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Michael Orlich
Publications    Scholarly Journals--Published
  • Martins MCT, Jaceldo-Siegl K, Orlich M, Fan J, Mashchak A, Fraser GE. A New
    Approach to Assess Lifetime Dietary Patterns Finds Lower Consumption of Animal
    Foods with Aging in a Longitudinal Analysis of a Health-Oriented Adventist
    Population. Nutrients. 2017 Oct 13;9(10). pii: E1118. doi: 10.3390/nu9101118.
    PubMed PMID: 29027960; PubMed Central PMCID: PMC5691734.
    ( 10/2017 ) Link...
    Life-course diet patterns may impact risk of disease, but little is known about
    dietary trends with aging. In a retrospective longitudinal analysis we estimated 
    lifetime intake of animal products and adherence to vegetarian dietary patterns
    among 51,082 Adventist Health Study-2 (AHS-2) subjects using data from a reliable
    life-course dietary (meats, dairy, eggs) questionnaire. Results showed a marked
    tendency to consume fewer animal products (in total) in older years and to reduce
    consumption of meat, poultry and fish, but not eggs or dairy. Among the 29% of
    elderly subjects who during their lifetime kept the same dietary pattern (LTS)
    were: LTS-vegans (1.1%), LTS-lacto-ovo vegetarians (31.2%), LTS-pesco vegetarians
    (0.49%), LTS-semi vegetarians (3.7%), and LTS-non-vegetarians (63.5%). Among the 
    71% of switchers were "Converters" (59.7%) who moved towards and "Reverters"
    (9.1%) who moved away from vegetarian diets, and Multiverters (31.2%), who had
    moved in both directions. LTS-non-vegetarians, and also reverters, were more
    overweight and showed a less healthy lifestyle than others. We conclude that the 
    dietary patterns are dynamic with strong trends to reduce animal foods and to
    adopt more vegetarian patterns with aging. The disease experience of subjects
    with different lifetime dietary patterns can be compared.
  • Orlich MJ, Singh PN, Sabaté J, Fan J, Sveen L, Bennett H, Knutsen SF, Beeson WL, Jaceldo-Siegl K, Butler TL, Herring RP, Fraser GE. Vegetarian dietary patterns and the risk of colorectal cancers. JAMA Intern Med. 2015 May 1;175(5):767-76. doi: 10.1001/jamainternmed.2015.59. PubMed PMID: 25751512; PubMed Central PMCID: PMC4420687. ( 5/2015 )
    IMPORTANCE: Colorectal cancers are a leading cause of cancer mortality, and their
    primary prevention by diet is highly desirable. The relationship of vegetarian
    dietary patterns to colorectal cancer risk is not well established.
    OBJECTIVE: To evaluate the association between vegetarian dietary patterns and
    incident colorectal cancers.
    DESIGN, SETTING, AND PARTICIPANTS: The Adventist Health Study 2 (AHS-2) is a
    large, prospective, North American cohort trial including 96,354 Seventh-Day
    Adventist men and women recruited between January 1, 2002, and December 31, 2007.
    Follow-up varied by state and was indicated by the cancer registry linkage dates.
    Of these participants, an analytic sample of 77,659 remained after exclusions.
    Analysis was conducted using Cox proportional hazards regression, controlling for
    important demographic and lifestyle confounders. The analysis was conducted
    between June 1, 2014, and October 20, 2014.
    EXPOSURES: Diet was assessed at baseline by a validated quantitative food
    frequency questionnaire and categorized into 4 vegetarian dietary patterns
    (vegan, lacto-ovo vegetarian, pescovegetarian, and semivegetarian) and a
    nonvegetarian dietary pattern.
    MAIN OUTCOMES AND MEASURES: The relationship between dietary patterns and
    incident cancers of the colon and rectum; colorectal cancer cases were identified
    primarily by state cancer registry linkages.
