Abstracts for The Adventist Health Study bibliography

Ref #1 - Hardinge MG
SO: Am J Clin Nutr. 1954; 2: 73-82
No Abstract

Ref #2 - Hardinge MG
SO: Am J Clin Nutr. 1954; 2: 83-88
AB: In the United States the vegetarian groups afford a singular opportunity to compare dietary intakes and serum cholesterol concentrations with those of control groups. Eighty-six lacto-ovo-vegetarian, twenty-six "pure" vegetarian, and eighty-eight non-vegetarian adults, adolescents, and pregnant women were studied. Lacto-ovo-vegetarians include milk and eggs in their diet but do not eat flesh of animals (meat, poultry, fish). "Pure" vegetarians eat no foods of animal origin. Details regarding the selection and composition of these groups, together with a report on their dietary practices, physical condition, and laboratory findings are described in the preceding paper. This study discusses the cholesterol findings.

Ref #3 - Hardinge MG
SO: Am J Clin Nutr. 1958; 6: 523-525
AB: An investigation of the nutritional, physical, and laboratory findings, together with the dietary and serum levels of cholesterol, of 88 non-vegetarian, 86 lacto-ovo-vegetarian, and 26 "pure" vegetarian adults, adolescents, and pregnant women was reported earlier. Lacto-ovo-vegetarians include milk and eggs in their diet but do not eat flesh of animals (meat, poultry, fish). "Pure" vegetarians eat no food of animal origin. The details concerning the selection and composition of these groups are described in the preceding papers. The present study deals with the fiber content of the diets of these several groups.
The food composition tables of the U.S. Department of Agriculture provided most of the data for the computation of the fiber content of the foods consumed. In a few instances information was also obtained from other sources.

Ref #4 - Wynder EL
SO: Calif Med. 1958; 89: 267-272
No Abstract

Ref #5 - Downs RA
SO: Bull Amer Assoc Pub Health Dent. 1958; 18: 19-21
No Abstract

Ref #6 - Wynder EL
SO: Cancer. 1959; 12: 1016-1028
AB: Numerous statistical investigations have indicated that smoking and excess drinking play a role in the etiology in certain diseases. Smoking is considered to be one of the causes of cancer of the respiratory tract and is also suspected to increase the risk for myocardial infarction. Excessive drinking, mostly of hard liquors, has been found to affect the development of cancer of the mouth, larynx, and esophagus. In view of the available evidence, it was of interest to study the incidence of cancer and coronary artery disease among a population group consisting mainly of nonsmokers and nondrinkers. The Seventh-Day Adventists, a religious group of about 300,000 members in the United States, represent such a group of individuals since their religion prohibits smoking and drinking.
The purpose of this study was, first, to review admission records of Seventh-Day Adventist hospitals and to determine the relative admission rates of Seventh-Day Adventists with a given disease compared to all other admissions and, second, to obtain data on the past and present smoking and drinking habits, as well as other background data on Seventh-Day Adventists.

Ref #7 - Donnelly CJ
SO: Public Health Rep. 1961; 76:209-212
No Abstract

Ref #8 - Hardinge MG
SO: Am J Clin Nutr. 1962; 10: 516-524
AB: A nutritional study of eighty-six lacto-ovo-vegetarians, twenty-six "pure" vegetarians and eighty-eight nonvegetarians, including a description of the diets with various nutrient calculations, was published earlier. The serum cholesterol levels of these groups as related to fat intake and the fiber in the diet have also been reported.
This report presents the component fatty acids and the iodine values of fats consumed by these subjects, and their correlations with the serum cholesterol values. A table of fatty acids compiled by us and a more recent one by the Department of Agriculture were used as the basis for these calculations.

Ref #9 - Dysinger PW
SO: Dis Chest. 1963; 43: 17-26
No Abstract

Ref #10 - Larsson E
SO: Obstet Gynecol. 1963; 22: 630-635
No Abstract

Ref #11 - Hardinge MG
SO: J Am Dietet Assoc. 1963; 43: 545-549
No Abstract

Ref #12 - Hardinge MG
SO: J Am Dietet Assoc. 1963; 43: 550-558
No Abstract


Ref #13 - Hardinge MG
SO: J Am Dietet Assoc. 1963; 43: 537-542
No Abstract

Ref #14 - Walden RT
SO: Am J Med. 1964; 36: 269-276
AB: Ischemic heart disease is not only the most common cause of death among adult white Americans but has apparently increased in frequency in recent years. There is a growing belief that this is partially related to environmental factors peculiar to the so-called "highly-civilized" societies. Among isolated segments of the population, however, the environment differs from that which encompasses most Americans. One such segment is the Seventh-day Adventists, a denomination in which the maintenance of a healthy body is incorporated into religious dogma.
The external factors that influence the lives of the Seventh-day Adventists are different from those of the average American in several respects. As a group, Seventh-day Adventists use much less meat and fat of animal origin, and they do not use caffeine-containing beverages. With infrequent exceptions, they do not use tobacco or alcohol in any form. Stresses related to the rapid pace of American life, and self-imposed tensions incident to worry, ambition to competition may also be less, although objective proof of this is difficult to obtain.
Wynder and Lemon found that hospital admissions for coronary artery disease were approximately 40 per cent less among Seventh-day Adventist men than among men in the general population, only 15 per cent less than that expected among Seventh-day Adventist women. In the Seventh-day Adventists observed, the marked difference in the pattern of ischemic heart disease between men and women that is seen in the general white population was not evident; in fact, there was rather a striking similarity between men and women in terms of incidence and age distribution.
The present study attempts to clarify possible interrelationships between environmental factors, serum esterified fatty acids and the occurrence of ischemic heart disease by comparing a population living under "atypical environmental conditions" (the Seventh-day Adventists), with one sharing a standard American environment (white adults in New York City).

Ref #15 - Lemon FR
SO: Cancer. 1964; 17: 486-497
No Abstract

Ref #16 - Wynder EL
SO: Am Rev Resp Dis. 1965; 91: 679-700
No Abstract

Ref #17 - Hardinge MG
SO: J Am Diet Assoc. 1966; 48: 25-28
AB: In earlier publications, we presented nutritional studies of eighty-six lacto-ovo-vegetarians, twenty-six pure vegetarians, and eighty-eight nonvegetarians. These include a description of the diets, nutrient intakes, and health findings, serum cholesterol levels as related to fat consumption, the fiber content of the diet, and the dietary fatty acids in relation to the serum cholesterol.
This paper considers the essential plus two related amino acids of the dietary proteins of our subjects.

Ref #18 - Lemon FR
SO: J-Amer-Med-Assoc. 1966; 198:117-126.
AB: There were 850 deaths among 11,071 Seventh-Day Adventist (SDA) men from 1958 to 1962. The group was similar to other men in California except for occupation, and older age distribution, and much less tobacco exposure. The total number of deaths observed and death from respiratory disease were approximately one half and one fourth, respectively, of that expected at comparable ages for California men. In the SDA group, the 28 deaths contributed to by emphysema or lung cancer were concentrated in a minority with a history of heavy tobacco usage; only one such death occurred among 3,913 (35%) SDA "lifetime" members who had never smoked. The findings from this study are consistent with previous epidemiologic studies and predictions of a large reduction in lung cancer and other mortality in any nonsmoking US population. The findings support the causal relationship of cigarette smoking to lung cancer but discount the "selection or constitutional" theory.

Ref #19 - Glass RL
SO: J Dent Child. 1966; 33: 22-23
No Abstract

Ref #20 - Holmes CB
SO: J-Dent-Res. 1967 Jul-Aug; 46(4): 650-5
AB: The prevalence of dental caries and periodontal disease has been observed to vary widely in population groups in countries throughout the world and to vary within the same population groups of the same country. The efforts to determine factors that have a correlation with periodontal disease have shown that age and oral hygiene explain more than 90 percent of the variance in group periodontal index scores. The single factor with the most profound effect on the prevalence and pattern of dental caries is the ingestion of adequate amounts fluorides, although there is an association of sugar consumption and dental caries prevalence as determined by ICNND teams.
Three studies suggest a lower dental caries prevalence in children of Seventh-Day Adventist children. The present study was conducted in 1963 and 1964 to extend this comparison to older children and to include other variables, such as oral hygiene, periodontal status, dietary patterns as reflected in 1-day diet histories, salivary caries susceptibility tests as measured by the SLC tube test and Lactobacillus plate count, and reported number of daily tooth brushing frequency. This report is limited to nine variables of interest: decayed surfaces (DS), missing surfaces (MS), filled surfaces (FS), DMF surfaces (DMFS), oral hygiene index (OHI-S), debris index (DI-S), calculus index (CI-S), periodontal index (PI), and tooth brushing frequency (TBF) in four groups (two Adventist groups and two non-Adventist groups). Details of the methods used in collecting and processing this data obtained with the DMFS index, PI and OHI-S have been presented previously.

Ref #21 - Marsh AG
SO: J-Am-Diet-Assoc. 1967 Nov; 51(5): 441-6
No Abstract

Ref #22 - Mozar HN
SO: Med-Arts-Sci. 1967 May-Aug; 21(2): 59-63
AB: Seventh-day Adventists do not drink alcoholic beverages and do not smoke for reasons which they believe are founded on health and moral principles. Many prefer a lactovegetarian diet and drink no coffee, tea, or other beverages containing caffeine.
Under the social pressures of a nonabstentious, affluent society, the practice of multiple abstentions could be a frustrating experience. Therefore, a representative population of Seventh-day Adventists was studied in order to assess the mental health status of such a relatively abstemious group.
This paper presents the results of a mental health home survey in which questionnaire-guided interviews were held with 265 white Seventh-day Adventist church members and an equal number of white nonmembers.

Ref #23 - West RO
SO: Am-J-Clin-Nutr. 1968 Aug; 21(8): 853-62
AB: The serum cholesterol levels and the dietary habits of a voluntary study group of 466 Seventh-day Adventists in Washington, D.C., suburban area were compared to determine the influence of diet on serum cholesterol levels in an adult population whose only environmental differences related to dietary practices - adherence to vegetarianism. This study matched vegetarians with nonvegetarians from the same base population according to several physical and demographic variables - place of residence, age, sex, marital status, height, weight, and occupation - and examined the effects of various levels of meat, fish, and fowl consumption (degrees of nonvegetarianism) on serum cholesterol levels. With the exception of those under 25 years of age, the results showed that the nonvegetarians had higher serum cholesterol levels than the vegetarians.

Ref #24 - Amundsen W
SO: Am Ann Deaf. 1968 Sep; 113(4): 896-7
No Abstract

Ref 25 - Lemon FR
SO: Arch-Environ-Health. 1969;18:950-955.
AB: The mortality and survival of 34,217 Seventh-day Adventists (SDAs) from 1960 to 1962 has been subjected to a life table analysis and compared to similar data for the simultaneous California population. The preferential survival experience and life expectancy of the SDAs is of a very high order - considering the ages (35 and above) to which the analysis was limited. The life expectancy advantage of SDAs at age 35 and over exceed present California life expectancies by an amount greater than that gained in the US population during the past 40 or more years. On the basis of prior detailed studies of the mortality experience of SDAs, we postulate that the great preponderance of this preferential life expectancy is due to the SDA practice of abstinence from the use of tobacco. We reason, inversely, that one of the important, and recently measurable, biologic costs of cigarette smoking is a substantial reduction in life expectancy, notably among US men.

Ref #26 - Cohen CA
SO: Am-Rev-Respir-Dis. 1972 Feb; 105(2): 251-61
AB: A comparison of respiratory symptoms and pulmonary function tests in two similar groups of nonsmoking adults who were chronically exposed to essentially the same mean value but different peak values of oxidant air pollution did not show a difference in the prevalence of symptoms suggestive of pulmonary disease. Analysis of different ventilatory parameters measured by spirometry and maximal expiratory flow-volume curves also did not indicate significant differences between the two groups. The study, therefore, did not support the hypothesis that chronic exposure of nonsmokers to twofold differences in peak values of oxidant air pollution results in either increased incidence of symptoms of chronic lung disease or impairment of lung function as reflected by spirometry or flow-volume loops.

Ref #27 - Starr P
SO: Amer J Clin Path. 1971; 56: 515-522
No Abstract

Ref #28 - Dysinger PW
SO: Med-Arts-Sci. 1972; 26(3): 27-41
No Abstract

Ref #29 - Kuzma JW
SO: Accid Anal Prev. 1973; 5: 55-65
No Abstract

\Ref #30 - Armstrong BK
SO: Am J Clin Nutr. 1974; 27:712-718
AB: Hematological, vitamin B12, and folate levels were measured in 562 members of the Seventh-day Adventist Church, of whom 431 were vegetarians. Vegetarians had a significantly higher mean serum folate than did non-vegetarians. Serum vitamin B12 levels correlated directly with both meat and egg intake. Subjects with a serum vitamin B12 level of <160 pg/ml had significantly higher mean MCV and MHC and lower mean total red and white cell counts and red cell folate than the rest of the group. Comparison of the vegetarians with the Busselton population showed similar differences. The prevalence of low hemoglobin levels was not significantly Different from that in the Busselton population, and there was no evidence of an excess of iron or folate deficiency among the Seventh-day Adventists. Only one volunteer was found to have suffered from symptomatic dietary vitamin B12 deficiency. A significant positive correlation among MCV, MHC, and age in men was found, apparently due to an increased sensitivity to vitamin B12 deficiency in older men. Young women also appeared more sensitive to the effects of vitamin B12 deficiency.

