Participants: Don Mckintosh (Host), Fraser Gary
Series Code: HFAL
Program Code: HFAL000190
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00:49 Hello and welcome to Health for a Lifetime.
00:52 I'm your host Don Mackintosh. 00:53 We're glad that you've joined us today. 00:55 We have an exciting topic today. 00:57 We're going to be talking about the Adventist Health Study. 01:00 There's been several studies done. 01:02 Our guest today is familiar with the studies that had been 01:04 done and he's also familiar with the study that is beginning 01:09 right now and is on-going Adventist Health Study 2. 01:13 If you'd like to be involved, and we hope that you will be 01:16 involved in the Adventist Health Study, 01:18 you can go to adventisthealthstudy. org. 01:21 Talking with us today is Dr. Gary Fraser. 01:24 He's a researcher and a cardiologist. 01:27 He has practiced also in internal medicine. 01:30 He's looked at epidemiology and has a masters in Public Health. 01:34 He teaches and practices at Loma Linda but really works with 01:38 an interdisciplinary research team from around the world. 01:42 When you look at Adventist Health Study, 01:44 isn't that right? 01:45 Yes, that's right. 01:46 So you have a board of directors from Harvard and Stanford 01:49 and all these different places and you've gotten some funding 01:54 to continue this Adventist Health Study. 01:57 I just want in this program to review what are the previous 02:02 studies, briefly, and then go into what we're looking 02:05 at in this new study. 02:06 Adventists provide a remarkable opportunity to particularly 02:12 study diet but also other factors in relation to 02:15 risk of chronic disease. 02:16 Mainly because we have a very wide variety of practice 02:20 within our group which a lot of people don't realize. 02:23 The first study of Adventists was way back in 1960. 02:27 We call that The Adventist Mortality Study. 02:29 The second study began in 1974. 02:31 We call it Adventist Health Study 1. 02:34 Most of the results that you will have heard about perhaps, 02:37 of which I've talked about, have come from that 02:40 study in 1974. 02:42 We have well along now, however; a great opportunity, 02:48 an exciting new study that we call Adventist Health Study 2. 02:51 This time we want to enroll 100,000 people from right across 02:55 the United States and also Canada, all Adventists 02:58 and all 30 years of age and over. 03:00 So far we have 86,000 people enrolled which is 03:05 a large number of people - small city. 03:08 So we're well along the way. 03:10 We do need a few more. 03:11 If people want to be involved, and we hope that you do, 03:16 you go to adventisthealthstudy. org 03:19 At the time of this airing it well may be under way, 03:24 the study may be in progress, but you can see what's happening 03:28 with the study and it may be that you're seeing this while 03:31 they still need people. 03:32 So go to the website, contact your local church or conference. 03:37 They all know how to get in touch with the 03:40 Adventist Health Study. 03:41 Be a part of the research. 03:44 Now in the initial study you looked at things like 03:47 heart disease and cancer and you saw that they're 03:49 actually was a real benefit between being a vegetarian 03:55 vs. non-vegetarian. 03:57 Yes, no question about that. 03:58 The Adventist experience is absolutely unique. 04:01 We recently had an article in the National Geographic 04:05 which show that the California Adventists are perhaps some 04:11 of the longest lived people in the world. 04:12 This appears to relate to their lifestyle. 04:15 The data's out there and I think the government 04:22 is involved in funding some of those studies, but it's 04:25 exciting new opportunity is to go to the next level. 04:29 What is it that you're going to be looking at? 04:32 A number of areas, but why is that people should be involved? 04:36 What are you going to look at? 04:37 How will it help? 04:38 Despite the fact that it might seem that we know a lot about 04:42 diet and chronic disease, in fact what we don't know 04:45 far exceeds what we know. 04:47 There's a lot of ifs, maybes, possiblys, and very few 04:53 certainties out there. 04:55 So to get greater certainty with many of these questions 04:59 we need very, very large studies. 05:01 This is why it might seem like a 100,000 people is a little 05:04 excessive but it's really not. 05:06 The particular questions that we got funded on are really three. 05:12 One is the whole question of soy intake and chronic disease. 05:19 Secondly, vitamin D and calcium and sunlight exposure - those 05:26 things are all related. 