine to decrease what's happening in the mouth. 126 00:10:03,370 --> 00:10:07,523 Another thing that's important is rinsing the mouth out so those fermentable 127 00:10:07,523 --> 00:10:11,817 carbohydrates don't stay there and that's done with basic water and also making 128 00:10:11,817 --> 00:10:15,738 sure that you have enough saliva. Individuals with conditions such as dry 129 00:10:15,738 --> 00:10:19,576 mouth also have a higher risk for developing dental cavities, because the 130 00:10:19,576 --> 00:10:21,802 saliva isn't there to help [UNKNOWN] the mouth. 131 00:10:21,802 --> 00:10:26,105 Alright. So does sugar cause hyperactivity? Was it that candy bar that 132 00:10:26,105 --> 00:10:30,768 got your kids running and screaming through the market? Well, even though it 133 00:10:30,768 --> 00:10:35,665 might seem like it, sugar is not the best choice for a growing child, but it's not 134 00:10:35,665 --> 00:10:39,876 going to cause hyperactivity. Now, it might spike blood sugar and have 135 00:10:39,876 --> 00:10:43,953 other negative effects if eaten in excess, but it's not causing the 136 00:10:43,953 --> 00:10:46,577 hyperactivity. While I'm free of being, blaming 137 00:10:46,577 --> 00:10:51,752 stimulants like caffeine and sugar, poor nutrition and micronutrition imbalances 138 00:10:51,752 --> 00:10:57,092 can have detrimental hormonal effects and the treatment of chronic malnutrition has 139 00:10:57,092 --> 00:11:00,722 been associated with improvements in behavioral issues, 140 00:11:00,722 --> 00:11:05,062 but overall, we can't just blame sugar. That's much too simplistic. 141 00:11:05,062 --> 00:11:09,654 There's far more at play here. Good healthy diet is very important for 142 00:11:09,654 --> 00:11:14,796 having a healthy child that does behave properly and even so a child with a very 143 00:11:14,796 --> 00:11:19,424 healthy diet may still have other factors coming into play that can lead to 144 00:11:19,424 --> 00:11:23,902 behavioral problems. How about weight gain? Can we blame the 145 00:11:23,902 --> 00:11:29,217 carbon sugar for tipping the scale? Now, they have been the target of ketogenic 146 00:11:29,217 --> 00:11:34,658 diets like the Atkins diet or South Beach diet and low fat craze is widespread, 147 00:11:34,658 --> 00:11:39,897 we can see it on our supermarket shelves. This comes about because people are 148 00:11:39,897 --> 00:11:44,500 struggling to find an easy solution for their battle with obesity, 149 00:11:44,500 --> 00:11:48,769 and the hardest part about weight management is not what you should or 150 00:11:48,769 --> 00:11:51,560 should not eat. We know what we should or should not eat 151 00:11:51,560 --> 00:11:56,158 or at least what we should eat more or less of, but it's making that happen. 152 00:11:56,158 --> 00:12:00,878 So combining our food choices with dealing practical, financial, emotional 153 00:12:00,878 --> 00:12:05,419 challenges, limitations in time and energy, overcoming stress or lack of 154 00:12:05,419 --> 00:12:09,916 motivation. Those I would say are far more likely to 155 00:12:09,916 --> 00:12:15,152 blame for our challenges with food. If we wanted to blame any sugar, we would 156 00:12:15,152 --> 00:12:18,132 maybe look to the added sugars in our food. 157 00:12:18,132 --> 00:12:23,836 These are going to be less satisfying and less satiating and we're more likely to 158 00:12:23,836 --> 00:12:29,228 overeat sugary, empty calorie foods than a high fiber carbohydrates. 159 00:12:29,228 --> 00:12:33,488 So if we think about this, let's break this down. 160 00:12:33,488 --> 00:12:40,473 If you, your body, burns 1, 953 calories a day and you eat 1,950 calories a day, 161 00:12:40,473 --> 00:12:45,822 just carbohydrates. Maybe just apples, for example, or just 162 00:12:45,822 --> 00:12:49,382 grapes. Will you gain weight? Now, even if 163 00:12:49,382 --> 00:12:53,312 they're just Twinkies, you're not going to gain weight. 