    RESULTS: During a mean follow-up of 7.3 years, 380 cases of colon cancer and 110 
    cases of rectal cancer were documented. The adjusted hazard ratios (HRs) in all
    vegetarians combined vs nonvegetarians were 0.78 (95% CI, 0.64-0.95) for all
    colorectal cancers, 0.81 (95% CI, 0.65-1.00) for colon cancer, and 0.71 (95% CI, 
    0.47-1.06) for rectal cancer. The adjusted HR for colorectal cancer in vegans was
    0.84 (95% CI, 0.59-1.19); in lacto-ovo vegetarians, 0.82 (95% CI, 0.65-1.02); in 
    pescovegetarians, 0.57 (95% CI, 0.40-0.82); and in semivegetarians, 0.92 (95% CI,
    0.62-1.37) compared with nonvegetarians. Effect estimates were similar for men
    and women and for black and nonblack individuals.
    CONCLUSIONS AND RELEVANCE: Vegetarian diets are associated with an overall lower 
    incidence of colorectal cancers. Pescovegetarians in particular have a much lower
    risk compared with nonvegetarians. If such associations are causal, they may be
    important for primary prevention of colorectal cancers.
  • Orlich MJ, Jaceldo-Siegl K, Sabaté J, Fan J, Singh PN, Fraser GE. Patterns of food consumption among vegetarians and non-vegetarians. Br J Nutr. 2014 Nov 28;112(10):1644-53. doi: 10.1017/S000711451400261X. Epub 2014 Sep 23. PubMed PMID: 25247790; PubMed Central PMCID: PMC4232985. ( 11/2014 )
    Vegetarian dietary patterns have been reported to be associated with a number of 
    favourable health outcomes in epidemiological studies, including the Adventist
    Health Study 2 (AHS-2). Such dietary patterns may vary and need further
    characterisation regarding foods consumed. The aims of the present study were to 
    characterise and compare the food consumption patterns of several vegetarian and 
    non-vegetarian diets. Dietary intake was measured using an FFQ among more than
    89 000 members of the AHS-2 cohort. Vegetarian dietary patterns were defined a
    priori, based on the absence of certain animal foods in the diet. Foods were
    categorised into fifty-eight minor food groups comprising seventeen major food
    groups. The adjusted mean consumption of each food group for the vegetarian
    dietary patterns was compared with that for the non-vegetarian dietary pattern.
    Mean consumption was found to differ significantly across the dietary patterns
    for all food groups. Increased consumption of many plant foods including fruits, 
    vegetables, avocados, non-fried potatoes, whole grains, legumes, soya foods, nuts
    and seeds was observed among vegetarians. Conversely, reduced consumption of
    meats, dairy products, eggs, refined grains, added fats, sweets, snack foods and 
    non-water beverages was observed among vegetarians. Thus, although vegetarian
    dietary patterns in the AHS-2 have been defined based on the absence of animal
    foods in the diet, they differ greatly with respect to the consumption of many
    other food groups. These differences in food consumption patterns may be
    important in helping to explain the association of vegetarian diets with several 
    important health outcomes.
  • Orlich MJ, Fraser GE. Vegetarian diets in the Adventist Health Study 2: a review of initial published findings. Am J Clin Nutr. 2014 Jul;100 Suppl 1:353S-8S. doi: 10.3945/ajcn.113.071233. Epub 2014 Jun 4. Review. PubMed PMID: 24898223; PubMed Central PMCID: PMC4144107. ( 6/2014 )
    The Adventist Health Study 2 is a large cohort that is well suited to the study
    of the relation of vegetarian dietary patterns to health and disease risk. Here
    we review initial published findings with regard to vegetarian diets and several 
    health outcomes. Vegetarian dietary patterns were associated with lower body mass
    index, lower prevalence and incidence of diabetes mellitus, lower prevalence of
    the metabolic syndrome and its component factors, lower prevalence of
    hypertension, lower all-cause mortality, and in some instances, lower risk of
    cancer. Findings with regard to factors related to vegetarian diets and bone
    health are also reviewed. These initial results show important links between
    vegetarian dietary patterns and improved health.
