The Adventist Health Message Unpacked

Since its organization as a denomination in the mid-19th century, the Seventh-day Adventist (SDA) church has been advocating the counsel of the church’s primary health reformer, Ellen White, which emphasizes the role of lifestyle in promoting health, happiness and enhanced spirituality1. In 1905, Ellen White consolidated her counsel into this graphic statement: “Pure air, sunlight, abstemiousness, rest, exercise, proper diet, use of water, trust in divine power – these are the true remedies”2. Consequently, it is not surprising that research on the health of SDA since the 1950’s has shown that they appear to enjoy low rates of chronic diseases and lower total mortality, despite living in areas where chronic diseases are prevalent3. Science is only now validating the significance of this 19th century counsel and its importance for physical and mental health as chronic disease rates escalate in the 21st century. Let’s examine the importance of each of these elements in light of current scientific knowledge

Does the Prescriptive Lifestyle of Seventh-day Adventists Provide Immunity from the Secular Effects of Changes in BMI?

Objective: To examine the effect of Seventh-day Adventist (SDA) membership on ‘immunity’ to the secular effects of changes in BMI. Design: Three independent, cross-sectional, screening surveys conducted by Sydney Adventist Hospital in 1976, 1986 and 1988 and a survey conducted among residents of Melbourne in 2006. Subjects: Two hundred and fifty-two SDA and 464 non-SDA in 1976; 166 SDA and 291 non-SDA in 1986; 120 SDA and 300-non SDA in 1988; and 251 SDA and 294 non-SDA in 2006. Measurements: Height and weight measured by hospital staff in 1976, 1986 and 1988; self-reported by respondents in 2006. Results: The mean BMI of non-SDA men increased between 1986 and 2006 (P Conclusion: The ‘prudent’ dietary and lifestyle prescriptions of SDA men appear to have ‘immunised’ them to the secular effects of changes that occurred among non-SDA men’s BMI. The dietary and lifestyle trends of SDA women did not reflect the increase in their BMI observed in 2006

Trends in BMI, diet and lifestyle between 1976 and 2005 in North Sydney

Although the prevalence of overweight and obesity in Australia has increased during the past 30 years, little is known about the dietary and behavioural antecedents of body mass index (BMI). We examined changes in mean BMI, diet, and other lifestyle behaviours between 1976 and 2005 and described the cross-sectional associations between these factors and BMI. A series of biennial biomedical surveys by Sydney Adventist Hospital from 1976 to 2005 allowed examination of BMI trends, while the selection of three surveys enabled detailed examination of likely dietary and lifestyle associations. Subjects included in this study were: 384 men and 338 women in 1976; 160 men and 146 women in 1978; 166 men and 141 women in 1980; 164 men and 142 women in 1982; 177 men and 13 women in 1984; 239 men and 227 women in 1986; 210 men and 225 women in 1988; 165 men and 148 women in 1990; 138 men and 167 women in 1992 and 270 men and 62 women in 2005. Height and weight were measured by hospital staff. Mean BMI increased in the early 1990s. Salt, coffee, cola, alcohol and meat consumption, dieting to lose weight and eating between meals were positively associated with BMI while physical activity, food variety, large breakfasts and consumption of spreads were negatively associated. Food consumption and daily activities have important associations with BMI, though their specific associations differ by sex. \u27Affluent\u27 lifestyle patterns appear to contribute to higher BMI, while a more \u27prudent\u27 lifestyle seems to protect from such increases.<br /

