VOLUME VII 2010/2011

The Studies’ Annual Newsletter

Present Activities and Progress in AHS-2 More

t is time for another Online I annual update about adventisthealthstudy.org AHS-2. Your membership in this study is Visit our greatly valued. Although it website to: will be another two to three years before we report the • Update Your main results from AHS-2, Contact Info there are several interim results we believe will • Read FAQs interest you. First, here are some of the activities that • Watch Media have occupied our small team of epidemiologists, Coverage of AHS nutritionists, statisticians, Headquarters : Part of the AHS-2 staff at . and physicians during • Meet Our 2010. biennial questionnaires and Parkinson’s and Research Team your reply-paid returns is others. But rest assured, Tracking: We do our best over $200,000 every two security and privacy of to keep in contact with all • Learn About years, and the information your information is always a 96,000 of you—not an easy you provide is vital. primary concern with any Previous Studies task! Thousands of AHS-2 portion of our study. members move each year Cancer and Disease: As Check back often as we will be (we hope that for most it is the main goal of AHS-2 is to Progress: We have updating our site regularly! moving on to better things). determine links between published more than 30 Keeping names and dietary habits and cancer professional articles from addresses current is risks, we must find all new AHS-2 (page 4) . As we are essential. Many of you do a cancers that develop still in the developmental great job of keeping us among our 96,000 study and “waiting” phase of the informed. For others we members across the U.S. study, many of these rely on checking the and Canada. Each state and reports are rather National Change of province has its own cancer technical, but we have Address computerized registry with its own highlighted those studies of database. So far we have regulations, application a more general interest in lost track of only 1% to 2% processes, requirements, this newsletter (pages 4-6). of study members for more and costs. So far we have Funding: It is the than one year. concluded agreements with investigators’ task to seek 39 registries, and have Inside this issue: Questionnaires : funds to cover costs and to linked data with most. Designing the biennial expand the study. In the questionnaires about AHS-2 also has the potential last three years at least Recent Funding 2 hospitalizations is far from to search for lifestyle eight major grant simple. You may be causes of many other applications have been Post-Doc Fellows 2 surprised how easy it is to aside from cancer. written. These each take form a confusing new about a month to prepare. You Asked... 3 question (not our goal, by In our biennial In these challenging fiscal questionnaires we ask the way!). times, what was previously Vitamin D and 4 about other diseases. relatively easy to keep So even if you get stuck on Several of our ongoing funded has become much a question, please give us a studies relate to these. You more difficult. Competition Metabolic Syndrome 5 call to seek clarification to may receive a call or letter is fierce and larger complete the form. The cost from us that focuses on Religion Study Results 6 of up to four mailings of the heart disease, arthritis, Continued on page 8 ... Community Gardens 7 AHS-2

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Latest Funding Provides Fellowships By Karen Jaceldo Siegl

hile awaiting further funding fellows to gain experience, W from the National Cancer develop research skills, and Summary of Institute, AHS-2 has been operating publish research papers using data Recent Funding through the support of the School of from the 96,000 participants of the Public Health at Loma Linda AHS-2 cohort. from the University (LLU). $200,000 For our post-doctoral fellowships, World Cancer Research Fund Dr. Gary Fraser has continued to we looked for applicants with write grants, and in 2010 the World strong analytical skills and $800,000 from the Cancer Research Fund awarded previous training in epidemiology, U.S. Department of Agriculture AHS-2 $200,000 over the next four biostatistics, medicine, nutrition, years to complete the matching of all biosciences, or related fields. We new cancers from the 96,000 received applications from of different denominations and in members of AHS-2 with all U.S. and individuals with diverse community settings ( page 7 ). One Canadian cancer registries. educational training, ethnic goal of the project is to record a backgrounds, and nationalities. We AHS-2 also received an $800,000 step-by-step process that can be are pleased that Dr. Nico Rizzo and grant from the U.S. Department of repeated in any church. Dr. Michael Orlich, shown below, Agriculture (USDA) in May 2010 to were awarded fellowships in 2010. As always, we at AHS-2 can’t thank train future researchers and to you enough for your continued provide intervention in Black/African The USDA grant also supports a support! American communities in San project that will educate and Bernardino County. This grant will motivate behavioral change in Karen Jaceldo Siegl, DrPH, is a provide an opportunity for talented Black/African American churches Co-Investigator for AHS-2.

