Cohort profile the adventist health study 2

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Many also avoid caffeine-containing African-Americans resulted in the National Cancer Institute beverages. However, adherence to these recommendations is funding Loma Linda University to undertake AHS-2, with the quite variable. Adventists in North America are almost entirely a non- Table 1 provides an overview and compares some character- smoking population.

The vast majority are non-drinkers and istics of AHS-2 with the other Seventh-day Adventist cohort the small number who consume alcohol do so infrequently. But studies in California. Two previous longitudinal studies in California showed a small percentage are total vegetarians, many follow a lacto-ovo-vegetarian diet or eat meat less than once per week semi-vegetarian and about What does it cover?

AHS-1 10—13 from —88 indicated that Adventists had lower The primary aims of the currently funded study are to risks for most cancers, cardiovascular disease and diabetes. These provide further evidence of a possible protective role of vitamin studies also showed the advantage of a vegetarian diet among D for these cancers; to further evaluate a possible protec- Adventists, found strong evidence that meat increased risk tive effect of dietary calcium on risk of colon cancer, and a of colon cancer13 and coronary heart disease11,15, and that nut possible hazardous effect on risk of prostate cancer; and to help consumption reduced risk of coronary heart disease11, Other decide whether dietary linolenic acid increases risk of prostate significant associations between cancers and other foods have cancer.

The study will also investigate possible dietary causes for the In the USA, it is estimated that there will be 1 new particularly high incidence of prostate cancer in a population of cases of cancer in prostate , breast and African-American men, and compare this incidence with that colon It has been suggested that the lower incidence of a Caucasian male population adhering to a broadly similar lifestyle.

Who is in the sample? The sample includes Seventh-day Adventist church members E-mail: tbutler llu. There are smaller num- bers from other ethnic minorities. Although church membership records do not contain data on age, race and gender, church officials estimate that of those members who regularly attend English language churches and are 30 years or older, approximately 90 are Black members and are non-Black members Figure 1.

Enrolment commenced in February and by May more than 96 participants had completed the lengthy lifestyle questionnaire. There is a wide geographic spread of participants Figure 2. The data presented in this article pertains to the 90 participants for whom information on the reported variables has been checked and is currently available.

Recruitment The basic recruitment model targeted the two major English- was church-by-church and staged by geographic region. For video, posters and announcements were provided. This challenging during the 7—8 weeks of promotion. However, the actual process has never previously been attempted.

Because each recruitment approach differed between the Black and non- state registry has its own set of requirements and application Black churches. Promotion consisted of brief presenta- will be streamlined in the next few years, thus also benefiting tions to the congregation and the distribution of enrolment other national cancer studies.

The completed forms were sent to the AHS-2 office for programmer travels to each state and uses identical protocols processing and enrollees were mailed a questionnaire. The possible matches are then resolved with churches received a personalized enrolment certificate and an software developed by AHS-2 and even with larger registries AHS-2 ballpoint pen. In addition, previous 2 years.

Limited additional data on lifestyle and coordinators and pastors received a financial incentive of demographic factors is also collected. The second HHF mailed in included Reminder postcards were mailed to all non-responding additional questions about sun exposure. In year two, the local recruitment model was supplemented with a national advertising campaign and Clinics in churches featured articles in church magazines mailed to Subject to the availability of funding, during years —10, we Adventist households, presentations at regional church con- plan to conduct clinics in churches to collect fasting blood vocations and on Adventist TV stations.

All advertising specimens and subcutaneous fat from much of the cohort. Finally, a single direct mail invitation was sent to from church to church testing about 35 subjects each day.

The bio-repository will enable us to use biological variables as prospective exposures to complement dietary analyses How often will study subjects be and provide additional information about mechanisms and to followed-up?

Table 1. The first 5 years of the study concentrated on cohort assembly, collection of baseline lifestyle and health history data, quality control of the data and validation studies for the What has been measured? The self-administered question- naire is quite lengthy and takes on average 1. It consists of nearly data fields divided into Follow-up of morbidity and mortality outcome is accomplished sections for medical, diet, physical activity, female history, in several ways: identified by participant self-report followed by supplement use and vegetarian food consumption.