Trends in BMI, diet and lifestyle between 1976 and 2005 in North Sydney

Although the prevalence of overweight and obesity in Australia has increased during the past 30 years, little is known about the dietary and behavioural antecedents of body mass index (BMI). We examined changes in mean BMI, diet, and other lifestyle behaviours between 1976 and 2005 and described the cross-sectional associations between these factors and BMI. A series of biennial biomedical surveys by Sydney Adventist Hospital from 1976 to 2005 allowed examination of BMI trends, while the selection of three surveys enabled detailed examination of likely dietary and lifestyle associations. Subjects included in this study were: 384 men and 338 women in 1976; 160 men and 146 women in 1978; 166 men and 141 women in 1980; 164 men and 142 women in 1982; 177 men and 13 women in 1984; 239 men and 227 women in 1986; 210 men and 225 women in 1988; 165 men and 148 women in 1990; 138 men and 167 women in 1992 and 270 men and 62 women in 2005. Height and weight were measured by hospital staff. Mean BMI increased in the early 1990s. Salt, coffee, cola, alcohol and meat consumption, dieting to lose weight and eating between meals were positively associated with BMI while physical activity, food variety, large breakfasts and consumption of spreads were negatively associated. Food consumption and daily activities have important associations with BMI, though their specific associations differ by sex. “Affluent” lifestyle patterns appear to contribute to higher BMI, while a more “prudent” lifestyle seems to protect from such increases

The Epidemiology of Cryptosporidiosis in Victoria, 2001-2009

Cryptosporidiosis is a protozoan parasitic infection that most commonly presents as gastroenteritis and less commonly infects the respiratory and biliary tracts. Enteric symptoms usually include diarrhoea, bloating, cramping, abdominal pain, vomiting and fever. The disease is usually mild and self-limiting but in immunocompromised individuals is prolonged and can lead to death. The infective dose in humans is low and the incubation period ranges from one to 12 days, with an average of seven days. The infectious period lasts from the onset of symptoms, as the oocysts are excreted in the stool, until several weeks after symptoms resolve. The oocysts are widespread and may remain infective outside the body for two to six months, particularly if the environment is moist. They are highly resistant to standard levels of chemical disinfection of water such as chlorine. Outbreaks have been reported in day care centres, and been associated with drinking water, recreational water (waterslides, swimming pools and lakes) and consumption of contaminated beverages. In Australia, increases in notifications tend to occur in the warmer months and over irregular cycles, with more than 3000 cases notified in Australia in 2002, 2005 and 2006. Cryptosporidiosis became notifiable in both Australia and Victoria in 2001, with more than 15,000 cases notified between 2002 and 2009. The aim of this study was to describe the epidemiology of notified cases of cryptosporidiosis in Victoria for the period 2001 to 2009 in terms of age, sex, location and season

A Positive Association Between Cryptosporidiosis Notifications and Ambient Temperature, Victoria, Australia, 2001-2009

Increased temperatures provide optimal conditions for pathogen survival, virulence and replication as well as increased opportunities for human-pathogen interaction. This paper examined the relationship between notifications of cryptosporidiosis and temperature in metropolitan and rural areas of Victoria, Australia between 2001-2009. A negative binomial regression model was used to analyse monthly average maximum and minimum temperatures, rainfall and the monthly count of cryptosporidiosis notifications. In the metropolitan area, a 1°C increase in monthly average minimum temperature of the current month was associated with a 22% increase in cryptosporidiosis notifications (IRR 1.22; 95% CI 1.13 – 1.31). In the rural area, a 1°C increase in monthly average minimum temperature, lagged by 3 months, was associated with a 9% decrease in cryptosporidiosis notifications (IRR 0.91; 95% CI 0.86 – 0.97). Rainfall was not associated with notifications in either area. These relationships should be considered when planning public health response to ecological risks as well as when developing policies involving climate change. Rising ambient temperature may be an early warning signal for intensifying prevention efforts, including appropriate education for pool users about cryptosporidiosis infection and management, which might become more important as temperatures are projected to increase as a result of climate change

The Merged Reflect/Complete Health Improvement Program (CHIP) in the South Pacific - A Pilot Study