164 00:12:53,312 --> 00:12:58,942 Can we blame certain foods for tipping the scale without regard to the quantity 165 00:12:58,942 --> 00:13:04,432 we consumed? How easy would it be to eat 1,500, 1,900, calories of apple versus 166 00:13:04,432 --> 00:13:11,090 1,500, 1,900, calories of icecream? So if you're still guessing, the answer 167 00:13:11,090 --> 00:13:14,318 is no, carbohydrates don't make us fat. 168 00:13:14,318 --> 00:13:20,360 Calories, in excess, increase fat deposition and do lead to weight gain. 169 00:13:20,360 --> 00:13:24,275 There's no one food to blame for tipping the scale, 170 00:13:24,275 --> 00:13:30,477 even the cupcakes, veggies, burgers, all these foods can be part of a healthy 171 00:13:30,477 --> 00:13:35,752 diet, even our party things. When think about what [UNKNOWN] this 172 00:13:35,752 --> 00:13:39,757 weight gaining, again, it's not multifactorial component. 173 00:13:39,757 --> 00:13:45,467 Even though, eating unhealthy might lead you to be hungry or type of vitamin or 174 00:13:45,467 --> 00:13:49,817 mineral deficiency. It's more the complex components that are 175 00:13:49,817 --> 00:13:53,406 going to lead to obesity. All the components to our food, the 176 00:13:53,406 --> 00:13:58,226 proteins, the vegetables, the fruits, the whole grains, fiber, vitamins and 177 00:13:58,226 --> 00:14:01,339 minerals, play a role in our health. We need them, 178 00:14:01,339 --> 00:14:05,268 our body needs these components of food to make the machine run. 179 00:14:05,268 --> 00:14:09,182 It's the details of diet that dictate how healthy you'll be. 180 00:14:09,182 --> 00:14:13,742 If you're satiated by what you eat, if your body systems function normally, if 181 00:14:13,742 --> 00:14:18,405 your food helps you maintain even blood sugar and healthy digestion, if you have 182 00:14:18,405 --> 00:14:21,418 enough energy to do what you need to do all day long. 183 00:14:21,418 --> 00:14:25,914 If your food meets your body's needs, and meets your satiety needs, and taste 184 00:14:25,914 --> 00:14:30,302 needs, you're less likely to gain weight. Research indicates that the key to 185 00:14:30,302 --> 00:14:33,912 healthy weight management is self-awareness and self-monitoring. 186 00:14:33,912 --> 00:14:38,212 You not only know how much you're eating, you've all got an opportunity to 187 00:14:38,212 --> 00:14:41,007 self-monitor. Were you surprised by what you ate? When 188 00:14:41,007 --> 00:14:45,282 it comes to losing weight, burning more calories than you eat brings results. 189 00:14:45,282 --> 00:14:49,272 The best way to make sure that you're doing that is to write it down. 190 00:14:49,272 --> 00:14:54,357 So to summarize how can maybe carbohydrates seem to be tipping the 191 00:14:54,357 --> 00:14:57,938 scale, you may have talked to a friend or heard 192 00:14:57,938 --> 00:15:01,805 in the media it's the carbs that are making me fat. 193 00:15:01,805 --> 00:15:07,575 When I stop eating carbs, I lose weight. It's gotta be the carbs, it jus, that 194 00:15:07,575 --> 00:15:10,888 just makes sense. Well, if they're not writing what they're 195 00:15:10,888 --> 00:15:15,268 eating down, they don't know for sure how many calories they were eating before 196 00:15:15,268 --> 00:15:17,725 they cut carbs versus after they cut carbs. 197 00:15:17,725 --> 00:15:22,093 This balance is as simple as in and out, but the awareness and actual details of 198 00:15:22,093 --> 00:15:24,652 how much we're eating come to measurement. 