Ref #31 - Phillips RL
SO: Cancer-Res. 1975 Nov; 35(11 Pt. 2): 3513-22
AB: The Seventh-Day Adventist population abstains from smoking and drinking; about 50% follow a lacto-ovo-vegetarian diet; and most avoid the use of coffee, tea, hot condiments, and spices. Existing data on cancer mortality in Seventh-Day Adventists clearly document mortality rates that are 50 to 70% of general population rates for most cancer sites that are unrelated to smoking and drinking. Several approaches to determining whether this reduced risk is due to the unique Seventh-Day Adventist life-style or selective factors related to who choses to become and remain a Seventh-Day Adventist are described. A comparison of the mortality experience of Seventh-Day Adventist and non-Seventh-Day Adventist physicians shows equal cancer mortality, which is consistent with the hypothesis that the apparent reduced risk of cancer death in all Adventists may be due to selective factors. However, the results of a small case-control study of colon and breast cancer among Adventists show statistically significant relative risks for colon cancer of 2.8 for past use of meat. For current food use, the significant relative risks are 2.3 for beef, 2.7 for lamb, and 2.1 for a combined group of highly saturated fat foods. This strongly suggests that the lacto-ovo-vegetarian diet may protect against colon cancer. However, the evidence linking diet to breast cancer is less clear. Because of the marked variability in dietary habits within the Seventh-Day Adventist population, they will be a productive group for further study of diet and cancer.

Ref #32 - Ruys J
SO: Br Med J. 1976; 2: 87
AB: Vegetarians consume a diet free of or low in animal meat but containing, in addition to vegetable products, eggs and milk and their derivatives. The diet is low in saturated fats and high in polyunsaturated fats; it is also relatively high in beans and fiber, which may actively reduce serum cholesterol. Such diets would be expected to produce blood lipid levels lower than those found in the average population, and this has been confirmed in a few studies. Such studies have not been performed on adolescents or children. We report the results of a preliminary study of blood lipid levels in 183 Seventh Day Adventist (SDA) adolescents and compare them with the results of a previous study of adolescents from the general Australian population.

Ref #33 - Phillips RJ
SO: Am J Epidemiol. 1976; 104: 354-355
AB: The assessment of intake of specific nutrients is a challenging problem in epidemiologic studies. This study demonstrates how a food frequency questionnaire was used to obtain quantitative estimates of average individual intake of major nutrients. A self-administered 95-item food frequency questionnaire followed by five 24-hour recalls of food intake were obtained from a random sample of 75 vegetarian and 75 nonvegetarian Seventh-day Adventists. The 24-hour food recalls were obtained by telephone interview on five randomly selected days over a six-week period. Accuracy of estimating the food eaten was facilitated by providing participants with a book containing color life-size pictures of common foods. The average daily amount of major nutrients was computed from the 24-hour recall data. The reported frequency of use and average serving size of individual food items reported in the initial questionnaire were used as independent variables and the calculated intake of individual nutrients as the dependent variable in a stepwise multi-regression analysis. Prediction equations were obtained which estimate the amount of each person's intake of nine major nutrients. The last nutrient which contributed $ 0.015 to cumulative R2 value and had an F to enter of $ 4 was used as a cutoff point. The multiple R's attained were as follows (the number of independent variables used in the corresponding prediction equations are given in parentheses): saturated fat, .75 (13); unsaturated fat, .71 (11); fiber, .86 (12); animal protein, .76 (15); vegetable protein, .75 (10); calories, .77 (13); total sucrose, .66 (13); starch, .70 (10); and cholesterol, .66 (12). Several of the prediction equations include interesting unexpected food items. A total of 50 food items were used in one or more of the nine prediction equations. The prediction equations will be used in estimating major nutrient intake on a larger population of 60,000 Seventh-day Adventists from their reported usage of the 50 food items utilized in the prediction equations.

Ref #34 - Taylor CB
SO: Arterial Wall 1976 Oct; 3(4): 175-9
AB: Serum cholesterol levels and dietary habits were surveyed in 27 male and 34 female Seventh-day Adventist. All subjects studied were lacto-ovo-vegetarians and a few consumed some meat products. Their serum cholesterol levels, significantly lower than those of the United States general population, showed no sex difference but increased with age and were higher in overweight males. Their levels, however, were much higher than those of true vegetarians which was most likely attributable to their consumption, even though to a limited acount, of dairy foods.

Ref #35 - Walker AR
SO: Am-J-Clin-Nutr. 1976 Dec; 29(12): 1417-26
AB: Colon cancer, rare in the past, and in developing populations, currently accounts for 2 to 4% of all deaths in Western populations. Evidence suggests the primary cause to be changes in diet, which affect the bowel milieu interieur. It is possible that in sophisticated populations, the higher concentrations of fecal bile acids and sterols, and longer transit time, favor the production of potentially carcinogenic metabolites. Of secular changes in diet, evidence suggests that the following may have etiological importance: 1) the fall in intake of fiber-containing foods with its effects on bowel physiology, and 2) the decreased fiber but increased fat intakes, in their respective capacities to raise concentrations of fecal bile acids, sterols, and other noxious substances. For possible prophylaxis against colon cancer, recommendations for a lower fat intake, or a higher intake of fiber-containing foods (apart from fiber ingestion from bran) are extremely unlikely to be adopted. For future research, western populations with considerably lower than average mortality rates, e.g., Seventh-Day Adventists, Mormons, the rural Finnish population, as well as developing populations, demand intensive study. Also requiring elucidation are the respective roles of diet and of genetic constitution on concentrations of fecal bile acids, etc., and on transit time, in prone and nonprone populations.

Ref #36 - Phillips RL
SO: Natl-Cancer-Inst-Monogr. 1977 Dec; 47: 107-12
AB: Considerable evidence was found that Adventists are a low-risk population to develop cancer of many sites. Adventists have numerous unique life-style and dietary habits with great variability within the population in adherence to these practices as well as considerable variation in duration of exposure to these characteristics. Thus this study population will likely be extremely productive in identifying dietary habits or other life-style characteristics that are etiologically related to various cancer sites.

Ref #37 - Armstrong B
SO: Am-J-Epidemiol. 1977 May; 105(5): 444-9
The blood pressures (BP) in 418 vegetarian Seventh-day Adventist (SDA) volunteers in Western Australia were compared with those in 290 non-vegetarian volunteers in Narrogin, a Western Australian country town. The mean systolic and diastolic BPs in the SDAs, adjusted for age, sex, height and weight (128.7/76.2 mm of mercury) were significantly less than those in the Narrogin residents (139.3/84.5). It appeared unlikely that these differences could be explained by differences in alcohol, tobacco, tea, coffee or egg consumption, socioeconomic status or physical activity. There was, however, a gradient toward increasing BP with increasing egg intake in SDAs, and SDAs who drank tea or coffee had a higher mean diastolic BP than those who did not (mean difference of 4.2 mm of mercury). The possibility that selective bias or unmeasured environmental differences might explain the difference in BP between the two groups is discussed.

Ref #38 - Goldberg MJ
SO: Ann-Surg. 1977 Jul; 186(1): 97-100
Qualitative and quantitative fecal microflora was studied in a double blind fashion in 28 subjects. Fourteen were Seventh-Day Adventists, who were strict vegetarians, while the remaining 14 subjects were individuals consuming a general western diet. No statistically significant differences were identified in the fecal microflora of the two groups. The bacteriologic analysis included total aerobes and total anaerobes as well as each of the major fecal aerobes and anaerobes. This study seems to indicate that the dietary intake of animal fat and protein does not significantly alter the fecal microflora, a possibility which has previously been suggested as being part of the explanation for the higher incidence of colonic carcinoma in those who consume meat compared with vegetarians. It does not, however, invalidate the concept that dietary animal fat does increase bile acid degradation within the gastrointestinal tract, a factor which has been related to colon cancer. Future studies should be directed at identifying the factors that may be present in the gastrointestinal tracts of vegetarians which modify the ability of their colonic microflora to degrade bile acids, an essential step in the production of intraluminal carcinogens or co-carcinogens.

Ref #39 - Finegold SM
SO: Am-J-Clin-Nutr. 1977 Nov; 30(11): 1781-92
A comparison of 13 vegetarian Seventh Day Adventists with 14 nonvegetarian Adventists revealed relatively few statistically significant differences in fecal flora. A separate study involved a comparison of vegetarian Adventists (49 subjects), nonvegetarian Adventists (45), and non-Adventists on a conventional American diet (31) re: the incidence of the C. paraputrificum group in the fecal flora. The Adventist groups had significantly fewer C. septicum and C. tertium isolates than the non-Adventists. Reference to earlier diet studies done by our group revealed certain striking differences. Fusobacterium and C. perfringens counts were very low and lactobacillus counts very high in Adventists as compared with Japanese-Americans on either a Japanese or Western diet or Caucasian individuals on a conventional U.S. diet. Comparison of nonvegetarian Adventists with the other groups on a nonvegetarian Western diet also revealed several statistically significant differences. Finally, there were a number of significant differences in fecal flora when high risk groups (Japanese-Americans on Western diet and Caucasians on conventional U.S. diet) were compared with low risk groups (Japanese-Americans on a Japanese diet and Adventists).

Ref #40 - Phillips RL
SO: Am-J-Clin-Nutr. 1978 Oct; 31(10 Suppl): S191-S198
AB: Seventh-Day Adventists (SDAs) are a conservative religious denomination who abstain from tobacco and alcohol; approximately one-half follow a lacto-ovo-vegetarian diet. In this 6-year prospective study of 24,044 California SDAs age 35 and over, coronary heart disease (CHD) mortality rates for ages 35 to 64 and 65+ are 28% and 50% respectively, of the rates for the same age groups of the total California population. This reduced risk of CHD mortality among SDAs is partially due to abstinence from smoking; however, at least half the low risk among SDAs is likely attributable to other characteristics of the SDA lifestyle. The risk of fatal CHD among nonvegetarian SDA males, ages 35 to 64, is three times greater than vegetarian SDA males of comparable age (P less than 0.01), suggesting that the SDA diet may account for a large share of their low risk. This differential was much smaller for older SDA males and SDA females. Although the differential in risk of fatal CHD for male nonvegetarians versus vegetarians may be partially accounted for by other CHD risk factors, which are more frequent among nonvegetarians, a significant differential persists after adjustment for each of six other CHD risk factors.

Ref #41 - Macdonald IA
SO: Am-J-Clin-Nutr. 1978 Oct; 31(10 Suppl): S233-S238
AB: Cell-free extracts were prepared from mixed fecal anaerobic bacteria grown from stools of 14 vegetarian Seventh-Day Adventists, 16 omnivorous control subjects, and eight patients recently diagnosed with cancer of the large bowel. Preparations were assayed for NAD- and NADP-dependent 3alpha-, 7alpha- and 12alpha-hydroxysteroid dehydrogenases with bile salts and androsterone as substrates (eight substrate-cofactor combinations were tested). A significant intergroup difference was observed in the amounts of NAD- and NADP-dependent 7alpha-hydroxysteroid dehydrogenase produced: bowel cancer patients exceeded controls, and controls exceeded Seventh-Day Adventists. Other enzyme activity comparisons were not significant. The pH values of the stools were significantly higher in cancer patients compared to Seventh-Day Adventists; values were 7.03 +/- 0.60 and 6.46 +/- 0.58 respectively. The pH value for controls was 6.66 +/- 0.62. A plot of pH value versus NADP-dependent 7alpha-hydroxysteroid dehydrogenase tended to separate the cancer patients from the other groups. Comparative data suggest that much of the 3alpha-hydroxysteroid dehydrogenase active against bile salt is also active against androsterone.

Ref #42 - Finegold SM
SO: Am-J-Clin-Nutr. 1978 Oct; 31(10 Suppl): S116-S122
Although potent antimicrobial agents may effect rapid and significant changes in fecal microflora, changes in diet or dietary supplements usually produce modest changes by comparison. It may be, however, that even such minor changes may result in significant changes in metabolic activity, particularly in terms of production of possible carcinogens or cocarcinogens. It is clear that significant changes may occur in metabolic activity without major qualitative or quantitative changes in the fecal microflora. Other research that might help explain the epidemiological observations of the association between diet and colon cancer would be studies of the flora at different levels of the gastrointestinal tract (particularly the cecum and small bowel), studies of the mucosa-associated flora at different levels, and long-term dietary studies.

Ref #43 - Simons LA
SO: Am-J-Clin-Nutr. 1978 Aug; 31(8): 1334-9
AB: The influence of absorbed dietary cholesterol on plasma cholesterol concentration was studied in two populations, one Seventh Day Adventist (SDA) vegetarian and one nonvegetarian, representing a broad range of plasma cholesterol values and dietary cholesterol intakes. As a group, the SDA vegetarians had significantly lower levels of plasma cholesterol and triglycerides than did the nonvegetarians. This hypolipidemic pattern in the SDA vegetarians was apparently closely related to dietary habits, since another group of SDA who were nonvegetarian had significantly higher plasma cholesterol and triglyceride levels than their vegetarian counterparts. Both the dietary intake of cholesterol and the percentage absorption of cholesterol were lower in vegetarians than in nonvegetarians. The mass of cholesterol absorbed increased linearly with the mass of cholesterol ingested in all groups, but no relationship could be demonstrated between absorbed cholesterol and plasma cholesterol concentration.

