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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. - PowerPoint PPT Presentation
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Living Longer and Better:
The Health Experience of California Seventh-day
Adventists.
Larry Beeson, DrPH Associate Professor
School of Public HealthCo-investigator, AHS-2
Adventist Health StudyBackground
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
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.
Biomedical Research
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 PreventionPublic Health ServiceNational Institutes of Health
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) ?
Question
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 andBible 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 byLoma 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)
AHSMOG 1976-20066,328 SDA25+ yearsCalifornia
Adventist Health StudiesU.S.A. 1958-2012
1966 1974
1950 201020001990198019701960
AMS 1958-198525,153 SDA 25+ years California
AHS-1 1974-200634,198 SDA25+ yearsCalifornia
AHS-2 2002-97,000 SDA30+ yearsUSA & Canada
12,000overlap
5,649overlap
ARHS2006-11,000
Dietary AssessmentIncreasing 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.pageAdventist 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.
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
Regular exercise Eating plant-based diet Eating small amounts of nuts regularly Maintaining normal body weight Not smoking
Adventist Health Study-1 demonstrated that 5 simple habits Adventists have promotedfor over 100 years extend their life by as much as 10 years in both men and women
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).
Men Women
Californians 43.9 49.5
California Adventists 51.2 53.9
Vegetarian Adventists 53.3 55.7
Extra Years
California Adventists 7.3 4.4
Vegetarian Adventists 9.4 6.2
Different Types of ‘Vegetarians’
1. Lacto-Ovo-vegetarians
2. Fish-eating (pesco) ‘vegetarians’.
3. High and low processed food vegetarians.
4. Soy and non-soy vegetarians.
5. Vegans and Fruitarians.
High lacto
Low lacto
1) Measures of association between exposure and health outcome:
“Relative Risk” = “Risk Ratio” = “RR”
2) Statistical significance Biologic significance ??
“p-value”
Brief Introduction to Epidemiology
The Relative Risk (RR)
Incidence of disease (in those “exposed”)
Incidence of disease (in those “not exposed”)RR =
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
High
Lowor
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.
All Californians All Adventists
Men
Cause of Death (%)
% 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 85.8
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† †† †††
†††
††
†††
†
†††
†††
†††
†††
†††
†††
†††
Meat intake and risk of different cancers.
0
0.5
1
1.5
2
2.5
Colon Ovary
Never
< 1/ week
1+/ week
Colon Prostate Ovary Ovary Postmenopausal
P (t): 0.01 ns <.01 0.02
RR
Total meat intake and risk of colon cancer
1
1.5
1.85
0
0.5
1
1.5
2
Never < 1/week 1+/week
P (trend)=0.01
(0.92-2.45)
(1.16-2.87)
RR
Red meat intake and risk of colon cancer, among those who eat white
meat < 1x/week.
1
1.4
1.9
0
0.5
1
1.5
2
Never < 1/week 1+/week
P (trend) = 0.02
(0.87-2.25)
(1.16-3.11)
RR
White meat intake and risk of colon cancer, among those who eat red meat < 1x/week.
