Carbohydrate Intolerance

Written by Dr. Shalini Aul, MBBS, DND | Article Reviewed by Dietitian julia samuel, M.Phil on Jul 18, 2018
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Carbohydrate Intolerance

As the name suggests, carbohydrate intolerance is an aversion to a particular type of carbohydrate or sugar due to the deficiency of the enzymes required for its digestion. The enzyme deficiency makes the body incapable of processing or digesting a particular carbohydrate or a starch. It is known as lactose intolerance if the body is intolerant to milk and dairy products.

Carbohydrate intolerance is of two types, primary and secondary. Primary intolerance occurs when there is deficiency of an enzyme due to a genetic defect present since birth or which can develop after a certain amount of time when the production of enzymes reduce naturally in adults. The secondary type of carbohydrate intolerance occurs due to other medical diseases. This may be due to digestive disorders including “celiac disease” and “tropical sprue” which causes an insufficient production of enzymes, leading to the deposition and build up of fat in muscle tissue. Other diseases responsible for carbohydrate intolerance are protein deficiency, intestinal infections and treatment given for cancers, which include chemotherapy and radiotherapy.

The intensity and severity of symptoms are dependent on the magnitude of enzyme deficiency, that is, more the enzyme deficiency, more severe is the symptom. The symptoms usually occur around half an hour to two hours after ingestion of the aversive carbohydrate, which may range from feelings of being mildly bloated to diarrhea. This is because of the fermentation of the undigested sugars by the bacteria in the intestine, which is responsible for the gaseous production, flatulence, cramping and bloating.

In growing children, the chief symptoms include diarrhea and a failure to gain weight. Diarrhea, usually watery in nature (osmotic type) is responsible for throwing out other nutrients out of the intestine before they can be absorbed, causing malnutrition.

Diagnosis: Oral tolerance tests are used to assess the individual's ability to digest the carbohydrate being evaluated or investigated. In this test the specific carbohydrate being studied is given by mouth in liquid form and a number of blood tests are done to evaluate its digestion.

Treatment and Cure:The body is unable to produce enzymes in primary carbohydrate intolerance, and there is no available cure for the primary disease up to date. Symptomatic relief can be obtained by either avoiding the aversive carbohydrate or by substituting the absence of digestive enzymes with commercially available enzymes e.g., lactose intolerance patients and children should avoid milk products while infants should consume soy-based formula, or drink milk containing lactase enzymes.

The cure for the secondary causes of carbohydrate intolerance is by treating the underlying disease such as intestinal disorders or protein deficiency.

Prognosis & Prevention: Carbohydrate intolerance cannot be prevented because the causes of enzyme deficiency are not known. However, this disease can be controlled by a good diet that avoids the offending sugar and by taking commercially available digestive enzymes, which allows patients having this disease to lead a normal life.

References:

  1. Lanfer A, Hebestreit A, Ahrens W. Diet and eating habits in relation to the development of obesity in children and adolescents - (http://www.ncbi.nlm.nih.gov/pubmed/20631972)
  2. Guerreiro S, Alçada M, Azevedo I. Sugary drinks and glycemia - (http://www.ncbi.nlm.nih.gov/pubmed/20687984)
  3. Astrup A, Meinert Larsen T, Harper A. Atkins and other low-carbohydrate diets: hoax or an effective tool for weight loss? Lancet. 2004;364(9437):897–899. [PubMed]
  4. Wurtman RJ, Wurtman JJ. Brain serotonin, carbohydrate-craving, obesity and depression. Obes Res. 1995 Nov;3 Suppl 4:477S-480S - (http://www.ncbi.nlm.nih.gov/pubmed/8697046)
  5. van Dam RM, Seidell JC Carbohydrate intake and obesity. Eur J Clin Nutr. 2007 Dec;61 Suppl 1:S75-99 - (http://www.ncbi.nlm.nih.gov/pubmed/17992188)
  6. Drewnowski A, Kurth C, Holden-Wiltse J, Saari J. Food preferences in human obesity: carbohydrates versus fats - (http://www.ncbi.nlm.nih.gov/pubmed/1510463)
  7. Foster GD, Wyatt HR, Hill JO, McGuckin BG, Brill C, Mohammed BS, Szapary PO, Rader DJ, Edman JS, Klein S A randomized trial of a low-carbohydrate diet for obesity.
  8. Crapo, P. A., Reaven, G., Olefsky, J. (1976) Plasma glucose and insulin responses to orally administered simple and complex carbohydrates. Diabetes 25: 741–747.
  9. Jenkins, D. J., Wolever, T. M., Taylor, R. H., et al (1981) Glycemic index of foods: a physiological basis for carbohydrate exchange. Am J Clin Nutr. 34: 361–366.
  10. Joint FAO/WHO Expert Consultation (1998) Carbohydrates in human nutrition (FAO Food and Nutrition Paper 66) FAO Rome, Italy.
  11. Bell, S. J., Sears, BS. (2003) A proposal for a new national diet: a low-glycemic load diet with a unique macronutrient composition. Metab Syndrome Rel Disord. 1: 199–208.
  12. Bell, S. J., Sears, B. (2003) Low-glycemic-load diets: impact on obesity and chronic diseases. Crit Rev Food Sci Nutr. 43: 357–377. | Article | PubMed | ISI |
  13. Brand-Miller, J. C., Holt, S. H. A., Pawlak, D. B., McMillan, J. (2002) Glycemic index and obesity. Am J Clin Nutr. 76(suppl): 281S–285S. | PubMed | ISI | ChemPort |
  14. Sandrou, D. K., Arvanitoyannis, IS. (2000) Low-fat/calorie foods: current state and perspectives. Crit Rev Food Sci Nutrition. 40: 427–447.
  15. Ludwig DS. The glycemic index - Physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. JAMA 2002; 287: 2414-2423
  16. Ludwig DS. The glycemic index - Physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. JAMA 2002; 287: 2414-2423
  17. Das SK, Saltzman E, Gilhooly CH, DeLany JP, Golden JK, Pittas AG, Dallal GE, Bhapkar MV, Fuss PJ, Dutta C, McCrory MA, Roberts SB. Low or moderate dietary energy restriction for long-term weight loss: what works best?Obesity (Silver Spring). 2009 Nov;17(11):2019-24. Epub 2009 Apr 23.
  18. Atkins, Robert (2003-09-25). Dr. Atkins'' New Diet Revolution, Revised Edition. .Evans. ISBN 978-1590770023.


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