199 00:15:24,652 --> 00:15:29,565 What you choose to eat depends on cost, time, taste, and who you're responsible 200 00:15:29,565 --> 00:15:32,696 for eating. Unhealthy food, empty calories, and a 201 00:15:32,696 --> 00:15:37,609 diet high in added sugar is more likely to bring in more calories, even though it 202 00:15:37,609 --> 00:15:42,565 does taste good, it's less filling than fiber, less satiating and much easier to 203 00:15:42,565 --> 00:15:46,622 overeat. Now, when people do go on low-carb diets, 204 00:15:46,622 --> 00:15:51,922 yes, there are physiological changes occurring. But over time, two individuals 205 00:15:51,922 --> 00:15:56,947 on low-carb versus moderate-carb diet eating the same amount of calories, 206 00:15:56,947 --> 00:16:01,022 having the same caloric need are going to both lose weight. 207 00:16:01,022 --> 00:16:06,098 So if there's any one key though to healthy weight management, I would say 208 00:16:06,098 --> 00:16:10,161 it's in fiber and protein with a little bit of fat. 209 00:16:10,161 --> 00:16:16,193 Fiber fills you up, protein keeps you full, and fat makes things taste good. 210 00:16:16,193 --> 00:16:22,898 All in moderation, again, but proper food combining the roles of food in our diet 211 00:16:22,898 --> 00:16:26,628 can also be a part. I was helping manage weight more easily, 212 00:16:26,628 --> 00:16:30,232 so while we're talking about sugar, let's talk about the un-sugars, 213 00:16:30,232 --> 00:16:34,560 they've also been blamed for some things along the years, certainly some of them, 214 00:16:34,560 --> 00:16:38,661 more and more chemical in nature than others, and some individuals may choose 215 00:16:38,661 --> 00:16:41,768 not to consume them. They much rather just moderate their 216 00:16:41,768 --> 00:16:46,042 sugar or sweets intake, but since we'd like to know a little bit about what they 217 00:16:46,042 --> 00:16:50,147 mean and so that you can understand what they are, I will help a little bit about 218 00:16:50,147 --> 00:16:52,602 those. The first artificial sweetener to appear 219 00:16:52,602 --> 00:16:56,002 on the market was saccharin, tt was marketed as Sweet'N Low, and it 220 00:16:56,002 --> 00:16:59,977 still is, and in addition to the tabletop sweetener, you can find saccharin in 221 00:16:59,977 --> 00:17:03,146 low-sugar versions of foods, like gums or diet soda. 222 00:17:03,146 --> 00:17:07,969 Saccharin isn't digestible, but it is absorbed through the gut and will be 223 00:17:07,969 --> 00:17:12,625 excreted in your urine unchanged. It was the subject of some controversy 224 00:17:12,625 --> 00:17:17,778 due to some findings of associations with bladder tumors developing in male rats 225 00:17:17,778 --> 00:17:22,672 fed high doses of sodium saccharine, but following research did not find any 226 00:17:22,672 --> 00:17:28,044 significant association in human being. That being said, it is still a chemical 227 00:17:28,044 --> 00:17:33,377 that you are introducing into your body and just like every other nutrient or 228 00:17:33,377 --> 00:17:37,373 non-nutrient edible product, I would say moderation is the key. 229 00:17:37,373 --> 00:17:41,813 A newer sugar alternative actually derived from sugar is sucralose. It's 230 00:17:41,813 --> 00:17:45,582 marketed as Splenda. Splenda's useful in cooking, because it 231 00:17:45,582 --> 00:17:48,937 is highly stable and it will maintain it's sweetness. 232 00:17:48,937 --> 00:17:53,565 It does not provide calories because it isn't digested and like the other 233 00:17:53,565 --> 00:17:57,250 [UNKNOWN] sweeteners, it will be excreted in the urine. 234 00:17:57,250 --> 00:18:00,304 A third kind of sweetener released is aspartame. 235 00:18:00,304 --> 00:18:05,189 This is sold as Equal and NutraSweet. Aspartame is used in diet sodas and other 236 00:18:05,189 --> 00:18:08,268 drinks. It's in processed foods and these foods 237 00:18:08,268 --> 00:18:13,404 will typically be marketed as low sugar. It's also used in sweetened medications. 