Living Longer and Better: The Health Experience of California Seventh-day Adventists.

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Living Longer and Better:
The Health Experience of
California Seventh-day
Adventists.
Larry Beeson, DrPH
Associate Professor
School of Public Health
Co-investigator, AHS-2
Adventist Health Study
Background
More than 95% of the half-trillion health
care dollars ($500,000,000,000) in the
U.S. each year goes to treat rather than
prevent disease
Issues in Science & Technology
Biomedical Research
Epidemiology: The study of the distribution
(who, when, where) and causes (determinants)
of health and disease in populations.
Nutritional Epidemiology: The study of diet as
promoting or preventing the onset of disease.
Epidemiologic evidence suggests that choosing carefully and
eating a well-balanced diet, you may reduce your cancer risk:
1. Eat a variety of foods every day
2. Include fresh fruits and vegetables, especially those high
in vitamin A and C
3. Choose leafy green and yellow-orange vegetables
4. Keep intake of all fats low (both sat. & unsaturated)
5. Limit your use of butter, margarine, cream, shortening
6. Avoid hidden fats in salad dressing and snack foods
7. Choose lowfat or skim milk and lowfat cheeses
8. Choose fruit instead of high fat desserts
9. Eat foods with fiber for example:
a) Whole grain breads
b) Raw fruits and vegetables
c) Beans, Peas, Seeds
10. Do not drink alcohol in excess
11. Do not smoke
Cancer Prevention
Public Health Service
National Institutes of Health
Question
Can we observe measurable health benefits
in a people (e.g. SDAs) who have been
practicing for more than 140 years the
current recommendations of health-related
organizations (ACS, AHA, CDC, NIH) ?
Adventist Literature
“Animals are becoming more and more
diseased, and it will not be long until
animal food will be discarded by many
besides Seventh-day Adventists … The
Lord will teach many in all parts of the
world to combine fruits, grains, and
vegetables into foods that will sustain and
will not bring disease.”
1902 - Vol 7, Testimonies, pg 124-6
Adventist Literature
“Seventh-day Adventists are handling
momentous truths. More than forty years
ago [<1869] the Lord gave us special light
on health reform, but how are we walking in
that light? … On the subject of temperance
we should be in advance of all other people.”
1909 - Vol 9, Testimonies, pg 158
Adventist Literature
“In this age of the world the use of tobacco is
almost universal. Women and children suffer
from having to breathe the atmosphere that
has been polluted by the pipe, the cigar, or …
the tobacco-user. Those who live in this
atmosphere will always be ailing.”
1882 - Vol 5, Testimonies, pg. 440
Adventist Literature
“The liability to take disease is increased
tenfold by meat eating.”
1868 - Vol 2, Testimonies, pg 64
Adventist Literature
“Health is a treasure. Of all temporal
possessions it is the most precious.
Wealth, learning, and honor are dearly
purchased at the loss of the vigor of
health. None of these can secure
happiness, if health is lacking.”
1890 - Christian Temperance and
Bible Hygiene, pg 150
Adventist Literature
“Fruits, grains, and vegetables, prepared in
a simple way, free from spice and grease of
all kinds, make … the most healthful diet.”
1870 - Vol 2, Testimonies, pg. 369
Adventist Literature
“It is a mistake to suppose that muscular
strength depends on the use of animal
food. The needs of the system can be
better supplied, and more vigorous health
can be enjoyed, without its use.”
1905 - Ministry of Healing, pg. 316
Adventist Literature
“Education in health principles was never
more needed than now… Many transgress
the laws of health through ignorance, and
they need instruction. But the greater
number know better than they do. They
need to be impressed with the importance
of making their knowledge a guide for
life.”
1905 - Ministry of Healing, pg. 126
Seventh-day Adventists will
continue to be a unique population
for epidemiologic study
1. They are interested in health,
hence cost effective postal
contacts are likely to
produce good response
rates.
2. There are few subgroups
in society that have the
same range of exposures
such as diet. This should
increase statistical power
in testing hypotheses.
