Nutrition Honor - Advanced

Science & Health

Requirements

1. Have the Nutrition Honor.

   Answer: You need to have completed the (regular) Nutrition Honor before starting the Advanced one. — Nutrition is one of the health honors most valued by Pathfinders (aligned with the 8 principles of Adventist Health). The regular version is a mandatory foundation — without understanding nutrients, specific diets (advanced) make no sense.

2. Read a book about Nutrition.

   Answer: You must read a complete book (not a magazine, blog or article) about Nutrition. — Reading is the basis for going deeper — diets/restrictions only make sense with a bibliographic foundation. Ellen White wrote extensively about nutrition in "Counsels on Diet and Foods" (1938), a classic Adventist reference aligned with modern science on several points.

3. What is a diet? Explain the following types and in which cases they are indicated:
   • Low-sodium
   • Low-calorie
   • Diabetic
   • High in protein and low in carbohydrates
   • Fat restriction
   • High in fiber
   • Protein restriction

   Answer: A diet is a person's regular eating pattern (what is eaten day to day), and not just a regimen to lose weight. Every therapeutic diet requires medical indication and nutritional monitoring. 1) Low-sodium: with little sodium (little salt) — indicated for hypertension and kidney and heart diseases. 2) Low-calorie: with fewer calories than are expended — indicated for weight loss and obesity. 3) Diabetic: with control of carbohydrates, sugars and the glycemic index — indicated for diabetes. 4) High-protein and low-carbohydrate: more protein and less carbohydrate — indicated, under guidance, in some cases of weight loss and muscle mass gain. 5) Fat restriction: with little fat — indicated for high cholesterol, gallbladder problems and heart diseases. 6) High-fiber: with lots of vegetables, fruits and whole grains — indicated for constipation and to help control blood sugar and cholesterol. 7) Protein restriction: with less protein — indicated in advanced kidney or liver disease, so as not to overload these organs. — Each diet treats a specific medical condition — they should not be self-applied without guidance. Poorly done restrictive diets cause nutritional deficiencies. Always MEDICAL indication + NUTRITIONAL monitoring.

4. What nutritional guidance should be given to a person who decides to be a strict vegetarian (vegan).

   Answer: You need to ensure B12 (mandatory supplementation), iron (dark vegetables + vitamin C), proteins (legumes with cereals), calcium (dark leafy greens, tofu) and omega-3 (flaxseed, chia). Regular nutritional monitoring is essential. — B12 exists naturally only in animal foods — a vegan without supplementation develops megaloblastic anemia in 2-5 years. The legume+cereal combination (rice+beans) generates a complete protein with all 9 essential amino acids. B12 supplementation has been the consensus since 1990.

5. Study the book Counsels on Diet and Foods, by Ellen White, and give an oral presentation of at least 10 minutes explaining the advantages of an ovo-lacto-vegetarian diet.

   Answer: "Counsels on Diet and Foods" was compiled in 1938 from the writings of Ellen White (1827-1915). Several of her principles predate modern science: stimulants, refined sugar, intervals between meals — themes today validated by studies in chronobiology and endocrinology.

6. What is the difference between saturated fats, unsaturated fats and trans fats? Which of them is healthier and why?

   Answer: SATURATED: solid at room temperature (meat, butter, cheese). UNSATURATED: liquid (olive oil, avocado, fish). TRANS: artificially hydrogenated (margarine, industrial fried foods). The UNSATURATED one is the healthiest — it lowers bad cholesterol. Trans is the worst, and should be avoided. — Trans fat increases LDL (bad cholesterol) AND reduces HDL (good) — a unique double negative effect. The WHO recommended, starting in 2018, the global elimination of trans fats by 2023. Omega-3 and omega-6 (unsaturated) are essential — the body does not produce them, so the diet must provide them.