05:27 It turns out that they probably are related to risk of cancer. 05:31 It's interesting that many people don't realize that. 05:34 And the third thing is some of the fatty acids that are 05:38 different between vegetarians and non-vegetarians. 05:41 Some of these relate to inflammation and that might be 05:43 important for cancer as well. 05:45 Let's go back and talk a little bit about the mechanisms 05:47 that are involved and why it is that they are so interested. 05:50 I guess again the people that say whether or not this is 05:53 something worthy of funding, something worthy to look at, 05:56 are groups from all over the place. 05:58 It's not just people at Loma Linda. 05:59 It's people from Harvard, Stanford, all these different 06:02 places, and they say, "This is a valid question to ask. " 06:06 Yes, that's correct. 06:07 Why is it that they're saying that looking at soy consumption 06:11 as it relates to what you call chronic disease? 06:13 What are the mechanisms that are intriguing them? 06:17 Give us a little more information on that. 06:20 In part I think that these are important because there is such 06:25 a lot of information in the popular press that suggests that 06:31 Americans should be taking isoflavone pills and eating soy 06:34 products for a wide variety of things. 06:36 Yet it turns out the evidence to support that is still somewhat 06:40 insecure. 06:41 So we have potential problems here of a lot of people doing 06:47 something that you don't entirely know how 06:49 beneficial it is. 06:50 The interesting thing is that outside of the Far East 06:54 there is no easily identified population apart from Adventists 06:58 in the United States, particularly, 06:59 who eat lots of soy. 07:01 There have been a number of studies in the Far East 07:04 that look kind of interesting is that people who eat soy may have 07:08 reduced breast cancer, maybe prostate cancer, and it maybe 07:12 that it's different in different times of the life 07:14 that you eat the soy. 07:16 For instance, two studies have indicated that it's maybe the 07:20 soy girls eat in their adolescence that protect them 07:23 from breast cancer in later life. 07:25 That work is largely being done in the Far East. 07:29 The kinds of soy products they eat back there are different 07:31 than the kind of soy products in general that we have 07:33 available here. 07:35 We think that the active principle in all of these 07:38 are isoflavones. 07:40 Those are chemicals which are very interesting 07:42 because they are actually plant estrogens. 07:45 We know that estrogens are particularly important for 07:48 cancers of the breast and they also have a big influence on 07:51 cancers of the prostate, interestingly. 07:54 So plant estrogens is thought may have influence on some 07:58 of these hormonally dependent cancers in interesting ways. 08:01 We already have a little bit of data on Adventists from 08:04 Adventist Health Study 1 that suggests that soy consumption, 08:08 soy milk consumption might reduce the risk of prostate 08:11 cancer. 08:12 But that's only really the beginnings of the evidence. 08:15 We need so much more. 08:16 Particularly in the African American, 08:18 the black Adventist population, prostate cancer 08:21 is such a problem. 08:23 In fact blacks in general, not just Adventists, where the 08:26 risks appear to be about double than the white population. 08:29 We don't know why. 08:30 If we can find some preventative principles in that group, 08:33 it would be a great improvement. 08:35 Especially the African American or it doesn't have to be 08:40 American, the black culture, if you can be involved 08:43 in the study, contact them. 08:45 This is going to be very helpful to look at that. 08:48 So you are going to look at soy consumption. 08:52 How do you go about that? 08:55 You're a researcher, a statistician as well as a 08:58 a cardiologist in internal medicine. 09:00 How do you know for sure that the samples you're getting 09:04 are actually accurate? 09:06 A very good question because trying to find out what 09:10 one person eats let alone a 100,000 people eat, there's a 09:14 tremendous challenge. 09:16 We have put together a large questionnaire. 09:21 Larger than we would like but it's large because it needs 09:23 to be large. 09:24 Then we've done a number of side studies where we've taken 09:29 the results from this questionnaire from smaller 09:31 groups of people and then taken those same people 09:34 and gotten much more detailed information. 