Carbohydrates

0:04 [music] Welcome to the week six session on uh the next macronutrient. We're going to talk about the carbohydrates which is the major energy source for our human body. At the end of this session, the student will be able to identify its occurrence in the body, understand the composition classification functions dietary sources, and daily recommended allowances. The carbohydrates uh or hydrates of carbon or nothing but the organic compounds that are made up of carbon, hydrogen and oxygen. So those that yield energy upon oxidation are

0:52 called energy nutrients. Uh similarly carbohydrate, protein and fats are all coming under these energy nutrients. It is utilized as a fuel for the human body. The major uh carbohydrate is the most vital source of energy for the nervous tissue especially the central nervous tissue. So if you see the structure here uh it has carbon, hydrogen and oxygen present here. That's the major uh composition that you can see here. and also it is considered to be the major fuel for the human body. History of carbohydrate uh goes way back in 1844 where skimmit found carbohydrate as a

1:39 component that contained carbon, hydrogen and oxygen. Whereas uh a French physiologist Claude Bernard he is the one who discovered that animal storage form of carbohydrate is nothing but liver glycogen. So this is with regard to the history. So it's been discovered long long ago. And when it comes to the occurrence where all we can find the uh carbohydrate being present and what form of carbohydrate is being utilized. So if you see in the blood it is the form of glucose and it is major function is in the form of energy transport whereas in the liver it is stored as glycogen and it [snorts] helps in blood glucose

2:25 regulation. Similarly in muscle also it is present as glycogen and it's needed as a local energy for contraction. [snorts] In cell membrane it is uh in the is it is present in the form of glyoproteins or glyolippids. The major uh function would be cell recognition and signaling. Connective tissues are present in the form of proteoglycans and it's important for structural support. In nucleus it is present as ribos or deoxyibbos which is nothing but RNA and DNA backbone. So that is how the carbohydrate is present in the different uh organs in the different forms and it is required for different performing

3:10 different functions. So coming to the classification of car carbohydrate. This particular slide we have discussed in uh week one also where we have understood that the carbohydrates are basically classified as simple carbohydrates uh which is nothing but monossaccharides, disaccharides and oligosaccharides. This which comes under simple carbohydrates. Whereas complex carbohydrates we have polysaccharides. Under monossaccharides, it's nothing but the single uh glucose molecule which is glucose, fructose and galactose. Whereas if you see in disaccharides we have glucose, fructose and galactose here as a primary carbon number. When it

3:56 comes to the reducing sugars, it is the maltos and the lactose. Maltose is nothing but a combination of disaccharides which is glucose plus glucose. Whereas uh lactose is nothing but glucose plus galactose. That's the difference that you can see. Whereas a non-reducing sugar if you see it's the sucrose that is the glucose plus the fructose which forms as a sucrose. So this is the major classification that you should know [snorts] which is the monossaccharide disaccharide and next we move on to the oligosaccharides. Under oligosaccharides based on the number of carbons it is divided as tricaccharides tetraaccharides. Tricaccharides are nothing but three molecules. Tetra is four which is

4:41 rafinos stachio arabinos and all that. Examples would be rafio and stakio. You can see here [snorts] and when it comes to uh complex carbohydrates the common term that we normally follow is the polysaccharides where you can see hetroolysaccharides are there and homopolysaccharides are there under that the difference again is seen as cellulose heparin and all that. So that that is what you should know as polyaccharides are nothing but uh non-starch polysaccharides even fiber is coming under that category only. Moving on to the functions there are multiple function that you can see with regard to the carbohydrates. First and foremost function is the

5:29 providing energy for the intermediate use of the body. 1 gram of carbohydrate is provides about 4 kilo calories. For example, the body store of carbohydrate is 300 g. They roughly provide 300 into 4 which is 1,200 kiloalorie which is enough to last for only few hours. The blood sugar is maintained through continuous replenishment by gluconioenesis from fats and proteins. So gluconioenesis is nothing but the formation of glucose from non carbohydrate sources which is the fat and the protein. Always [snorts] blood sugar gets maintained by continuous replenish replenishment of this particular thing by gluconioenesis