3. The relative absence of
cigarette smoking and
alcohol consumption
allow examination of the
effects of other exposures
(e.g. diet) without the
potential confounding of
tobacco and alcohol.
4. The church structure (i.e.
“letters of transfer”)
facilitates the tracking of
subjects who move after
initial enrollment in a
study thus minimizing
lost-to-followup.
5. Marked tendency towards
vegetarianism makes this
population probably the
closest of any subgroup to the
lifestyle recommendations of
several official bodies
seeking to prevent cancer and
atherosclerotic vascular
disease.
Research On Adventists by
Loma Linda Epidemiologists
1. Adventist Mortality Study (1958 - 1985)
2. Adventist Health Study [ - 1] (1974 - 2006)
3. Adventist Health Study - 2 (2002 - future)
4. Adventist Health Study on Smog
(AHSMOG) (1976 – future)
5. Adventist Health and Religion Study (AHRS)
(2006 – future)
Adventist Health Studies
U.S.A. 1958-2012
AMS
1966
1958-1985 1974
25,153 SDA
25+ years
California
1950
1960
1970
12,000
overlap
ARHS
200611,000
AHS-2 200297,000 SDA
30+ years
USA & Canada
5,649
overlap
1980
1990
AHSMOG 1976-2006
6,328 SDA
25+ years
California
AHS-1 1974-2006
34,198 SDA
25+ years
California
2000
2010
Dietary Assessment
Increasing Complexity
Adventist Mortality Study (1958 - 1980)
• 4-page questionnaire
• n = 25,153
Adventist Health Study-1 (1974 - 2006)
• 20-page questionnaire
• n = 34,198
Adventist Health Study-2 (2002 - ????)
• 52-page questionnaire
• n = 97,000
www.llu.edu/public-health/health/index.page
Adventist Health Study Home
About the Study
Enrollment Form
Common Questions
Progress of Enrollment
News and Events
Promotion Resources
The Research Team
Contact Us
Previous Studies
Selected references
Bibliography
Back
1. Hardinge MG, Stare FJ: Nutritional studies of vegetarians. I
Nutritional, physical, and laboratory studies. Am J Clin Nutr
1954; 2:73-82.
…
303. Fraser GE, Shavlik DJ. Ten years of life. Is it a matter of
choice? Arch Int Med 2001;161:1645-52.
308. Chan J, Knutsen SMF, Blix GG, Lee JW, Fraser GE. Water,
other fluids and fatal coronary heart disease: The Adventist
Health Study. Am J Epidemiol 2002; 155:827-33.
313. Singh PN, Sabaté J, Fraser GE. Does low meat consumption
increase life expectancy in humans? Am J Clin Nutrit 2003;
78(suppl):526S-32S.
315. Willett W. Lessons from dietary studies in Adventists and
questions for the future. Am J Clin Nutr 2003; 78:539S-43S.
Oxford Univ. Press, 2003, pp 371
Available from Amazon.com
Areas with an unusual cluster
of centenarians (age 100+):
1) Sardinia
2) Okinawa
3) Costa Rica
4) Loma Linda (only area in the
United States) thanks to
the AHS research team
Proportions of Life Table Subjects Surviving to Ages
65 Years and 85 Years.
Percentage of males surviving
Percentage of females surviving
Country
To Age
65
To Age
85
To Age
65
To Age
85
Australia
74.7
17.6
86.4
38.4
Canada
75.1
19.6
86.3
40.0
Germany, Fed. Rep.
