Pediatric Nutrition in Practice

Digestible and Non-Digestible Carbohydrates 47

1

mended intake level has been proposed by differ-
ent authorities. The European Food Safety Au-
thority (EFSA) panel recommends that 45–60%
of energy should be provided as carbohydrates
[4] ; however, the data concerning infants and

young children are limited. For infants, human

milk can be used as a model, meaning that the

minimum carbohydrate intake should be 40% of

total energy, and lactose should be the main di-

gestible carbohydrate [1]. After early infancy, the

intake of digestible carbohydrates should increase

until reaching the recommended amounts for

adults [1]. However, it should be taken into ac-

count that not only quantity but also carbohy-

drate type, carbohydrate origin and food process-

ing can influence the rate of carbohydrate release;

this glycaemic potential of the different carbohy-

drates can be valorised by the glycaemic index

(GI). The GI is defined as the area under the glu-

cose response curve after consumption of a 50-

gram carbohydrate portion of a test food, and ex-

pressed as the percentage of response to the same

amount of carbohydrate from a standard food

taken by the same subject [5]. It was proposed

that a diet with a low GI increases satiety and,

consequently, reduces voluntary energy intake

due to slower glucose and insulin release, which

could have a preventive effect with regard to over-

weight and obesity; however, data on children

and adolescents are limited and have yielded in-

consistent findings [6]. On the contrary, higher

consumption of added sugars (which have a high

GI) can displace other macronutrients, increase

Ta b l e 1. The main types of carbohydrates

Class Subgroup Components

Sugars Monosaccharides Glucose, galactose, fructose
Disaccharides Sucrose, lactose, trehalose, maltose
Polyols Sorbitol, mannitol

Oligosaccharides Maltooligosaccharides Maltodextrins
Other oligosaccharides GOS, FOS, polydextrose

Polysaccharides Starch Amylose, amylopectin, modified starches, resistant
starch, inulin
Non-starch Cellulose, hemicellulose, pectins, hydrocolloids

GOS = Galactooligosaccharides; FOS = fructooligosaccharides. Adapted from FAO/WHO report [5] and Cummings
and Stephen [2].

Complex digestible carbohydrates

Smaller units (including disaccharides)

Disaccharides and monosaccharides

Monosaccharides – absorbed in

small intestine

• Glucose: actively, energy required;
  sodium cotransport


• Fructose: facilitated diffusion,
  no energy required


• Galactose: actively, energy required;
  sodium cotransport

Salivary

amylase

Pancreatic

enzymes

(amylase)

Brush border

disaccharidases

Fig. 1. Digestion and absorption of glycaemic carbohy-
drates.

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