6:15 in the blood and the RBCs only depend on glucose for their uh activity. So always remember that energy is uh needed for almost all the activities that happens in the body. Next in the liver, liver uh glycogen is protected by the liver from the glycogen will actually present in the liver will protect the liver from bacterial toxins and poisonous substances. Glucronic acid produced by the liver from carbon carbohydrates converts the harmful substances containing alcoholic or the phenolic group into harmless compounds that are excreted. Also they produce the

7:00 acetile group which combines with sulfonomides to produce harmless acetile forms that are excreted in the kidneys. So major uh form of uh glycogen in the liver uh source of carbohydrate in the liver is glycogen and that helps to protect the liver from bacterial toxins and poisonous substances. Next in the central nervous system which is nothing but the brain the [snorts] brain will use about uh 5 g per hour of glucose for its energy. So if you see only the glucose is used as the major energy source for the brain. Moving on to the heart the efficiency of

7:48 the heart uh depends on the availability of carbohydrate as a fuel. So it starts pumping efficiently. This supply of uh energy is derived from the blood and the glycogen which is stored in the heart muscle. The heart has a reserve reserve store for glycogen that can be used in emergency. When there is a temporary hypoglycemia, a healthy heart is not damaged due to this reserve. When a damaged heart contains very little reserve of uh glycogen, this is subjected to low BP which is nothing but blood pressure. Therefore, angginal pectus is experienced. So that is how it is being uh important when we talk about the

8:36 function of the carbohydrates in in the heart under muscle contraction. Carbohydrate is the most efficient and the economic fuel for the muscles. The energy is derived from glycogen in the muscles. If we have adequate oxygen supply, the lactate is produced which is oxidized for energy with inadequate oxygen supply. Whereas carbohydrates are broken down raises the blood lactate to produce lactic acidosis. In the sense carbohydrates are should have [snorts] adequate oxygen supply to carry out its activity so that it does not have any other further complications. Protein sparing effect as discussed in

9:24 the under energy section proteins are only used for producing the helping in the building up of tissues, maintaining the tissues and repairing the tissues. When carbohydrate and fat is not adequate in your body, then only protein will come into play. When carbohydrates are and fats are supplied to meet the energy demands, proteins are being spared for growth and repair activity. So when carbohydrates are adequate in your body, proteins are spared for growth and repair effect. That is the protein sparing effect of carbohydrates. Imagine a car is having fuel in terms of uh petrol and

10:10 uh your body needs more of energy in terms of carbohydrate and fat. When all the resources of protein and energy is gone [snorts] protein uh comes into play. I mean to say when all the sources of carbohydrate and fat is gone, protein comes into play. Since I gave example as a car, the petrol is the major source, right? And they have all the four tires to carry on the functioning of the uh running of the car. What if one tire is getting uh affected or there's a puncture in the tire, you replace that with a stean? Similarly, the protein will come into play with that. So protein helps to give

10:56 the energy in that case where the other activity of growth and repair will not be taken care by the protein because carbohydrate and fat is depleted in the body. Protein comes into play. That is why our body has to be given the adequate carbohydrates and fats to spare the protein from the growth and repair activity. The endogenous breakdown of protein is reduced if the patient is given a daily minimum of 150 g of carbohydrate for energy. When the carbohydrate is insufficient to meet the energy requirements, then amino acids undergo a process called deamination that will help to produce a glucose formation and then [snorts] nitrogen is

11:43 converted to ura by the liver and excreted by the kidneys. So this is the major mechanism that you should remember. So thereby if the carbohydrates are really adequate in your body, you don't have to worry about the protein sparing effect. So that means the protein will not be used up for energy purposes. Therefore this protein sparing effect is helped by the carbohydrate adequate amount of carbohydrates in your body. Next major function is about the ketosis. So we discussed about the protein. Then we move on to the fat. Ketosis and carbo carbohydrate

12:29 metabolism. When a person is having a normal metabolism, the fat will undergo ketogenesis to form ketone bodies. Ketogenesis is nothing but breakdown of fat and into ketone bodies. Ketone bodies are used as a major source of energy. but only to a limited extent. When carbohydrates are not utilized in your body or it is not readily available in your body, then comes fat. Fat is broken down as greater quantities for energy and increased amount of ketone bodies are produced. Ketone bodies in blood is uh referred to as ketoneia. Ketone bodies in ura urine is referred to as ketonura.

