living longer, better, balanced lives 55 years of...

Living Longer, Better, Balanced Lives The Health Experience of Seventh-day Adventists

Fred Hardinge, DrPH, RDAssociate HM DirectorGeneral Conference!

Data courtesy of Gary Fraser, MBBS, DrPHDirector of AHS-2

Adventist Mortality Study 23,000 in California

1958-‐1966

1955 201020001990198019701960 2015

Adventist Health Study-‐1 34,000 in California

1974-‐1988

Adventist Health Study-‐2 96,000 in USA & Canada

2002-‐Present

Adventist Health & Smog Study 7,000 in California 1976-‐Present

Adventist Religion & Health Study 11,000 in USA & Canada

2006-‐Present

55 years of Adventist Health Studies

Why Study Adventists?

Most don’t smoke Most don’t drink Wide range of dietary habits

Summary of AHS-1

• Adventists in California have a dramatic extension of life expectancy with lower rates of heart disease and many cancers.

• The main effect appears to be a later age of death whatever the cause of death. The causes of death were to same.

• This seems to relate to increased intake of fruits, vegetables, nuts, whole grains, soy, and less meat.

Adventist Health Study-2(AHS-2) 2001 – 2014+

About 96,000 subjects More than 25,000 Black study members

Mean age at enrollment 58.7 years Age range 30-110 years 35% male, 65% female

Main Focus of AHS-2

Soy Meats

Dairy products Dietary fats Vegetables

BMI Diet & disease in

African-Americans

What do we look like?

Smoking Status

Never

Smoked

Past S

moker

Curren

t Smok

er

0 22.5 45 67.5 90

1.5

18.79

80.06

Alcohol Use

Never

Past Use

Current Use

0.00 15.00 30.00 45.00 60.00

6.8

33.8

59.4

Coffee Consumption

Never

1 Cup or Less Per Day

2+ Cups Per Day

0.00 17.50 35.00 52.50 70.00

8.49

22.48

69.03

Diet: Mean Servings Per Week

0.00

5.50

11.00

16.50

22.00

Cruciferous Veg Fish Fruits Legumes Tomatoes

6.24.7

20.4

0.84.3

Five Dietary PatternsDiet Definition

Total vegetarian Eat meat, fish and dairy less than once monthly

Lacto-ovo-veg Eat meat and/or fish less than once monthly, and dairy more than once monthly

Pesco-veg Eat meat less than once monthly and fish at least once monthly,

Semi-vegetarian Eat meat at least once monthly but less than once weekly

Non-vegetarian No specific dietary restrictions as to frequencies of meat, fish and dairy

Total Vegetarians 9,062 9.4%

LO Vegetarians 30,103 31.4%

Semi-Vegetarians 4,801 5.0%

Pesco-Vegetarians 9,793 10.2%

Non-Vegetarians 42,241 44.0%

AHS-2 Dietary Patterns

Dietary Status by Age Group76+

50-75

30-49

0% 25% 50% 75% 100%

Total Lacto-Ovo Vegetarian Pesco-Vegetarian Semi-Vegetarian Non-Vegetarian

34.4%

47.4%

52.4%

39.2%

25.7%

26%

Daily Meat Intake – Non-Vegetarians

White Non-vegetarians: 41.3 grams /day

Black Non-vegetarians: 61.1 grams/day

Calcium Intake

0.0000

250.0000

500.0000

750.0000

1000.0000

Total Lacto Pesco Semi Non

Dietary Supplement

Vitamin B12 Intake (Including Supplements)

0.0

4.0

8.0

12.0

16.0

20.0

24.0

Total Lacto Pesco Semi Non

Weight Differences

100

120

140

160

180

200

193

180 181

164

188

171177

161 161

146

Total Lacto-ovo Pesco-veg Semi-veg Non-veg

Poun

ds

Female 5’ 6” tall

Male 5’ 10” tall

Dietary Pattern and Percent Treated for Hypertension

0%

28%

0.2410.216

0.197

0.140

0.090


Dietary Pattern and Percent ReportingHigh Cholesterol

0%

18%

0.1510.148

0.120

0.097

0.050


Also supported by studies of non-Adventist vegetarians

Dietary Pattern and Percent Treated for Diabetes

0%

9%

0.075

0.060

0.047

0.032

0.021


Dietary Pattern and Total Mortality*Risk Factor RR 95% Confidence Intervals

Non-vegetarian 1.00

Total 0.85 0.71-- 0.93

Lacto-ovo- 0.91 0.82 – 0.96

Pesco- 0.81 0.69 – 0.88

Semi- 0.92 0.80—1.06*Adjusted for age, gender, and ethnicity.

Red Meat and Total Mortality*

Risk Factor RR 95% Confidence Intervals

No red meat 1.00

1 oz/day (28 g) 1.27 1.19– 1.35

2 oz/day (56 g) 1.61 1.42 – 1.83

3 oz/day (84 g) 2.05 1.70 – 2.47

*Adjusted for age, gender, and ethnicity.