Ref #44 - Trahms CM
SO: AM J Clin Nutr.1978; 31: 720
AB: The growth and food intakes of young children on meatless diets were compared to apparently healthy well-nourished children in the United States. Seventh Day Adventist preschool children (n=45) were evaluated with three day food records and standardized anthropometric measurements.
The one to three year olds consumed 99±22 kcal/kg/day of energy and 3.1±0.8 gm protein/kg/day. The four to six year olds consumed 90±19 kcal/kg/day of energy and 2.7±0.6 gm protein/kg/day. These intakes compared favorably to accepted standards.
Weight to height ratios of the children were compared to North Central Region (NCR) data. These ratios were found to be similar. The mean weight : height ratio of two to three year old males was 0.83 (NCR 0.87) and females 0.79 (NCR 0.85). The ratio for four to six year old males was 0.94 (NCR 0.97) and females 0.96 (NCR 0.96). Thus a meatless diet can support adequate growth and be an adequate dietary pattern for the preschool child when carefully formulated.

Ref #45 - Webster IW
SO: Med-J-Aust. 1979 May 19; 1(10): 417-20
AB: A comparison of health status between 779 Seventh-day Adventists, who have a strong commitment to heal-related life styles, and two other groups of people--8363 persons referred by general practitioners and 9825 volunteers--was made. The Seventh-day Adventists showed less impairment of systolic and diastolic blood pressures, of plasma cholesterol and plasma urate concentrations, and of lung ventilatory capacity; and less obesity at most specific ages. With increasing age, the level of breathlessness, reported heart disease, hypertension, and hypertensive and diuretic therapy in this sample approached that of the comparative groups, possibly because of natural attrition of high-risk persons in the latter. Depression, sleeplessness, use of sedatives and tranquillizers were lower in the Seventh-day Adventists; although, once again, a drawing together of the three groups in older age categories was evident. It is concluded that the life style of Seventh-day Adventists is conducive to lessened morbidity, delayed mortality, and decreased call on health services in comparison with the general population.

Ref #46 - Berkel J
Drukkerij Insulinde, Amsterdam/Netherlands, 1979
Book

Ref #47 - Smith S
SO: Fed Proc. 1979; 38: 713
AB: Questionnaires on attitudes toward and knowledge of nutrition and its relationship to cancer (CA) were sent to 1000 randomly selected Oregon Seventh-day Adventists (SDA). Responses came from 208 of 500 females (F) and 123 of 500 males (M). A higher percentage of M (68%) than F (53%) were vegetarians (V). 61% of the respondents strongly agreed that there is a relation between nutrition and CA. From 90-95% of both M and F agreed that some foods contain CA causing substances. Lower percentage of respondents strongly agreed to more specific statements relating CA to nutritional (N) factors such as fiber (45%), fat (27%), obesity (22%) and protein (14%). A higher percent of F than M rated food choice factors of cost, N value, health and caloric content as very important. Caloric content of foods was more important to the non-V (NV) than V. 35% of the F took vitamins daily. VM (19%) were less likely to take vitamins daily than NVM (39%). More F (50%) than M (24%) studied nutrition in high school. More F (73%) than M (53%) said they knew the seven signs of CA. Of an additional 15 respondents who had CA, 7 of them were V. Responses from the CA subjects followed the general trends of the other respondents. Data suggests that SDA (88%) as a group agree that there is a relation between nutrition and cancer, but are less sure of the specific relationships. V more strongly agree than NV that there is a relationship and that specific nutrients are related to cancer risk. (No Refs)

Ref #48 - Entsrom JE
SO: CA-A Cancer Journal for Clinicians. 1979; 29: 352-361
AB: What can we learn by studying populations that develop chronic diseases at relatively low rates compared with the general population? Are there protective factors that minimize or delay an individual's risk of developing and dying from heart disease, cancer, diabetes? A number of epidemiologic studies have examined relatively low rates of disease around the world. These have been directed primarily at coronary heart disease. This approach is being applied more extensively to cancer. In studying cancer etiology, it is as important to identify populations at relatively low risk as it is to identify populations at relatively high risk. From those at low risk, clues to protective mechanisms emerge; from those at high risk, clues causative mechanisms emerge. Based on these findings, interventions may be introduced to challenge apparent risk factors.

Ref #49 - Armstrong B
SO: Am-J-Clin-Nutr. 1979 Dec; 32(12): 2472-6
Urinary sodium, potassium urea, creatinine, uric acid, plasma urea, creatinine, cholesterol, blood pressures, height, weight, and skinfold thickness were measured in some or all of 106 matched pairs of vegetarians (mainly Seventh-Day Adventists) and nonvegetarians. Mean blood pressures were lower in vegetarians (141.9/88.9 mm) than nonvegeterians (148.0/90.9 mm) but the urinary excretion of sodium was higher, although not significantly, in the vegetarians (mean of 169.7 compared with 161.2 mmole/day). The vegetarians also had a higher urinary potassium excretion (62.9 mmole/day) than the nonvegetarians (54.8 mmole/day) thus giving them a lower mean sodium to potassium ratio (3.0 compared with 3.3). Both systolic and diastolic blood pressures correlated positively with plasma cholesterol levels which were less in vegetarians (6.0 mmole/liter) than nonvegetarians (6.6 mmole/liter). They also correlated positively with the urinary sodium to potassium ratio, but only in nonvegetarians. It was concluded that dietary sodium does not explain the blood pressure differences between vegetarians and nonvegetarians.

Ref #50 - Simons L
Med J of Australia 1979; 2:148
Letter to the Editor

Ref #51 -Bachrach S
SO: Pediatrics. 1979 Dec; 64(6): 871-7
Nutritional, racial, cultural, and environmental factors have combined to produce a resurgence of vitamin D deficiency rickets in urban Philadelphia. Between January 1974 and June 1978, 24 cases were diagnosed at the Children's Hospital of Philadelphia. Patients' ages ranged from 4 to 58 months. Presenting complaints included seizures, swollen wrists, pathologic fractures, and developmental regression. Sixteen patients were below the third percentile for length and weight. Laboratory results indicated vitamin D deficiency in nursing mothers as well as in infants. All infants had been breast-fed and all were black. Ingestion of vitamin D was limited by exclusion of meat and/or dairy products in 21, and no infants had consistently taken supplemental vitamins. Nineteen were members of Muslim or Seventh Day Adventist faiths. Endogenous synthesis of vitamin D was limited by dark skin, by dressing in long garments with hoods and veils, and by air pollution in a densely populated northern city. The return to a more "natural" diet, free of food additives, has been accompanied by the return of a classic disease of industrial society. Effective management required patience and respect for religious convictions. With treatment, there was correction of chemical and skeletal abnormalities, but few patients showed catch-up growth.

Ref #52 - Gori GB
SO: Cancer. 1979 May; 43(5 Suppl): 2151-61
It has been estimated that 80--90% of the cancer rate in the U. S. can be attributed to environmental factors. For the last 20 years the role of smoking has been recognized by the scientific community. However it is only recently that the role of diet, i.e., food and beverages in carcinogenesis has begun to be recognized. It is likely that diet is more important than smoking in cancer causation. Both human and animal studies support this assumption. The study of special populations in the U. S. such as the Mormons and the Seventh Day Adventists also point to the potential of reducing U. S. cancer rates and individual risk factors through the modification of dietary habits. The major hypotheses of the role of dietary and nutritional factors in cancer etiology are examined in light of current scientific knowledge. General guideline for the reduction of risk from the major chronic diseases are also discussed.

Ref #53 - Marsh AG
SO: J-Am-Diet-Assoc. 1980 Feb; 76(2): 148-51
Lacto-ovo-vegetarian women fifty to eighty-nine years of age lost 18 per cent bone mineral mass while omnivorous women lost 35 per cent. This study established that this difference could not be explained by a greater bone density in the lacto-ovo-vegetarians during the third, fourth, and fifth decades of life. The possibility of higher sulfur content in the meat-containing diet, the effect of excess phosphorus, and the effect of an acid-ash diet are discussed. From the standpoint of a general survey, comsumption of calcium-containing foods was not appreciably different in the two groups. It is, therefore, concluded that lacto-ovo-vegetarian diet may be beneficial in extended protective health care in terms of defense against, or control of, bone mineral loss in the later years of a woman's life.

Ref #54 - Phillips RL
SO: J Environ Pathol Toxicol 1980; 3:157-69
No abstract

Ref #55 - Phillips RL
SO: Banbury Report 4. New York, 1980, Cold Spring Harbor Lab. Pp. 93-108
No abstract

Ref #56 - Phillips RL
SO: J-Natl-Cancer-Inst. 1980 Nov; 65(5): 1097-1107
AB: In previous reports concerning cancer among Seventh-Day Adventists (SDA), comparisons were made only with the general population. This report compared California SDA to a sample of non-SDA who were demographically similar to SDA. The study consisted of 17 years of follow-up (1960--76) on 22,940 white California SDA and 13 years of follow-up (1960--72) on 112,725 white California non-SDA. Both groups completed the same base-line questionnaire in 1960. Deaths were ascertained by annual contacts with each study member and by computer-assisted record linkage with the California State death certificate file. Results indicated that, with the exception of colon-rectal cancer and smoking-related cancers, the difference in risk of fatal cancer between SDA and non-SDA was substantially reduced when SDA were compared with a more socioeconomically similar population. The persistence of the low risk for colon-rectal cancer can probably be attributed to some aspect of the diet or life-style of the SDA.

Ref #57 - Phillips RL
SO: Am J Epidemiol 1980; 112:296-314
No abstract

Ref #58 - Reddy BS
SO: Mutat-Res. 1980 Aug; 72(3): 511-22
AB: Because of potential significance of fecal mutagens in the pathogenesis of colon cancer, the dietary pattern and fecal mutagens of 3 populations with distinct risk for the development of colon cancer, a high-risk population in New York Metropolitan area (non-Seventh-Day Adventists), a low-risk population of vegetarian Seventh-Day Adventists in New York Metropolitan area and a low-risk population in rural Kuopio, Finland were studied. The average daily intake of protein was the same in the 3 groups, but the sources were different, a greater portion coming from meat in the New York non-Seventh-Day Adventists and from vegetables in Seventh-Day Adventists. The intake of fat was lower in Seventh-Day Adventists and higher in Kuopio and in New York non-Seventh-Day Adventists. The intake of dietary fiber was high in Kuopio compared to other groups. Fecal samples collected for 2 days were freeze-dried extracted with peroxide-free diethyl ether, partially purified on a silica-gel column and assayed for mutagenicity using the Salmonella/mammalian microsome mutagenicity test. The mutagenic activity was observed with Salmonella typhimurium tester strain TA98 without microsomal activation and with TA100 with and without microsomal activation in high-risk subjects from New York consuming a high-fat, high-meat diet. The incidence of fecal mutagen activity was higher in volunteers from New York consuming a high-fat, high-meat diet compared to low-risk rural Kuopio population. None of the vegetarian Seventh-Day Adventists showed any mutagenic activity.

Ref #59 - Reddy BS
SO: Cancer-Lett. 1980 Aug; 10(2): 123-32
Dietary patterns and fecal mutagens of 2 population groups with a distinct risk for colon cancer, high-risk, non-Seventh-Day Adventists and a low-risk, vegetarian Seventh-Day Adventists, in the New York metropolitan area were studied. The diet histories indicate that the intake of protein was identical in the 2 groups; a greater portion coming from meat in non-Seventh-Day Adventists and from vegetables in the Seventh-Day Adventists. The intake of fat was lower in Seventh-Day Adventists. Fecal samples were extracted with dichloromethane, partially purified on silica and assayed for mutagenic activity using the Salmonella/mammalian microsome mutagenicity test. When tested alone, fecal extracts from both groups were non mutagenic in TA98 and TA100 strains. Fecal extracts of non-Seventh-Day Adventists and Seventh-Day Adventists enhanced the mutagenic activity induced by 2-AAF in TA98 and TA100 (co-mutagenic activity). However, non-Seventh-Day Adventists showed a significantly higher co-mutagenic activity in TA98 than did Seventh-Day Adventists.

Ref #60 - Kondo AT
SO: Dissertation - Univ. Microfilms International, Ann Arbor, MI

Ref #61 - Harris RD
SO: Am-J-Public-Health. 1981 Dec; 71(12): 1342-9
AB: Distribution of systolic and diastolic blood pressures (measured with an automated blood pressure recorder) of two large groups of children-3,159 from Seventh-Day Adventist (SDA) schools and 4,681 from non-SDA schools-are reported. They boys and girls were from four different ethnic groups and attended grades one through 10 in 29 Southern California schools. The analysis of the data failed to show significant differences in mean blood pressure levels between the two groups of children at all ages, despite marked differences in life-style between the two groups, and despite the fact that adults from the two population groups have marked differences in mortality from diseases associated with elevated blood pressure. A comparison between boys and girls showed significantly higher trends in mean systolic blood pressure for boys after age 12. Inter-ethnic comparisons of blood pressure revealed that Black children of both sexes had slightly higher mean blood pressure levels at all ages.