13:17 So if you see uh there are other functions of the carbohydrates include um the when you provide uh energy in the form of carbohydrate to our healthy bacteria in our body that stimulates the growth of intestinal bacteria because uh more of soluble fiber when it is in the colon the colonic bacteria will survive and it helps in producing some good microbes that will inhibit the other uh infections in your body. Similarly, carbohydrate also forms a bulk or it provides fiber or bulk

14:02 which is major to our uh digestive tract. Cellulose is resistant to human digestive enzymes. That means the uh fiber which is present in the food items are not having a enzyme to get digested in the human body. What happens is they slowly pass through the digestive tract and they regulate the movement of food through the intestine and that is how it is calculated. So therefore 1 g of soluble fiber yields 2 kilo calories. So when we talk about the functions we have uh looked into the variety of functions of the carbohydrates. First is the energy production and then in the liver how it is glycogen is stored and

14:49 how fat is utilized and how protein uh comes into play pro as protein sparing effect and how the u microbes or the intestinal microbes are being stimulated by the f uh carbohydrate rich food and how fiber plays an important role. So these are the some of the major functions of carbohydrate that I would like to highlight on. Next we move on to the major uh uh digestion of carbohydrates. If you see in the mouth the digestion of starch begins in the mouth. You can see here uh the more you chew the high fiber food it slows the eating and it stimulates the flow of saliva. Here the

15:36 there are enzymes like salivory amias in the saliva which starts to work. This particular saliva will split the starch into shorter polysaccharides and maltos. So the digestion of the starch starts only in the mouth with regard to the chewing and also in the salivary amalas activity that will start splitting the starch into shorter polyaccharides and maltos. In the stomach you can see that uh the swallowed bolus gets mixed up with the stomach's acid which is nothing but hydrochloric acid and gastric juice and proteins are also uh playing a role here with regard to the digestive enzymes. Here the

16:23 amalas deactivates after contact with HCl which is the hydrochloric acid secreted by the stomach and the food is then passed into the small intestine. In the small intestine most carbohydrate digestion takes place in the small intestine. As you can see uh pancreatic amias which is the major uh enzyme which is present in the small intestine which will uh helps in the breakdown of polysaccharides to shorter glucose chains and disaccharides. So if you see uh for example the food that you uh eat gets converted to glucose chains shorter glucose chains and disaccharides like glucose plus glucose or maltos like that as the food

17:11 passes into the brush border of the intestine it is acted upon by the respective enzyme. For example, if it is a lactose, okay, then there is a enzyme called lactase which is present in the brush border that will be acted upon and this lactase will break down the lactose into glucose and galactose. That is how it is getting broken down to monossaccharides. Once the glucose and galaptose is released into the intestine, they get readily absorbed by the body into the bloodstream. >> [snorts] >> In the large intestine we have uh many things that happens in the large intestine. So if you see uh most of the carbohydrates especially the fiber rich foods they

17:57 escape digestion and reach the large intestine. Here you can see short chain fatty acids are being released because the fermentation of the fiber takes place with regard to the different uh microbial metabolism. [snorts] So it produces energy and all that. When it comes to short- chain fatty acids, soluble fiber will release these short- chain fatty acids on fermentation and also some volatile acids will be produced. So if you see acetate uh butyrate and propionate are called as short chain fatty acids. So they are also released into the blood and once this is released they form the fuel for the

