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Adventist Health Study

Michael Orlich



  • October 26, 2012
    2:00 PM
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good afternoon everyone welcome to our seminar this afternoon my name is Michael Orland and I am a researcher with Adventist health studies of research fellow and I also work at Loma Linda and the preventive medicine department drinking the venom medicine residency there and they asked us to do a presentation from the Adventist health study the theme of the overall conference here is testimony and they thought that I been this full study provided sort of a global testimony for Adventism in some way and so will explore that concept a little bit together mainly my main objectives are to give you an overview and update of the study so that you understand well these are the objectives this is a CME seminar so if you're signed up for that picture you sign in today and also do your evaluation form after that would be appreciated him but the objective is to look a little bit at the history of Adventist health study is experiment several over a considerable period of time to discuss some of the key findings of the earlier studies as well as some recent findings of the current study of Venice all study to and to describe some of the immediate future goals and expectations for the current study and then to ask together some important questions about what is the meaning of Adventist health study to seventh at the niacin to the world than in what way is it a testimony I will provide those answers but already some of the questions a little bit of an overview looking back at the history of this study this is actually the third major Adventist health buddy if you will although recall it at once holds thirty two research on the subject add venison how goes back ways to run to those the first Dean of the school of Public health the Doctor Harding as he did a doctorate in public health at Harvard and then did studies nutritional studies of Seventh-day Adventist vegetarians and back at that time people were most concerned about the nutritional adequacy of a vegetarian diet in his studies were along those lines the fifties in the fifties it was the first Adventist health study that we referred to as Adventist mortality study it's designated AMS here and it was among California Seventh-day Adventists and values in the seventies there was a follow-up study of about thirty five thousand California Seventh-day Adventists all white or Caucasian and were still following him many of those subjects today out of that study there is also some study the recall being off smog study and it's looking at the effects of air pollution are small in those studies subjects that live in Southern California and then more recently starting in two thousand two two two thousand seven we enrolled nearly a hundred thousand Seventh-day Adventists across North America so much wider population United States and Canada letters with more ethnic diversity with a substantial percentage of African Americans as well as Caucasians and molar numbers of other racial and grooves and with greater power over all because of larger numbers so studies and Seventh-day Adventists have been recognized by study funders at the National Institutes of Health as being important in a number of ways are certain advantages and of course disadvantages to studies among happiness like there would be in any other group among Adventists one of the helpful things is his visible homogenate even as helpful as well as heterogeneity that's helpful homogenate he is in regards to certain lifestyle characteristics like the use of tobacco and alcohol of those of the month the two that you can point to most easily where there's very little use of these substances in the population and sort of your study studying other endpoints in your worried about those this potential confounders the low prevalence of those in the population is helpful similarly if you're worried about potential unmeasured confounders that confusion could confuse the findings of your your variable of interest the fact that there's a lot shared by this population means that there may be less variability in some of those unmeasured confounders potentially and at the same time there's quite a bit of heterogeneity particularly particularly in terms of diet and that's the main the main thing that were studying is the effects of diet and Adventist health studies particularly when it comes to the range of vegetarian spectrum the user need the use of animal products and sorted by implication the use of variety of other plant food there is much greater range of any text going from zero up to very high intakes compared to an average population like say nurses health study or something like that so the obvious Mars mortality studies started back in the fifties as I said and it was at the same time as a larger American Cancer Society study and it will allowed mortality comparisons between these two groups and this was one of the first things that pointed to a longevity advantage among Adventist these are a brief summary of some of the results of lower risk of coronary heart disease among vegetarians administrators and nonvegetarian Adventist also there was a mortality association with Agnes and the negative association with green salads compared to other Californians of this is comparing to the American Cancer Society study of Venice experienced lower rates of death for all cancers of lung cancer colorectal cancer breast cancer and coronary heart disease in these initial results served as an impetus for some of the later funding of additional studies you say well these folks are living longer and having a reduced risk of certain diseases so why is that it's great to know that that's true on but why are there certain factors in their lifestyle that everybody could benefit from so the first Adventist health figure out an assault thirty one the enrollment was in the seventies as I say funding lasted until nineteen eighty eight in one form or another initially by the cancer institute in the heart long blood and then aging all part of the National Institutes of Health these were some other key findings from Adventist health study one vegetarians have a lower risk of obesity hypertension diabetes and death from all causes compared and nonvegetarian cabinets and men the risk of fatal heart disease was significantly related to the intake regular not an whole-grain consumption were associated with a lower risk of coronary heart disease but not finding was a surprising one at the time and has since been verified in a number of other large cohort studies and certainly could be pointed to as a key contribution about this whole study one of the risk of colon cancer was increased by eighty eight percent and nonvegetarians compared to vegetarian happiness with legumes having a protective effect and evidence the one they saw the adverse effects for colon cancer risk both for red meat and white needs the white meat is not well-established and other studies where is red meat is an on Avenue S average Adventists on average excuse me administer men live seven three years longer and women four four years longer than other Californians on and then I met a reduction in prostate cancer risk with tomato consumption these are some key findings from Adventist health study one the awesome log study as I said was a subsegment of the Adventist health study one population those living in Southern California where ambient air pollution levels could be measured and because it's a mostly non-smoking population when when you're looking at the effects of this long for air pollution on the risk of sidelong cancer the effect is probably rather small and it's hard to detect small effects of and have them be statistically significant and not overwhelmed by some confounding factor when when you have a very strong potential confounders like smoking the hopeless cause in so that that's one of the reasons why this population was good for that in this research is still ongoing is very hard research to direction then the more recent Adventist health study to starting in two thousand two perhaps just a show of hands how many of you are enrolled as study subjects had been assaulted thank you very much thank you it couldn't be done without you how many may I say were enrolled in an assault but he won anybody all right special thank you to their horses they said