Health and Religion

Did You Ever See a Sick Adventist? They do get sick, but studies show that Adventists enjoy a health edge over most people.

Fred G. Hardinge, D.H.Sc., R.D. (Loma Linda University), is associate pastor and health educator of the Capital Memorial Seventh-day Adventist church in Washington, D.C.
No, we aren't saying Adventists never get sick! Actually, we have borrowed the above title from the January, 1978, issue of Eternity where it appeared in connection with an article outlining the benefits of Old Testament health regulations.

Although Adventists, in common with everyone else, do get sick from time to time, we have used this title to point out the fact that compared with the general population, Adventists seemingly enjoy certain advantages in the area of health and longevity. Studies released just last year indicate that some Adventists may even have the health edge on certain other Adventists! Read the article and find out why it isn't always easy to find a sick Adventist.—The Editors.

The primary health concerns of many people today are coronary heart disease, cancer, and strokethe major killers in the United States. A significant portion of the $4.6 billion spent for research in medicine and health related activities during 1976 was allocated to these three diseases. 1 Actually, $4.6 billion, although a lot of money, is small change compared to the $139.3 billion that individuals spent on personal health care in 1976. This figure represents 8.6 percent of the gross national product for that year! What can be done about these staggering costs?

Today we know that disease is rarely caused by only one factor, but rather is the result of multiple causes viruses and bacteria, a person's level of resistance or susceptibility, and exposure to such environmental factors as industrial chemicals or polluted air. Even though a person is susceptible to a specific dis ease, evidence suggests that by changing his life style he can change his resistance level, thus altering the chain of events leading to disease and premature death.

Because of their unique life style in America, Seventh-day Adventists have been the subjects of scientific studies probing the relationship of health habits and life style to mortality and sickness rates. The results are encouraging for all Americans who are willing to make some changes in their habits of living in exchange for better health.

Studies done in California from 1958 to 1965 showed that Seventh-day Adventists in that state had a significantly lower risk of dying from a number of various diseases than did persons of corresponding age and sex in the general California population. For the three leading causes of death in the United States cancer, coronary heart disease, and stroke the Adventist death rate is only slightly over half the death rate of the general population. (This does not mean that only half of Seventh-day Adventists die! All Adventists die eventually; they just die later. Their risk of dying at any given age is about half the risk in the general population.)

The life expectancy at age 35 of the average California male is 71 years; for his Adventist counterpart it is 77 years, or a survival advantage of six years. For the typical California woman, the life expectancy is 77 years, and for her Adventist counterpart, it is 80 years, a survival advantage of three years. 2

No doubt many reasons account for these differences. Certainly the Adventist church's ban on the use of tobacco and alcohol is a strong contributing factor. Because of abstaining from these substances, Adventists may be better able to fight disease, or may actually experience fewer major diseases. Better health habits in general (with an in creased ability to handle stress and pressure) and a unique religious philosophy could in part explain the low mortality. People who choose to become Seventh-day Adventists usually commit themselves to extensive changes in life style. Adventists strongly emphasize education and family life; they are deeply committed to their church, and these factors might also explain the lower risk of death and disease.

One of the distinctive aspects of the Adventist life style is diet. Although not required by the church, adherence to a lacto-ovo-vegetarian diet is highly recommended. This lacto-ovo-vegetarian diet contains no meat, fish, or poultry, but does include dairy products and eggs. Nearly all Adventists abstain from pork and other Biblically defined unclean meats (see Lev. 11). Most also avoid coffee, tea, and other caffeine-containing beverages, hot spices and condiments, and highly refined foods. Their diet includes large amounts of vegetables, fruits, whole-grain cereals and breads, and nuts, thus yielding a fiber intake somewhat above the diet of the average population.

As might be expected, the risk of coronary heart disease in Adventists is low. As shown by the California studies cited above, Adventists have just over one half the number of deaths from heart attacks as does the general population. Part of this reduced risk can be attributed to the lack of smoking. However, even when nonsmokers in the general population are compared with Adventists, the Adventist still has a fairly significant difference in coronary heart dis ease risk, which apparently must be accounted for by other characteristics. These other characteristics may be the dietary and health practices recommended by the church.

Of course, not all members of the church follow all of the suggested health and dietary practices. Adherence to proscriptions on smoking and drinking is excellent, but adherence to other habits and practices varies considerably. In a random sample of Seventh-day Adventists in southern California, 24 percent were lifetime vegetarians, about 28 per cent had changed to a vegetarian diet at some point, end 48 percent were currently eating varying amounts of meat. 3

This marked variation in adherence to the church's dietary recommendations provides investigators with an opportunity to test the hypothesis that the risk of coronary heart disease is related to diet. Seventh-day Adventists make good subjects for such a study since they are a noninstitutional group that is fairly representative of the general American population and that has subgroups with varying dietary habits. The Adventist Health Study conducted by Loma Linda University School of Health, funded by the National Cancer Institute, recently published a preliminary report on death rates due to coronary heart disease among California Adventists with differing dietary habits. 4

This study revealed that the risk of fatal coronary heart disease among nonvegetarian Adventist men aged 35-64 is three times greater than among vegetarian Adventist men of comparable ages, thus suggesting that diet may account for a large share of the vegetarians' low risk. The differential between vegetarians and nonvegetarians was smaller for Adventist men and women over 65.