Dietary Pattern and CHD Mortality*Risk Factor RR 95% Confidence Intervals

Non-vegetarian 1.00

Total 0.91 0.67– 1.10

Lacto-ovo- 0.90 0.80 – 1.12

Pesco- 0.80 0.64 – 1.05

Semi- 0.85 0.58—1.07


Dietary Pattern and Total Cancer*Risk Factor RR 95% Confidence Intervals

Non-vegetarian 1.00

Total 0.92 0.65 - 0.93

Lacto-ovo- 0.90 0.83 – 1.02

Pesco- 0.94 0.82 – 1.11

Semi- 0.94 0.66 - 0.97


Red Meat and Colon Cancer*

Risk Factor RR 95% Confidence Intervals

No red meat 1.00

1 oz/day (28 g) 1.35 1.07– 1.71

2 oz/day (56 g) 1.83 1.14 – 2.93

3 oz/day (84 g) 2.48 1.22 – 5.03


Breast Cancer and Dietary Pattern

• A total vegetarian diet is associated with reduced risk of breast cancer, both post and pre-menopausal.

• Could this benefit be due to soy isoflavones? • Early evidence suggests this is a benefit.

Prostate Cancer and Dietary Pattern

• Total vegetarians appear to have the lowest risk. • Could it be the soy isoflavones they consume? • Could it be the lycopene found in tomatoes that reduces

the risk of this cancer?

Adventist Religion & Health Study

Commenced in 2006

Funded by the National Institutes of Aging

11% sample of AHS-2 members

10,988 enrolled, 3,764 are Black subjects

Completed an additional 20-page questionnaire • Assessed: faith, worship, prayer, Sabbath, social, psychological, and stress factors

Religion and Health

“Faith in God's love and overruling providence lightens the burdens of anxiety and care. It fills the heart with joy and contentment in the highest or the lowliest lot. Religion tends directly to promote health, to lengthen life, and to heighten our enjoyment of all its blessings.” Patriarchs and Prophets, p. 600

Summary: ARHS Discoveries So FarAdventists have a better physical and mental quality of life than others With age, physical quality of life decreases and mental quality of life tends to increase There is an inverse association between religious coping and depression Sabbath-keeping is associated with better mental and physical quality of life.

The vegetarian advantage is very clear almost everywhere!

What is the Optimum Vegetarian Diet!

!

So far pure vegetarians look very good, but not yet convincingly superior to lacto-ovo vegetarians. !

We need to keep looking as the data grows more robust.

Overall Conclusions• Vegetarian diets have clear and important effects on risk of

chronic disease • Diets are very complex and dissecting out the active

components is difficult, but an on-going task in AHS-2 • Which type of vegetarian diet is best will probably have no

simple answer, as one diet is unlikely to be best for all disease outcomes

• Strong conclusions require strong evidence—AHS-2 will help provide this evidence.

Practical Conclusion

The evidence is right now sufficient to support a diet that: • may still include some lacto-ovo foods (used primarily as

condiments); • is otherwise plant-based, or trends strongly in that

direction. • avoids all red meats!

If you wait to modify your lifestyle until all the details are known--for sure you will be dead!

Suggestions for a Healthy Animal-free Diet

Ensure ample grains, vegetables, legumes, fruits, nuts, seeds and berries. Avoid replacing animal foods by refined, sweet, fatty commercial products, even if from plant sources. Obtain adequate sunlight and emphasize high calcium vegetables, or supplement with calcium. Consider algal supplements high in omega-3 fatty acids. Take a supplement of vitamin B12 regularly.

Finding Balancein an Unbalanced World

Adventists Are Often Quick to Espouse Spurious Health Claims

“No Oil Diet”

Raw vs Cooked Food

Zone Diet

Masticate 60+ times per bite

Wheat Belly / Grain Brain

Vegan Diet as the “Gold Standard”

The Only Balanced Person is YOU!

Evaluating Scientific Claims

Carefully evaluate the messenger: 1.Are they really who they claim to be? 2.Did they get the education they claim to have? 3.Do their peers in that field agree with them? 4.Is their life consistent with their message? Critically evaluate the message being presented: 5.Is there good research to back up the claims? 6.Are the results consistent? 7.Has this been corroborated by other research?

Wise Counsel

Remember, in every audience you speak to, there may be someone who knows more about at least a small area than you do. Don’t disappoint them by your ignorance! Don’t make things up!

"If they see that we are intelligent with regard to health, they will be more ready to believe that we are sound in bible doctrines.” Counsels on Health p 452

SleepRelax

No Alcohol

Physical ActivityPrayer

Bible Study

No Smoking Sunlight

Can We Balance the Bad with the Good?

High Stress

CoffeePoor Diet

Non-Biblical Concept

“In looking to Jesus, by studying His life and character, by earnestly desiring to be like Him, our minds will be balanced in the right direction, that we may overcome selfishness, and choose a course of righteousness. . . .” SD 159

Biblical Concept of Balance

©2012 Fred Hardinge

Gratefully accept the health God gives me...


Focus my lifestyle choices only on the healthful and wholesome.


Cheerfully yield my desires and appetites to the sovereignty of His love.


Rejoice in the benefits He grants me as I make wholesome choices through His abundant Grace.

“So whether you eat or drink or whatever you do, do it all for the glory of God.” I Cor 10:31

living longer, better, balanced lives 55 years of...

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