Ref #62 - Fraser GE
SO: J Chron Dis. 1981; 34: 487-501
AB: Although experimental work has supported the influence of diet on serum cholesterol levels, it has been puzzling that several large cross-sectional studies have failed to demonstrate such relationships. Five hundred and seventeen Seventh-day Adventist, who largely vegetarian, were investigated to obtain serum cholesterol levels and a food frequency dietary record. A stepwise multivariate analysis revealed significant relationships between diet and serum cholesterol in this cross-sectional study.
The analysis was split to Europeans and Polynesians and relationships were found for both groups between serum cholesterol and such variables as use of butter as a breadspread, use of margarine as a breadspread , a specific predetermined linear combination of saturated and polyunsaturated fats (2S-P). These relationships are consistent with the hypothesis that in these free-living people dietary fats influence serum cholesterol in the fashion predicted from previous experimental work.
Consideration is given to some of the difficulties in using stepwise regression programs with this type of data. This data did not clearly support the threshold hypothesis in relating diet to serum cholesterol.

Ref #63 - Insel PM
SO: J-Psychosom-Res. 1981; 25(6): 505-11
AB: Preliminary analyses of data relating blood pressure levels in children to psychosocial factors suggest there are small but significant and important associations between blood pressure and an adolescent lifestyle that emphasizes Control, Ambitiousness, Competitiveness, Order and Organization, Religious Orientation, and strong pressures to achieve. Seventh-day Adventist children compared to public school children perceive a stronger emphasis on Religious Orientation and Family Control.

Ref #64 - Kuzma JW
SO: Proc of the 19th Natl Mtg of the Public Health Conference on Records and Statistics, DHHS Publication No. (PHS) 81-1214, 1981.
No abstract

Ref #65 - Waaler H
SO: Tidsskr Nor Laegeforen. 1981; 101: 623-627
AB: Observation of 17 years mortality among Norwegian adventists shoes a clear low mortality for all age groups, most clearly for men. We have calculated that adventists have an increased life duration of approximately 4 and 2 years for men and women, respectively. This corresponds to the increases life duration one would obtain if the mortality due to ischemic heart disease were eliminated. The results are in good agreement with extensive investigations in the United States.

Ref #66 - Nestel PJ
SO: Metabolism. 1981 Oct; 30(10): 941-5
AB: Vegetarians have lower than average plasma lipid levels. Possible mechanisms were studied by measuring the kinetics of LDL-B protein and HDL-AI protein in 7 young male vegetarians and 6 omnivorous control subjects; sterol balances were also determined in a further study with the 6 additional control subjects whose intake of cholesterol was low. Plasma total cholesterol, LDL cholesterol and LDL-B protein were significantly lower in the vegetarians and plasma AI protein concentrations also tended to be lower. The flux or production of LDL was significantly lower, 9.1 +/- 2.3 mg/kg/d (mean +/- SD) compared to 11.8 +/- 0.6 mg/kg/d in the controls and appeared to explain the low levels of LDL. The fractional removal rate of HDL-AI protein was significantly greater in the vegetarians (0.043 +/- 0.011 versus 0.027 +/- 0.011 for the fractions of pool 1 cleared per hour) and appeared to account for the low plasma AI levels. In the second study, bile acid excretion was significantly lower in the vegetarians and estimated cholesterol synthesis was in the low normal range. Low rates of LDL-B protein formation have been reported in other subjects with low LDL cholesterol concentrations and in the vegetarians presumably reflect the composite of several dietary factors.

Ref #67 - Shultz TD
SO: Diss Abstr Int (B). 1981; 41(11): 4068-B
AB: Adult males and females were recruited from the Corvallis area, and the group was comprised of 51 Seventh-Day Adventist (SDA) vegetarians (SV), 16 SDA non-vegetarians (SNV), 53 non-vegetarians (NV), and 18 hormone dependent cancer subjects (HDCS). Approx 50% of the SDA population consume vegetarian diets, which may contain higher amounts of fiber than NV diets and may adversely affect their vitamin B-6 (B-6) and selenium (Se) status. The B-6 status of SV, SNV, NV, and HDCS as assessed by dietary B-6, plasma pyridoxal-phosphate (PLP), urinary 4-pyridoxic acid and total urinary B-6 did not differ; however, HDCS currently receiving chemotherapy had significantly lower PLP levels than non-therapeutic HDCS. Selenium levels of the SV, SNV, NV and HDCS were low and well below values reported elsewhere in the United States, but similar in all groups. SDA endocrine related cancer rates are lower than the general population. Investigation of the relationship between diet and plasma estrone (E1), estradiol (E2), estriol (E3), dehydroepiandrosterone sulfate (DHEA-S), and prolactin (PRL) levels for SV, SNV, NV, and HDCS was done. Also, estimation of dietary fat (F) intake from 32 F containing foods was determined from a questionnaire reflecting the dietary intakes of 14 SV and 9 NV premenopausal women during the past yr. The premenopausal SV were consuming approx 25% less F than NV, and used significantly less fried foods (P less than or equal to 0.01). Premenopausal NV plasma levels of E1 and E2, but not E3, were significantly greater than that of SV (P less than or equal to 0.02; P less than or equal to 0.05). Comparisons of the other male or female SV and NV groups E1, E2, E3, DHEA-S, and PRL levels were not different. Regression analysis of the questionnaire data revealed no significant positive correlations between F intake and SV or NV premenopausal levels of any of the three estrogens. However, according to regression analysis involving 3-day dietary intake av, premenopausal SV E2 and E3 levels were positively correlated with intakes of linoleic acid and protein (P less than or equal to 0.01; also, premenopausal NV prolactin levels were correlated with intakes of oleic and linoleic acid and total fat (p less than or equal to 0.005; P less than or equal to 0.02; P less than or equal to 0.01). Therefore, based on these findings and other current evidence, it may be wise to premenopausal women to reduce meat intake and other products of high fat content.

Ref #68 - Fraser GE
SO: Am-J-Clin-Nutr. 1981 Jul; 34(7): 1272-7
AB: Several previous studies have indicated that vegetables may lower serum total cholesterol. This study, using a Latin square experimental design, investigates the effect of three vegetable supplements (vegetable roots, vegetable leaves and stalks, whole grains) on serum lipoprotein cholesterol. The results from each vegetable supplement are compared to the results from a sucrose supplement of equal caloric content. Dietary fat, alcohol consumption, cigarette smoking, body weight, and physical activity are all controlled in the experimental design or the analysis. The results show that the effect of vegetables on serum cholesterol is not confined to one vegetable grouping or one type of lipoprotein cholesterol. Vegetable leaves and stalks are associated with lower values of very low-density lipoprotein cholesterol (and possibly low-density lipoprotein cholesterol) and total cholesterol. Whole grains are associated with lower values of low density lipoprotein cholesterol and total cholesterol. In addition to the actual cholesterol lowering effect compared to sucrose, the lack of an increase, suggests some advantage in the use of these vegetable groupings (even roots) as a replacement for fat in the diet, and vegetable leaves and whole grains as a replacement for sucrose.

Ref # 69 - Sanchez A
SO: Medical Hypotheses. 1981; 7: 1339-45
AB: Body size and body composition have been suggested as the best explanation for the temporal trend toward early menarche over the last 100 years. There is evidence from human and animal studies that indicates that body size is not the primary factor in influencing the occurrence of menarche. The data actually show that diet may be a primary environmental control mechanism of menarche especially since it alters hormone levels. We see diet as an etiological factor in both the long term and immediate control of menarche. In the long term it influences body size and development leading to menarche. In the short term it acts at a critical state to precipitate the onset of menarche and related physiological changes. This hypothesis does not exclude other less important factors associated with menarche. Our data shows that the present trend toward early menarche can be reversed when a balanced vegetarian diet is selected in place of the ordinary American diet.

Ref #70 - Armstrong BK
SO: J-Natl-Cancer-Inst. 1981 Oct; 67(4): 761-7
AB: In comparison with matched nonvegetarian women, postmenopausal vegetarian women were found to have lower urinary levels of estriol and total estrogens, lower plasma prolactin levels, and higher plasma sex hormone-binding globulin (SHBG) levels. These differences were not explained by differences in body weight or obesity. Plasma SHBG levels were highly correlated with plasma high-density lipoprotein cholesterol levels, which were also higher in vegetarians than in nonvegetarians. These hormonal differences may explain the lower rates of endometrial and possibly breast cancer that have been observed previously in vegetarian women.

.Ref #71 - Shultz TD
Book Chapter

Ref #72
SO: Sth African Med J. 1981; 59: 925
Editorial: Studies in English-speaking countries have established that those who belong to the Seventh-Day Adventist Church tend to be more healthy and to live longer than the average population. The latest study of this group comes from Norway, where Waaler and Hjort (T. Norske Laegeforen., 1981, 101, 623) discuss statistics for the period 1960-1977. The results must gladden the heart of any health educator, since it seems clear that the healthy lifestyle of these people is responsible for the fact that they live longer that anyone else. There are over 5000 of them in Norway and the reduction in mortality from the expected figure amounts to 72% for men and 83% for women. This means that on average the men live 4 years longer and the women 2 years longer than others. In order to achieve an increase in longevity of this magnitude in the entire population, ischemic heart disease would have to be eliminated for example.
The authors looked at the connection between longevity and health, and showed that for both ischemic heart disease and cancer the figures were lower for Adventists. Examination of the figures also suggests that there has been no genetic selection, a conclusion which American observers have also reached. Their longevity cannot be due to the fact that they belong to a privileged social class, since an examination of their distribution among social classes revealed no advantage over the general population. Nor could their geographic distribution in Norway explain the difference.
The likeliest explanation is the fact that they do not use tobacco, alcohol, coffee, tea or any drugs of addiction, and that they use fruit and vegetables freely (in fact, 50% are entirely vegetarian). They also encourage exercise, good working habits and regular sleep. It may well be that a better state of mental health helps to promote good health. Some light might be cast on this last point by a comparison with other religious groups who are not following the same lifestyle.
The authors comment that these natural experiments are much more instructive and reliable than experimental studies of the type of controlled clinical trials.

Ref #73 - Anderson BM
SO: Am-J-Clin-Nutr. 1981 Jun; 34(6): 1042-8
AB: Iron and zinc status of 56 Seventh-Day Adventist Canadian women (mean age 52.9 +/- 15.3 yr) following vegetarian diets for 19 +/- 17 yr were investigated. Energy, protein, iron, available iron, zinc, and total dietary fiber intakes were calculated from 3-day dietary records. Hemoglobin, serum iron, total iron binding capacity, serum and hair zinc concentrations were also determined. Plant products provided 92 and 77% of the total dietary iron and zinc intakes, respectively. Calculated mean daily intakes (+/- SD) for energy, protein, iron, zinc, and total dietary fiber were 1630 +/- 354 kcal, 58 +/- 14 g, 12.5 +/- 3.0 mg, 9.2 +/- 2.5 mg, and 30.9 +/- 11.0 g, respectively. Mean hemoglobin (13.1 +/- 1.0 g/dl), calculated serum transferrin saturation (37.5 +/- 12.9%), mean serum zinc (99 +/- 24 microgram/dl), and hair zinc concentrations (187 +/- 44 ppm) were all within the normal range. The iron and zinc status of these long-term Seventh-Day Adventist vegetarian women appeared adequate despite their low intake of readily absorbed iron and zinc from flesh foods and their high intake of total dietary fiber and phytate.

Ref #74 - Gray GE
SO: Prev Med. 1982; 11: 103-107
AB: Seventh-Day Adventist women in California have a decreased mortality rate from breast cancer. If this lower rate is due to the fact that many Adventists are lactoovovegetarians ("vegetarians") then one may find reduced levels of suggested risk factors for breast cancer in such Adventists. We studied this by comparing plasma and urine sex horrmone levels in Seventh-Day Adventist "vegetarian" and "nonvegetarian" girls aged 14 to 17. No differences were found between the two groups in Day 11 estrogens and prolactin, or in Day 22 estrogens, progesterone, and prolactin. Mean heights, weights, and ages at menarche were also similar. The Adventists were similar in height, weight, and age at menarche, and had similar plasma hormone levels, when compared with non-Adventist "control" girls.

Ref #75 - Snowdon DA
SO: Banbury Report 11, 1982
AB: Seventh-day Adventists (SDAs) are a religious group with low risk of death due to ischemic heart disease, cerebrovascular disease, cancer of the stomach, colon, prostate, breast, lung, and other cancer sites, as well as other diseases (Phillips et al. 1980a,b). The low risk of death from several of these diseases is probably due, in part, to the unique life-style that characterizes this religious group. Adventists generally avoid the use of tobacco, alcohol, spices, pork, and beverages containing caffeine. In addition, approximately 50% of all Adventists adhere to a lacto-ovo-vegetarian diet - a vegetarian diet that includes milk and egg products. Other behavioral and social components also characterize the SDA life-style.
Two principal questions will be addressed in this report. This first question is whether age at baptism is related to the risk of fatal ischemic disease. In other words, is the risk of ischemic heart disease in persons who join the Adventist religion as children different than the risk of those who convert to the Adventist religion as adults?
The second major question addressed in this report is whether the relationship between age at baptism and risk of ischemic heart disease differs among various subgroups of Adventists. These subgroups will include males, females, vegetarians, nonvegetarians, former cigarette smokers, and those who have never smoked.