Meet Our Post-Doc Fellows

ico S. Rizzo , PhD, has seminars on health issues for he is currently an assistant N an Italian heritage, but the general public in Europe, professor in public health was born and raised in the U.S., Asia, and nutrition and biology. He Germany. He speaks three Micronesia. He obtained a joined AHS-2 as a fellow in languages (German, MSc in nutrition science from July 2010. During his time English, and Italian) and is the Justus Liebig Universität with AHS-2, he will be a trained vocalist (bass). He in Gießen, Germany, and a involved in analysis and enjoys riding his mountain PhD in medicine from writing papers on bike and hiking in the hills Karolinska Institutet in developing nutrient indices, surrounding Loma Linda Stockholm, Sweden. Dr. Rizzo dietary correlates of and Riverside. In the 1990s, came to LLU in 2009 as a , and the Nico S. Rizzo he served as a minister in postdoctoral fellow in the association between diet Italy. He also conducted Nutrition Department, where and diabetes.

ichael J. Orlich , MD, disease, which he traces ment Chair, and finally M grew up in Indiana and, back to when his father had Acting Dean at Weimar as a child, sang in the National a heart attack at age 53; and College. He recently com- Children’s Choir. These days, a general interest in learn- pleted a Preventive Medi- you will find him training for a ing. He obtained his MD cine Residency at LLU and marathon when he is not busy from the University of Michi- started his doctoral studies working as a physician and gan in 2001, and completed in epidemiology. In August researcher. According to Dr. a Family Practice Residency 2010, he joined AHS-2 as a Orlich, three longstanding from Tacoma Family Medi- research fellow. His primary interests have shaped his life: cine in 2004. He then research area will be an missions/ministry, which he worked as staff physician for investigation of rheumatoid attributes to his mother; nutri- two years in Weimar, Calif., arthritis and dietary risk tion, lifestyle, and chronic and became Health Depart- factors. Michael Orlich VOLUME VII

Page 3 Anticipating Results By Allan Handysides

arlier Adventist Health Study E scientific findings have validated In the News the core of the Adventist lifestyle as By Hanni Bennett being both qualitatively and quantitatively beneficial.