73.4
14.2
85.8
31.7
Hungary
60.9
8.2
79.3
21.0
Japan
80.8
23.6
89.5
41.1
Sweden
78.7
20.4
88.4
39.8
United Kingdom
75.0
14.5
84.6
32.7
United States
72.0
19.5
84.1
39.3
California Adventist
86.7
41.0
89.3
54.4
California Adventist
Vegetarians
89.2
48.6
94.1
60.1
An Extra 10 Years of Life
Adventist Health Study-1 demonstrated that
5 simple habits Adventists have promoted
for over 100 years extend their life by as much
as 10 years in both men and women





Regular exercise
Eating plant-based diet
Eating small amounts of nuts regularly
Maintaining normal body weight
Not smoking
Effects of Individual Risk Factors To
Increase Life Expectancy
Variable
Men
Women
Vegetarianism
2.38 yrs
1.65 yrs
Vigorous Exercise
2.14 yrs
2.19 yrs
Frequent Nut Consumption
2.87 yrs
1.18 yrs
Avoid High BMI
1.51 yrs
1.90 yrs
Never Smoked
1.33 yrs
1.49 yrs
Health Habits and Life Expectancy in Adventists
Men
Women
‘Best’-Lifestyle1
87.0 years
88.5 years
‘Converse’-Lifestyle2
76.2 years
79.8 years
Difference
10.8 years
8.7 years
1Vegetarians
who exercise vigorously at least 3 times weekly, eat nuts >4 times each week.
BMI < 25.90 (males), <25.20 (females), never smokers.
2 Converse of the above, including eating nuts <1/week, BMI greater than limits shown above.
Life Expectancy at Age 30 years (1985).
Californians
California Adventists
Vegetarian Adventists
Extra Years
California Adventists
Vegetarian Adventists
Men
43.9
51.2
53.3
Women
49.5
53.9
55.7
7.3
9.4
4.4
6.2
Different Types of
‘Vegetarians’
1.
Lacto-Ovo-vegetarians
High lacto
Low lacto
2. Fish-eating (pesco) ‘vegetarians’.
3. High and low processed food vegetarians.
4.
Soy and non-soy vegetarians.
5.
Vegans and Fruitarians.
Brief Introduction to Epidemiology
1) Measures of association between exposure and health
outcome:
 “Relative Risk” = “Risk Ratio” = “RR”
2) Statistical significance  Biologic significance ??
 “p-value”
The Relative Risk (RR)
Incidence of disease (in those “exposed”)
RR =
Incidence of disease (in those “not exposed”)
or
High
Low
If: RR is less than (<) 1, then exposure is reduces risk of disease
If: RR is equal to (=) 1, then exposure is unrelated to disease
If: RR is greater than (>) 1, then exposure increases risk of
disease
Statistical Significance: (p-value)
p (probability)-value: The probability that an observed value
from a statistical test (e.g. RR) could have
occurred by chance, if the comparison
groups were really alike.
In biomedical research (i.e. Epidemiology), we traditional say
that if the p-value is less than (<) 5%, then another explanation
(e.g. biology) is a better explanation of the observation than is
chance alone.
Percentages Dying From the Named Causes and Average Ages at
these Fatal Events: California non-Adventists and Adventists.
Men
Cause of Death (%)
All Californians
All Adventists
%
%
Age
(Years)
Age
(Years)
Disease of the Heart
39.0
75.7
40.4
82.9
†††
Malignant Neoplasms (Cancer)
23.4
71.2
19.0 ††† 77.9
†††
Cerebrovascular Disease (Stroke)
6.6
79.4
8.7
Unintentional Injuries
2.9
59.5
3.5
69.6
COPD and Allied Conditions
5.6
76.3
2.5 †††
82.6
†††
Pneumonia and Influenza
4.5
81.8
6.1
87.8
†††
Diabetes
1.1
73.0
1.3
81.6
†††
†
p<0.05; ††p<0.01;
†††
p<0.001
††
†
85.8
†††
†††
Effect of meat.
Meat intake and risk of different
cancers.
RR
2.5
P (t): 0.01
ns
<.01
0.02
2
1.5
Never
< 1/week
1
1+/week
0.5
0
Colon
Colon
Prostate
Postmenopausal
Ovary
Ovary
Ovary
Total meat intake and risk of colon
cancer
RR
2
P (trend)=0.01
1.85
1.5
1.5
(1.16-2.87)
(0.92-2.45)
1
1
0.5
0
Never
< 1/week
1+/week
Red meat intake and risk of colon cancer,
among those who eat white meat < 1x/week.
RR
2
P (trend) = 0.02
1.9
(1.16-3.11)
1.5
1.4
1
(0.87-2.25)
1
0.5
0
Never
< 1/week
1+/week
White meat intake and risk of colon cancer,
among those who eat red meat < 1x/week.