Ref #76 - Turjman N
SO: Cold Spring Harbor Laboratory, New York, 1982
Book Chapter

Ref #77 -Rouse IL
SO: Clin-Exp-Pharmacol-Physiol. 1982 May-Jun; 9(3): 327-30
AB: 1. The association between vegetarianism and blood pressure was studied in relation to obesity, sex and aspects of lifestyle in 180 Seventh-day Adventists and 113 Mormons aged 25-44 y. 2. Volunteers completed a questionnaire, a 1-day diet record and submitted to standardized measurements of blood pressure, heart rate and body size. 3. Ninety-eight Adventist "vegetarians' were comparable to the 113 Mormon omnivores for strength of religious affiliation, consumption of alcohol, tea and coffee and use of tobacco, but were significantly less obese. 4. Obesity correlated positively with blood pressures in males and females of both diet classes. Age showed a positive correlation with blood pressure in females only. 5. Adjustment of blood pressures for age and Quetelet Index indicated that there is an additional blood pressure reducing effect associated with a vegetarian diet.

Ref #78 - Ferguson LR
SO: Alan R Liss, Inc., New York, 1982
Book Chapter

Ref # 79 - Nnakwe N
SO: Proc Nebraska Academy of Sciences and Affiliated Societies 1982; 92:29
AB: The objective of the project was to compare the calcium and phosphorus utilization of vegetarians and omnivores consuming either self-selected or laboratory controlled vegetarian diets. In Study A, 3-day dietary records of Seventh-Day Adventist omnivore and vegetarian students were collected. Students ate primarily in a lacto-ovo-vegetarian food service. Vegetarian students consumed significantly higher amounts of calcium and phosphorus than did omnivore students suggesting that under the conditions described the vegetarian students were making superior food pattern selections. No significant differences in blood serum calcium and phosphorus levels between these two groups were found. In Study B, vegetarian and omnivore students consumed laboratory controlled vegetarian diets. The vegetarian students excreted significantly less fecal calcium and, thus, exhibited better calcium utilization characteristics than did the omnivore subjects. This suggests that with time some adaptation to vegetarian diets may occur which results in improved calcium utilization. No statistically significant differences were demonstrated between the two groups attributable to phosphorus utilization.

Ref #80 - Miller-AB
SO: Cancer. 1982 Dec 1; 50(11 Suppl): 2533-40
AB: The incidence of gastrointestinal cancers differ greatly internationally. Blacks have higher rates than whites for esophagus, stomach, liver, and pancreatic cancer in the U.S. Differences also occur between other racial groups. Studies on migrants suggest environmental causes for these differences. Stomach cancer rates have fallen, intestine cancer is stable, pancreatic cancer rates rose, but are now falling in males. The incidence of colon, rectal, breast, corpus-uterus, ovary, and prostate cancer are positively correlated, but colon or rectal and stomach cancer are negatively correlated. Colon and rectal cancer mortality are positively and stomach cancer negatively associated with social class. Esophageal, liver, colon, and pancreatic cancer in males are higher in urban areas. Seventh Day Adventists and Mormons show a low risk of colon cancer. Internationally intake of fat is correlated with colon, rectal, and pancreatic cancer, and starch with stomach cancer.

Ref #81 - Fraser GE
SO: Circulation. 1983 Feb; 67(2): 405-12
AB: We studied the relationship between physical fitness and blood pressure in 228 school children. The data were collected as part of the Loma Linda Child-Adolescent Blood Pressure Study. Systolic and diastolic blood pressures were lower in children above average fitness than in children below average fitness among preadolescent and adolescent boys and girls. On multivariate analysis, adjusting for skinfold thickness, an index of lean arm mass, height and age, the relationship between fitness and systolic blood pressure was statistically significant for preadolescent boys and for adolescents of both sexes. The multivariate relationship was not clearly seen for diastolic blood pressure. Multivariate techniques showed that significant correlates of fitness were obesity in preadolescents, age in adolescent boys and height in adolescent girls. Predicted pulse rates for stages 6-10 of a modified Balke treadmill protocol are given in appendix 1 for preadolescent and adolescent boys and girls.

Ref #82 - Shultz TD
SO: Am-J-Clin-Nutr. 1983 Jan; 37(1): 114-8
AB: Human blood selenium (Se) levels have been related to the types of food consumed, bioavailability of Se, and various disease states, including cancer. Some of these interrelationships were investigated in this study in Corvallis, OR (a low soil-Se region) using adult vegetarian and omnivorous subjects, some of whom had hormone-dependent cancer. The study groups were comprised of 48 Seventh-day Adventist vegetarians, 16 Seventh-day Adventist nonvegetarians, 52 non-Seventh-day Adventist nonvegetarians, and 16 nonvegetarian hormone-dependent cancer subjects. Fasting blood samples and 3-days dietary intake information were obtained from each subject. Whole blood Se levels, measured fluorimetrically, correlated positively with dietary protein, riboflavin, niacin, and oleic and linoleic acids but not with 11 other nutrients. Due to limited literature values, dietary Se could not be assessed. There was no significant difference in blood Se values between the four groups (which ranged from 0.069 microgram Se/ml for Seventh-day Adventist nonvegetariants to 0.112 +/- 0.050 microgram Se/ml for non-Seventh-day Adventists nonvegetarians and nonvegetarian hormone-dependent cancer patients). All values were well below averages reported for other regions of the United States. These data suggest a relationship between blood Se and the consumption of meat, milk, and cereal products, but it is not simply a difference between the vegetarian and nonvegetarian diets.

Ref #83 - McEndree LS
SO: Nutr Rep Int 1983; 27:199-206
AB: The ability of vegetarian diets to provide adequate amounts of available iron to iron deficiency vulnerable groups has been questioned. Iron utilization has been shown to be inhibited by soy protein, milk protein, egg albumin, phytates and fiber, all of which are found in abundance in vegetarian diets. The primary objective of the current study was to determine iron intakes and iron nutritional status of lacto-ovo-vegetarian students and omnivore students eating in a lacto-ovo-vegetarian food service. In this survey, iron intakes of both groups were low, but intakes of omnivore subjects tended to be poorer than were those of the vegetarian subjects, suggesting that the omnivore subjects made poorer food choices than die the vegetarians. Biochemical indexes of iron nutritional status, however, did not indicate the omnivore subjects to be in poorer nutritional status than vegetarians. Hemoglobin, hematocrit and serum iron levels were not different between the two groups. One group of vegetarian students did have a statistically lower level of serum ferritin than did the omnivore counterparts. Both groups were not considered anemic, but neither did they have enough iron stores to cope with heavy menstrual losses or pregnancy without possible jeopardy to their iron nutritional status.

Ref #84 - Marsh AG
SO: Am-J-Clin-Nutr. 1983 Mar; 37(3): 453-6
AB: Past studies indicate postmenopausal women who eat meat may experience greater bone mineral loss than lacto-ovo-vegetarian women. The present study extends those findings by comparing bone mineral in adult lacto-ovo-vegetarian and omnivorous males. Bone mineral mass was determined by direct photon absorptiometry in 320 lacto-ovo-vegetarian and 320 omnivorous males 20 to 79 yr old. Lacto-ovo-vegetarians were Seventh-day Adventists committed to their diet for at least 20 yr. Measurements were made at a cortical site along the radius. No statistical differences were identified between bone mineral mass in the lacto-ovo-vegetarian and omnivorous males in any decade examined. When contrasted against significant differences between bone mineral mass in postmenopausal omnivores and lacto-ovo-vegetarians, the data presented here may be interpreted as indicating that some factor associated with meat consumption is increasing bone mineral losses in postmenopausal females while having no observable effect in males.

Ref #85 - Phillips RL
SO: Cancer-Res. 1983 May; 43(5 Suppl): 2403s-2408s
AB: Deaths from cancers of the large bowel, breast, and prostate were ascertained over a 21-year period among 21,295 white California Adventists. Compared to non-Adventists, the age-sex-adjusted mortality for large bowel cancer was substantially reduced among Adventists. Adventists also showed a minimum reduction in mortality for breast and prostate cancer. Fatal large bowel cancer within the Adventist group was unrelated to meat use. However, coffee use showed a substantial positive association with fatal large bowel cancer. Although this association may be indirect or spurious, it deserves further investigation. Weak nonsignificant associations were observed between cancers of the breast and prostate and meat use.

Ref #86 - Jensen OM
SO: J-Natl-Cancer-Inst. 1983 Jun; 70(6): 1011-4
AB: Cancer risk was studied in 781 male Seventh-Day Adventists (SDA) and 808 male members of other temperance societies. Standardized morbidity ratios for all cancers were 0.69 among SDA and 1.05 among other temperants. Significantly decreased risks of cancers were noted among SDA for cancer of the colon [observed/expected (O/E): 0.13], cancer of the respiratory system (O/E: 0.17), cancer of the lung (O/E: 0.15), and cancer of the bladder including papilloma (O/E: 0.13). No significant deviations from expectations were noted among members of other temperance societies. Thus risks of tobacco-associated cancers were markedly decreased among SDA. The risk of alcohol-associated cancers (cancers of the oral cavity, pharynx, esophagus, and larynx) taken together was also decreased (O/E: 0.7), although not significantly so. When the results were compared with those of a previous study of Danish brewery workers who had a high average daily beer intake, the present investigation provides further support that the alleged association between beer consumption and the occurrence of rectal cancer is of a noncausal nature. The explanation for the decreased risk of colon cancer should probably be sought in the dietary practices of SDA.

Ref #87 - Rouse IL
SO: J-Hypertens. 1983 Jun; 1(1): 65-71
AB: The association between blood pressure and a vegetarian diet was studied in relation to obesity, sex, age and lifestyle in 98 Seventh-day Adventist (SDA) lacto-ovo vegetarians, 82 SDA omnivores and 113 Mormon omnivores aged 25 to 44 years. Mean blood pressures adjusted for age, height and weight were significantly lower in SDA vegetarians than in Mormon omnivores (115.6/68.7 and 121.2/72.2, respectively, in males and 109.1/66.7 and 114.9/72.6, respectively, in females) and were not related to past or current use of alcohol, tobacco, tea and coffee, physical activity, personality or religious observance. Mean blood pressures in SDA omnivore males (121.7/71.7) were similar to those in Mormon males, while those in SDA omnivore females (109.9/67.4) were similar to SDA vegetarian females. Quetelet's Index in these subgroups demonstrated the same pattern as blood pressure and may reflect, in part, the high level of physical activity in female SDA omnivores. The prevalence of mild hypertension (greater than or equal to 140 mmHg systolic or greater than or equal to 90 mmHg diastolic) was 10 and 8.5% in Mormon and SDA omnivores, respectively, compared with 1 to 2% in SDA vegetarians. Analysis of diet records showed that vegetarians ate significantly more dietary fibre, polyunsaturated fat, magnesium and potassium and significantly less total fat, saturated fat and cholesterol than did Mormon omnivores. SDA omnivores had a dietary pattern which was less homogeneous, and which lay between those of the other groups. Which, if any, of these dietary differences were responsible for the blood pressure differences could not be determined in this study.

Ref #88 - Phillips RL
SO: Food and Nutrition Press, 1983
Environmental Aspects of Cancer - Book Chapter

Ref #89 - Shultz TD
SO: Nutr-Cancer. 1983; 4(4): 247-59
AB: The relationship between dietary nutrients and plasma estrone, estradiol-17 beta, estriol, dehydroepiandrosterone sulfate, and prolactin levels was investigated in 14 premenopausal Seventh-day Adventist vegetarian (SV) women and 9 premenopausal non-Seventh-day Adventist nonvegetarian (NV) women. The SV subjects consumed less fat, especially saturated fat, and used significantly less fried food than the NV subjects. Plasma levels of estrone and estradiol-17 beta in the SV subjects were significantly lower than in the NV subjects. SV estradiol-17 beta and estriol levels were positively correlated with linoleic acid and protein intake, while NV prolactin levels were significantly correlated with intakes of oleic and linoleic acids and total fat. The data suggest that specific dietary nutrients were related to the hormonal milieu of these SV and NV subjects.

Ref #90 - Snowdon DA
SO: Intervention in the Aging Process, 1983 Alan R. Liss, New York
Book Chapter

Ref #91 - Shultz TD
SO: J-Am-Diet-Assoc. 1983 Jul; 83(1): 27-33
AB: The dietary intakes of Seventh-day Adventist (SDA) vegetarians and nonvegetarians, as well as of non-SDA nonvegetarians, were generally adequate. However, even though iron and vitamin B6 intakes exceeded 100% and 90% of the RDAs for all men, 26% and 19% of the women were consuming less than 60% of the RDAs for iron and vitamin B6.

Ref #92 - Berkel J
SO: Int-J-Epidemiol. 1983 Dec; 12(4): 455-9
AB: The mortality pattern of Seventh-Day Adventists (SDAs) in the Netherlands was assessed during a ten-year study period, 1968-1977. Of 522 deceased SDAs the causes of death of 482 could be ascertained. Standardized Mortality Ratios (SMR) for total mortality (SMR = 0,45), cancer (SMR = 0,50) and cardiovascular diseases (SMR = 0,41) as well as for various subgroups differed significantly from the total Dutch population. Mean age at death as well as life-expectation at baptism were significantly higher in SDAs, both in males and females, as compared with Dutch males and females. A health survey among a sample of the total SDA population and a group of 'friend' controls' was done in order to try to explain the differences in mortality pattern and life expectancy. It is concluded that evidence was found for the thesis that abstinence from cigarette smoking is the main factor explaining the low mortality from ischaemic heart diseases among SDAs, while presumably an appropriate (prudent) diet confers additional benefit for example on colon cancer mortality.