238 00:18:13,404 --> 00:18:18,283 The compound aspartame is made of aspartic, aspartic acid and phenylalanine 239 00:18:18,283 --> 00:18:24,258 with with [INAUDIBLE] Now, unlike other artificial sweeteners, aspartame cannot 240 00:18:24,258 --> 00:18:28,508 be used in cooking, it will be denatured and lose its taste. 241 00:18:28,508 --> 00:18:33,385 And the primary concern with aspartame is in certain individuals with 242 00:18:33,385 --> 00:18:37,447 phenylketonuria or PKU. Individuals with PKU cannot digest 243 00:18:37,447 --> 00:18:39,520 aspartame, it's toxic to them, 244 00:18:39,520 --> 00:18:43,030 this is because they can't break down phenylalanine. 245 00:18:43,030 --> 00:18:47,831 They actually are missing the enzyme phenylalanine hydroxylase or have 246 00:18:47,831 --> 00:18:51,827 insufficient amounts to convert phenylalanine to tyrosine. 247 00:18:51,827 --> 00:18:56,361 These are both amino acids. When you cannot convert phenylalanine to 248 00:18:56,361 --> 00:19:00,654 tyrosine, phenylalanine, phenylalanine will build up in the blood and cause 249 00:19:00,654 --> 00:19:06,189 toxicity, particularly in the brain. So people with PKU do need to avoid foods 250 00:19:06,189 --> 00:19:11,861 rich in phenylalanine or any alternative sweetened product or any alternative 251 00:19:11,861 --> 00:19:16,213 sweetened products with Equal or NutraSweet, with aspartame. 252 00:19:16,213 --> 00:19:21,481 And the food levels will actually contain information about their aspartame content 253 00:19:21,481 --> 00:19:24,698 and a warning. Other sweeteners may be marketed for 254 00:19:24,698 --> 00:19:29,069 their anticariogenic property, as I mentioned, or the sugar alcohols. 255 00:19:29,069 --> 00:19:32,342 These include sorbitol, mannitol, and erythritol. 256 00:19:32,342 --> 00:19:37,547 These are digested, but not metabolized and, or they're metabolized very slowly, 257 00:19:37,547 --> 00:19:42,282 and they do have minimal calories relative to sugar. Because the digestion 258 00:19:42,282 --> 00:19:46,577 is slow, not all the sugar alcohol gets absorb, absorbed and some of this can 259 00:19:46,577 --> 00:19:49,618 actually cause GI irritation and diarrhea . 260 00:19:49,618 --> 00:19:54,023 The good news for dentists is that sugar alcohols are not metabolized by, or 261 00:19:54,023 --> 00:19:56,782 bacteria. Chewing gums sweetened with sugar 262 00:19:56,782 --> 00:20:01,230 alcohols can help prevent cavities, because each stick gum helps clear the 263 00:20:01,230 --> 00:20:05,603 mouth, increase the saliva and there's not a fermentable carbohydrate. 264 00:20:05,603 --> 00:20:10,600 Looking at a gum label, you'll actually see claims relating to artificial 265 00:20:10,600 --> 00:20:16,236 sweeteners sugarless or even the claim that it does not promote tooth decay. 266 00:20:16,236 --> 00:20:20,309 And again, this is because it's not broken down by bacteria. 267 00:20:20,309 --> 00:20:26,172 Finally stevia is derived from a perenial shrub and is 30 times sweeter than sugar. 268 00:20:26,172 --> 00:20:30,182 It's available in powder and liquid concentrate, tea, or tablet forms. 269 00:20:30,182 --> 00:20:33,762 Refined stevia is considered non-nutritive and is cariostatic. 270 00:20:33,762 --> 00:20:37,980 It's marketed as having no effect on blood sugar, but in current research is 271 00:20:37,980 --> 00:20:42,331 still underway to determine the effects of whole leaf or crude stevia on blood 272 00:20:42,331 --> 00:20:46,263 sugar, the kidneys, and the cardiovascular, and 273 00:20:46,263 --> 00:20:51,510 reproductive systems. So, I hope you've learned a little bit 274 00:20:51,510 --> 00:20:57,877 more about carbs and what sugar does or does not do and can now be one to help 275 00:20:57,877 --> 00:21:02,674 stop blaming sugar for things that sugar was not causing.