RR
3.5
P (trend) = 0.006
3.29
3
(1.60-6.75)
2.5
2
1.5
1
0.5
0
1.55
1
Never
(0.97-2.50)
< 1/week
1+/week
Meat Consumption and Cancer
Meat Frequency
Cancer Site
Never
<1/week
>1/week p values
Colon
1.00
1.50
1.85
.01
Prostate
1.00
1.15
1.41
NS*
Ovary
1.00
1.39
1.75
<0.10
(Postmenopausal)
1.00
1.59
2.30
0.02
Bladder
<3/week
1.00
* Not statistically significant
>3/week
2.38
0.01
Nut Consumption and
Coronary Heart Disease
P(t) <.001
P<.001
P(t) <.001
P<.001
1
Relative Risk
0.9
0.8
0.7
0.6
Nuts <1 time/wk
0.5
Nuts 1-4 times/wk
0.4
0.3
Nuts 5+ times/wk
0.2
0.1
0
Definite Non-Fatal MI
Fatal
Nut Consumption and
Coronary Heart Disease
P(t) <.001
P<.001
P(t) <.001
P<.001
1
Relative Risk
0.9
0.8
0.7
0.6
Nuts <1 time/wk
0.5
Nuts 1-4 times/wk
0.4
0.3
Nuts 5+ times/wk
0.2
0.1
0
Events 66 85 33
Women
66 85 33
Men
Nut Consumption and
Coronary Heart Disease
P(t) <.05
P<.05
P(t) <.001
P<.001
1
Relative Risk
0.9
0.8
0.7
0.6
Nuts <1 time/wk
0.5
Nuts 1-4 times/wk
0.4
0.3
Nuts 5+ times/wk
0.2
0.1
0
Events 63 55
15
NonVegetarians
79 76 57
Vegetarians
Nut Consumption and
Coronary Heart Disease
P(t) <.05
P<.05
P(t) <.001
P<.001
1
Relative Risk
0.9
0.8
0.7
0.6
Nuts <1 time/wk
0.5
Nuts 1-4 times/wk
0.4
0.3
Nuts 5+ times/wk
0.2
0.1
0
Events 65 85
34
Age <80
77 47 38
Age 80+
RR‡ of FATAL CHD according to Intake
of WATER in MALES (n=11,257)
1.2
.001
.0002
.0004
.0003
1
1
1
p (trend)
1
1
0.8
0.6
.65
0.4
.67
.60
.64
Glasses/day
.46
.38
.39
0.2
0
Events 25 51 48
‡
Adustments: Age
24 34 37
22 42 33
+ Smoking, Ed, + Energy
BMI, BP
.33
17 33 23
+ Other
Fluids
<=2
3 to 4
5+
RR‡ of FATAL CHD according to Intake
of WATER in FEMALES (n=15,840)
p(trends) NS
1.2
1
1
1
1
1
0.8
0.6
0.4
.54
.59
.57
.61
.57
.52
.41
.44
0.2
0
Events 23 40 52
‡
Adustments:
Age
18 34 43
13 17 26
+ Smoking, Ed, + Energy
BMI, BP
13 17 26
+ Other
Fluids
Glasses/day
<=2
3 to 4
5+
RR‡ of FATAL CHD according to WATER
INTAKE Males & Females (n= 27,342)
Age & Sex Adjusted
1.6
1.4
1.2
1
RR 0.8
<.01
<.05
1
1
p (trend)
Glasses/day
0.6
0.4
0.54
0.52
50
60
0.62
0.50
0.2
0
Events
28
Normotensive
20
40
41
Hypertensive
<=2
3 to 4
5+
RR‡ of FATAL CHD according to WATER
INTAKE Males & Females (n= 27,342)
Age & Sex Adjusted
1.6
1.4
1.2
1
RR 0.8
.003
.02
p (trend)
1
1
Glasses/day
0.6
0.57
0.4
0.57
0.46
0.54
0.2
0
Events
23
52
58
Meat <1/week
24
35
37
Meat 1+/week
<=2
3 to 4
5+
RR‡ of FATAL STROKE according to