When nonvegetarian Adventists who ate meat, poultry, or fish less than four times per week were compared with those who consumed meat four or more times per week, no significant differences appeared in coronary heart dis ease deaths. The primary difference was between vegetarians and nonvegetarians.

This finding could be due to inaccurcies in the self-reported amount of meat eaten. Adventist nonvegetarians may tend to under-report the amount of meat eaten, even though they are very willing to identify themselves as nonvegetarians. However, when all men over age 35 were classified as pure vegetarians, lacto-ovovegetarians, or non vegetarians, an obvious gradient appeared. The pure vegetarians had the lowest risk, the nonvegetarians the highest risk. Lactoovovegetarians were in the middle.

One interesting result of the study was that no statistically significant difference in the relative risk of fatal coronary heart disease was established between vegetarian and nonvegetarian Adventist women. (The relative risk between the two groups of women was 1.21 versus 3.04 for men.)

An unexpected finding was that women 35 years of age and older who reported eating a pure vegetarian diet had the highest risk of all Adventist women, very little below risk probabilities among the general population of women. These pure vegetarians may represent an extremely select group with other characteristics that increase their risk, or they may have some type of dietary deficiency that increases their risk of coronary heart disease.

The fact that dietary habits among Adventist women seem to have little effect on death from coronary heart dis ease may not be so surprising in the light of conflicting evidence that women may not carry the same risk patterns as men, especially in the diet-related risk factor of serum cholesterol. 5 Elevated serum cholesterol levels are associated with diets rich in saturated fats and cholesterolmeat being one of the richest sources.

In considering other possible risk factors of coronary heart disease, re searchers found a higher frequency of self-reported hypertension, diabetes, obesity, use of coffee and dairy products, and lack of exercise among nonvegetarians. Thus it appears that Adventists who follow a nonvegetarian diet are often associated with other factors that could account for some or all of the increased risk of coronary heart disease. It is also quite possible that a nonvegetarian diet may actually be directly related to some risk factors, such as hypertension, 6 obesity and diabetes. 7 Likewise, vegetarians may be presumed to follow better health habits in areas other than diet, thus contributing to a lower risk of coronary heart disease.

It is apparent (even if the reasons are "not fully known) that Seventh-day Adventists have coronary heart disease death rates 50 percent lower than the general population. This reduced risk is partially due to abstinence from smoking, but at least half is probably attributable to other characteristics of the Adventist life style. Even after adjustment for six other factors, there is a significant difference in risk between vegetarian and nonvegetarian Adventists, thus supporting the hypothesis that diet is an important risk factor in coronary heart disease.

As a group, Adventists have recognized the importance of adopting a life style in harmony with the laws of life established by God in the Garden of Eden (see Gen. 1 and 2). The lesson for everyone, Adventist or not, is that individuals can largely determine their physical well being if they are willing to accept the challenge of choosing a life style in compliance with health laws.

REFERENCES

1 USDHEW. Health: United States (Washington, D.C.: Government Printing Office, 1977).

2 E. L. Wynder, F. R. Lemon, and I. J. Bross, "Cancer and Coronary Artery Disease Among Seventh-day Adventists," Cancer 12:1016, 1959. F. R. Lemon, R. T. Walden, and R. W. Woods, "Cancer of the Lung and Mouth in Seventh-day Adventists: Preliminary Report on a Population Study," Cancer 17:486, 1964.

F. R. Lemon and J. W. Kuzma, "Biologic Cost of Smoking: Decreased Life Expectancy," Arch.
Environ. Health 18:950, 1969.

R. L. Phillips and J. W. Kuzma, "Role of Life Style and Dietary Habits in Risk of Cancer Among Seventh-day Adventists, Cancer Research (suppl.) 35:3513, 1975.

3 R. L. Phillips and J. W. Kuzma, "Rationale and Methods for an Epidemiological Study of Cancer Among Seventh-day Adventists," Natl. Cancer Inst. Monogr. 47:107, 1977.

4 R. L. Phillips, F. R. Lemon, W. L. Beeson, and J. W. Kuzma, "Coronary Heart Disease Mortality Among Seventh-day Adventists With Differing Dietary Habits; a Preliminary Report, Am. Journal of Clinical Nutr. (suppl.) 31:191, 1978.

5 W. B. Kannel, M. J. Garcia, P. M. McNamara, and G. Pearson, "Serum Lipid Precursors of Coronary Heart Disease," Human Pathol. 2:129, 1971.

6 F. M. Sacks, B. Rossner, and E. Kass, "Blood Pressure in Vegetarians," Am. J. Epidemiol. 100:390, 1974.

7 P. D. Gulati, M. B. Rao, and H. Vaishnaua, "Diet for Diabetics," Lancet 2:297, 1974.


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Fred G. Hardinge, D.H.Sc., R.D. (Loma Linda University), is associate pastor and health educator of the Capital Memorial Seventh-day Adventist church in Washington, D.C.

May 1979

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