ave you noticed all the Many Adventists are awaiting results H publicity about from the current Adventist Health Seventh-day Adventists Study and have high expectations. lately? First there was the “While we wait, let’s not article about longevity in Within the ranks of the vegetarian National Geographic a few community, there are many beliefs neglect what we already years ago. This stirred the that have become almost “sacred.” I have been shown is interest of local and have tried to assure myself I will be national newspapers who willing to accept the new findings important: Exercise, rest, eagerly interviewed AHS-2 with equanimity, but I am wondering temperance, faith, investigators about the how I will feel if some cherished Adventist lifestyle and the beliefs are proved erroneous. findings of the study. Then sunshine, fresh air, and the book “The Blue Zones” Imagine our reaction if a pesco- clear, pure water.” was published, and more vegetarian diet (fish-containing) recently the DVD “The trumps the lacto-ovo-vegetarian! Or everyone to pray for the continued and Adventists” was released. what if those pleasantly plump BMI improved financial support of this most Not only are interviews valuable project. with Dr. Gary Fraser and 26-27 folk do better than the BMI 23 other investigators aired types? The study could also show split While we wait, let’s not neglect what we on 3ABN and local church results. For example, vegans could do already have been shown is important: channels, but reporters better cardiac-wise, but worse in the Exercise, rest, temperance, faith, and film crews are coming cancer category. from all over the world, sunshine, fresh air, and clear, pure including from Norway, As our anticipation grows, we in the water. These things, when coupled with France and Brazil, to find General Conference Health Ministries a well-balanced vegetarian diet, applied out more about AHS and Department applaud our Loma Linda with optimism and integrity, will permit the Adventist lifestyle! All colleagues and all who are Adventists to engage in service that of this is happening participating. Funding issues related reflects the care and compassion of because 34,000 church to budget cuts and the recession may Jesus. Our lives must truly be those of members in California living praise, full of the celebrations of participated in AHS-1 35 slow some of the flow of data, but we years ago. are prepared to be patient. This is a health. study worth waiting for. We expect to Allan Handysides, MD, is the director of the As you know, this time we learn a great deal from everyone’s have enrolled 96,000 Health Ministries Department of the General church members from the hard work, and we encourage Conference. U.S. and Canada. This larger number will give us even more valuable data. Once the data are analyzed, we expect our Meet the Editor publications will be met e are pleased to announce we have hired Jennifer Frehn as with equally great interest. W And the credit will have to AHS-2’s Project Editor. Jennifer has worked as an editor for largely go to you, the several newspapers and most recently for an online advertising members who have spent company in Orange County, Calif. In 2009, she served as a time filling out the detailed volunteer English teacher in Peru. She enjoys comedy and hiking. questionnaires and Hopefully she will be able to explore the hills around Loma Linda answering follow-up once she is settled in. questions when necessary. So, the next time you hear This newsletter is Jennifer’s first product with us, and we hope you Jennifer or read reports about the enjoy reading it. Her next task will be to bring our website up-to- Frehn benefits of the Adventist date and to make it more user-friendly so you will be able to access lifestyle, give yourself a new information regarding AHS-2, update us of new addresses or telephone pat on the back for helping numbers, etc. Some of Jennifer’s time will also be devoted to writing articles for make this buzz possible. publication in church papers, and answering inquiries from the press. AHS-2

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Do Vegetarians Get Short-Changed on Vitamin D? By Nico S. Rizzo study published by have lower blood levels of A previous AHS-2 post-doc vitamin D than non-vegetarians. fellow Dr. Jacqueline Chan et al. The results demonstrated that a looked at the vitamin D status of vegetarian diet was not associ- vegetarians, partial vegetarians ated with lower levels of vitamin and non-vegetarians. D. Other factors, such as vitamin D supplementation, degree of Vitamin D is an important skin pigmentation, and amount hormone in the prevention of and intensity of sun exposure osteoporosis and rickets but had a greater influence on beyond that has major functions vitamin D levels in blood than in the prevention of heart diet. disease, cancers, diabetes and in the regulation of the immune As you can see, your participa- “A vegetarian diet was not system. Foods naturally rich in tion in AHS is helping us answer associated with lower levels of vitamin D are all from animal important health questions and vitamin D. Other factors, such as sources. The only naturally provide a scientific basis for occurring plant sources of lifestyle interventions that can be vitamin D supplementation … and vitamin D are certain mush- of great help to the public. Many intensity of sun exposure had a rooms, in which it is present in thanks for your participation. only small amounts. Considering greater influence on vitamin D these facts, the investigators Nico S. Rizzo, PhD, is an AHS-2 levels than diet.” wondered if vegetarians would Research Fellow.

AHS-2 Papers Published Researchers’ Thoughts ... On Falling Asleep Below is a breakdown of the subject matter of AHS-2 papers published so far. To read AHS-2 results indicate 53% of Blacks and 24% of Whites the abstracts, visit adventisthealthstudy.org. sleep six or fewer hours per night. We know that some- on selected health effects of times schedules prevent sleeping the recommended 9 vegetarian and other lifestyle seven to nine hours per night, but in other cases, adults characteristics . simply have a hard time falling asleep. We wondered, what do researchers do to fall asleep faster? on recruiting and working with 6 Black study members . “I find that going over a statistical problem in my mind can be relaxing. When I can on development of new statistical no longer quite formulate the problem in my 7 techniques to improve accuracy. mind, I know the ‘drift to sleep’ has started. It, however, can be a two-edged sword. If the problem is really tough and I badly need it 3 on psychosocial/religious solved, the anxiety can have the opposite effect, keeping me factors and disease. awake!” - Dr. Gary E. Fraser, Director of AHS-2 5 on how well our questionnaire listen to audiobooks. Usually history or religion measures diet . “I spirituality. These are interesting, but not stimulating/ on a description of the main exciting, so they are good for sleep. Audible.com, Amazon, 4 and iTunes are places to get high-quality audiobook AHS-2 study and religion recordings. Librivox.org has free audiobooks, though the substudy . reading/recording quality is not always good.” - Dr. Michael Orlich, AHS-2 Research Fellow Total : 34 VOLUME VII