09:37 For instance, we've had them tell us 8 times, 09:39 8 different days, on the phone everything they ate. 09:43 And then it looked like people eat a lot of soy on this very 09:47 detailed way of accessing their diet, do they, the same 09:50 people that looked like they had a lot of soy on the 09:54 questionnaire? 09:55 In fact the correlations is good enough that we believe that the 09:59 data we get on the questionnaire are reasonably accurate. 10:02 The other thing we've just done is that we've taken a group 10:06 of about 200 people who gave us an over night urine, some of the 10:12 same people that are involved in the study, and we measured 10:15 the isoflavones, these phytoestrogens in the urine. 10:17 Then that way you know for sure what they have. 10:19 That's right. 10:20 Then we related that to what they told us 10:21 on the questionnaire. 10:22 And again the correlations between those two 10:24 were quite strong. 10:26 Of course you have to be certain that you're getting 10:31 good information. 10:32 What about the sunlight, vitamin D, calcium connection? 10:37 What's the mechanism there? 10:39 Why is it that they are funding that? 10:41 Vitamin D is something which everybody knows prevents 10:46 rickets and osteomyelitis - bone health. 10:49 But it turns out in the last 10 years or so, scientists have 10:53 come to realize that it's a much more interesting substance 10:57 than that. 10:59 It turns out that it's probably got 11:01 anti-inflammatory properties. 11:02 It also helps cells mature and stop dividing in a disorganized 11:08 way, which of course is the characteristic of cancer. 11:11 And so we have some evidence already that vitamin D 11:15 is an anti-cancer principle. 11:17 We have some evidence also that it prevents high blood pressure. 11:23 It probably has some anti-inflammatory capacity 11:27 which helps it prevent even recurring heart disease. 11:30 This is all cutting edge kind of material and the 11:33 evidence is highly suggestive but it's not really secure. 11:36 This is why we get funded to look at this. 11:38 But it's a very, very interesting substance. 11:42 Moreover, probably most Americans are mildly or 11:46 moderately deficient. 11:48 Where does the sunlight come in? 11:51 Most of the vitamin D we get actually comes from 11:53 sun exposure. 11:55 Some of it comes from dairy products that have been 11:59 supplemented with vitamin D and others will come from 12:03 fish, oil of fish, those that eat fish, 12:04 which is really about the only natural product 12:06 that has much vitamin D. 12:08 But we can make all the vitamin D we need in the skin, 12:11 providing we have adequate sun exposure. 12:14 But getting adequate sun exposure in the way that is 12:18 necessary is actually quite difficult. 12:20 It turns out that in latitudes 30 degrees and north is only 12:24 about 3 or 4 months of the year that the sun actually works. 12:28 And moreover, it's only between about 10 a. m. and 3 p. m. 12:32 that it works. 12:33 So there's a lot of people, of course, cover up. 12:36 A lot of people use a lot of sun block. 12:39 And of course there is some point to all that, because too 12:42 much sun exposure is not good for skin health and skin cancer. 12:46 But there's a very happy medium that needs to be struck. 12:50 Unfortunately, many people are not meeting that standard. 12:54 As we talk today 86,000 people that are signed up 12:59 from all over the United States. 13:01 Some of them are to the North and to the South 13:04 of that latitude that you're... 13:06 So you'll be able to take those groups and look at them? 13:09 It will be a very powerful study. 13:11 What about the African American and the melanin in their skin? 13:15 Are you looking closely at that relationship specifically 13:19 for them? 13:20 Very much so. 13:21 We do believe that there's not very much evidence on that 13:26 group yet. 13:27 We're going to provide some of the best evidence that 13:29 probably their vitamin D levels are lower, in fact, 13:34 than Caucasians. 13:35 In fact we've already in a preliminary way done some 13:38 analysis of that sort demonstrated that is the case. 13:42 Interestingly, the bone health of black Americans is, 13:47 if anything, better than white Americans. 13:49 So there's a dissonance there. 13:50 But whether the vitamin D protective qualities on cancer 13:55 and heart disease might still show themselves in the black 14:00 community because of their lower levels of vitamin D remains 14:03 an open possibility. 14:05 We're talking with Dr. Gary Fraser. 14:08 He's the principle researcher at the Adventist Health Study. 14:11 We'd like you to be a part of that. 14:14 I don't know when you'll be watching this but as we make 14:17 the program we definitely need more help and people enlisting 14:20 in this study. 