Ref #93 - Semmens J
SO: Metabolism 1983; 32:428-32
AB: The significance of sex hormone levels in determining variation in high-density lipoprotein cholesterol (HDL-C) concentrations was studied in healthy Seventh-day Adventists (vegetarians) and Mormons. These groups were selected to avoid the confounding effects of alcohol consumption and cigarette smoking on HDL-C concentrations. Multivariate analysis showed that testosterone has a strong negative association with HDL-C in men (t=3.99, P<0.001) and women (t=2.04, P<0.05) when controlled for other variables including the concentration of sex-hormone-binding globulin (SHBG). Sex-hormone-binding globulin showed an independent positive association with HDL-C in men (P<0.001) and women (P<0.001). We postulate that the sex hormones affect HDL-C levels by regulating the activities of two important enzymes involved in the production and catabolism of HDL, namely, lipoprotein lipase and hepatic endothelial lipase. Other factors contributing independently to variation in HDL-C levels in this study were, in men, age and triglyceride, and in women, apoprotein-HDL, triglyceride, systolic blood pressure, heart rate, body mass index, and triceps skinfold thickness. Plasma estradiol concentrations were not significantly associated I either sex.

Ref #94 - Semmens JB
SO: Clin-Chim-Acta. 1983 Oct 14; 133(3): 295-300
AB: The associations between sex-hormone-binding globulin capacity (SHBG), age, body mass index (BMI), and physical fitness have been studied in 34 men and 36 women. Multivariate analysis was used to look for independent associations with SHBG. The data indicate that when controlled for a number of other factors SHBG levels are related, in men but not in women, to age (positively, p less than 0.001) and BMI (negatively, p less than 0.001).

Ref #95 - Jedrychowski W
SO: Polski Tygodnik Lekarski 1983; 32:14-7 (in polish)
AB: The study aimed at verifying an opinion that life duration parameters of the Adventist Church followers are higher than in the general population. The study included members of the Adventist Church in Krakow. Probability of survival in particular age groups of this population was determined with Tables of Life Duration, and the obtained results were compared to the parameters of the Polish Tables of Life Duration. Survival index of the Adventist Church followers over 40 years of life was markedly higher than that in the general population both males and females inhabiting large cities. In the general population, survival index was higher in females than in males. No such difference was noted in the Adventist Church followers. The study shows the important influence of lifestyle and health promoting behavior of life-span.

Ref #96 - Abu-Assal M
SO: Nutr Rep Int 1984; 29 (2):485-94
AB: The zinc status of 12 pregnant vegetarian and 17 pregnant nonvegetarian women, aged 23-36 years, was investigated. Fasting plasma samples were collected at a mean gestational age of 37 ± 2 weeks and a mean postpartum time of 11± 7 weeks. Dietary zinc intake, calculated from 3-day dietary records, was 10.5 ± 4.0 mg and 10.9 ± 3.0 mg for the vegetarians and nonvegetarians respectively. Dietary zinc intakes did not correlate with plasma zinc levels. Only one-half of the women in each group were consuming above 50% of the Recommended Dietary Allowance for zinc. Last trimester mean plasma zinc levels of the vegetarians and nonvegetarians were 47.9 ± 12.4 ug/dl and 42.9 ± 9.5 ug/dl respectively. While mean plasma zinc levels of the vegetarians rose only 24% (p<0.2) after term compared with an increase of 55% (p<0.001) in nonvegetarians after term, no significant difference was observed between the postpartum ainc measurements of the 2 groups. A lacto-ovo vegetarian diet did not appear to compromise the zinc status of pregnant women. The birthweights of infants born to the vegetarian mothers were negatively correlated with maternal plasma zinc levels.

Ref #97 - Davidson L
SO: Clin-Sci. 1984 Sep; 67(3): 347-52
AB: Resting and stimulated plasma noradrenaline and adrenaline concentration were compared in 45 females and 45 males of similar age who did not smoke, drink alcohol or caffeine-containing beverages. At rest plasma noradrenaline levels were consistently higher in females and adrenaline levels higher in males. These sex-related differences were maintained after isometric exercise, mental arithmetic and cold pressor testing. Resting noradrenaline concentration was negatively correlated with Quetelet index in males and positively correlated with age in females. These findings, based on precise catecholamine measurements under standardized conditions in subjects of similar age, reveal important sex-related differences which need to be taken into account in assessing sympatho-adrenal activity, particularly in relation to mechanisms in essential hypertension.

Ref #98 - Böing H
SO: Akt Ernähr 1983; 8:187-91
AB: Prospective epidemiological studies with Californian Seventh-day Adventists yielded lower standardized mortality ratios for some diseases for Adventists compared to the total population. These differences concern cardiovascular diseases, cerebrovascular diseases, but also cancer, in particular cancer of the colon and the lung, and they even remained when a control group was used resembling the Adventists in many features more closely than the general population. For some diseases, differences in the mortality rates with increasing adherence to the Adventist lifestyle were observed, while these findings were absent in women. So far, no conclusive explanations could be found for the differences in mortality. Results gained from other populations of vegetarians do, however, point to a possible nutritional influence.

Ref #99 - Rouse IL
SO: Aust-N-Z-J-Med. 1984 Aug; 14(4): 439-43
AB: This paper reviews the association between a vegetarian diet and a number of risk factors for cardiovascular disease investigated in a series of epidemiological and experimental studies. Ninety-eight Seventh-day Adventist "vegetarians" were similar to 113 Mormon omnivores for strength of religious affiliation, consumption of alcohol, tea and coffee and use of tobacco, but were significantly less obese and had significantly lower blood pressures adjusted for age, height and weight. A random sample of forty-seven Adventist vegetarians had significantly lower home blood pressures, serum cholesterol levels and blood pressure responses to a cold-pressor test than Mormon omnivores carefully matched for age, sex and Quetelet's index. In a controlled dietary intervention study mean systolic and diastolic blood pressures and serum cholesterol fell significantly during feeding with a vegetarian diet--an effect unrelated to changes in other lifestyle factors. Dietary analysis indicated that a vegetarian diet provided more polyunsaturated fat, fibre, vitamin C, vitamin E, magnesium, calcium and potassium and significantly less total fat, saturated fat and cholesterol than an omnivore diet. There was no evidence for a difference between vegetarians and omnivores in levels of catecholamines, plasma renin activity, angiotensin II, cortisol or serum and urinary prostanoids.

Ref #100 - Masarei-JR
SO: Aust-N-Z-J-Med. 1984 Aug; 14(4): 400-4
AB: Vegetarian diets produce moderate but appreciable changes in serum lipid levels. A six-week intervention study in which other aspects of life-style were kept constant showed that levels of total cholesterol, LDL-cholesterol and HDL-cholesterol fell 0.22, 0.19 and 0.07 mmol/l, respectively, while triglyceride levels increased non-significantly 0.12 mmol/l. The ratio of total cholesterol to HDL-cholesterol did not change. A comparison of groups of habitual vegetarians and omnivores matched for other aspects of lifestyle showed rather larger differences in atherogenic lipid levels: 0.71 and 0.67 mmol/l for total- and LDL-cholesterol; the difference in HDL-C levels was 0.04 mmol/l; triglyceride was 0.19 mmol/l greater in vegetarians. 92% of the variation in intakes of major nutrients was accounted for by three derived factors; changes in levels of most of the lipids were associated in each case with one of the factors. The resultant falls in the levels of total- and LDL-cholesterol in people adopting a vegetarian diet probably contribute to a reduction in cardiovascular risk.

Ref #101 - Shultz TD
SO: FASEB 1984
AB: Vitamin B-6 levels have been related to dietary intake and various disease states, including breast cancer (BCa). To explore this relationship, fasting blood and 24 h urines were obtained from 14 vegetarian (V), 16 non-vegetarian (NV), and 17 hormone dependent cancer subjects (HDCS) women 45-83 yr of age. All HDCS had been in clinical remission for at least 6 months. The 3 groups were subdivided into vitamin users (VU) and non-users. Dietary intake was estimated from a 3-day diet record. Plasma pyridoxal phosphate (PLP) was analyzed by an enzymatic method. Urinary B-6 (UB6) and 4-pyridoxic acid (4PA) were determined by microbiological and fluorimetric methods, respectively. B-6 intakes for V, NV and HDCS were similar providing 85% of the RDA for V and NV, and 75% for HDCS. There were no significant differences found for PLP, 4PA, and UB6 between nonvitamin user V, NV, and nontherapeutic HDCS or for age categories within groups; however, there were significant differences for mean PLP values (pmol/ml) between V (30.78±11,16; p#0.05), NV (39.32±16.34; p#0.025), nontherapeutic HDCS (35.60±6.88; p#0.005) and chemotherapeutic BCa, HDCS (13.59±8.66), respectively. In VU (1-2.6 mg/d), PLP, 4PA, and UB6 increased slightly, while with >5mg B-6/d a 4-6 fold increase was seen. Since dietary B-6 intakes were similar for all groups, it seems likely that the chemotherapeutic Bca HDCS low PLP values may be associated with impaired B-6 metabolism.

Ref #102 - Cooper R
SO: Am J Epidemiol 1984; 140:471-7
AB: The life-style of adolescents attending a Seventh-day Adventist boarding school was evaluated as it related to cardiovascular risk factors. The diet contained 34% calories as fat, with 11% derived from saturated fat. Total serum cholesterol levels were low (mean, standard deviation = 138±15 mg per dl), and apolipoprotein B level was low as well (46 ±9 mg per dl). The high-density lipoprotein cholesterol level was within the usual range (52.4±13.3 mg per dl). Mean blood pressures were also low (systolic, 104.1±9.6 mm of mercury; diastolic, 65.7±9.7 mm of mercury). There was no self-reported use of cigarettes. If this life-style were to continue through adulthood, the incidence of premature atherosclerotic disease, particularly coronary artery disease, for this group might well be reduced, compared with other North Americans, as suggested by findings from previous studies of adult Seventh-day Adventists.

Ref #103 - Zollinger TW
SO: Am-J-Epidemiol. 1984 Apr; 119(4): 503-9
AB: Survival rates were compared among 282 Seventh-day Adventists and 1675 other white female cancer cases following diagnosis during the 30-year period, 1946 to 1976, at two California hospitals owned and operated by the Seventh-day Adventist Church. The Adventist women had a more favorable 5-year relative survival pattern than the other women (69.7% vs. 62.9%) as well as a higher probability of not dying of breast cancer. The differences, however, were no longer significant when stage at diagnosis was taken into account. It seems likely that the lower breast cancer death rates reported among Seventh-day Adventist women as compared with the general population result in part from better survival patterns due to earlier diagnosis and treatment.

Ref #104 - Kahn HA
SO: Am-J-Epidemiol. 1984 May; 119(5): 775-87
AB: This report examines the association between mortality from all causes during a 21-year period and frequency of consumption of 28 specific foods among 27,530 adult California members of the Seventh-Day Adventist Church. Food consumption was measured at the beginning of the study (1960) by a self-administered questionnaire. Deaths were identified by computer-assisted matching of study subjects to the file of death certificates for all deaths that occurred in California during 1960-1980. All-cause mortality showed a significant negative association with green salad consumption and a significant positive association with consumption of eggs and meat. For green salad and eggs, the association was stronger for women; for meat, the association was stronger for men. All the observed associations were adjusted for age, sex, smoking history, history of major chronic disease, and age at initial exposure to the Adventist Church.

Ref #105 - Snowdon DA
SO: Am-J-Public-Health. 1984 Aug; 74(8): 820-3
AB: In 1960, the coffee consumption habits and other lifestyle characteristics of 23,912 white Seventh-day Adventists were assessed by questionnaire. Between 1960 and 1980, deaths due to cancer were identified. There were positive associations between coffee consumption and fatal colon and bladder cancer. The group consuming two or more cups of coffee per day had an estimated relative risk (RR) of 1.7 for fatal colon cancer and 2.0 for fatal bladder cancer, compared to the group that consumed less than one cup per day (RR = 1.0). These positive associations were apparently not confounded by age, sex, cigarette smoking, or meat consumption habits. In this study, there were no significant or suggestive associations between coffee consumption and fatal pancreatic, breast, and ovarian cancer, or a combined group of all other cancer sites.

Ref #106 - Snowdon DA
SO: Am-J-Epidemiol. 1984 Aug; 120(2): 244-50
AB: Findings described in this report are for 6,763 white male Seventh-day Adventists who completed a dietary questionnaire in 1960. Between 1960 and 1980 mortality data were collected on cohort members. Overweight men had a significantly higher risk of fatal prostate cancer than men near their desirable weight. The predicted relative risk of fatal prostate cancer was 2.5 for overweight men. Suggestive positive associations were also seen between fatal prostate cancer and the consumption of milk, cheese, eggs, and meat. There was an orderly dose-response between each of the four animal products and risk. The predicted relative risk of fatal prostate cancer was 3.6 for those who heavily consumed all four animal products. The results of this study and others suggest that animal product consumption and obesity may be risk factors for fatal prostate cancer.