Page 5 Your Health Tips Understanding Metabolic Syndrome By Michael Orlich

e at AHS appreciate your W interest in science and health. In Latest Results this column, we want to share tips on You Asked… how you can be healthy. This is only R ecent research by AHS-2’s Dr. general advice, so for specific medical Nico S. Rizzo et al. found that By Hanni Bennett vegetarians and those who rarely ate instruction, please ask your physician. meat had a lower prevalence of the metabolic syndrome Metabolic Syndrome (MetS) when Question : What Have you heard of “metabolic compared to non- foods are included in syndrome”? Here is a primer to help vegetarians. These you understand what it is, why it is new results were centenarian Dr. based on a random Geraldine Branch’s important, and what you can do. sample of the AHS-2 longevity “superfood” population. list, mentioned in the What is the Metabolic Syndrome? previous newsletter? In the metabolic syndrome (MetS), Adventists traditionally have low changes in your metabolism can show intakes of alcohol and refrain from smoking, two factors that are associated Answer : “I enjoy a up as a pattern of abnormal physical and laboratory findings. While exact with the development of the MetS. great variety of Further analysis showed that vegetables, but high up definitions can vary, these are the five vegetarians had the lowest risk of on the list are all dark main features of the MetS: having the MetS even after adjusting for green leafy vegetables, 1) Abdominal obesity , meaning a sex, ethnicity, alcohol intake, smoking, such as kale, collards, waist measurement more than 40 physical activity, and dietary energy chard, etc.; grains inches in a man or 35 inches in a intake. The results suggest a vegetarian (quinoa, brown rice, woman. dietary pattern can play a favorable role in lowering the risk of the MetS and millet, barley, oatmeal); 2) High fasting blood sugar , greater than 100mg/dl. can have a beneficial role in preventing and all fruits,” Dr. diabetes and cardio-metabolic Branch shared. She said 3) High triglycerides (blood fat), diseases. These results have been she tries to stay away greater than 150mg/dl. published in Diabetes Care. from foods with a high 4) Low HDL (good cholesterol), less glycemic index, but than 40mg/dl for a man or less than occasionally indulges in 50mg/dl for a woman. cholesterol . Your blood pressure also sweet potatoes, yams 5) Elevated blood pressure , greater goes up. All of this sets the stage for a and carrots. than 130/85mmHg. If either number is higher risk of heart disease. higher, that counts. Question : Why don’t If you have three or more of the five What Can I Do About It? you save postage by features, you meet the criteria for the Avoiding fat build-up around your sending questionnaires MetS. waistline is very important. Watch for members in the your calorie consumption. To do that, same household in one Why Does It Matter? focus on foods that have lots of water envelope? It matters because it means you have and fiber in them, like fresh fruits and an increased risk of developing both vegetables, while limiting the amount Answer : Great heart disease and diabetes. of high-fat and refined foods, which question! The mailings are rich in calories. are all computerized. What Causes It? To manually sift through Science has not yet provided all of the Exercise can help you get rid of the them and look for the answers to this question. What seems belly fat that causes the MetS, even same addresses would clear is abdominal obesity plays a big without losing weight. If you already be time consuming and role. The fat tissue that builds up have the MetS, by making these more expensive than around your waistline releases changes and losing the fat around your the extra postage. chemicals in the blood that cause your middle, you can often go back to However, do feel free to body to become resistant to insulin, normal lab values and lower your risk send all of your family’s which can make your blood sugar go of developing diabetes and heart questionnaires back in up. It also changes how your body disease. one envelope and handles different types of cholesterol, include the unused causing more fats to build up and Michael Orlich, MD, is an AHS-2 envelope. depleting your levels of good Research Fellow. AHS-2