WATER Intake in M & F with Stroke Hx
(n=614)
1.6
Relative Risk
1.4
<.05
<.01
1
1
<.02
.08
p (trend)
1.2
1
0.8
.84
0.6
0.4
1
1
Servings /day
.71
.66
.60
.55
.43
.45
.47
15 28 21
13 26 21
9 20 14
0.2
0
Events 15 37 27
‡
Adj:
(Age & Sex) (+ BP, Smoking,
BMI)
(+ Ex
or Diab)
( + Other) Fl
1 to 2
3 to 4
5+
Whole Grain or White
Bread and
Coronary Heart Disease
1
Relative Risk
0.9
0.8
0.7
0.6
White
0.5
Mixed
0.4
0.3
Whole
Wheat
0.2
0.1
0
Non-Fatal MI
Fatal CHD
Relative Risk of fatal CHD
according to Exercise
Status
Age & Sex Adjusted
(Adventist Mortality and Adventist Health Studies)
1
0.9
0.8
Relative Risk
0.7
Low
Exercise
0.6
0.5
Medium
Exercise
0.4
0.3
0.2
0.1
0
Women
Men
High
Exercise significant
Other diseases in Adventists:
Vegetarians vs Nonvegetarians.
Weight Differences Between Vegetarians
and Non-Vegetarians
Vegan
Lacto-ovo
Pesco-veg
Semi-veg
Non-veg
Pounds
200
180
180
171
160
140
188
161
164
177
161
146
120
100 =
0
Female
Male
193
181
DIABETES
Prevalence and diet patterns.
Associations between Vegetarian Status and
the Prevalence of Diabetes in Adventists
MEN
Vegetarian
Status
WOMEN
Adjusted
95%
Adjusted
for Age and Confidence for Age and
BMI
Interval
BMI
95%
Confidence
Interval
Vegetarian
1.00
Semivegetarian
1.29
0.97-1.71
0.98
0.80-1.20
Nonvegetarian
1.72***
1.36-2.19
1.60***
1.36-1.88
*** p<.0001
1.00
ARTHRITIS
Prevalence and diet patterns.
Risk of prevalent rheumatoid
arthritis and meat intake. Females.
2
1.8
1.6
1.4
1.2
RR
1
0.8
0.6
0.4
0.2
0
Meat intake:
1.26
(1.21-1.43)
Never
< 1x /wk
1.49
(1.31-1.7)
1+ /wk
# Adjusted for age, BMI, education, oral contraceptive use,
number of live births, smoking and alcohol intake.
Risk of prevalent rheumatoid
arthritis and meat intake. Males.
2
1.8
1.6
1.4
1.2
RR
1
0.8
0.6
0.4
0.2
0
Meat intake:
1.19
(1.05-1.34)
Never
< 1x /wk
# Adjusted for age, BMI, education,
number of live births, smoking and alcohol intake.
1.43
(1.20-1.7)
1+ /wk
Selected Risk Factors in
Adventists:
Vegetarians vs Nonvegetarians.
Relative Risk of Incidence of
HYPERTENSION Requiring
Medication (1960-76)
according to Vegetarian Status
(Adventist Mortality and Adventist Health Studies)
All values significant.
2.5
Relative Risk
2
1.5
Vegetarian (meat
<1/wk)
SemiVegetarian
(meat 1-2x/wk)
NonVegetarian
(meat 3+x/wk)
1
0.5
0
Women
Men
Associations between Vegetarian Status and
the Prevalence of Hypertension in Adventists.