1
1.55
3.29
0
0.5
1
1.5
2
2.5
3
3.5
Never < 1/week 1+/week
P (trend) = 0.006
(0.97-2.50)
(1.60-6.75)
RR
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
<3/week >3/week
Bladder 1.00 2.38 0.01
* Not statistically significant
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
Nuts <1 time/ wk
Nuts 1-4 times/ wk
Nuts 5+ times/ wk
Nut Consumption and Coronary Heart
Disease
FatalDefinite Non-Fatal MI
Rela
tive
Ris
k
P(t) <.001P<.001
P(t) <.001P<.001
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
Nuts <1 time/ wk
Nuts 1-4 times/ wk
Nuts 5+ times/ wk
Nut Consumption and Coronary Heart
Disease
Events 66 85 33 66 85 33 MenWomen
Rela
tive
Ris
k
P(t) <.001P<.001
P(t) <.001P<.001
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
Nuts <1 time/ wk
Nuts 1-4 times/ wk
Nuts 5+ times/ wk
Nut Consumption and Coronary Heart
Disease
Events 63 55 15 79 76 57
NonVegetarians Vegetarians
Rela
tive
Ris
k
P(t) <.05P<.05
P(t) <.001P<.001
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
Nuts <1 time/ wk
Nuts 1-4 times/ wk
Nuts 5+ times/ wk
Nut Consumption and Coronary Heart
Disease
Events 65 85 34 77 47 38
Age <80 Age 80+
Rela
tive
Ris
k
P(t) <.05P<.05
P(t) <.001P<.001
RRRR‡‡ of of FFATALATAL CHDCHD according to according to Intake of Intake of WWATER ATER inin MMALESALES (n=11,257)(n=11,257)
‡‡ Adustments: Adustments: Age + Smoking, Ed, + Energy + Other Age + Smoking, Ed, + Energy + Other BMI, BPBMI, BP Fluids Fluids
1
.65
.46
1
.60
.38
1
.67
.39
1
.64
.33
0
0.2
0.4
0.6
0.8
1
1.2
<=2
3 to 4
5+
Rel
ativ
e R
isk
EventsEvents 25 51 48 24 34 37 22 42 33 17 33 23 25 51 48 24 34 37 22 42 33 17 33 23
.001 .0002 .0004 .0003 p (trend)
Glasses/day
RRRR‡‡ of of FFATALATAL CHD CHD according to according to Intake of Intake of WWATER ATER inin FFEMALESEMALES (n=15,840)(n=15,840)
‡‡ Adustments: Adustments: Age + Smoking, Ed, + Energy + Other Age + Smoking, Ed, + Energy + Other BMI, BPBMI, BP FluidsFluids
1
.54.59
1
.57.61
1
.41.52
1
.44
.57
0
0.2
0.4
0.6
0.8
1
1.2
<=2
3 to 4
5+
Rel
ativ
e R
isk
EventsEvents 23 40 52 18 34 43 13 17 26 13 17 2623 40 52 18 34 43 13 17 26 13 17 26
p(trends) NS
Glasses/day
RRRR‡‡ of F of FATALATAL CHD according to CHD according to WWATERATER
I INTAKE NTAKE Males & FemalesMales & Females ( (n= 27,342n= 27,342) )
1
0.54 0.52
1
0.620.50
0
0.2
0.4
0.6
0.8
1
1.2
1.4
1.6
<=2
3 to 4
5+
RR
EventsEvents 28 50 60 20 40 41 28 50 60 20 40 41
Glasses/day
Normotensive Hypertensive
<.01 <.05 p (trend)
Age & Sex Adjusted
RRRR‡‡ of FATAL CHD according to of FATAL CHD according to WATERWATER
INTAKE INTAKE Males & FemalesMales & Females ( (n= 27,342n= 27,342))
1
0.570.46
1
0.57 0.54
0
0.2
0.4
0.6
0.8
1
1.2
1.4
1.6
<=2
3 to 4
5+
RR
EventsEvents 23 52 58 24 35 37 23 52 58 24 35 37
Glasses/day
Meat <1/week Meat 1+/week
.003 .02 p (trend)
Age & Sex Adjusted
RRRR‡‡ of of FFATALATAL STROKE STROKE according to according to WATER WATER Intake in Intake in MM & & F F withwith Stroke Stroke HxHx
(n=614)(n=614)
1 .84
.55
1
.66
.43
1
.60 .45
1
.71
.47
0
0.2
0.4
0.6
0.8
1
1.2
1.4
1.6
1 to 23 to 45+
‡‡ Adj: (Adj: (Age & Sex) (+ BP, Smoking, (+ Ex ( + Other) Age & Sex) (+ BP, Smoking, (+ Ex ( + Other) Fl Fl BMI)BMI) or Diab) or Diab)
Rel
ativ
e R
isk
EventsEvents 15 37 27 15 28 21 13 26 21 9 20 1415 37 27 15 28 21 13 26 21 9 20 14
<.05 <.01 <.02 .08 p (trend)
Servings /day
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
Non-Fatal MI Fatal CHD
White
Mixed
WholeWheat
Whole Grain or White Bread and Coronary Heart
Disease
Rela
tive R
isk
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
Women Men
LowExercise
MediumExercise
HighExercise -significant
Relative Risk of fatal CHD according to Exercise StatusAge & Sex Adjusted
(Adventist Mortality and Adventist Health Studies)
Rela
tive
Ris
k
Weight Differences Between Vegetarians and Non-Vegetarians
100
120
140
160
180
200
Vegan Lacto-ovo Pesco-veg Semi-veg Non-vegPounds
=
Female Male0
146
161
193
181188
177
161
180
164171
Associations between Vegetarian Status and the Prevalence of Diabetes 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 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
Risk of prevalent rheumatoid arthritis and meat intake.