Page 6 Religious Participants Report Better Health By Jerry Lee

e know from how responses had home have more W previous research changed. We just negative emotions. that people who attend completed a second set of These negative church live longer. What clinics to measure emotions predict worse is not as clear is why this physical and memory physical health. occurs. Early researchers changes in the Southern • Individuals who had thought it might simply be California participants. experienced sexual that church attenders take We have learned some trauma or physical better care of themselves. interesting things. Overall, abuse were more likely They are less likely to Adventists report better to report a diagnosis of drink and smoke, and they physical and mental health fibromyalgia, and those are more likely to than comparable non- with physical abuse “Individuals exercise. However, a Adventists. In addition: reported experiencing who engaged healthy lifestyle is only the most pain from their part of the story. in secular • The advantage Advent- fibromyalgia. ists have over non- activities on In the first Adventist Adventists on mental Health Study, we looked • Individuals who Sabbath had health is bigger in older only at people who were engaged in secular age groups than in poorer healthy to begin with. activities on Sabbath younger age groups. reported Lifestyle predicted who had poorer reported physical health. Those physical lived longer, but even • Not surprisingly, taking lifestyle into who said Sabbath health.” divorced individuals had relieved tensions and account, those who more depressive attended church still lived promoted feelings of symptoms than non- calm and peace longer than those who did divorced individuals but not. reported better mental divorced individuals who health. The Adventist Religion used positive religious and Health Study is funded coping (for example, said So far, four papers have by the National Institute on they looked to God for been accepted for Aging to gain insight into strength) had fewer publication and at least the religion and health depressive symptoms 12 papers have been connection. In 2006 and than those who did not presented at professional 2007, 10,988 of you filled use positive religious meetings. Now we are out a questionnaire about coping. moving into our most your religious beliefs and interesting phase — • Individuals who practices, stressful life finding out how religious experienced childhood experiences, psychologi- beliefs and practices as poverty are more cal characteristics and well as psychosocial and religious. However, social life. A smaller group biological factors childhood poverty also of you who lived in contribute to later mental relates to more abusive Southern California gave health, physical health, and conflictual families in blood and urine samples, hospitalizations, and childhood, particularly in did physical performance mortality. With your White rather than Black testing (e.g., grip continued participation, participants. Those who strength) and memory we hope to understand experienced an abusive testing, and allowed us to how religious life can home as a child are less measure blood pressure, lead to a healthier and likely to be religious. weight, body fat, and waist happier life. Thank you for all of your support. and hip circumference. • Religious individuals Last year we sent out a have less negative Jerry Lee, PhD, is Principal second questionnaire to emotions and those who Investigator of the Adventist 7,000 participants to see experienced an abusive Religion & Health Study. VOLUME VII