7. What is the difference between HDL and LDL cholesterol? Which foods are rich in each of them?

   Answer: HDL is the "good" cholesterol — it carries cholesterol from the arteries to the liver. LDL is the "bad" one — it deposits cholesterol on the arterial walls (plaques). Rich in HDL: fish (salmon), olive oil, nuts. Rich in LDL: red meats, fried foods, processed meats, industrialized sweets. — Foods do not contain HDL/LDL directly — these are particles produced by the liver. Foods INCREASE one or the other: saturated fats raise LDL, omega-3 and fiber raise HDL. The ideal LDL/HDL ratio is below 3:1. Statin is the most prescribed medication in the world for controlling LDL.

8. Make a chart listing the fruits, vegetables and greens common in your region and in which months of the year their harvest occurs. What is the importance of giving preference to seasonal vegetables?

   Answer: Research the fruits/vegetables/greens of your region and organize them into a monthly harvest chart. Importance: seasonal foods are CHEAPER, TASTIER and MORE NUTRITIOUS (harvested at their peak), in addition to a lower environmental impact (they do not require a greenhouse or long transport). — CEAGESP and CONAB publish official harvest tables by region. Eating seasonally reduces cost by 30-50% compared to imported out-of-season food. Nutritionally, fruits harvested ripe have 20-40% more vitamins than those harvested green for long international transport.

9. What are enteral nutrition and parenteral nutrition? In which cases are they indicated?

   Answer: ENTERAL: through a tube into the stomach/intestine, it keeps the digestive tract active. Indicated for a patient who cannot swallow but has a healthy intestine. PARENTERAL: intravenous, a total bypass of the digestive system. Indicated in intestinal obstruction or after major abdominal surgery. — Enteral is PREFERABLE whenever possible — it preserves the intestinal flora and is cheaper. Parenteral is a last resort (more expensive, with a risk of infection in the catheter). Both are industrial formulas with balanced macro- and micronutrients, adjusted by a hospital nutritionist according to the patient's needs.

10. Carry out the following:
    • Keep a food diary based on your own diet for 1 week.
    • What is the recommended daily portion of the following nutrients for your weight, sex, and age:
    • Based on the diary kept in item “a”, compare the recommended daily amount of the nutrients above with the amount you actually consume. What needs to be / should be changed in your diet?

    Answer: For 7 days, record EVERYTHING you eat (meals + snacks + drinks + portions). Calculate the daily recommendation (protein: 0.8g/kg, carbohydrates: 50% of calories, fat: 30%, fiber: 25g, water: 35ml/kg). Compare what you consumed vs the recommendation and propose 3-5 concrete changes. — Recommendations come from the DRI (Dietary Reference Intakes) and SBAN (Brazilian Society of Food and Nutrition). Apps such as MyFitnessPal facilitate the automatic calculation. The food diary is the #1 tool of nutritionists — without it, nutritional intervention is just a baseless guess.

11. Read Leviticus 11 and explain why God classified animals as clean and unclean.

    Answer: In Leviticus 11 God separates clean (ruminants with a split hoof, fish with scales and fins) and unclean (pig, seafood without scales, birds of prey). Reasons: HEALTH (carnivores and scavengers accumulate toxins), SPIRITUAL DISTINCTION (Israel set apart from the pagans) and SYMBOLISM (clean vs unclean). — Modern science confirms several risks: pigs harbor trichinosis, seafood concentrates heavy metals, birds of prey accumulate toxins. Adventists follow this guidance to this day (1 Cor 10:31). The "Adventist Health Study-2" showed measurable health benefits of this diet when followed.

12. The following diseases are caused by what type of nutritional deficiency?
    • Night blindness
    • Rickets
    • Hemolytic anemia
    • Megaloblastic anemia
    • Iron-deficiency anemia
    • Goiter
    • Scurvy
    • Marasmus
    • Kwashiorkor

    Answer: 1) Night blindness: vitamin A deficiency. 2) Rickets: vitamin D deficiency. 3) Hemolytic anemia: vitamin E deficiency. 4) Megaloblastic anemia: vitamin B12 or folic acid (folate) deficiency. 5) Iron-deficiency anemia: iron deficiency. 6) Goiter: iodine deficiency. 7) Scurvy: vitamin C deficiency. 8) Marasmus: severe general caloric deficiency (a lack of energy/food in general). 9) Kwashiorkor: protein deficiency, even when there are enough calories in the diet. — Marasmus and Kwashiorkor are the two main forms of severe childhood malnutrition (PEM — Protein-Energy Malnutrition) — kwashiorkor has a typical swelling (edema) from a lack of protein. Goiter was endemic in Brazil until the mandatory iodization of table salt in 1953.

