AMEN 2012: Testimony

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Adventist Medical Evangelism Network (AMEN)

AMEN 2012 Seminars

Jennifer Schwirzer

Cutting Edge Counseling: Clinical Experience in the Healing Power of the Gospel

And so some people know me through my scripture songs and different things that I've done with that.

When I was early on in that music part of my life, I lost the name Schwoerzer because people couldn't say it.

You know, they'd get up to introduce me and they'd say, and now we'll hear from Jennifer Jill Sch...

And they just couldn't get the word out of their mouth.

So I decided to lose that, and I started to be Jennifer Jill.

But then I started to write books and get more serious.

And I finally grew up, I guess, and figured out what I wanted to be when I grew up.

And I went back to school and got a degree and wrote some serious books and decided I should go back to my real name, Jennifer Jill Schwerzer.

Kind of like the sound that a blender makes, okay?

And you all know blenders because you're vegans, right?

My first name means white 1 and schwerzer means painted black.

But actually, I'm married to a wonderful man for 33 years.

And I think I understand there's research that the brain works better when you're wearing bare feet.

So I'm a little quantitative study, or qualitative study, I should say, walking around proving it.

Because I just feel, when I get up to speak, I just feel compelled to take my shoes off.

I figure maybe I'm on holy ground or something.

But anyway, so I have 2 young adult daughters.

You can be in the midst of this urban area, and then suddenly you're in the country.

There's a beautiful park called Fairmount Park that cuts right through the center of the city.

In fact, you can ride a bike from the suburbs straight to the art center downtown.

I've really enjoyed being there over the last 10 years.

Great ethnic mix, great culture, the oldest city in the US, and a lot of natural beauty all around.

So I live there, And I work with a local church doing evangelism, surprise.

We have the most exciting thing that's kind of making my heart beat these days is a church plant that we have with young people where my pastor, Pastor Tara Vincross, has started a canvassing program in the summer called Pennsylvania Youth Challenge.

We have 30 strong canvassers come for the last, I think we're going on our fourth year.

And collectively over last summer we reached, I believe it was 75, 000 homes by going door to door.

So there are great things happening in Philadelphia.

We decided to take that young energy and start a church plant.

And so we have an organization called REACH Philadelphia, which Don't ask me, all those letters have significance, but I don't remember what they're all standing for.

But Reach Philadelphia is obviously about, surprise, reaching Philadelphia.

We have 8 interns that live in 2 houses, housing that was donated.

1 of them donated through my non-profit ministry.

And they live in those homes and they do either part-time or full-time evangelism for Philadelphia.

They're doing a block party this weekend.

They're doing evangelistic series in their homes with doctrinal teaching.

There's a kid that happens to have 1 of those big, loud proclamation voices.

You know how some people just have a lot of vocal volume?

I just went out with him last week, and he's just a ball of energy.

And he just bursts out with, I am here in the name of the most high God.

So we have a lot of really encouraging and exciting stuff going on among the young people.

And as you can see, that's what animates me these days.

I guess I like hanging out with the young people because I'm not so young anymore.

But by the way, did you know that there's research that shows that hanging out with young people and interfacing with young people and being in relationship and dialogue with younger people actually helps to stave off aging of the brain and prevent dementia.

I'm kind of rattling on here, but let me tell you this.

There's a certain level of self-consciousness when you're with people that look perfect and young and in the flush of youth and are so energetic and you're kind of getting old and starting to break down.

It is a little self-consciousness factor and you kind of wonder if they'll like you and want to be around you.

What I have found is the exact opposite, that they love it when older people just join with them in friendship and support them and encourage them.

They will wrap their hearts and their arms around you and you will be most welcome in their lives has been my experience.

So anyway, that's what I'm doing these days in Philadelphia and really enjoying it.

Michael Orlich

Adventist Health Study

My name is Michael Orlich, and I am a researcher with Adventist Health Studies, a research fellow, and I also work at Loma Linda in the preventive medicine department directing the preventive medicine residency there and They asked us to do a presentation from the Adventist Health Study the theme of the overall conference here is testimony and they thought that Adventist health study provided sort of a global testimony for Adventism in some way.

And so we'll explore that concept a little bit together.

Mainly, my main objectives are to give you an overview and an update of the study so that you understand it well.

This is a CME seminar, so If you're signed up for that, make sure you sign in today and also do your evaluation form after.

But the objective is to look a little bit at the history of Adventist health studies, as there have been several over a considerable period of time, to discuss some of the key findings of the earlier studies, as well as some recent findings of the current study, Adventist Health Study 2, and to describe some of the immediate future goals and expectations for the current study, and then to ask together some important questions about what is the meaning of Adventist health study to Seventh-day Adventists and to the world?

I won't provide those answers, but I'll raise some of the questions.

A little bit of an overview, looking back at the history of the study.

This is actually the third major Adventist health study, if you will, although we call it Adventist health study 2.

Research on Seventh-day Adventists and health goes back a ways to the first dean of the School of Public Health, Dr.