  • Jacobs DR Jr, Orlich MJ. Diet pattern and longevity: do simple rules suffice?  A commentary. Am J Clin Nutr. 2014 May 28;100(Supplement 1):313S-319S. [Epub ahead of print] PubMed PMID: 24871470; PubMed Central PMCID: PMC4144105. ( 5/2014 )
    Nutritionism reduces dietary advice to statements about a few nutrients, with
    sometimes unintended implications for science, industry, and the public. Although
    reductionist questions about nutrition are legitimate scientifically, a nutrient 
    focus in the public arena forces the food industry to compete with the use of
    nutrient statements. Consumers must interpret information that may not be correct
    or relevant. The theory of food synergy, which postulates that the many
    constituents of individual foods and dietary patterns act together on health,
    leads to the idea that dietary policy would be clearer if it focused on foods. To
    illustrate this method, the food-based A Priori Diet Quality Score was described 
    in the Iowa Women's Health Study; a substantial total mortality reduction for
    increasing quartiles of the score was found. The simple food-based rules implied 
    in this a priori score support minimizing meat, salt, added sugar, and heavily
    processed foods while emphasizing phytochemical-rich foods. These principles
    could help improve nutrition policy, help industry to supply better food, and
    help to focus future scientific research. Although an understanding of what foods
    are best for health is a step forward in nutrition, other major challenges
    remain, including getting high-quality food to the masses and food
    sustainability.
  • Singh PN, Arthur KN, Orlich MJ, James W, Purty A, Job JS, Rajaram S, Sabaté J. Global epidemiology of obesity, vegetarian dietary patterns, and noncommunicable  disease in Asian Indians. Am J Clin Nutr. 2014 May 21;100(Supplement 1):359S-364S. [Epub ahead of print] PubMed PMID: 24847857; PubMed Central PMCID:  PMC4144108. ( 5/2014 )
    An increase in noncommunicable disease (NCD) in India has been attributed to an
    epidemiologic transition whereby, due to urbanization, there is an increase in
    traditional cardiovascular disease risk factors such as obesity. Accumulated
    biomarker data on the "Asian Indian phenotype" identify central obesity, which
    occurs at a lower body mass index (BMI), as a particularly potent risk factor in 
    Asian Indians. A revised WHO case definition for obesity in India [BMI (in
    kg/m(2)) >25] has identified an obesity epidemic that exceeds 30% in some cities 
    and rivals that in Western nations. This review summarizes 2 key lines of
    evidence: 1) the emergence of an obesity epidemic in urban and rural India and
    its contribution to the NCD burden and 2) the role of a "nutrition transition" in
    decreasing the whole plant food content of diets in India and increasing risk of 
    obesity and NCDs. We then present new epidemiologic evidence from Asian Indians
    enrolled in the Adventist Health Study 2 that raises the possibility of how
    specific whole plant foods (eg, nuts) in a vegetarian dietary pattern could
    potentially prevent obesity and NCDs in a target population of >1 billion
    persons.
  • Orlich MJ, Singh PN, Sabaté J, Jaceldo-Siegl K, Fan J, Knutsen S, Beeson WL, Fraser GE. Vegetarian dietary patterns and mortality in Adventist Health Study 2. JAMA Intern Med. 2013 Jul 8;173(13):1230-8. doi: 10.1001/jamainternmed.2013.6473. PubMed PMID: 23836264; PubMed Central PMCID: PMC4191896. ( 7/2013 )
    IMPORTANCE: Some evidence suggests vegetarian dietary patterns may be associated 
    with reduced mortality, but the relationship is not well established.
    OBJECTIVE: To evaluate the association between vegetarian dietary patterns and
    mortality.
    DESIGN: Prospective cohort study; mortality analysis by Cox proportional hazards 
    regression, controlling for important demographic and lifestyle confounders.
    SETTING: Adventist Health Study 2 (AHS-2), a large North American cohort.
    PARTICIPANTS: A total of 96,469 Seventh-day Adventist men and women recruited
    between 2002 and 2007, from which an analytic sample of 73,308 participants
    remained after exclusions.
    EXPOSURES: Diet was assessed at baseline by a quantitative food frequency
    questionnaire and categorized into 5 dietary patterns: nonvegetarian,
    semi-vegetarian, pesco-vegetarian, lacto-ovo-vegetarian, and vegan.
    MAIN OUTCOME AND MEASURE: The relationship between vegetarian dietary patterns
    and all-cause and cause-specific mortality; deaths through 2009 were identified
    from the National Death Index.