13. What harm to health do the following eating habits cause:
    • Excessive salt use
    • Excessive sugar use
    • High-fat diet
    • Excessive use of condiments
    • Use of processed foods
    • Stimulant foods, such as: black/mate/green tea, coffee, guaraná syrup/guaraná powder
    • Soft drinks and artificial juices
    • Eating between meals
    • Eating in large quantities

    Answer: 1) Excessive use of salt: raises blood pressure and favors hypertension and stroke. 2) Excessive use of sugar: favors diabetes, obesity and cavities. 3) A diet rich in fats: increases cholesterol and the risk of heart disease and obesity. 4) Excessive use of condiments: irritates the stomach and favors gastritis and heartburn. 5) Use of processed foods: an excess of sodium, fat, sugar and additives, some linked to cancer, in addition to favoring obesity. 6) Stimulant foods (black/maté/green tea, coffee, guaraná syrup/guaraná powder): cause insomnia, agitation, dependence and can harm the heart and the absorption of nutrients. 7) Soft drinks and artificial juices: a lot of sugar and additives, leading to obesity, cavities and diabetes. 8) Eating between meals (snacking): does not give the stomach a rest and leads to metabolic dysregulation and weight gain. 9) Eating in large quantities: chronically overloads digestion, causing indigestion and obesity. — The WHO recommends a maximum of 5g of salt/day (the Brazilian average is 12g — almost 3x more). Sugar: a maximum of 25g/day (2 cans of soda already exceed this). Caffeine becomes addictive in 3-5 days of regular use. Eating between meals keeps insulin high chronically — a key factor in insulin resistance (prediabetes).

14. Study the following diseases and, about each one, explain: how it occurs, signs and symptoms, how to prevent them (when applicable) and what changes are necessary in the diet of a person who has them:
    • Diabetes
    • Systemic arterial hypertension (high blood pressure)
    • Osteoporosis
    • Celiac disease
    • Lactose intolerance
    • Atherosclerosis

    Answer: For each disease explain how it occurs, signs/symptoms, prevention and the changes in diet: 1) DIABETES — the pancreas does not produce enough insulin or the body resists it; symptoms: a lot of thirst, hunger, frequent urination, fatigue. Prevention: a healthy weight, exercise, avoiding sugar and an excess of refined carbohydrates. Diet: control carbohydrates and the glycemic index, split meals into smaller portions, prioritize fiber and whole grains, avoid simple sugar. 2) HYPERTENSION — chronically high blood pressure (>140/90); often silent, it can cause headache, dizziness. Prevention: little salt, a healthy weight, exercise, no tobacco/alcohol. Diet: low-sodium (reduce salt and processed foods), rich in potassium (fruits, vegetables), a DASH-type pattern. 3) OSTEOPOROSIS — loss of bone mass makes the bones fragile; symptoms: easy fractures, pain, loss of height. Prevention: calcium + vitamin D + weight-bearing exercise from a young age. Diet: foods rich in calcium (dark green leaves, tofu, sesame, milk/dairy if ovo-lacto) and vitamin D (sun, fortified foods). 4) CELIAC DISEASE — an autoimmune reaction to gluten that damages the intestinal villi; symptoms: diarrhea, bloating, weight loss, malabsorption, anemia. There is no prevention (genetic). Diet: TOTAL and permanent removal of gluten (wheat, rye, barley); use rice, corn, cassava, quinoa. 5) LACTOSE INTOLERANCE — a lack of the enzyme lactase to digest lactose; symptoms: gas, cramps, diarrhea after dairy. Diet: reduce/eliminate milk and dairy or use lactose-free/plant-based products (and ensure calcium from other sources). 6) ATHEROSCLEROSIS — a buildup of fatty plaques on the walls of the arteries, narrowing them; it can cause a heart attack/stroke. Prevention: do not smoke, exercise, control cholesterol and blood pressure. Diet: reduce saturated and trans fat, increase fiber, good fats (olive oil, nuts), fruits and vegetables. — All of them have a strong dietary component. Type 2 diabetes and hypertension are reversible with a change in diet + exercise. Osteoporosis: calcium + vitamin D + weight-bearing load (strength training) prevents it. Atherosclerosis begins in childhood with a diet rich in saturated fat — prevention lasts a lifetime.