Females.
00.20.40.60.8
11.21.41.61.8
2
RR
1.49(1.31-1.7)
# Adjusted for age, BMI, education, oral contraceptive use, number of live births, smoking and alcohol intake.
1.26(1.21-1.43)
Meat intake: Never < 1x /wk 1+ /wk
Risk of prevalent rheumatoid arthritis and meat intake. Males.
00.20.40.60.8
11.21.41.61.8
2
RR
1.43(1.20-1.7)
# Adjusted for age, BMI, education, number of live births, smoking and alcohol intake.
1.19(1.05-1.34)
Meat intake: Never < 1x /wk 1+ /wk
0
0.5
1
1.5
2
2.5
Women Men
Vegetarian (meat<1/ wk)SemiVegetarian(meat 1-2x/ wk)NonVegetarian(meat 3+x/ wk)
Relative Risk of Incidence of HYPERTENSION Requiring Medication (1960-76) according to Vegetarian Status(Adventist Mortality and Adventist Health Studies)
All values significant.
Rela
tive
Ris
k
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 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
Frequency of High Cholesterol by Dietary Status and Race
0%
5%
10%
15%
20%
Blacks Whites
Vegan Lacto-ovo Pesco-veg Semi-veg Non-veg
Fruit and Cancer
Cancer Site
Fruit Types
Frequency Relative Risk
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
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
0.9
0.7
0.3
0
1
Rela
tiv
e R
isk
Relative risk* of prostate cancer by intake of soy milk.
P(t) = .02
*Adjusted for age, BMI, consumption of coffee, whole milk, eggs and citrus fruit and age at first marriage.
*Adjusted for age, BMI, consumption of coffee, whole milk, eggs and citrus fruit and age at first marriage.
Jacobsen et al,
(0.5-1.4)
Never < daily 1 x/day 2+ day# men 10,875 902 395 223
(0.4-1.4)
(0.1-0.9)
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 Men Women Combined
Gender Women
Men
1.00
1.63***
Meat Vegetarian<1/wk
>1/wk
1.001.56**
1.59**
1.001.18
1.03
1.001.31**
1.21**
Exercise LowMedium
High
1.000.86
0.70**
1.000.84
0.73**
1.000.85
0.71***
Nuts <1/wk1-4/wk
>5/wk
1.001.04
0.85
1.000.77*
0.68**
1.000.87
0.73**
Smoking NeverPast
1.001.04
1.001.09
1.001.04
Church Attendance 3-4/mo1-2/mo
<1/mo
1.000.76
1.55
1.001.70
1.38
1.001.23
1.58**
**p<0.01 *** p<0.001
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 Men Women Combined
Sex Women
Men
1.00
1.50***
Meat Vegetarian<1/wk
>1/wk
1.000.99
1.09
1.001.02
1.08
1.001.01
1.09*
Exercise LowMedium
High
1.000.80***
0.75***
1.000.81***
0.81***
1.000.81***
0.79***
Nuts <1/wk1-4/wk
>5/wk
1.000.87*
0.78***
1.000.89**
0.88**
1.000.89***
0.84***
Smoking NeverPast
1.001.09*
1.001.15*
1.001.13**
Church Attendance 3-4/mo1-2/mo
<1/mo
1.000.99
1.32*
1.001.20
1.17
1.001.12
1.25**
*p<0.05 **p<0.01 ***p<0.001
Meat seems to be one of the “villains” associated with
• Coronary Heart Disease (CHD)
• Colon cancer
• Bladder cancer
• Ovarian cancer
Summary1. 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 vegetarianlifestyle reduces the risk of many chronic diseases such as:
• CHD• Cancer• Obesity• Arthritis• Diabetes
SummaryAHS “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 ???)
SummaryAHS “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.
SummaryAHS “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
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]