June 25, 2009

Adventist Health Studies: Past, Present, and Future

2009 1518 page16 caphe idea that a religion can advocate certain health behaviors is not unique to Adventists. Mormons, or Latter-day Saints, do not smoke or drink alcohol. Many Hindus are vegetarian. Eastern Orthodox believers participate in holy days of “fasting,” during which they refrain from eating meat. Because our marvelous bodies represent the peak of a stupendously complex and wonderful creation, many people take seriously the moral responsibility to carefully care for their bodies—but few more seriously than Seventh-day Adventists.

Where Did the Health Message Originate?
The Adventist Church’s traditional health message is a well-known and important feature of Adventism and rests on an increasingly solid scientific foundation. Church cofounder Ellen White, while explaining her vision of 1863, did not have or need scientific credentials. Indeed, the science of the day would have hindered rather than helped. Instead, she laid out a number of simple ideas that were at the time fairly revolutionary as a package, although not individually unique. Contemporary Adventist scholar Leo Van Dolsen once summarized these simple health principles—nutrition, exercise, water, sunlight, temperance, air, rest, and trust—in terms that were easy for most people to understand.
Nearly 150 years following that 1863 health vision, people expect credible health information to come from sources such as books written by researchers and scientists, as well as the opinions of health professionals who base their information on scientific evidence. Even within the ranks of Adventism, some question the wisdom of health principles written almost a century and a half ago.
2009 1518 page16Partly as a response to these trends, and after much discussion among church leaders and health professionals, the church gave the go-ahead in the late 1950s for researchers at Loma Linda University to subject the principles of the church’s health message to scientific scrutiny. “What if the science was not supportive?” some must have wondered. Yet their faith that the prophetic messages would hold firm in light of scrutiny was strong.
Where Is the Health Study Now?
Today, Loma Linda University researchers are partway through the third—and a very extensive—world-class study of Adventist health. The first study, which began in 1958, clearly demonstrated that Adventist Californians lived longer than other Californians, and that fewer died of heart disease and from smoking-related cancers. The study provided some of the earliest evidence in the United States that smoking tobacco was hazardous to health. The Adventist Mortality Study was featured prominently in the surgeon general’s reports of the day.
This first study also provided strong hints that within the Adventist population many differences existed in health experience. One of the great advantages of this population (perhaps only from a researcher’s viewpoint) is that not all Adventists are vegetarian. Indeed, about 50 percent of members in these studies are nonvegetarian, and strong comparisons can be made between Adventists who live and eat very differently from one another.
The second study, beginning in 1974, took advantage of this new research opportunity to ask more detailed questions about the effects of particular foods and food groups on the risk of cancer and heart disease. It also compared Adventists who ate or did not eat certain foods. Results showed that nonvegetarian Adventists experienced much more heart disease than vegetarian Adventists, particularly among the younger and middle-aged (which is up to at least age 70 in many Adventists!). The nonvegetarians also had about 60 percent more colon cancer, as well as more ovarian and bladder cancer. Moreover, on average, they lost about five years of life compared to the vegetarians.
The study was also the first to show that frequent consumption of small quantities of nuts appears to greatly protect against heart disease. This is now confirmed by numerous other studies. Also noted was that whole grains protect against heart disease. Many other associations between diet, cancer, and heart disease appeared likely in this data, but are not, as yet, so firmly established.
Even vegetarian Adventists eventually die, and it turns out that they die of much the same things as other Adventists and other Americans—but at much later ages.
California Adventists, considered a longevity “blue zone,” have recently gained a lot of attention. It may not be without significance that arguably the most extensive positive publicity that the Adventist Church has ever enjoyed comes from the manifest effects of its health message, an advantage that many Adventists have experienced for generations.
The Third Time Around
Now we have Adventist Health Study-2 (AHS-2). Why another study? The second study enrolled 34,000 California Adventists. Yet, it was too small to give definitive answers about diet and cancer. Employing newer questionnaires and statistical methods, researchers now have completed enrollment of AHS-2 with more than 96,000 Adventists from every state of the U.S.—and every province and territory of Canada.2009 1518 page16
Our results on diet and cancer will not be available for another three to four years. A few interim observations and results, however, are of interest. These largely relate to comparisons between vegetarian (about 45 percent of study members) and nonvegetarian Adventists:
• The lacto-ovo vegetarians are on average low dairy consumers. Some have wondered if Adventist vegetarians tended to overeat dairy and get most of their fat and much protein from this source. This is generally not the case.2009 1518 page16
• The average Adventist in AHS-2 is overweight with a BMI (body mass index) of 27, where a value of greater than 25 defines overweight. Adventist Church members have largely followed the nation in this regard. Vegetarian Adventists, however, are less heavy (BMI of 25, on average), and the 4 percent of Adventists who are vegan are on average much lighter still (BMI of 23). Partly as a result of this lower BMI, the vegetarians and vegans experience much less diabetes, lower blood pressures, and less hypertension. Protein intake (animal and vegetable proteins are about equally effective) appears to protect against weakened bones and wrist fractures, as does regular physical activity.
• One particularly interesting observation is that vegetarian and especially vegan Adventist women are much less likely than nonvegetarian Adventist women to undergo routine mammography screening against breast cancer—a possibly dangerous indication of lesser regard for conventional preventive medical strategies.
Looking to the Future
What does the future hold for these studies? The federal agency funding AHS-2 has experienced severe fiscal difficulties during the past two to three years. Unfortunately, AHS-2, along with many similar studies, has been caught up in this and is presently not fully funded. Times are already better within the agency, however, and we are busy seeking renewed funding—although it may take another one to two years to accomplish this. In the meantime, Loma Linda University is ensuring the study’s survival and “good health.”
AHS-2 can provide information about the effects of soy consumption and probably also the effects of meat consumption as can no other existing study. It also will be able to determine the possible effects of a wide variety of fruits and vegetables on risk of various chronic diseases. Thus we soon expect a robust period of new discovery.
I believe that the Lord gave the health message to the Adventist Church not only for its own members but also to share with others. The main goal of the AHS-2 research is to play a small part in improving the health of the nation, indeed the world, and so enhance people’s lives. The 96,000 members of AHS-2 all play a vital role in this endeavor. As lead researcher of the study, I express my personal gratitude—as well as that of Loma Linda University and the Adventist Church—to all the participants, who have spent in total some 200,000 hours filling in long questionnaires. In particular, we recognize the 25,000 participating Black Adventists, because minority populations have not been adequately studied until very recently. The efforts on the part of all participants will pay off handsomely. 
Health study participants should send address and/or phone number changes in writing to Adventist Health Study-2, Evans Hall #203, 24785 Stewart Street, Loma Linda University, Loma Linda, CA 92350, U.S.A.; by calling 1-800-247-1699 or 1-909-558-4868; or by e-mail: [email protected].
Gary E. Fraser, M.B., CH.B., PH.D., M.P.H., FPACP, F.A.C.C., is the lead researcher for the Adventist Health Studies. He is Director of the Center for Health Research, Loma Linda University School of Public Health.