14:21 You can go to adventisthealthstudy. org 14:24 to be a part of that. 14:25 Contact your local Health and Temperance Leader 14:28 in your conference and they can get you contact information. 14:31 When we come back we'll continue talking about the exciting 14:35 opportunity we have in Adventist Health Study 2. 14:37 We hope that you join us. 14:40 Have you found yourself wishing that you could 14:42 shed a few pounds? 14:43 Have you been on a diet for most of your life, 14:46 but not found anything that will really keep the weight off? 14:49 If you've answered yes to any of these questions, then we 14:52 have a solution for you that works. 14:55 Dr. Hans Diehl and Dr. Aileen Ludington 14:57 have written a marvelous booklet called, 15:00 Reversing Obesity Naturally, and we'd like to send it to you 15:03 free of charge. 15:04 Here's a medically sound approach successfully used 15:07 by thousands who are able to eat more 15:10 and loose weight permanently 15:11 without feeling guilty or hungry through lifestyle medicine. 15:15 Dr. Diehl and Dr. Ludington have been featured on 3ABN 15:18 and in this booklet they present a sensible approach to eating, 15:22 nutrition, and lifestyle changes that can help you prevent 15:25 heart disease, diabetes, and even cancer. 15:28 Call or write today for your free copy: 15:41 Welcome back. 15:42 We're talking with Dr. Gary Fraser. 15:44 We're talking about the Adventist Health Study. 15:46 This is an exciting opportunity. 15:48 I hope that you are a part of it already if you're a 15:51 Seventh-day Adventist Christian. 15:52 If not, go to adventisthealthstudy. org 15:56 Dr. Fraser you've been sharing just some fascinating things 15:59 not only about what's been done which really lays the foundation 16:04 for these... 16:05 You wrote a book, published by Oxford, what is it, about 16:08 250-300 studies that have been done on Seventh-day Adventists? 16:11 Yes, published studies. 16:14 So people look at them. 16:16 They are like one of the only vegetarian groups in the 16:19 Western cultures as opposed to maybe the East and then also 16:24 this National Geographic recently was published 16:27 that profiles the Okinawians, Sardinians, and the 16:30 Seventh-day Adventists. 16:31 But the real thing is this exciting opportunity that we 16:36 have now is based on the research that was done 16:38 a number of years ago isn't it? 16:39 Oh, it very much so. 16:40 So this Adventist Health Study 2 we talked in the first half 16:45 about soy consumption and the possible relationship between 16:49 that and chronic diseases like cancer. 16:51 You also talked about sunlight, vitamin D, calcium connection. 16:58 But there's other things that also they are 17:02 wanting to look at. 17:03 One of them is dietary fats. 17:04 What's the mechanism there? 17:06 Why are they looking at that? 17:07 Well, of course vegetarians, are people who trained 17:11 in that direction have a rather different intake of fatty acids 17:17 than non-vegetarians. 17:19 Specifically they have much less of the saturated fat. 17:23 Or turning it over, the non-vegetarians eat much more 17:28 saturated fat. 17:29 That has all kinds of implications for the blood 17:33 cholesterol and heart disease, of course. 17:35 But it probably also has some implications for cancer risks. 17:39 Also, the meat and dairy products contain a particular 17:45 long chain unsaturated fatty acid called arachidonic acid. 17:51 That turns out to be the pre-cursor of a whole slew 17:55 of chemicals in the body that tend towards promoting 17:59 inflammation in the system. 18:01 So that maybe important as well. 18:03 As I said before, this is on the edge of the research 18:07 somewhat and these are interesting ideas that still 18:10 need to be explored further. 18:12 But on animals and laboratory works this is how it looks. 18:15 There's another array of chemicals that tend to be 18:20 anti-inflammatory that are based on a different set of 18:25 fatty acids that are based on linolenic and some of the fats 18:30 that we find in oily fish. 18:33 So there are these two families of fatty acids and the products 18:39 that they produce that are found in very different 18:42 proportions among vegetarians and non-vegetarians. 18:45 And probably are important for both heart disease and certain 18:50 cancers because inflammation plays an causal role in both 18:54 of these. 18:55 For instance, cancer of the prostate and cancer of the colon 18:58 and probably some of the others. 