they were they were sitting for over a hundred thousand Seventh-day Adventists initially didn't like it there but that about ninety six thousand of the total study subject population in the United States and Canada with about a quarter of that being African-Americans of vendors is a study of the other useful study to known as the library is named biopsychosocial 's virtual console study over the advanced religion and whole study on which it is comprised of about ten thousand subjects from Adventist health study to and looking at issues are as you may guess of psychology and spirituality and social factors on health very interesting study that reminds me units that pause just for a moment and do a little bit of show and tell here which I intended to do I brought a few things that we could pass around and you can look up on I just want to get them back up and this is the those who haven't enroll that's the questionnaire for an assault but needs to and this is the questionnaire for the religion and health study state can get an idea of what some of the questions are that were asked and since this is a professional audience on a couple of other resources I thought you might be interested in if you really want there's very little that we can go over in one hour and I'm not up on every facet of the Adventist health studies on Doctor Fraser by the way is out of the country right now so he can be here but he would've loved to but the Doctor Fraser wrote a book published by Oxford University press and this would summarize everything you know sort of about four near two thousand from the previous studies in one other book that certainly worked while on the topic of vegetarian nutrition is that of Doctor of Jong Solitaire is the one of the coinvestigators without an assault study and also the director of the nutrition department the school of Public health Mrs. 's book vegetarian nutrition another resource that I would point you to which all have a slide on later is our website just simply every WW app in this whole study Ward and for example you can find links to all of the published articles as well as media releases and videos and old news and letters than questionnaires so you can pretty much learn almost everything you need to about an assault study and research just by going to our website which has been newly redesigned in this lot better than it was a couple of years ago and I might also say that for those of you who are particularly interested in this topic of diet and health and vegetarian diets and their impact on the risk of disease and on longevity on there's a very good conference that's the only every five years at Loma Linda University that's coming up this February and it's the international vegetarian nutrition Congress and it's really very good so you could take a look for thou through the school of Public health website at Loma Linda University or just googling that it's in February I don't recall the dates that I noticed the week before the American College of preventive medicine but also take a look about us that's a great learning opportunity will help by cutting-edge research so to speak from a leading scientists who are studying nutrition and health specifically vegetarian diets is okay starting the twenty fourth of thank you very much appreciate the okay so I thought I'd pass those around seem to get to see those long talking on we mentioned some of the key findings of Adventist health study one alters a look at a couple of things first of all we have these survival curves comparing the Adventist health study population of Adventist health study one to the California population and I'm sure you're familiar with the survival curve concept where you start with everybody living and end up with not many living on and deserve this is by age and you can see there's a pretty consistent gap there from over a wide range forty five years up to ninety five two hundred years there's a persistent difference in the curve for the otherness in this study population compared to the general California population without Dennis living longer C one to be higher up on the page and this is for Adventist women I should say that this is a similar curve for men and you see the gap a little bit greater and seems and in many of the findings particularly in terms of mortality and longevity that there is an extra advantage for men Doctor Fraser and colleagues did a paper where they sought to look at a number of factors that might be contributing to this mortality advantage that might work together to have benefits and this is for women of these were some of the factors that they are identified that together would have a cumulative advantage of so this would be the life expectancy if you will with all of these categories of variable set to a medium risk would be sort of average and then this is the difference between high and low and this is Gmail to so you did all of these factors and if you are low risk and all of these factors all of these categories you would end up with this kind of a spread in terms of your longevity risk on which is about ten years if you see from eighty nine to seventy nine having none of the factors and tedious versus all of the factors advantageous since about ten years question on in this study I do believe that the HRT hormone replacement therapy was on was a identified as a beneficial factor among difference of ten years total there eighty nine two seventy nine not caused by hormone replacement therapy this is a cumulative effect if you are adding all of these beneficial so you say okay did you go to start at the left and you work your way to the right and say okay now I'm just vegetarian versus nonvegetarian I did this must risk now of going vegetarian and I exercise versus nonvegetarian and I don't exercise as much difference and that's how it comes that's probably true on and of course it matters what direction you put them in on because if you flip the order around you know their relative importance that may change him this is just looking I believe that vegetarian versus nonvegetarian there was little power and have been assaulted by the one to look at a total vegetarian or vegan diet cause of the numbers were very small it's all vegetarians no this is the same for men and the men as you see the life expectancy is lower than women of our couple of years they see the same comments Brad developing and so this is an estimate on of the percent of the population among the Venice who lost a certain number of years based on this schema and so almost everybody lost at least one year of life that they could have had statistically by having something wrong in their their risk profile but very few people had everything that that was an interesting model am these are and insulted when cancer findings on summarize we can't spend much time on this and I don't know all the details myself but I'll point out a couple of key things on the current study the specific aims are to look at cancer risk vegetarian diets and cancer risk her diet and cancer risk will have a lot more power eventually with the current study on the power is limited in the first study and so we can get an idea on the major cancers on you see there wasn't much of a finding for breast cancer when looking at the diet and those sorts of things in happiness health thirty one there were more interesting findings for both cancer and prostate cancer in men on and for colon cancer there was a reduced risk with fiber intake on with legumes and increased risk with needs and this was all red meat and white need in the self-study one those of the key findings there and those are the ones that I would actually put the most confidence in going forward this slide is really just to say that when you start looking at a rarer cancers on one cancer is of course a common cancer in the general population but rare in this population when you start looking at rarer cancers the numbers were so small that I would hesitate to draw any conclusions these findings would be more up hypothesis generating and on I just want to make the point that Adventist health study one continues to result in publications and continues to add to the general knowledge about diet lifestyle and health for example other recent publications looking at body weight and longevity over the long term and at old ages as well and so is grass from this recent research by Doctor promising on


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