15. Study the following eating disorders and explain the health risks, how it is possible to detect them and what the appropriate treatment is. Which professionals should be involved in the treatment of a person with these illnesses? Give a talk presenting the information obtained to the Pathfinders of the Excursionist and Guide Classes or to the class of adolescents (Sabbath School).
    • Anorexia
    • Bulimia
    • Hyperphagia
    • Orthorexia

    Answer: 1) Anorexia: severe food restriction out of an intense fear of gaining weight and a distortion of body image. Risks: severe malnutrition, a drop in blood pressure and heartbeat, heart problems, weak bones and the risk of death. Detection: marked weight loss, refusal to eat, excessive exercise and a distorted view of one's own weight. 2) Bulimia: episodes of binge eating followed by compensatory behaviors, such as induced vomiting, laxatives or fasting. Risks: wearing of the teeth, esophageal injury, potassium imbalance and heart problems. Detection: going to the bathroom right after eating, food disappearing and weight fluctuations. 3) Hyperphagia (binge eating disorder): episodes of eating large quantities without control, but without the purging of bulimia. Risks: obesity, diabetes, hypertension and emotional distress. Detection: eating in secret, eating even without hunger and guilt after the episodes. 4) Orthorexia: an obsession with eating only what is considered "healthy" and "pure". Risks: a very restricted diet that may lack nutrients, social isolation and anxiety. Detection: rigid dietary rules and distress when departing from them. 5) Professionals involved in the treatment: care is provided by a multidisciplinary team, usually a doctor/psychiatrist, psychologist and nutritionist (and the family's support). — Anorexia has the highest mortality rate among psychiatric disorders (5-10%). Bulimia destroys dental enamel through vomiting. Orthorexia, newer, was described in 1997 — common in those who follow extreme restrictive diets. Treatment requires continuous, long-term multidisciplinary monitoring.

16. What are dietary supplements? With the help of a nutritionist, indicate the most common ones and explain in which cases they are really necessary. Mention the risks of using each of them without the proper guidance of a nutritionist or doctor.

    Answer: Dietary supplements are products with concentrated nutrients (vitamins, minerals, proteins, amino acids, fiber) used to COMPLEMENT the diet, never to replace it. The most common ones and when they are really necessary: 1) WHEY/PROTEIN — when protein intake through food is insufficient (athlete, elderly, post-surgery). Risk without guidance: kidney and liver overload, weight gain. 2) CREATINE — performance in intense exercise. Risk: fluid retention, kidney overload in predisposed people. 3) VITAMIN D — proven deficiency, little sun exposure. Risk: hypervitaminosis (excess calcium in the blood, kidney stones). 4) VITAMIN B12 — mandatory for vegans/strict vegetarians and the elderly. Risk: taking it alone can mask deficiencies without correcting the cause. 5) OMEGA-3 — low intake of fish, high cholesterol/triglycerides. Risk: in excess, it increases bleeding time. 6) IRON — diagnosed iron-deficiency anemia. Risk: excess causes constipation, abdominal pain and even poisoning (dangerous for children). General risks of using ANY supplement without the guidance of a nutritionist/doctor: poisoning from an excess of vitamins/minerals, interaction with medications, overload of the kidneys and liver, masking diseases, an imbalance between nutrients and unnecessary spending on a product you do not need. — A supplement without a prescription is a waste in most cases — the body eliminates the excess through urine. Some vitamins in excess are toxic (A, D, E, K — fat-soluble ones accumulate). Always have a blood test BEFORE supplementing — knowing whether there is a real deficiency avoids unnecessary spending and risk.