And he did a doctorate in public health at Harvard and then did studies, nutritional studies of Seventh-day Adventist vegetarians.

And back at that time, people were most concerned about the nutritional adequacy of a vegetarian diet, and his studies were along those lines.

The 50s, in the 50s, was the first Adventist health study that we referred to as Adventist mortality study.

And it was among California Seventh-day Adventists.

And then in the 70s, there was a follow-up study of about 35, 000 California Seventh-day Adventists, all white or Caucasian.

And we're still following many of those subjects today.

Out of that study, there's also a sub-study that we call the Off-Smog Study, and it's looking at the effects of air pollution, or smog, in those study subjects that live in Southern California.

And then more recently, starting in 2002 to 2007, we enrolled nearly 100, 000 Seventh-day Adventists across North America, so a much wider population, United States and Canada that is, with more ethnic diversity, with a substantial percentage of African Americans as well as Caucasians and smaller numbers of other racial and ethnic groups and with greater power overall because of the larger numbers.

So studies among Seventh-day Adventists have been recognized by study funders at the National Institutes of Health as being important in a number of ways.

There are certain advantages and, of course, disadvantages to studies among Adventists like there would be in any other group.

Among Adventists, 1 of the helpful things is there's both homogeneity that's helpful as well as heterogeneity that's helpful.

Homogeneity is in regards to certain lifestyle characteristics like the use of tobacco and alcohol.

Those are the 2 that you could point to most easily where there's very little use of these substances in the population.

And So if you're studying other endpoints and you're worried about those as potential confounders, the low prevalence of those in the population is helpful.

Similarly, if you're worried about potential unmeasured confounders that could confuse the findings of your variable of interest.

The fact that there's a lot shared by this population means that there may be less variability in some of those unmeasured confounders, potentially.

And at the same time, there's quite a bit of heterogeneity, particularly in terms of diet.

And that's the main thing that we're studying, is the effects of diet in Adventist health studies, particularly when it comes to the range of vegetarian spectrum, the use of meat, the use of animal products, and sort of by implication, the use of a variety of other plant foods, there's much greater range of intakes, going from 0 up to very high intakes compared to an average population like say the nurses health study or something like that.

So the Adventist mortality study started back in the 50s, as I said, and it was at the same time as a larger American Cancer Society study, and it allowed mortality comparisons between these 2 groups.

And this was 1 of the first things that pointed to a longevity advantage among Adventists.

These are a brief summary of some of the results.

Lower risk of coronary heart disease among vegetarian Adventists compared to non-vegetarian Adventists.

Also there was a mortality association with eggs and a negative association with green salads.

Compared to other Californians, this is comparing to that American Cancer Society study, Adventists experienced lower rates of death for all cancers, lung cancer, colorectal cancer, breast cancer, and coronary heart disease.

And these initial results served as impetus for some of the later funding of additional studies.

You say, well, these folks are living longer and having a reduced risk of certain diseases.

It's great to know that that's true, but why?

Are there certain factors in their lifestyle that everybody could benefit from?

So the first Adventist Health Study or Adventist Health Study won.

As I say, funding lasted until 1988 in 1 form or another, initially by the Cancer Institute, and then heart, lung, blood, and then aging, all part of the National Institutes of Health.

These were some key findings from Adventist Health Study 1.

Vegetarians had a lower risk of obesity, hypertension, diabetes, and death from all causes compared to non-vegetarian Seventh-day Adventists.

In men, the risk of fatal heart disease was significantly related to beef intake.

Regular nut and whole grain consumption were associated with a lower risk of coronary heart disease.

The nut finding was a surprising 1 at the time and has since been verified in a number of other large cohort studies and certainly could be pointed to as a key contribution of Adventist Health Study 1.

The risk of colon cancer was increased by 88% in non-vegetarians compared to vegetarian Adventists, with legumes having a protective effect.

And Adventist Health Study 1, they saw adverse effect for colon cancer risk, both for red meat and white meat.

The white meat is not well established in other studies, whereas red meat is.

And on average, Adventist men live 7.3 years longer, and women 4.4 years longer than other Californians.

And then a reduction in prostate cancer risk with tomato consumption.

These are some key findings from Adventist Health Study 1.

The Osmog study, as I said, was a subsegment of the Adventist Health Study 1 population, those living in Southern California where ambient air pollution levels could be measured.

And because it's a mostly non-smoking population, when you're looking at the effects of smog or air pollution on the risk of, say, lung cancer, the effect is probably rather small, And it's hard to detect small effects and have them be statistically significant and not overwhelmed by some confounding factor.

And when you have a very strong potential confounder, like smoking, it's a hopeless cause.

And so that's 1 of the reasons why this population was good for that.

Then the more recent Adventist Health Study 2, starting in 2002.

And perhaps just a show of hands, how many of you are enrolled as study subjects in the Adventist Health Study 2?

How many, may I say, were enrolled in Adventist Health Study 1?

They were shooting for over 100, 000 Seventh-day Adventists.

Initially didn't quite get there, but about 96, 000 is the total study subject population in the United States and Canada, with about a quarter of that being African Americans.