Web obtaining hospital records, linkage with State Tumor Registries Table 2 and linkage with the National Death Index in and The food frequency component is the largest and most important part of the questionnaire. For each index we The Adventist cohort has some advantages that assist us identified 3—4 key variables. For moderate lists are maintained by each local church, and when a member amounts of missing data rescue telephone calls are made or the moves from one Adventist church to another, a paper trail of missing blank pages are re-mailed.

We then use the NCS i church transfer is usually created. Also, many Adventists locate scanner to optically scan the questionnaire data to a computer or retire in predominantly Adventist communities. This What has AHS-2 found? The study was started in , and by early recruitment was almost complete. Web Tables 3—5 report some baseline Calibration study lifestyle characteristics and prevalence data. Incidence data will A calibration study of participants now enrolled , soon be collected and will accrue to numbers adequate for to conclude in , provides validation data for self-reported analyses by , when we expect to have incident colon diet, physical activity and sun exposure.

Web Table 3 reports demographic characteristics. Adventist of whom See Web Table 3 three h dietary recalls and two 1 week physical activity Web Table 4 describes selected lifestyle and dietary character- recalls, 6 months apart. In the middle of the dietary recalls istics. Notably, only 1. Mean body mass index was A mobile team of two females and An over-night urine Of particular interest is the wide diversity of dietary status in sample is collected and aliquoted, blood pressure and body this population.

Based on the analysis of 27 relevant food composition are measured. Blood is drawn and a subcutaneous questions, 4. For the last subjects, we used a This provides an index of tanning to help validate non-vegetarian.

A wide distribution is also seen in the sun exposure. In AHS-1 —88 , we were able to track What are the main strengths and In AHS-2, we devote considerable effort to minimize attrition. This includes: an annual newsletter; quarterly est in health research; low levels of smoking and alcohol email communication to participants with an email contact; consumption that reduce the effect of confounding; support at articles in church magazines; presentations at annual church all levels of church organization and cooperation of local regional convocations and promotion of the AHS-2 website.

Cancer, coronary artery disease, and smoking: a and unique in scope: conducting church-based clinics preliminary report on differences in incidence between Seventh-day across North America using mobile teams of technicians to Adventists and others. Calif Med ;— Cancer and coronary artery disease with 60 state and provincial tumour registries. Both compo- among Seventh-day Adventists.

Cancer ;— Diet, Life Expectancy and Chronic Disease. Studies of Seventh-day and both will establish tested methodologies that will benefit Adventists and Other Vegetarians. New York: Oxford University Press, other large nationwide cohort studies. Association between tionnaire—this discouraged many from participating; the low reported diet and all-cause mortality. Twenty-one year follow-up on 27, adult Seventh-day Adventists. Am J Epidemiol proportion of males, especially Black males; low representation ;— Mortality in Spanish; a somewhat lower disease risk group, thus among California Seventh-day Adventists for selected cancer sites.

Diet and lung cancer in California Seventh-day Adventists. Am J Epidemiol ;— A possible protective effect Where can I find out more and what is of nut consumption on risk of coronary heart disease. Arch Int Med ;— The probable role of nuts in preventing coronary The study is still in progress and access to the data is not yet heart disease. Primary Cardiology ;— Dietary risk factors for colon cancer in a low-risk tion on specific projects. Further details of the study are population.

Ten years of life. Is it a matter of choice? Linda University. Meat consumption and fatal ischemic heart disease. Prev Med ;— Dietary habits and breast cancer incidence among seventh-day adventists. Cancer Supplementary data ;— Supplementary data are available at IJE online. Cohort study of diet, lifestyle, and prostate cancer in adventist men.

Does high soy milk intake Acknowledgements reduce prostate cancer incidence? Cancer Causes Control ;— Cancer up. The cooperation and support of church officials, and the statistics, CA Cancer J Clin ;— Population-based case-control study of US and Canada were invaluable for the success of recruitment.