18:42 large intestine again. So that's the cycle. So more you feed the large intestine it is good and it maintains the pH and all that. So thereby [snorts] even colonic bacteria colonic mucosa is being preserved. That's the digestion of carbohydrates. How it takes place in the stomach? Starting with the mouth, stomach, small intestine and large intestine. Once the glucose is released as a monossaccharide, glucose and galactose are actively transported [snorts] via the sodium gradient from from the ex extracellular to the intracellular environment en uh energizing the glucose transport. So that's how the glucose and galactose are getting transported via

19:29 the sodium gradient uh pump. Whereas fructose appears to be transported via passive facilitated fructose mechanism. So even fructose can be easily absorbed in your body and uh disac the aical half or 2/3 of the villi. So if you see this is the villi villas or the villi is very important for absorption. Therefore the maximum absorption takes place in the vai. So your disaccharidase activity like your lactase maltase sucra and all that will be present here and then they are broken down to the simpler monossaccharides like glucose, galactose or glucose plus glucose. When it comes to the maltos sucrose like

20:16 glucose plus fructose will be released all that are then absorbed majorly with regard to the vi. So what are the factors that affect the digestion and absorption of carbohydrates. So if you see the rate at which the digested carbohydrate enters the small intestine plays a very important role. As we discussed before salivary plays an important role here. The stomach is also here and the pancreatic amala is here in the kim is formed. That's then it enters the intestine. The rate at which the digested carbohydrate enters the small intestine always have a role to play with regard to the absorption part. Similarly, the type of food mixture that

21:02 is present here also plays an important role. the condition of intestinal membrane also plays an important role with regard to the absorption. So once the uh glucose is released how is it is maintained in the body the maintenance of blood glucose levels is very important when we talk about the other comp component of carbohydrate metabolism. So when you see a person with hypoglycemia having 30 to 50 mg per dl of sugars in the body [snorts] when the brain is deprived of energy hypoglycemia takes place. Symptoms include fatigue, irritability, [snorts] sweating and headache. If it is less than 30 mg per

21:49 dl, coma and death can occur. Liver roots the glucose needed by the body converts into glycogen for storage. So major uh purpose is the liver is to store the glucose in the form of energy and then converts when it is needed for the body and then it is converted to a glucose. The normal blood glucose levels are being maintained when there is no carbohydrate in the diet. So with this you can easily identify that when a person is fasting or not eating anything adequately just imagine the liver will convert the gluc glycogen which is stored into glucose and that will be utilized in the various activities of the body. Non-carbohydrate

22:37 sources like fat and protein are converted into glucose via gluconioenesis. That's the major step. So if you see a hypoglycemic person and a normal uh blood cell and a hyperglycemia you can see how the blood sugar is being uh depicted here. So the major sources of carbohydrates include sugars, syrups, cereal grains like rice, wheat, bajra, joar and all that and even pulses provide some amount of carbohydrate have some amount of carbohydrate. Even dried fruits are there. Fruits [snorts] and vegetables widely vary in their carbohydrate content. Exceptions are bananas, dates,

23:24 potatoes and sweet potatoes have a high carbohydrate content present in them. Whereas if you see egg, fish, poultry, cheese, fresh milk and meats except liver will contain little carbohydrates in them. So if you see the variety of foods that are listed out here are the major sources of carbohydrate. When I talk about simple versus complex carbohydrate, simple sugars are nothing but all your monossaccharides and disaccharides. Complex carbohydrates are long chain and they [snorts] are coming under polyaccharides category. So the sugar length of simple carbohydrates will be very short and here it is long. The digestion speed is very fast here. So it

24:09 gets rapidly digested that's why the blood sugar levels can go high if you see but whereas complex carbohydrates it you have fiber in it and it can slowly uh gradual rise in the blood sugar is seen the energy duration is short whereas it's longlasting fiber content is really low in uh uh sugar simple sugars example is uh sucrose that I would say whereas complex carbohydrates they have polysaccharides and they have cellulose in them which is very good in fiber. Examples include candy, soda, fruit juices which comes under simple carbohydrates. Whereas complex carbohydrates you can talk about oats, lentils and vegetables. The nutrition value includes that it often gives