Men
Women
Vegetarian Status
Adjusted for
Age and BMI
95%
Confidence
Interval
Adjusted for
Age and BMI
95%
Confidence
Interval
Vegetarian
1.00
Semivegetarian
1.66
1.34-2.07
1.50
1.30-1.73
Nonvegetarian
2.26
1.87-2.73
2.31
2.04-2.61
1.00
Frequency of High Cholesterol
by Dietary Status and Race
Vegan
Lacto-ovo
Pesco-veg
Semi-veg
20%
15%
10%
5%
0%
Blacks
Whites
Non-veg
Fruit and Cancer
Cancer
Site
Fruit
Types
Frequency
Relative
Risk
Ovary
All fruits
<5/wk
1-2/day
>2/day
1.00
1.24
0.59
Pancreas
Raisins, dates,
dried fruit
<1/month
> 3/wk
1.00
0.19
Prostate
Raisins, dates,
dried fruit
<1/wk
1-4/wk
> 5/wk
1.00
1.17
0.62
Lung
All fruits
<3/wk
3-7/wk
>1/day
1.00
0.30
0.26
SOY MILK
Soy Foods
1. Reduces cholesterol
2. Isoflavone phytoestrogens
(Genistein, daidzein, equol)
3. May affect risk of cancers, heart disease,
osteoporosis, and other disorders
4. American Adventists consume a great deal of
soy as a non-meat complete protein
Relative risk* of prostate cancer
by intake of soy milk.
1
0.9
P(t) = .02
(0.5-1.4)
Relative Risk
0.7
(0.4-1.4)
0.3
(0.1-0.9)
0
# men
Never
10,875
< daily
902
1 x/day
395
*Adjusted for age, BMI, consumption of coffee, whole milk,
eggs and citrus fruit and age at first marriage.
2+ day
223
Jacobsen et al,
Tomatoes and Cancer
Tomato Frequency
Cancer Site <1/week 1-4/week >5/week
p values
Prostate
1.00
0.64
0.60
.10
Ovary
1.00
0.72
0.32
.001
Fruit and Cancer
Cancer
Site
Fruit
Types
( Fruit Frequencies)/Risk Ratios
Ovary
All fruits
(<5/wk) 1.00;
(1-2/day)1.24;
(>2/day) 0.59
Pancreas
Raisins, dates,
dried fruit
(<1/month) 1.00;
(> 3/wk) 0.19
Prostate
Raisins, dates,
dried fruit
(<1/wk) 1.00;
(1-4/wk) 1.17;
(> 5/wk) 0.62
Lung
All fruits
(<3/wk) 1.00;
(3-7/wk) 0.30;
(>1/day) 0.26
The Independent Effects of Traditional Lifestyle Risk Factors and
Psychosocial and Religious Participation Variables on
Coronary Heart Disease (CHD) Mortality in California Adventists
ALL VARIABLES
Variable
Level
Gender
Women
Men
Meat
Vegetarian
<1/wk
>1/wk
1.00
1.56**
1.59**
1.00
1.18
1.03
1.00
1.31**
1.21**
Exercise
Low
Medium
High
1.00
0.86
0.70**
1.00
0.84
0.73**
1.00
0.85
0.71***
Nuts
<1/wk
1-4/wk
>5/wk
1.00
1.04
0.85
1.00
0.77*
0.68**
1.00
0.87
0.73**
Smoking
Never
Past
1.00
1.04
1.00
1.09
1.00
1.04
Church Attendance
3-4/mo
1-2/mo
<1/mo
1.00
0.76
1.55
1.00
1.70
1.38
1.00
1.23
1.58**
**p<0.01 *** p<0.001
Men
Women
Combined
1.00
1.63***
The Independent Effects of Traditional Lifestyle Risk Factors and
Psychosocial and Religious Participation Variables on
All-Cause Mortality in California Adventists
ALL VARIABLES
Variable
Level
Sex
Women
Men
Meat
Vegetarian
<1/wk
>1/wk
1.00
0.99
1.09
1.00
1.02
1.08
1.00
1.01
1.09*
Exercise
Low
Medium
High
1.00
0.80***
0.75***
1.00
0.81***
0.81***
1.00
0.81***
0.79***
Nuts
<1/wk
1-4/wk
>5/wk
1.00
0.87*
0.78***
1.00
0.89**
0.88**
1.00
0.89***
0.84***
Smoking
Never
Past
1.00
1.09*
1.00
1.15*
1.00
1.13**
Church Attendance
3-4/mo
1-2/mo
<1/mo
1.00
0.99
1.32*
1.00
1.20
1.17
1.00
1.12
1.25**
*p<0.05 **p<0.01 ***p<0.001
Men
Women
Combined
1.00
1.50***
Meat seems to be one of the
“villains” associated with
• Coronary Heart Disease (CHD)
• Colon cancer
• Bladder cancer
• Ovarian cancer
Summary
1. As a group, risk of CHD is much lower in
Adventists but this is especially so below the age
of 70 years.