19:00 So this inflammation process sets people up for the cancer 19:04 which is related to the fatty acids is basically what 19:08 you're saying - one of those two chains? 19:10 Yes, that seems to be the case particularly in animal work and 19:13 laboratory work and also some preliminary work 19:17 in whole people. 19:19 But we need to build on that. 19:21 This is how research is done. 19:22 You've got the National Institute of Health. 19:24 You've got all those different boards and it's very competitive 19:27 as fundings kind of evaporates. 19:30 You told me it's something like 12% of proposals that are sent 19:34 get funded. 19:35 But when they look at it they say, "What's been happening 19:38 in the animal studies, why is it we should give you the funding?" 19:42 That's the essence of it. 19:45 In fact I just put together another application for our 19:48 next 5 years. 19:49 You are faced with the problem, or the challenge I should say, 19:53 of putting together a compelling story that this is something 19:57 that really needs to be done and moreover you can do 20:00 it better than anyone else. 20:01 This proposal you're putting together is actually 20:05 going the next step not just questionnaires but actually have 20:09 blood samples that are drawn and different things among 20:14 church groups in the churches around the country. 20:17 Yes, we have one of the first studies that's right across 20:21 the nation and also Canada. 20:23 As you pointed out that's got this big range of latitude 20:27 but it's also got other advantages but challenges 20:31 as well because think about the problem of getting blood 20:35 from perhaps 50-60,000 people, we won't get it from everybody. 20:39 Scattered across that geographical range we plan to 20:43 conduct clinics in perhaps 3,000 plus churches. 20:46 Well, you know there is always Federal Express or these other 20:50 things now today. - laughter - 20:51 Maybe you'll have some kind of centralized lab or something. 20:55 Now another thing you're looking at is genetics and how they may 21:00 modify results from what we eat or don't eat or what we 21:05 do or don't do. 21:06 Yes, this is becoming very much in the fore of research 21:12 of this sort today. 21:13 One can really not do research on diet without taking into 21:17 account the fact that people are genetically different. 21:20 What we mean by that is that they metabolize 21:23 foods in different ways. 21:24 So even though we may feel that eating tomatoes is protective 21:28 against ovarian cancer in general, that might hide 21:31 the fact that there is a certain sub group of woman that get 21:35 tremendous advantage from eating tomatoes and another 21:37 sub group who get no advantage. 21:39 So on average it looks like a moderate advantage. 21:42 But it would be so much better if we could identify the people 21:46 that got the huge advantage and focus on them rather than 21:49 wasting our efforts on those that don't get any advantage 21:51 from eating tomatoes. 21:52 For instance, that's just an example. 21:54 This is one of the reasons that we would like to get the blood 22:00 that we talked about before. 22:01 We can then divide our population up into people who 22:05 are metabolically different and see if we can find those 22:09 sub groups who are responders and non-responders to these 22:12 different foods. 22:14 A quick question. 22:15 You are a cardiologist. 22:16 I want to ask this. 22:17 Speaking of genetics, we have people that go through 22:19 health programs we've held at our church over the last 22:23 few years - coronary health improvement program, the CHIP 22:26 program that Hans Diehl originated and we take a 22:28 blood sample at the beginning and at the end. 22:31 We have people that are Seventh-day Adventists 22:35 that have really been vegans, I guess you'd say, and some of 22:39 them will just have a really high cholesterol and they're 22:44 not eating any animal products. 22:47 What are the genetics with that? 22:49 Is that a genetic thing? 22:50 There is a lot of genetics. 22:52 Probably the genetic determinates about cholesterol 22:56 is stronger than the dietary on average. 22:59 I've had exactly the same experience as you. 23:02 I run the lypic clinic at Loma Linda University and I have 23:05 vegetarians who are totally confused by the fact that their 23:08 cholesterol is higher than they think it should be. 23:11 Now that means that whatever your genes are, however, you 23:16 still get benefit from having an appropriate diet. 23:19 If my cholesterol was now 250 because I have some genes that 23:24 are not so good, if I didn't have an appropriate diet 23:27 they would probably be 300. 