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Carbohydrate Intolerance


Overview :

Carbohydrates are the primary source of energy and, along with fats and proteins, one of the three major nutrients in the human diet. Carbohydrates are classified according to their structure based on the number of basic sugar, or saccharide units they contain.

A monosaccharide is the simplest carbohydrate and called a simple sugar. Simple sugars include glucose (the form in which sugar circulates in the blood), fructose (found in fruit and honey), and galactose (produced by the digestion of milk). These simple sugars are important because they can be absorbed by the small intestine. Two simple sugars linked together make a disaccharide. The disaccharide sugars present in the diet are maltose (a product of the digestion of starch), sucrose (table sugar), and lactose (the sugar in milk). These disaccharides must be broken down by enzymes into two simple sugars so that they can be absorbed by the intestine. Polysaccharides are much more complex carbohydrates made up of many simple sugars, the most important of which are glycogen, which is stored in the liver, and starch.

Digestion of sugars

Digestion of food begins in the mouth, moves on to the stomach, and then into the small intestine. Along the way, specific enzymes are needed to process different types of sugars. An enzyme is a substance that acts as a catalyst to produce chemical changes without being changed itself. The enzymes lactase, maltase, and isomaltase (or sucrase) are needed to break down the disaccharides; when one or more is inadequate, the result is carbohydrate intolerance.

Types of intolerance

Carbohydrate intolerance can be primary or secondary. Primary deficiency is caused by an enzyme defect present at birth or developed over time. The most common is lactose intolerance. Secondary deficiencies are caused by a disease or disorder of the intestinal tract, and disappear when the disease is treated. These include protein deficiency, celiac disease, and some intestinal infections.

Adult lactose intolerance is the most common of all enzyme deficiencies, and it is estimated that 30-50 million Americans have this condition. Some racial and ethnic populations are affected more than others. Lactose intolerance is found in as many as 75% of African Americans, Jewish Americans, Mexican Americans, and Native Americans, and in 90% of Asian Americans. Descendants of Northern Europeans and some Mediterranean peoples usually do not develop the condition. Deficiencies in enzymes other than lactase are extremely rare.




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