Ref #107 - Calkins BM
SO: Am-J-Clin-Nutr. 1984 Oct; 40(4 Suppl): 887-95
AB: A study was designed to compare nutritional and metabolic parameters on subjects with a spectrum of vegetarian and nonvegetarian dietary patterns. The method of selection of the study population, the description of its characteristics, and the data collection protocol are described. Anthropometric measurements of vegetarians and nonvegetarians are reported and compared with previously reported measurements on similar populations.

Ref #108 - Calkins-BM
SO: Am-J-Clin-Nutr. 1984 Oct; 40(4 Suppl): 896-905
AB: A 3-day diary with portion sizes weighed by the subject and a 24-h recall were obtained on 50 sets of subjects: Seventh-day Adventist lacto-ovo-vegetarians and nonvegetarians, and general population nonvegetarians, matched on age (+/- 5 yr), sex, marital status, education, type of milk preferred, and an index of the frequency of dairy and egg product use. An additional 18 unmatched persons who follow a pure vegetarian dietary pattern (use no meat, fish, fowl, dairy, or egg products) were recruited into the study. The rational for the dietary methods used is presented and details of each of the methods used are given. The results of the nutrient analysis of the 24-h recall and 3-day diary are presented. The 3-day nutrient intake means for the four groups are compared to the sex-specific recommended daily allowance both with and without supplements. The contribution of nutritional supplements to the nutrient intake is discussed. All groups show adequate or excess intake levels of calories, protein, and fat when either the 24-h recall or the 3-day diary values are considered. The higher intake of calories noted among nonvegetarians can be explained by a higher intake of both fat and protein in these groups. A, B, and C vitamin levels (3-day dairy estimates) are adequate both with and without supplements. Calcium intake is much below recommended levels for pure vegetarian females. Iron intake is low for all females. A heme iron source does not improve the intake levels for nonvegetarian females. A comparison of these results with prior reports of nutrient intake among Seventh-day Adventists is presented.

Ref #109 - Rider AA
SO: Am-J-Clin-Nutr. 1984 Oct; 40(4 Suppl): 906-13
AB: Data obtained from two vegetarian and two nonvegetarian populations by 24-h diet recall, 3-day weighed diet diary, analysis of 3-day composite food samples, and measurement of certain biochemical parameters were compared. Correlations for group means (both sexes combined) for values obtained by 24-h recall versus 3-day diet diary were protein, r = 0.96 and total calories r = 0.86. For 3-day diet diary with food analysis, protein r = 0.89, fat r = 0.90 and for reported protein intake with serum prealbumin r = 0.74, with urinary urea nitrogen r = 0.87. Correlations were low for comparisons of means of male groups for most parameters. Individual correlations for reported protein intake and biochemical parameters were lower for males than for females. This suggests that male subjects may require special attention to insure accuracy of reporting and specimen collection. These findings indicate comparability of data from 24-h recall and 3-day diary, and agreement of dietary records with certain biochemical parameters. Protein and fat intake as determined from chemical analysis of a composite food sample correlated well (r = 0.89; r = 0.90) with that calculated from food tables.

Ref #110 - Rider AA
SO: Am-J-Clin-Nutr. 1984 Oct; 40(4 Suppl): 914-6
AB: In a study designed to characterize dietary patterns of vegetarian and nonvegetarian populations, chemical analysis of 3-day composite food samples showed lower fat content of food of vegetarians than that of nonvegetarians; pure vegetarians had the lowest. Unsaturated fatty acids were highest in the food of the pure vegetarian group. No significant difference was seen in percentage protein of the food consumed by male vegetarians and nonvegetarians while the food of female vegetarians was of lower protein content than that of the nonvegetarians. The relationship of these findings to the lower incidence of colon cancer in vegetarian populations remains to be determined.

Ref #111 - Rider AA
SO: Am-J-Clin-Nutr. 1984 Oct; 40(4 Suppl): 917-20
AB: Selected biochemical parameters (serum protein, albumin, prealbumin, total retinol-binding protein, vitamins A and E, total carotenoids, and urinary urea and creatinine) were determined in healthy, free-living vegetarian and nonvegetarian subjects. The groups studied were composed of Seventh-day Adventist pure vegetarians, Seventh-day Adventist lacto-ovo vegetarians, Seventh-day Adventist nonvegetarians, and general population nonvegetarians. No values indicative of nutritional deficiencies were observed in any of the subjects. Serum carotenoid levels were significantly higher in Seventh-day Adventist pure vegetarians than in members of the other groups. Mean values for serum vitamin A showed no differences between the dietary groups, although 41% of general population nonvegetarian subjects (the group considered at highest risk for colon cancer) had serum vitamin A levels in the upper quartile of the distribution. From these data no conclusions can be drawn relating to the role of dietary habits as determinants of colon cancer risk.

Ref #112 - Kritchevsky D
SO: Am J Coin Nutr 1984; 40:921-6
AB: Serum cholesterol, high-density lipoprotein cholesterol, and triglycerides of three groups of Seventh-day Adventists (SDAs) - true vegetarians, lacto-ovo vegetarians, and nonvegetarians - and the general population were measured and related to age, sex, and diet. True vegetarian SDAs had the lowest cholesterol levels while cholesterol levels of the other three groups were similar. Triglyceride levels were highest in the true vegetarian SDAs and lowest in general population. Cholesterol levels rose with increasing age while percentage of high-density lipoprotein cholesterol fell. Female SDAs in all three dietary groups had higher cholesterol levels than males. In all four groups percentage of high-density lipoprotein cholesterol was higher in females than in males. In the male subjects, cholesterol levels varied linearly and inversely with carbohydrate intake. Protein and fat intake in true vegetarian SDAs and lacto-ovo vegetarian SDA groups were lower than in the nonvegetarian SDA and general population groups. The differences in protein and fat intake were reflected in elevations in serum cholesterol levels. In the female subjects, cholesterol levels were also inversely correlated with carbohydrate intake but not as distinctly as in the males. True vegetarian SDA females ingested less protein and fat than the other three groups and exhibited lower serum cholesterol levels. Cholesterol levels in lacto-ovo vegetarian SDA, nonvegetarian SDA, and general population female subjects were similar and did not reflect differences in protein or fat intake. The true vegetarian dietary lifestyle resulted in lowest cholesterol levels, however, if it was breeched to the least extent, cholesterol levels rose. Thus, intake of skim, low fat, or whole milk resulted in similar serum cholesterol levels as did low or high egg consumption.

Ref #113 - Nair PP
SO: Am-J-Clin-Nutr. 1984 Oct; 40(4 Suppl): 927-30
AB: Cholesterol and fat are implicated as dietary factors enhancing the risk for colon carcinogenesis. Plant sterols such as beta-sitosterol when added to diets of experimental animals treated with colon carcinogens reduce tumor yields and counteract the proliferative changes associated with carcinogenesis. The question of whether the diet of human populations at low risk for colon cancer is mirrored in their sterol composition is addressed in this study. Four study groups consisting of 18 Seventh-day Adventist (SDA) pure vegetarians, 50 SDA lacto-ovo vegetarians, 50 SDA nonvegetarians, and 50 general population nonvegetarians were selected from the greater Los Angeles basin, and 3-day composite diets were analyzed for their sterol composition. The most significant index of dietary sterol status is the ratio, beta-sitosterol + stigmasterol/cholesterol (plant sterol/cholesterol ratio). The values for the four groups ranged from 0.49 to 16.0 (general population nonvegetarians = 0.49; SDA-nonvegetarians = 0.98; SDA lacto-ovo vegetarians = 3.26; SDA pure vegetarians = 16.0). The data also show that the absolute amounts of cholesterol consumed as a factor by itself might not be as significant as its relationship to total plant sterols in the diet.

Ref #114 - Nair PP
SO: Am-J-Clin-Nutr. 1984 Oct; 40(4 Suppl): 931-6
AB: Cholesterol and its metabolites, together with bile acids, are implicated as risk factors in the genesis and progression of colon cancer. This study was designed to determine differences in the neutral sterol composition of stools from four different population groups differing in their dietary habits as well as in their expected rates for colon cancer. Four study groups consisting of 18 Seventh-day Adventist (SDA) pure vegetarians, 50 SDA lacto-ovo vegetarians, 50 SDA nonvegetarians, and 50 general population nonvegetarians were selected from the greater Los Angeles Basin area. Three-day composite stool samples were lyophilized and then analyzed for their neutral sterol composition. Cholesterol excretion values consistently showed an age-dependent peak in 46- to 50-yr age group for the total population, SDA lacto-ovo vegetarian and SDA-nonvegetarian subgroups being the principal contributors to this age-dependent phenomenon. The SDA pure vegetarians exhibited the lowest fecal concentrations and daily excretion of cholesterol as expected since their intake of dietary cholesterol is insignificant. Among the other SDA, regardless of whether they are lacto-ovo vegetarians or nonvegetarians, their cholesterol excretion patterns were similar but higher than in the nonvegetarians from the general population. Since dietary intakes of cholesterol are not significantly different among the two nonvegetarian groups, the differences in excretion values are attributable to differences in colonic metabolism. The ratio of cholesterol/cholesterol metabolites showed generally lower values among nonvegetarians compared to the matched group of lacto-ovo vegetarians. The observation was made that fecal cholesterol and its metabolites tend to be higher among nonvegetarians compared to those in the corresponding vegetarian groups.

Ref #115 - Turjman N
SO: Am-J-Clin-Nutr. 1984 Oct; 40(4 Suppl): 937-41
AB: High levels of fecal bile acids have been associated with populations at high risk for developing colon cancer. In this study, 168 subjects were drawn from populations that show low and high mortality from colon cancer [pure vegetarians, lacto-ovo vegetarians, and nonvegetarians Seventh-day Adventists (SDA) and demographically comparable group from the general population]. Lyophilized aliquots of 3-day stool samples were examined for levels of primary (cholic and chenodeoxycholic acids) and secondary (deoxycholic and lithocholic acids) bile acids. Total bile acids (mg/g lyophilized stools) were statistically different among dietary groups: SDA pure vegetarians 2.16 +/- 0.32, SDA lacto-ovo vegetarians 3.66 +/- 0.41, SDA nonvegetarians 4.39 +/- 0.44, general population nonvegetarians 6.04 +/- 0.75; but were similar when stool weights, body weights, and fat intake were taken into account. The most striking difference was evident in the ratio of secondary to primary bile acids: when compared to SDA pure vegetarians, both SDA lacto-ovo vegetarians and SDA nonvegetarians had twice the ratio while values for general population nonvegetarians were five to six times. The data indicate that these differences in excretion patterns among dietary groups reveal distinctly characteristic metabolic features associated with diet and lifestyle.

Ref #116 - Stich HF
SO: Int-J-Cancer. 1984 May 15; 33(5): 625-8
AB: The effect of dietary components on the levels of nitrosoproline ( NPRO ) excreted over a 24 h period in the urine was examined in volunteers ingesting known amounts of various food products. The ingestion of nitrite-preserved meats (85-170 g per meal), including canned, rolled or Yunnan ham, cured pork, luncheon meat, and various Chinese and European-style sausages, led to urinary NPRO excretion levels ranging from 2.5 to 78.5 micrograms/24 h, whereas the consumption of non-preserved meat and fish products, including chicken, herring, salmon, shrimp, ground beef (hamburger), pork chops and beef liver, led to relatively low NPRO excretion levels, ranging from 0.0 to 0.8 micrograms/24 h. The urinary NPRO levels of 22 vegetarians and 14 lacto-vegetarians averaged 0.8 and 1.4 micrograms/24 h, respectively. A change from a nitrite-preserved meat diet to a vegetarian diet was accompanied by an approximately six-fold reduction in urinary NPRO levels; however, these remained above control levels for at least 3 days following the dietary change. The relatively high NPRO levels following the ingestion of nitrite-preserved meats could not be reduced by nitrite-trapping chemicals, including ascorbic acid, ferulic acid, caffeic acid, or phenolic-containing mixtures such as coffee and tea, which were effective in suppressing endogenous NPRO formation following the intake of nitrate and proline. The high urinary NPRO levels after ingestion of preserved meat products appear to be due to the consumption of preformed NPRO . An understanding of the relative contribution of preformed and endogenously formed nitrosamines appears to be essential when designing dietary intervention programmes.