24:55 calories and uh only here it is high in uh nutritional value because it has it provides vitamins, minerals and fiber. How do we make right choice when it comes to the carbohydrate? Too [snorts] many simple carbohydrates can lead to weight gain because it uh only provides calories and there will be a type 2 diabetes risk here. Energy crashes and fatigue is common. Tooth decay because of uh consumption of too much of sugary items like candies and all that. So tooth decay is common here. The benefits of complex carbohydrates include stable energy levels throughout the day. There [snorts] will be better a better weight management scene and the gut health is

25:40 also improved. As I said more of fiber richch foods will help you to maintain your colonic bacteria and improve the gut health. Reduce the risk of heart diseases and diabetes malitus. So kindly make right choice of carbohydrate. Avoid too much of simple carbohydrates. go more for complex carbohydrates and that's being depicted here also when it comes to the requirements and terms ICMR makes no exact recommendation of for carbohydrate a minimum of 50 to 60%age of dietary calories may be from carbohydrates the terms include high carbohydrate low carbohydrate carbohydrate restricted high fiber or residue low fiber or residue is the

26:28 common things that we are looking at when it comes to the recommendation or requirement from the ICMR. Next I move on to the disorders of carbohydrate metabolism. Having heard about the classification functions their digestion and absorption and all that. When it comes to carbohydrate metabolism if there are disorders they lead to a lot of complications. You must have heard about type 1 diabetes melitus, type two diabetes malitus, gestational diabetes melitus and also microvascular complications, macrovascular complications. M uh micro include your nephropathy, neuropathy, uh macrovascular include all the deep vein uh problems. So all this are

27:16 complications of uh carbohydrate metabolism. So we start with type 1 diabetes melitus where if you see insulin deficiency is common here and they further divided into type 1A and LDA which is a latent autoimmune diabetes in uh adults. So that's the major thing. If you see the insulin is either deficient or it is uh not in functioning properly. Type one there will be a deficiency basically. [snorts] Type two if you see the insulin is resistant and there is also relative deficiency. So they there can be either pre-diabetic or maturity in uh onset diabetes of the young. So if

28:03 you see uh under pre-diabetes we can find that impaired fasting glucose or impaired glucose tolerance will be there and the hb1c will be within this range. Whereas the maturity onset diabetes uh are present in young non-obese individuals. That's the major thing. [snorts] When it comes to gestational diabetes, gestational diabetes onset uh occurs during only during pregnancy for some people. They they are classified as class one and class 2. Under class A1 uh they can be controlled with diet alone. fasting uh plasma glucose will be this range and there will be low risk of complications if it's well well managed whereas under class A2 they require

28:50 insulin or oral hypoglycemics and the levels are little higher when compared to the class A1 there may be high risk of macrosomia uh high birthw weightight uh babies hypoglycemia and this has to be screened with 75 g of oral glucose tolerance test at 24 to 28 weeks of gestation. That is very important. We have the other type of uh carbohydrate metabolism which is nothing but the pancreatic diabetes militus which is caused by the pancreatitis cystic fibrosis. If there is any pancreatic surgery or hemocromattosis both insulin deficiency and gluccohon deficiency may occur. The endocrine causes include uh excess

29:37 counter regulatory hormone such as Cushing syndrome with regard to cortisol and acromegali because of growth hormone defects fiochromosytoma regard to the catacolamines and gluco. Drug induced include the corticoststeroids thiocy diuretics antiscychotics like olenszipene, clausopene all this when they are consumed even that leads to the carbohydrate disorder. Tacrolymus is another one protease inhibitors are some of the drugs that are that can affect the diabetes. Genetic syndromes like down syndrome, Turner syndrome, Linfly syndrome. All this also leads to the

30:23 carbohydrate metabolism defects. So what are the other carbohydrate disorders that you can see here is lactose intolerance because of the lactase enzyme deficients, fructose malabsorption, fructoia will be there, galactosemia, hereditary fructose intolerance, you can see glycogen storage disease, there are lots under this pentos phosphate pathway defects. So these are some of the things that you should know. uh just remember what is this. So we have discussed about the functions classifications also the major disorders of carbohydrate metabolism. We must also know about these terms called glycemic index glycemic load and all that. When

