Associations between diet and cancer, ischemic heart disease, and all-cause mortality in non-Hispanic white California Seventh-day Adventists

Results associating diet with chronic disease in a cohort of 34 192 Califor nia Seventh-day Adventists are summarized. Most Seventh-day Adventists do n ot smoke cigarettes or drink alcohol, and there is a wide range of dietary exposures within the population. About 50% of those studied ate meat produc ts <1 time/wk or not at all, and vegetarians consumed more tomatoes, legume s, nuts, and fruit, but less coffee, doughnuts, and eggs than did nonvegeta rians. Multivariate analyses showed significant associations between beef c onsumption and fatal ischemic heart disease (IHD) in men [relative risk (RR ) = 2.31 for subjects who ate beef greater than or equal to 3 times/wk comp ared with vegetarians], significant protective associations between nut con sumption and fatal and nonfatal MD in both sexes (RR approximate to 0.5 for subjects who ate nuts greater than or equal to 5 times/wk compared with th ose who ate nuts <1 time/wk), and reduced risk of IHD in subjects preferrin g whole-grain to white bread. The lifetime risk of IHD was reduced by appro ximate to 31% in those who consumed nuts frequently and by 37% in male vege tarians compared with nonvegetarians. Cancers of the colon and prostate wer e significantly more likely in nonvegetarians (RR of 1.88 and 1.54, respect ively), and frequent beef consumers also had higher risk of bladder cancer. Intake of legumes was negatively associated with risk of colon cancer in n onvegetarians and risk of pancreatic cancer. Higher consumption of all frui t or dried fruit was associated with lower risks of lung, prostate, and pan creatic cancers. Cross-sectional data suggest vegetarian Seventh-day Advent ists have lower risks of diabetes mellitus, hypertension, and arthritis tha n nonvegetarians. Thus, among Seventh-day Adventists, vegetarians are healt hier than nonvegetarians but this cannot be ascribed only to the absence of meat.