Ref #117 - Kurup PA
SO: Am-J-Clin-Nutr. 1984 Oct; 40(4 Suppl): 942-6
AB: The role of fiber in human diet in preventing a number of chronic diseases has been a widely debated topic in recent years. The claim that populations at low risk for colon cancer generally consume a more fiber-rich diet than those at high risk, has been used to postulate a protective role for this group of substances. In this study we asked the question whether populations leading different dietary lifestyles and who are at varying risks for colon cancer show marked differences in their dietary and fecal profiles of various fiber components. Four study groups consisting of Seventh-day Adventist (SDA) pure vegetarians, SDA lacto-ovo vegetarians, SDA nonvegetarians, and a group of general population nonvegetarians were selected from the greater Los Angeles Basin area. Three-day composite diets, and stools were analyzed for neutral detergent fiber (NDF), hemi-cellulose, lignin, cellulose, cutin + silica, and pectin. The percentage composition and the daily intake and output of each of these components were computed for each population group. The dietary profile revealed a trend (not statistically significant) toward generally higher daily intake values among the vegetarian subgroups, neutral detergent fiber values in g/day: SDA pure vegetarians, 63.0 +/- 7.9; SDA-lacto-ovo vegetarians, 55.8 +/- 3.5; SDA nonvegetarians, 57.2 +/- 3.5; general population nonvegetarians, 52.5 +/- 4.9), lignin, cellulose, and pectin being the major contributors to this difference.(ABSTRACT TRUNCATED

Ref #118 - Tepper SA
SO: Am-J-Clin-Nutr. 1984 Oct; 40(4 Suppl): 947-8
AB: The binding of glycocholic and glycochenodeoxycholic acids to dried defatted residues of homogenized diets consumed by four dietary groups has been measured. The four groups were true vegetarian Seventh-day Adventists (SDA), lacto-ovo vegetarian SDA, nonvegetarian SDA, and the general population. Glycocholic acid was bound to the same extent (7 to 9%) by all four dietary residues. The true vegetarian SDA residues bound significantly more glycochenode-oxycholic acid than those of either lacto-ovo vegetarian SDA (p less than 0.001) or non-vegetarian SDA (p less than 0.001). The general population residue bound significantly more glycochenodeoxycholic acid than did those of nonvegetarian SDA (p less than 0.001). Binding of glycochenodeoxycholic acid was significantly correlated with dietary neutral detergent fiber (p less than 0.001), hemicellulose (p less than 0.01) and cellulose (p = 0.01). There was no corre-lation between the binding of glycochenodeoxycholic acid and dietary lignin, pectin, or cutin.

Ref #119 - Goodman GT
SO: Am-J-Clin-Nutr. 1984 Oct; 40(4 Suppl): 949-51
AB: Elevated levels of serum hexosaminidase (beta-2-acetamido-2-deoxy-D-glucoside; N-acetamidodeoxy-D-glucohydrolase, EC 3.2.1.30)(HEX) have been found in patients with cancer. In view of the reported low levels of colon cancer among Seventh-day Adventists (SDA) we determined levels of total HEX, and its heat-labile (HEX-A) and heat-stable (HEX-B) isozymes in vegetarian SDA, lacto-ovo vegetarian SDA, nonvegetarian SDA, and the general public. Lowest levels of total HEX and highest percentage of HEX-B were found in vegetarian SDA. The levels in the other three groups were comparable, and these differences were seen at all age levels. Female subjects exhibited significantly lower total HEX levels than the males but the percentage of HEX-B was the same.

Ref #120 - Snowdon DA
SO: Prev-Med. 1984 Sep; 13(5): 490-500
AB: In 1960 the meat-consumption habits of 25,153 California Seventh-Day Adventists were assessed by questionnaire. Between 1960 and 1980 ischemic heart disease deaths were identified. Meat consumption was positively associated with fatal ischemic heart disease in both men and women. This association was apparently not due to confounding by eggs, dairy products, obesity, marital status, or cigarette smoking. The positive association between meat consumption and fatal ischemic heart disease was stronger in men than in women and, overall, strongest in young men. For 45- to 64-year-old men, there was approximately a threefold difference in risk between men who ate meat daily and those who did not eat meat. This is the first study to clearly show a dose-response relationship between meat consumption and ischemic heart disease risk.

Ref #121 - Howden GF
SO: P-N-G-Med-J. 1984 Sep-Dec; 27(3-4): 123-31
AB: The island of Aua 143 miles off the N.E. coast of Papua New Guinea has a population consisting of (41%) Roman Catholics who chew betel nut regularly and (59%) Seventh Day Adventists who do not. This provided an ideal opportunity to compare the effects of betel nut chewing on all aspects of dental health against an identical population who did not chew and therefore provided an excellent control. The results of this survey showed, for those of the population who had never lived away from the island, that for betel nut chewers the prevalence of dental caries was 23% whereas for non-chewers it was considerably and statistically significantly greater at 49%. The amount of dental caries as measured by DMFT was also considerably and statistically significantly greater for this group of non-chewers at 1.162 compared with 0.364 for chewers. The above findings confirmed the work of other investigators which at the time of this survey were not known to the author, and this led to a laboratory investigation of the possibility that the betel nut stain may mediate its effect by acting as a chemical or physical barrier against the acid attack of dental caries. Betel nut stained teeth from PNG, which had been extracted due to periodontal disease were prepared with "windows" of enamel from which the betel nut stain had been removed, and their roots were protected by layers of varnish. These teeth were maintained in an "Artificial Caries Medium" at pH's of 3.5, 4.0 and 4.5 for several months.(ABSTRACT TRUNCATED AT 250 WORDS)

Ref #122 - Nnakwe N
SO: Nut Rep Intl 1984; 29:365-9
AB: The objective of the project was to compare the calcium and phosphorus intakes and status of vegetarians and omnivores consuming self-selected diets in a lacto-ovo-vegetarian food service. For 3 days, Seventh-day Adventist omnivore and vegetarian students who ate primarily in a lacto-ovo-vegetarian food service kept dietary diaries. Samples of all foods served were collected and were analyzed for calcium and phosphorus content. Fasting blood samples were also drawn from the subjects and serums were analyzed for calcium and phosphorus content. Vegetarian students consumed significantly higher amounts of calcium and phosphorus than did omnivore students suggesting that under the conditions described the vegetarian students were making superior food pattern selections. No significant differences in blood serum calcium and phosphorus levels between these two groups were found.

Ref #123 - Snowdon D
SO: Am J Epidemiol 1984; 120:480
AB: In 1960, 7,036 white Seventh-day Adventist married couples were identified and, during the following 21 years, deaths were ascertained among 65-94-year-old members of this group. These married couples were a subgroup of a population of approximately 25,000 Adventists who completed a questionnaire at the beginning of the study in 1960. Risk of death among subjects who experienced bereavement due to the loss of their spouse during follow-up was compared to the risk among the subjects who remained married. Bereaved subjects experienced a significant excess risk of death from all causes combined, ischemic heart disease, and stroke. Bereaved and married subjects, however, had approximately the same risk of death from all cancers combined. The age- and sex-adjusted relative risk of death from all causes combined for bereaved subjects compared to the married subjects was 1.5 (95% confidence interval (CI) = 1.3-1.7) during the first five years of bereavement, and 1.7 (95% CI = 1.4-2.1) during the first year of bereavement, and 2.2 (95% CI = 1.5-3.3) during the first two months of bereavement. Other findings from this study indirectly suggest that involvement in church religious and social activities does not lower the excess risk of death among bereaved subjects.

Ref #124 - Hodgkin-JE
SO: Chest. 1984 Dec; 86(6): 830-8
AB: The prevalence of respiratory symptoms, as ascertained by questionnaire, was evaluated in 6,666 nonsmokers who had lived for at least 11 years in either a high photochemical pollution area (4,379 individuals) or a low photochemical pollution area (2,287 individuals). Of these, 5,178 had never smoked, and none was currently smoking. The risk estimate for "definite" COPD, as defined in this study, was 15 percent higher in the high pollution area (p = 0.03), after adjusting for sex, age, race, education, occupational exposure, and past smoking history. Past smokers had a risk estimate 22 percent higher than never smokers (p = 0.01). Multivariate analysis showed a significant effect of air pollution on the prevalence of "definite" COPD which univariate analysis failed to demonstrate.

Ref #125 - Modeste NN
SO: Intl Quarterly of Community Health Education 1984-85; 5(3):203-11
AB: This cross-sectional study presents an assessment of factors associated with elevated blood pressure in Seventh-day Adventists in the Caribbean. Four-hundred-thirty-three subjects were randomly selected from the English-speaking Caribbean population. Subjects ranged in age from twenty-one to sixty: 150 were males and 283 females. Eighty percent were Negroes of African descent, 12 percent mixed, 8 percent Indians of East Indian descent, and 3 percent of Spanish background. The study utilized the PRECEDE model developed by Green and associates to examine factors for hypertension. A positive correlation was found between body mass index (weight in Kg/height in M2) and hypertension in both sexes. Age was also significantly associated with hypertension. Normotensive females had a slightly higher intake of potassium than hypertensives, while hypertensive males tended to have higher levels of calcium. Other factors, such as parental history of blood pressure, vegetarian diet, sugar and fat intake, or Type A/B personality showed no relationship to hypertension. The vast majority of participants were Type B. This study provides baseline information for use in selecting those features which will be emphasized in a health education program, as well as baseline data for evaluation of health education in the Caribbean.

Ref. #126 - Spuehler J
SO: Federation Proc. 1985; 23:49-52
AB: Specific nutrients may modify hormonal balance and contribute to breast cancer etiology. This study investigated relationships between nine dietary nutrients and plasma and urine hormone levels. Ten SDA vegetarian (SV), and 10 SDA non-vegetarian (SNV) women were studied. For each 3-day study period, diet records, fasting midluteal bloods and 24 h urines were collected. All were similar as to age, height, weight, age at menarche, menstrual cycles, and body fat measures. Urinary unconjugated estrone, estradiol-17ß (E2) and estriol, as well as plasma E2, dehydroepiandroesterone-sulfate (DHEA-S), prolactin (Prl) and progesterone were determined by RIA. SNV consumed significantly more protein (p<0.025), total and saturated fats (p<0.02, p<0.005), oleic and linoleic acids (p<0.02, p<0.05), and cholesterol (p<0.001) than SV; SV consumed more crude fiber (p<0.05). Hormonal status of SV and SNV did not differ significantly. SV DHEA-S levels correlated positively with total and saturated fats, and cholesterol (r=0.66, p<0.025; r=0.68, p<0.025; r=0.64, p<0.025, respectively). SNF Prl levels were positively correlated with dietary protein, total and saturated fats (r=0.75, p<0.01; r=0.64, p<0.025; r=0.64, p<0.025, respectively). These data suggest a possible relationship between hormonal balance and dietary milieu.

Ref #127 - Jedrychowski-W
SO: Scand-J-Soc-Med. 1985; 13(2): 49-52
AB: The purpose of the work was to test the hypothesis that the survival rate is higher among the Seventh Day Adventists (SDA) than in the general population of Poland, because of the strictly respected customs adhered to by members of this church community, such as abstinence from smoking and from alcohol. The data on life expectancy in the SDA community covered a total of 236 members of this denomination in Krakow (86 males and 150 females). The survival probability rates were estimated by the life table method, for both men and women separately, and were subsequently compared with the corresponding parameters of the Polish Life Tables. Over a period of 10 years, in which these data were studied, there were 11 deaths in males and 24 deaths in females. Mean age at death was 71.9 years among men and 75.1 among women. The survival curves traced over the age groups of both sexes of SDA members were fairly similar, but they were markedly higher than in the general population of Poland. In the general population the survival rates for people over 40 years old were higher in females than in males, whereas no corresponding sex differences in rates concerning SDA members were observed. The greater benefit in life expectancy is gained in the SDA group in comparison with men in the general population. This is attributable to their abstinence from very harmful habits, otherwise more widespread in this sex group.

Ref #128 - Halvorsen GA
SO: Tidsskr Nor Laegeforen 1985; 24:1620-5
AB: In Norwegian

Ref #129 - Phillips RL
SO: J Natl Cancer Inst. 1985 Feb; 74(2): 307-17
AB: Associations between fatal colon or colorectal cancer and frequency of use of meat, cheese, milk, eggs, green salad, and coffee, as well as percent desirable weight, are described with the use of 21 years of follow-up for 25,493 white California Seventh-Day Adventists. Associations are presented in terms of relative risk (RR) of colorectal cancer for heavy or light exposure versus rare exposure. There were no clear relationships evident between colon or rectal cancer and meat, cheese, milk, or green salad use. Egg use was positively associated with risk of fatal colon cancer in both males (RR = 1.6) and females (RR = 1.7). Coffee use was positively associated with both colon and rectal cancer mortality in males and females, particularly for colon cancer during the last 11 years of follow-up (male RR = 3.5; female RR = 1.9). Overweight (percent of desirable weight greater than or equal to 125) was associated with an increased risk of fatal rectal cancer in both sexes combined (RR = 2.8) and colon cancer in males only (RR = 3.3). Furthermore, eggs, coffee, and overweight appear to be independently associated with risk of both colon and colorectal cancer. These three factors may explain a substantial portion of the colorectal cancer mortality differential between Adventists and U.S. whites (62% for males; 30% for females).

Ref #130 - Snowdon DA
SO: Am-J-Public-Health. 1985 May; 75(5): 507-12
AB: We propose the hypothesis that a vegetarian diet reduces the risk of developing diabetes. Findings that have generated this hypothesis are from a population of 25,698 adult White Seventh-day Adventists identified in 1960. During 21 years of follow-up, the risk of diabetes as an underlying cause of death in Adventists was approximately one-half the risk for all US Whites. Within the male Adventist population, vegetarians had a substantially lower risk than non-vegetarians of diabetes as an underlying or contributing cause of death. Within both the male and female Adventist populations, the prevalence of self-reported diabetes also was lower in vegetarians than in non-vegetarians. The associations observed between diabetes and meat consumption were apparently not due to confounding by over- or under-weight, other selected dietary factors, or physical activity. All of the associations between meat consumption and diabetes were stronger in males than in females.

Ref #131 - Lipkin M
SO: Cancer-Lett. 1985 Mar; 26(2): 139-44
AB: The proliferation of epithelial cells in colonic mucosa was studied in humans at varying degrees of risk for colon cancer.