23:28 So it's always worth while living properly but there are 23:32 that group of people who will probably need medications in 23:36 addition to get them down to the levels we now know are 23:40 ideal. 23:41 So in other words, just because it's genetic and it wasn't 23:44 anything you did wrong, it's still not something to ignore. 23:47 If you have cholesterol that's elevated you need to get 23:50 it down. 23:51 Oh, very much so, that's the case, yes. 23:53 Ok, so we've talked about the opportunity we have with 23:56 Adventist Health Study 2, building on what's happened with 24:00 Adventist Health Study 1. 24:02 One other thing, and I want to bring it up in this segment 24:05 as well, is you're going to look at religion and religiosity as 24:10 it relates to mortality. 24:12 Talk with us a little bit about that. 24:13 Initially it started off that people noticed that 24:17 Seventh-day Adventists and Latter Day Saints and 24:20 some others had some differences in their health experience. 24:23 So that's kind of a denominational identifier. 24:27 Then people got to looking at church attendance, 24:30 many different denominations and found that the people 24:34 attended church more regularly had a lower risk of mortality 24:38 and in particular coronary heart mortality. 24:40 Then got to thinking that it probably just wasn't attendance 24:44 that was important. 24:45 So what could it be? 24:47 It was probably something much more subtle than that. 24:51 It may be several things. 24:52 There's usually not just one factor in these. 24:54 Religion can have... it can interface with your life in 24:59 many, many different ways and provide potential protection 25:04 and also for harm, actually. 25:05 So we need to dig a lot deeper than that. 25:09 We're interested in things like prayer life, attitudes to prayer 25:13 amongst Adventist, but not only Adventist, the Sabbath day, 25:17 and the concept of the Sabbath day rest. 25:19 Many people will interpret the Sabbath in a very different way 25:25 to others. 25:26 Some will go out and do all kinds of activities in nature 25:32 others take it very literally as a rest. 25:35 Others see it as a burden, wishing they were able 25:38 to do something else. 25:39 So you're going to be looking at those? 25:41 Exactly. 25:42 That will be fascinating. 25:45 I think this will be applicable to not just to 25:48 Seventh-day Adventists, of course, but we'll learn 25:50 lessons for just about everybody. 25:52 Yes, and that's of course we got funded because 25:54 we could make the point that Adventist have many things in 25:58 common with many other denominations. 25:59 What we would learn amongst Adventists, with the great 26:02 variety that we have of practice and belief will be applicable 26:05 in a broader sense. 26:07 Now, I don't want to put you on the spot or anything, 26:09 but you're a researcher from Loma Linda University, you've 26:12 been a Seventh-day Adventist a number of years. 26:16 The writings of Ellen White, sometimes people respond in 26:20 different ways to those, but as a researcher over the last 26:24 30 years, do you have more or less confidence in Ellen White 26:28 as you're coming through this research? 26:29 Oh I think the advice that she gave the church on health has 26:36 been just a marvelous benefit. 26:37 Here we are as a group that have had for 140 years 26:44 in her writings information which the general population 26:49 has really only had, or only getting now, or certainly not 26:53 had for more than 10 or 15 years. 26:55 I see in Adventism this being a gift which is our 26:59 responsibility to give to our neighbors and friends 27:03 to the world, not something to keep to ourselves. 27:06 Thank you so much, Dr. Fraser, for what you do 27:09 in research and for what you're doing at Loma Linda 27:13 and spearheading this. 27:14 The Lord has really gifted you to be in that position. 27:17 I know you take it seriously. 27:18 Thank you for what you do. 27:19 Thank you for being with us today. 27:21 Thank you for the invitation. 27:22 Thank you for joining us today on Health for a Lifetime. 27:25 If you have not become a part of the Adventist Health Study, 27:28 I think that Dr. will agree with me, please sign up now 27:31 especially if you're an African American, but no matter 27:35 what you are continue to be involved in the process. 27:39 adventisthealthstudy. org is where you would go to sign up 27:44 or you can contact the people in your local 27:46 church or conference. 27:47 This research that's done today can help not only you but it can 27:53 help many other people. 27:54 So take it serious and thank you for joining us. |
Revised 2014-12-17