    RESULTS: There were 2570 deaths among 73,308 participants during a mean follow-up
    time of 5.79 years. The mortality rate was 6.05 (95% CI, 5.82-6.29) deaths per
    1000 person-years. The adjusted hazard ratio (HR) for all-cause mortality in all 
    vegetarians combined vs nonvegetarians was 0.88 (95% CI, 0.80-0.97). The adjusted
    HR for all-cause mortality in vegans was 0.85 (95% CI, 0.73-1.01); in
    lacto-ovo-vegetarians, 0.91 (95% CI, 0.82-1.00); in pesco-vegetarians, 0.81 (95% 
    CI, 0.69-0.94); and in semi-vegetarians, 0.92 (95% CI, 0.75-1.13) compared with
    nonvegetarians. Significant associations with vegetarian diets were detected for 
    cardiovascular mortality, noncardiovascular noncancer mortality, renal mortality,
    and endocrine mortality. Associations in men were larger and more often
    significant than were those in women.
    CONCLUSIONS AND RELEVANCE: Vegetarian diets are associated with lower all-cause
    mortality and with some reductions in cause-specific mortality. Results appeared 
    to be more robust in males. These favorable associations should be considered
    carefully by those offering dietary guidance.
  • Singh Pramil N, Arthur Kristen N, Orlich Michael J, James Wesley, Purty Anil, . . . Sabate Joan. (2014). Global epidemiology of obesity, vegetarian dietary patterns, and noncommunicable disease in Asian Indians. American Journal of Clinical Nutrition, 100(1), 359S-364S. ( 7/2014 - Present ) Link...
    An increase in noncommunicable disease (NCD) in India has been attributed to an epidemiologic transition whereby, due to urbanization, there is an increase in traditional cardiovascular disease risk factors such as obesity. Accumulated biomarker data on the "Asian Indian phenotype" identify central obesity, which occurs at a lower body mass index (BMI), as a particularly potent risk factor in Asian Indians. A revised WHO case definition for obesity in India [BMI (in kg/m(2)) >25] has identified an obesity epidemic that exceeds 30% in some cities and rivals that in Western nations. This review summarizes 2 key lines of evidence: 1) the emergence of an obesity epidemic in urban and rural India and its contribution to the NCD burden and 2) the role of a "nutrition transition" in decreasing the whole plant food content of diets in India and increasing risk of obesity and NCDs. We then present new epidemiologic evidence from Asian Indians enrolled in the Adventist Health Study 2 that raises the possibility of how specific whole plant foods (eg, nuts) in a vegetarian dietary pattern could potentially prevent obesity and NCDs in a target population of >1 billion persons.
  Books and Chapters
  • Chapter title:  Risk of Cancer in Vegetarians (Chapter 5)
    Chapter authors: Michael J. Orlich and Renae M. Thomas
    Book title: Vegetarian Nutrition and Wellness
    Editor: Winston Craig
    Publisher: CRC Press, 2018

    ( 10/2018 ) Link...
  • Chapter 24. "Vegetarian Diets and the Microbiome" - Michael J. Orlich, Gina Siapco and Sarah Jung
    Vegetarian and Plant-Based Diets in Health and Disease Prevention
    1st Edition
    Editors: François Mariotti
    eBook ISBN: 9780128039694
    Hardcover ISBN: 9780128039687
    Imprint: Academic Press
    Published Date: 30th May 2017
    Page Count: 922 ( 5/2017 ) Link...
    https://www.elsevier.com/books/vegetarian-and-plant-based-diets-in-health-and-disease-prevention/mariotti/978-0-12-803968-7


  Non-Scholarly Journals
  • "Roy Branson: I Know in Part", a memorial poem, published in Spectrum ( 10/2015 )
  • "The Weightier Matters: Adventists and Obesity" by Gary E. Fraser and Michael J. Orlich in The Advenist Review ( 3/2015 )
  • A poem, "Communications Tower", published by Inlandia: INLANDIA: A LITERARY JOURNEY (THE OFFICIAL LITERARY JOURNAL OF THE INLANDIA INSTITUTE) ( 1/2015 ) Link...
  Abstract
  • Fraser G, & Orlich M. (2013). BIAS ASSOCIATED WITH SYSTEMATIC ERROR IN A BINARY DEPENDENT REGRESSION VARIABLE. Am J Epidemiol, 177, S103-S103. ( 6/2013 - Present )