Pediatric Nutrition in Practice

1 Specific Aspects of Childhood Nutrition

Key Words

Carbohydrate · Fibre · Glycaemic carbohydrate ·

Prebiotics

Key Messages

• A diet rich in slowly absorbed carbohydrates should
  be promoted while limiting the supply of rapidly
  absorbed carbohydrates and simple sugars


• Recommended intake of carbohydrates should be
  45–60% of total energy


• Avoidance of frequent consumption of juice or other
  sugar-containing drinks should be recommended


• Fibres, especially insoluble, can significantly increase
  stool mass and improve its consistency. Intake of 2 g
  per 1 MJ of energy is considered adequate


• Prebiotic carbohydrates alter the balance of the gut
  microflora towards a healthier one.
  © 2015 S. Karger AG, Basel

Introduction

An appropriate diet containing sufficient energy
is essential during the period of infancy and child-
hood due to rapid growth and development. Di-
gestible dietary carbohydrates are the main source
of energy – primarily lactose during infancy, and

starch and sugars later in life [1]. Based on their

chemical structure, carbohydrates are classified

as sugars, oligosaccharides and polysaccharides

( table  1 ) [2]. Another classification is based on

metabolic pathways and physiological effects.

Carbohydrates which provide the body with

monosaccharides are defined as ‘digestible’ (avail-

able or glycaemic) and carbohydrates that resist

digestion in the small intestine or are poorly ab-

sorbed are called ‘resistant’ (unavailable or non-

glycaemic) [3]. However, although resistant to di-

gestion in the small intestine, non-glycaemic car-

bohydrates are also able to provide the body with

energy through fermentation in the colon and ab-

sorption of short-chain fatty acids (SCFA) [2].

Digestible Carbohydrates

Digestible carbohydrates are a diverse group of

substances with the primary function of serving

as an energy source for all body cells. Their diges-

tion starts in the mouth and ends in the intestinal

brush border enzymes ( fig.  1 ). Chronic low car-

bohydrate intake results in ketosis, which could

cause long-term nutritional deficiencies. Carbo-

hydrates are the main energy source and a recom-

Koletzko B, et al. (eds): Pediatric Nutrition in Practice. World Rev Nutr Diet. Basel, Karger, 2015, vol 113, pp 46–50
DOI: 10.1159/000360316

1.3 Nutritional Needs

1.3.4 Digestible and Non-Digestible Carbohydrates

Iva Hojsak