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M embers at two California “We have so many studies that show that Blacks have Black Seventh-day Adventist higher rates of this and that. From the outside, it looks churches will soon gain green thumbs as part of a community like we’re not trying. We want to show that there are garden project put forth by AHS-2. communities that are actively trying to improve health.” Patti Herring, associate professor for health promotion and education at To prepare, Dr. Herring visited both MPH student involved in the project. churches and gave them their AHS-2 Loma Linda University (LLU), and Activities will include health “report card” showing what her students will help the San sermons, followed by potlucks and percentage of the church members Bernardino 16th Street SDA Church health education classes taught by who are in the study had reported and the Juniper Ave SDA Church LLU graduate students. There will diabetes, high blood pressure, high develop plots of land to grow their also be a clinic set up to give health cholesterol, etc. The report also own fruits and veggies. appraisals that include measuring stated the AHS-2 members’ Body blood pressure, height, weight, BMI, “Community gardens are the wave Mass Index (BMI), diet and lifestyle. cholesterol and glucose levels. of the future,” said Dr. Herring, who Dr. Herring showed a video on the Students will be recording a step- noted the project is on target with “Blue Zones,” a book highlighting by-step process for these health First Lady Michelle Obama’s “Let’s Loma Linda as one of five places crusades and gardens that can be Move!” campaign, part of which is where people tend to live longer. encouraging access to healthier repeated in any church. To Dr. foods. “As soon as the video stopped RoWandalla (Candi) Dunbar, the playing, members at the churches health ministries director for the Research shows that lifestyle beamed,” said Dr. Herring, who 16th Street Church, these activities diseases such as obesity and described how the church members will send a significant message. diabetes disproportionately affect were motivated by the national “We have so many studies that show Blacks/African Americans. Part of coverage of the Adventist health that Blacks have higher rates of this AHS-2’s goal has been to determine message. “They are extremely and that,” Dr. Dunbar said. “From why this is the case, then to put that excited about the community the outside, it looks like we’re not information to use. Funded by a garden.” grant from the U.S. Department of trying. We want to show that there Agriculture, the garden project AHS-2 will have a demonstration are communities that are actively brings two key factors of preventing plot at each site to serve as an trying to improve health, and that some lifestyle-related diseases, example. Church leaders will also we are willing to make those shown to be a challenge in these tend a plot. The remaining plots will changes to be healthier so we can communities: access to fresh be given to church families, who will be soldiers for Christ. I think it’s produce and safe outdoor activities. recruit non-Adventist families in the important for all of us, no matter community to share the space and what age or health level.” “I promised we were not just going join in health activities. to come into the community and take, take, take data and then they “There was definitely a lot of Stay tuned for U.S. regional BMI levels wouldn’t hear from us again,” Dr. positive response for doing for Black/African American AHS-2 Herring said. “This was a way for us anything that would involve the participants, available soon at to give back so we could improve community or church unity,” said adventisthealthstudy.org their health and quality of life.” May Wang, an LLU health education First Two: Members at Juniper Ave SDA church (left) and 16th Street SDA church, both in California, are excited to begin community gardens. Adventist Health Studies Evans Hall #203 24785 Stewart Street Loma Linda University Loma Linda, CA 92350 Do you have a new address or phone number? USA Correcting or updating your information helps us keep in contact and reduces the expense of follow-up. Please Address Service Requested correct any mistakes or changes to your contact information and return this page to the address listed below. Thank you in advance! Name ______Address ______City ______State/Province ______Zip/Post Code ______Phone ______E-mail ______

Contact Information Progress in AHS-2 (Continued from page 1) AHS-2 Director: Gary E. Fraser, MD, PhD institutions often fare best. “Although you Newsletter Editors: Nevertheless, we are pleased to Hanni Bennett announce new funding by the World Jennifer Frehn hear from us only Karen Jaceldo Siegl, DrPH Cancer Research Fund and the U.S. Department of Agriculture. A large a few times each T: (800) 247-1699 F: (909) 558-0126 grant application is also under review E-mail: [email protected] at the National Institutes of Health and year, there is much has received an excellent score. We Address: are hopeful it will be funded. Adventist Health Studies activity here at Evans Hall #203 Home Base: Loma Linda University 24785 Stewart Street benefits from AHS-2 in many ways. headquarters.” Loma Linda University The study provides high-quality Loma Linda, CA 92350 professional experience for carefully of the computer files checked and USA selected doctoral students and post- double-checked, and our surveillance doctoral fellows. These scholars come for new cancers well underway, the from several schools (School of Public study is poised to move ahead Health, School of Medicine, School of strongly. We are counting on your Help Us Save Money & Paper: Science and Technology), and some continued participation and support. Sign Up for an E-Newsletter from overseas. The study then benefits Thank you again for completing the from the enthusiasm of the students, questionnaires you receive every two To receive future newsletters their good ideas, writing and years. online instead of in print, analyses. send your full name and Wishing you much of God’s blessing preferred e-mail address So, although you hear from us only a for this year. to [email protected] with the few times each year, there is much subject line “E-Newsletter.” activity here at headquarters. We are Gary Fraser, MD, PhD presently a small team, but with most Director of the Adventist Health Studies