guidelines recommend that about 45–65% of daily
calories come from carbohydrates. This percentage
varies depending on age, general health, health prob-
lems (including being overweight or obese), and activ-
ity level.Interactions
There are no known adverse dietary interactions
associated with carbohydrates.Aftercare
Registered dietitians and nutritionists are the pro-
fessionals most qualified to educate individuals on the
role of carbohydrates in a healthy diet, as well as the
complications associated with low-carbohydrate
intakes. Medical doctors, including endocrinologists
(specialists that tread diseases of the endocrine
(glands) system, including diabetes) and nursing pro-
fessionals also play an important role in treating car-
bohydrate-related conditions such as diabetes, while
dietitians serve to make recommendations concerning
the nutritional needs of these individuals.Complications
When carbohydrate intake is low, there is insuffi-
cient glucose production, which then causes the body
to use itsproteinfor energy. This ultimately prevents
the body’s protein from performing its more impor-
tant functions, such as maintaining the body’s immune
system. Without carbohydrate, the body also goes into
a state of ketosis, in which by-products of fat break-
down, called ketones, accumulate in the blood. This
causes a shift in the acid-base balance of the blood,
which can be fatal.Diabetes
Diabetes is a disease in which the body cannot
metabolize carbohydrates, and either doesn’t make
or doesn’t respond to insulin, a hormone secreted by
the pancreas that is used to transport glucose to the
body’s cells. In individuals with type 1 diabetes, the
pancreas fails to produce insulin, thus causing blood
glucose levels to remain the same after meals. This
condition is known as hyperglycemia. These individu-
als must receive daily injections of insulin to control
their blood glucose levels. In type 2 diabetes, there may
be sufficient insulin, but the body’s cells may be resist-
ant to it. Once again, this causes blood glucose levels
to rise. Type 2 diabetes can be treated through oral
medication and proper diet, although the need for
insulin injections may develop later on. There is
some disagreement in the medical community aboutthe type of diet diabetics, especially type 1 diabetics,
should be on. The conventional diet is one of low-fat,
high-carbohydrate food, which is recommended by
the American Diabetes Association. Some doctors,
particularly endocrinologists, recommend theBern-
stein diet, which is low in carbohydrates and high in
fat, to maintain constant, normal blood sugar levels
throughout the day.Carbohydrate intolerance
Carbohydrate intolerance is the inability of the
small intestine to completely process the nutrient car-
bohydrate (a classification that includes sugars and
starches) into a source of energy for the body. This is
usually due to deficiency of an enzyme needed for
digestion. Lactose intolerance is the inability to digest
the sugar found in milk.Parental concerns
Parents should consult their child’s pediatrician,
physician, or endocrinologist if they are unsure the
child’s diet has a nutritionalbalance of carbohydrates.
A doctor also should be consulted before a child or
adolescent goes on a low-carbohydrate diet (such as the
Atkins, Zone, and Sugar Busters diets) for weight loss.Resources
BOOKS
Collins, P.M.Dictionary of CarbohydratesBoca Raton, FL:
Chapman & Hall, 2005.
Eliasson, Ann-Charlotte.Carbohydrates in Food (Second
Edition)Boca Raton, FL: CRC Press, 2006.
Stumpf, Walter, et al.Carbohydrates, Volume 14 (The Bio-
chemistry of Plants)Burlington, MA: Academic Press,
2007.
Warshaw, Hope S., and Karen M. Bolderman.Practical
Carbohydrate CountingAlexandria, VA: American
Diabetes Association, 2007.
PERIODICALS
(No author) ‘‘Continuing Carb Controversy: Are Carbohy-
drates the Culprits in Diabetes and Obesity?’’Food &
Fitness Advisor(July 2006): 3.
Anderson, Owen. ‘‘Got Carbs? A New Twist on the Carbo-
hydrate Conundrum.’’National Geographic Adventure
(August 2006): 34.
Anthony, Mark. ‘‘Glycemic Index: Use With Caution.’’Food
Processing(March 2006): 40–42.
Govindji, Azmina. ‘‘The Role of Carbohydrates in a Healthy
Diet.’’Nursing Standard(September 27, 2006): 56–64.
Moon, Mary Ann. ‘‘High-Carb, Low-Glycemic Index Diet
Cuts Weight, Cardiac Risk.’’Family Practice News
(September 1, 2006): 15.
Shute, Nancy. ‘‘The Scoop on Carbs and Fats. ’’U.S. News
& World Report(November 20, 2006): 89–90.Carbohydrates