31:11 you eat a particular food how long it is taking to raise the blood glucose that is called the glycemic index and that is being ranked with almost all the food items. It denotes the degree of blood glucose response to the to the ingestion of specific carbohydrate food in comparison with the response of standard diet. The rise of blood glucose after a meal does not depend only on the amount of carbohydrate ingested but also on the rapidity of absorption. So if you see the rise of blood glucose after a meal does not only depend on the amount of carbohydrate ingested but also on the rapidity of absorption. White bread is always used as a reference food and is generally accepted. So [snorts]

31:57 the rise in the blood glucose after the meal that you're giving is compared to the white bread how it causes the rise. So these two are matched and they come with this particular formula called glycemic index where the blood glucose area of the test food divided by the blood glucose area of the reference food into 100 is the calculation that you're going to use for the glycemic index. So if you see white bread the glycemic index is 100 and if you see the amount in carbohydrate containing 50 g is 101. The whole wheat bread also comes as 100.

32:45 Brown rice it is lesser. So it is really good. Even potatoes have 80 but the carbohydrate is here is 240. So we'll be calculating on the glycemic load also. Apple if you see it's really good. Banana is 84 and lentils is 38. You should not only uh understand that glycemic index but you should also know about glycemic load. It defined it is defined as a product of the glycemic index into carbohydrate divided by 100. So while the GI ranks foods by how fast they raise the blood sugar, the glycemic

33:30 load accounts for the typical portion size making it more practical for managing the blood sugar levels and preventing the spike. You if you know the carbohydrate if you see in the tableau column you know the car uh GI of uh white bread and the carbohydrate here. Now you apply this into this formula. Carbohydrate into GI into carbohydrate divided by 100 will give you the glycemic load. Some foods may have low glycemic index but high glycemic load. Those foods also have to be taken in caution. So this is the uh thing that I wanted to highlight on. So low GI foods are nothing but 55 or less. Moderate is 55

34:17 56 to 60 9 and you see high glycemic index is 70 or above. So that's even given here as glycemic load is 10 or less moderate is um medium is 11 to 19 and uh more is more than 20. So if you see apple is less here similarly it is having low GI also. So that is a very good food. Whereas in banana if you see it's both in medium category. Bread is also in the medium category. So just see how it is and then you calculate. If you see the whole bread minus it has a GI of 75 and that into calculated by the carbohydrate it gives a GL of this much. So that comes under this category. So that's how it is calculated. [snorts]

35:04 Next we are moving on to the major portion of the carbohydrate which is the dietary fiber. Dietary fibers are the plant constituents that don't have any digestive enzyme by the human. So it has to be um digested or fermented in the large intestine. They consist of cellulose hemiselulose pectin, mucilages and gums. So dietary fiber is the major component present in the fruits and vegetables. If you see they are found in the cell walls of the fruits, vegetables, legumes and grains. They are resistant to enzyatic digestion in the GI tract and they are fermented

35:50 by colonic bacteria and they form short chain fatty acids like acetate, propionate and butyrate. So these are the major things that you should remember. Dietary fiber is classified as many things which is the crude fiber and then soluble and insoluble fiber. So when we talk about the crude fiber, crude fiber is a residue that remains after the treatment of food with hot sulfuric acid and alkali. It is defined as the residue of the carbohydrate part of the dietary fiber that remains after the treatment with hot sulfuric acids like alkali and alcohol. Crude fiber is resistant to digestion and absorption in the GI tract. So

36:36 always you remember that's a residue that is being left out. Whereas dietary fiber which is the total dietary fiber is the plant constitutent that is not digested by the enzymes of the human GI tract. We don't have enzymes to digest the fiber. They are nothing but cellulose hemiselulose pectin mucilages and gums. Dietary fiber has two main types based on the water solubility. One is a soluble fiber and the other one is a insoluble fiber. So if you see a soluble fiber gets dissolved in the water they form gel and they also slows down the digestion. Example I would give here is pectin gums and mucilages. Pectin is nothing but the