Br J Cancer We thank the primary investigators, research staff, consultants ;— Cancer Sci ;— The study is still in progress and access to the data is not yet freely available but the investigators would welcome collaboration on specific projects.

Further details of the study are available from the study website www. We recognize the commitment of the 96 study participants in completing the lengthy lifestyle questionnaire and in follow-up.

The cooperation and support of church officials, and the thousands of recruitment volunteers in churches throughout US and Canada were invaluable for the success of recruitment. We thank the primary investigators, research staff, consultants and the pilot study Tumor Registrars.

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Search Menu. Article Navigation. Close mobile search navigation Article Navigation. Volume Article Contents How did the study come about? What does it cover? Who is in the sample? Enrolment methods. How often will study subjects be followed-up?

What has been measured? What is the rate of loss likely to be? What has AHS-2 found? What are the main strengths and weaknesses? Where can I find out more and what is the potential for collaboration? Journal Article.

E-mail: tbutler llu. Oxford Academic. Gary E Fraser. W Lawrence Beeson. R Patti Herring. Jacqueline Chan. Susanne Montgomery. Ella Haddad. Susan Preston-Martin. Hannelore Bennett , Hannelore Bennett. Karen Jaceldo-Siegl. Select Format Select format. Permissions Icon Permissions. How did the study come about? Open in new tab. Figure 1. Open in new tab Download slide. Figure 2. Distribution of participants by geographical region as of May 31, Cancer of the lung and mouth in Seventh-day Adventists: A preliminary report on a population study.

Google Scholar Crossref. Search ADS. Role of lifestyle and dietary habits in risk of cancer among Seventh-day Adventists. Google Scholar PubMed. Rationale and method for an epidemiologic study of cancer among Seventh-day Adventists.

Coronary heart disease mortality among Seventh-day Adventists with differing dietary habits: a preliminary report. Cancer, coronary artery disease, and smoking: a preliminary report on differences in incidence between Seventh-day Adventists and others.

Association between reported diet and all-cause mortality. Twenty-one year follow-up on 27, adult Seventh-day Adventists. Mortality among California Seventh-day Adventists for selected cancer sites. A possible protective effect of nut consumption on risk of coronary heart disease. The Adventist Health Study. Does high soy milk intake reduce prostate cancer incidence?

Population-based case-control study of soyfood intake and breast cancer risk in Shanghai. A case-control study of diet and prostate cancer in Japan: possible protective effect of traditional Japanese diet.

Adolescent and adult soy intake and risk of breast cancer in Asian-Americans. Understanding the challenges in recruiting blacks to a longitudinal cohort study: the Adventist Health Study.

Recruiting blacks to the Adventist Health Study: Do follow-up phone calls increase response rates? Comparing self-reported disease outcomes, diet, and lifestyles in a national cohort of black and white Seventh-day Adventists.

Sensitivity and PPV of tumor registry matching for a nation-wide cohort study. Feasibility of running clinics to collect biological specimens in a nationwide cohort study-Adventist Health Study a brief report.

A multivariate method for measurement error correction using pairs of concentration biomarkers. Comparison of adipose tissue fatty acids with dietary fatty acids as measured by hour recall and food frequency questionnaire in Black and White Adventists: the Adventist Health Study.

Validation of assessment of nutrient intake. Comparing biological measurements of vitamin C, folate, alpha-tocopherol and carotene with hour dietary recall information in non-Hispanic blacks and whites. Urinary 1-methyl histidine is a marker of meat consumption in black and white California Seventh-day Adventists. Validity of a physical activity questionnaire among African-American Seventh-day Adventists. Validity of selected physical activity questions in white Seventh-day Adventists and non-Adventists.

Guided multiple imputation of missing data: using a subsample to strengthen the missing-at-random assumption. Issue Section:. Download all slides. Supplementary data. Supplementary Data - zip file. Views 8, More metrics information. Email alerts Article activity alert. Advance article alerts. New issue alert. Receive exclusive offers and updates from Oxford Academic. Related articles in Web of Science Google Scholar.

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