Background/Aims: Chronic diseases (CDs) have reached epidemic proportions in Pacific Island countries. Unhealthy lifestyle is one of the major risk factors and lifestyle interventions have been shown to be efficacious for primary, secondary and early tertiary prevention. However, there is a paucity of evidence regarding effective community-based lifestyle interventions in the South Pacific (SP). This study examined the effectiveness of a contextualised version of the evidence-based CHIP intervention, utilising the low-literacy REFLECT approach. Methods: A 30-day cluster-RCT of 48 adults with elevated risk (waist circumference _ 92 cm for men and _ 80 cm for women), in two rural Fijian villages was conducted. Intervention participants (n ¼ 24) met three times a week to receive the program. Control participants (n ¼ 24) received only country-specific Ministry of Health literature. Outcome assessments at baseline and 30 days included BMI, WC, blood pressure, lipids and glucose. The extent of the change in each measures between intervention and control villages was assessed using mixed betweenwithin ANOVA. Results: In 30 days, significant reductions were recorded for intervention participant’s BMI (2%), SBP (10%), DBP (8%), T-cholesterol (6%), LDL (12%), HDL (15%) and blood glucose (10%), while triglycerides increased 35%. Only DBP (7%) and T-cholesterol (8%) decreased in the control group. Conclusions: This is the first lifestyle intervention using the REFLECT approach to target CDs in the SP. Significant reductions in selected CD risk factors were observed in 30 days, being comparable to cohorts in first world countries. Larger scale research is warranted to assess broader delivery of this lifestyle intervention across the SP. Funding source(s): N/

Don\u27t Forget the Brain: Lifestyle Medicine in the Century of Neurodegeneration

Neurology is often not discussed in lifestyle medicine circles, but it might be an area that will propel the cause of lifestyle medicine in the future. This is especially relevant in increasingly common neurodegenerative conditions such as Alzheimer’s disease, which have no known disease modifying therapy but lifestyle factors are implicated in causation

\u27Live More\u27: Study Protocol for a Community-Based Lifestyle Education Program Addressing Non-Communicable Diseases in Low-Literacy Areas of the South Pacific

Background Non-communicable diseases (NCDs) have reached epidemic proportions in Pacific Island countries. Unhealthy lifestyle is one of the major risk factors and lifestyle interventions have been shown to be efficacious for primary, secondary and early tertiary prevention. However, there is a paucity of evidence regarding effective community-based lifestyle interventions in the Pacific Islands. The Complete Health Improvement Program for high-income countries was contextualised for rural communities with relatively low-literacy rates in low-income countries using the REFLECT delivery approach. This study will assess the effect of this ‘Live More’ program to reduce participant’s NCD risk factors and improve lifestyle behaviours associated with health and wellbeing, in low-literacy communities in countries of the South Pacific. Methods/Design This study is a 6-month cluster-randomised controlled trial of 288 adults (equal proportions of men and women aged 18 years and over) with waist circumference of ≥92cm for men and ≥80cm for women in four rural villages in each of Fiji, Vanuatu and Solomon Islands. Participants will permanently reside in their village and be able to prepare their own meals. Two villages will be randomised to the ‘Live More’ intervention (n=24) or to control receiving only country specific Ministry of Health literature (n=24). Intervention participants will meet three times a week in the first month, then once a week for the next two months and once a month for the last three months. Themes covered include: NCDs and their causes; and the benefits of positive lifestyle choices, positive psychology, stress management, forgiveness and self-worth, and how these influence long-term health habits. Outcome assessments at baseline, 30-days, 3-months and 6-months include body mass index, waist circumference, blood lipids, blood pressure and blood glucose. Secondary outcomes include changes in medication and substance use, diet, physical activity, emotional health and supportive relationships, collected by lifestyle questionnaire at the same time points. Discussion This is the first lifestyle intervention using the Reflect approach to target NCDs. The findings from the study will be used to guide broader delivery of a lifestyle intervention to improve health and wellbeing across the South Pacific

Salmonellosis Outbreak Linked to the Consumption of Fried Ice-Cream

On 8 April 2011, the Communicable Disease Prevention and Control Unit (CDPCU) of the Victorian Department of Health was advised that three adolescents from the same family had been admitted to a metropolitan hospital for treatment of dehydration secondary to diarrhoea. Other symptoms included fever and vomiting. Initial enquires suggested that the adolescents may have become infected after eating fried eggs for breakfast at their aunt’s home over three consecutive days, or dinner at a Chinese restaurant. Six days later two more notifications of salmonellosis were received by CDPCU; both cases had eaten at the same Chinese restaurant. Also on this day, the Department was notified that Salmonella spp. was isolated from two of the original adolescent’s faecal specimens. An investigation was initiated to characterise the outbreak, identify the source and possible cause of the infection and to prevent ongoing transmission of the infection