2. Risk of many cancers is also much lower, and
this is not all explained by the absence of
cigarette smoking in Adventists.
3. Adventist men and women in California live
much longer that other Californians, this being
especially true of the vegetarians.
4. Adventists often have unusual dietary habits that
trend toward vegetarianism.
5. Age at virtually all common causes of death is
greater by several years.
Summary Cont’d
6. Individual foods that change risk are technically difficult to
identify, but the following are probable associations.
a) Nuts, and whole grain bread consumption decrease risk
of coronary heart disease (CHD).
b) Meat consumption probably increases risk of CHD
particularly in younger and middle-aged subjects.
c) Fruits, legumes (including soy-products), and tomatoes
probably decrease risk of several cancers.
d) Meat consumption probably increases risk of colon,
ovary, bladder and perhaps other cancers.
e) This list by no means exhausts the possibilities.
CONCLUSION
The studies on Adventists in
California suggest that a vegetarian
lifestyle reduces the risk of many
chronic diseases such as:
•
•
•
•
•
CHD
Cancer
Obesity
Arthritis
Diabetes
Summary
AHS “Firsts”
1. The AHS was the first epidemiologic
study to demonstrate that men who
consumed tomatoes & tomato products
frequently, importantly reduced their risk of
prostate cancer. (Is it licopenes alone or the
complexity of the food ???)
Summary
AHS “Firsts”
2. The AHS was the first study to
demonstrate that eating nuts 5 or more times
per week appears to significantly reduce the
risk of definite fatal CHD and definite
nonfatal myocardial infarction compared to
eating nuts less than once a week. Similar
findings were seen for eating whole wheat
bread.
Summary
AHS “Firsts”
3. AHS was the first to demonstrate that
intake of adequate amounts of water each
day may significantly reduce the risk of fatal
coronary heart disease (CHD). This
observed protection in both males and
females was independent of other established
CHD risk factors.
Summary
4. Those who consume a wide range of
fruits, vegetables, seeds, whole grains, and
nuts have less disease than those who follow
a typical American diet.
Summary
5. Vegetarians appear to be at lower risk than
omnivores for several fatal chronic diseases:
a) Cancers of the colon, breast, prostate
b) Cardiovascular disease
c) Diabetes
Summary
6. Vegetarians have more favorable heart
disease risk profiles:
a) Decreased blood pressure
b) Decreased serum cholesterol
c) Decreased prevalence of obesity
Summary
7. Cancer risk may be lower because of
several factors:
a) Increased plant sterol/cholesterol
ratio in the diet
b) Decreased primary/secondary bile
acids ratio
c) Favorable dietary factors, including
more fiber and less fat
Our Oldest Old
1,765 - aged 90 years +
99 - over 100 years
Lydia Newton
112 years
Our Centenarians
Marguerite 90,
(Lydia’s daughter)
Lydia 112
Marge Jetton 101
(turned 105 on 9/29/09)
Description of the AHS-1 Study
Beeson WL, Mills PK, Phillips RL, Andress M, Fraser GE:
Chronic disease among Seventh-day Adventists, A low risk
group. Rationale, Methodology and description of the
population. Cancer 1989;64:570-581.
Description of the AHS-2 Study
Butler TL, Fraser GE, Beeson WL, Knutsen SF, Herring RP,
Chan J, Sabate J, Montgomery S, Haddad E, Preston-Martin S,
Bennett H, Jaceldo-Siegl K. Cohort profile: The Adventist
Health Study-2 (AHS-2). Int J Epidemiol 2007; Aug 27:
[Epub ahead of print]
THANK YOU!
And for those who answered
our AHS questionnaires as
your voice is being heard
around the world !
www.llu.edu/public-health/health/index.page
(AHS web page)
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