37:24 inner soft pulpy portion of the fruit. Whereas insoluble fiber is nothing but they are resistant to hydraysis especially acids and and they add resistant to hydraulysis and they add bulk to the stool. So they are um present in the outer covering of the fruit or outer covering of the cereals. For example, oat brand. The outer covering of the oats is giving the cellulose and the hemiselos component to it that is having the insoluble fiber. So I've given this as an example here. If you see the crude fiber only by laboratory method we'll be able to identify whether it is a crude fiber because the residue is very much needed

38:10 only by acid and alkallay we'll be able to find out and dietary fiber which is again uh given in basic things and they are clinically relevant and this is used in the older food labeling whereas in the present food labeling we only see the fiber as total dietary fiber present in the most of the food items at the back of the label you can see. So coming to the high-fiber foods, high fiber foods are based on the clinical nutrition data. If you see they prioritize the whole and processed plant food. The brand wheat flour has the highest fiber about approximately 19 g per 100 g. Ragi and black gram has about 10 to 17 g per 100 g. Whereas green gram

38:57 whole contains 10 g per 100 g. Wheat and rice bowl will have about 11 gram per 100 gram. If you see curry leaves, tomatoes and bananas have 2 to 16 g per 100 g. That's a major contribution. If you see and dietary fiber is also important for various uh clinical uh conditions like obesity. If you eat a fiber richch food, it helps you to uh increase the satiety of the person and uh if you see fiber stays in the stomach for a longer period of time. Therefore, the gastric emptying time is delayed. So the lesser the gastric emptying time, the more the uh

39:44 weight reduction will be because the food stays in the stomach for a longer period of time. You don't eat uh more or you don't feel like eating. So that's the major component or the tricky portion that we can find out with regard to the fiber. Obesity uh in obesity fiber helps in increasing the satiety and it reduces the calorie intake by slowing the gastric emptying time. In heart diseases uh it the fiber helps in binding with the cholesterol and it lowers the low density lipoprotein which is a bad cholesterol via bile acid excretion. So it will reduce the cholesterol also and and coming to the diabetes or the blood

40:29 sugar control. It very slowly delays the glucose release and uh glucose absorption is also delayed and it reduces a postmeal blood sugar spikes. Fiber is very good for preventing cancer also. It dilutes the carcinogens, speeds the transit time, inhibits the bacterial ammonia and also major function of soluble fiber and uh insoluble fiber is it helps in relieving constipation because uh it causes bulk of the stool and it relieves constipation whereas soluble fiber helps in uh relieving the uh diarrhea also.

41:17 So if you see uh under digestion it increases the transit time and adds bulk helping in the prevention of uh constipation. Uh for sugar it is uh it delays the absorption of sugar and uh in cholesterol uh it reduces the cholesterol and thereby helps in preventing the heart diseases and also if you see cancer uh carinogens are diluted and they increase the colonic bacteria production or it protects the colonic bacteria. It promotes sigy and thereby helps in uh reducing the weight of the body for obese person. The recommended intake of fiber would be 25 to 38 g per day and so most people uh

42:05 consume less than half of this amount. So more the fiber that helps you to uh get away with all these uh disease conditions and therefore uh always prefer fruits rather than fruit juices. consume whole uh lentils, pulses and legumes. So they are very good sources of uh forming the bulk and helping you to reduce the uh weight also. So lot of health benefits that you can see with regard to fiber. Therefore fiber can be a major uh important factor when it comes to the clinical conditions. So with that we come to the end of the week six session on uh carbohydrates.

42:51 We have discussed more on the functions classification its uh digestion absorption how fiber can help play a role in preventing various disease conditions and all that [snorts] and we will have a question and answer session at the end of this week. Kindly go through the video and attempt those questions properly. Thank you and happy learning.