Then there's a sub-study of the Adventist Health Study II, known by various names, the Bio-Psychosocial-Spiritual Adventist Health Study, or the Adventist Religion and Health Study, which is comprised of about 10, 000 subjects from Adventist Health Study II and looking at issues, as you may have guessed, of psychology and spirituality and social factors on health.

That reminds me, I'm gonna pause just for a moment and do a little bit of show and tell here, which I intended to do.

I brought a few things that we could pass around and you can look at.

This is the, for those who haven't enrolled, that's the questionnaire for Adventist Health Study 2.

And this is the questionnaire for the religion and health study.

So you can get an idea of what some of the questions are that were asked.

And since this is a professional audience, A couple of other resources I thought you might be interested in.

If you really want, there's very little that we can go over in 1 hour, and I'm not up on every facet of the Adventist health studies.

Fraser, by the way, is out of the country right now, So he couldn't be here, but he would have loved to.

Fraser wrote a book published by Oxford University Press.

And this would summarize everything sort of about before year 2000 from the previous studies.

And 1 other book that's certainly worthwhile on the topic of vegetarian nutrition is that of Dr.

He's 1 of the co-investigators of the Adventist Health Study and also the director of the nutrition department in the School of Public Health.

And this is his book, Vegetarian Nutrition.

Another resource that I would point you to, which I'll have a slide on later, is our website, which is simply www.adventishealthstudy.org.

And for example, you can find links to all of the published articles, as well as media releases and videos and old newsletters and the questionnaires.

So you can pretty much learn almost everything you need to about Adventist health study and the research just by going to our website, which has been newly redesigned and is a lot better than it was a couple of years ago.

And I might also say, for those of you who are particularly interested in this topic of diet and health and vegetarian diets and their Impact on the risk of disease and on longevity There's a very good conference that's done only every 5 years at Loma Linda University that's coming up this February.

Keith Hanson

Joel Sabangan

Spirituality in Patient Care

I don't know how it is at your house, but at my house my wife is very much involved in health ministry that goes on.

We do some things Separately, we do some things together.

As we began to prepare for this particular talk for the AMEN meeting this year, we thought it would be a good idea to kind of showcase some community practices where family is involved.

And so we've asked a couple of physicians who I know have been active to share what their family does.

We had the pleasure of working together as family physicians on the island of Guam for several years.

Esther's been very active in the CHIP program and doing it in the community and Keith is active in health education and anxious to help the church mission grow.

So we're going to turn that over to him first.

Those that follow will be Joel and Graziella Sebangin, and they come from south central Oklahoma.

Joel did not grow up in a Seventh-day Adventist community or home, but was converted in medical school.

And has a passion along with Graziella for this whole lifestyle medicine and bringing Christ into the practice, making a difference.

And he's done some unique things as well.

I don't know, are you going to be sharing too?

I am in primary practice, family practice.

Brewster is just a little over an hour south of the Canadian border on Highway 97, right in the middle, center part on the east side of the mountains if you're acquainted at all with Washington State.

So when I got the invitation to talk here, I had to say it's a little bit with trepidation that I approach this.

I emailed George some emails talking about that issue.

So George has been very helpful and encouraging and I've appreciated working with him since the time of Guam.

We've gotten to get together several times since.

So spirituality and patient care here in San Diego.

I added a couple to them that are not in the thing, but particularly this is the scientific portion, if you will, understanding the need to do spiritual care and recognizing the volume of evidence supporting the benefits to spiritual care.

So exactly how do we go about doing it and why should we do it, et cetera.

I have several references that I had meant to bring here and actually show you.

One's this handbook, and I didn't, I left them in the room.

Handbook of Religion and Health, this many of you may be acquainted with, it's fairly thick volume and it's actually has kind of summarized all the studies that they could find on religion and health.

And I used to think, well, there's not very many.

And in reality, there's probably over 4, 000 studies that have been published on religion and health and the outcomes of that.

And so what I will be doing today is not picking specific studies, but showing you the overwhelming evidence of what religion does and what the studies have shown in that respect.

The second is Spirituality and Patient Care, also by Harold Koenig.

He has a very good book and brings up some cautions as well, which I think are worthwhile seeing.

How many of you have seen that book, Gray Matter?

It's about, it's done by a neurosurgeon, an interventional neuro-endovascular neurosurgeon.

And it starts his whole story of how he started about doing it.

The first time he went to when he tried to sneak in and pray with the patient and then get out before the nurses noticed or, you know, and then the whole process of going through getting, seeing what it did for his patients and then how it, the nurses appreciated it and then other physicians and his whole process, what happens when you have a bad outcome, et cetera.

So it's very well done and certainly well worth reading.

And then finally, my personal testimony as to what we do in Brewster.

So I hope to get through the scientific portion fairly quickly so that you can do that.

1 of the reasons for doing spiritual care is this statement.

Notice to its by the Joint Commission Accreditation of Hospital Organizations, better known as JACO, that requires that a spiritual history be taken.

Renote that word, requires that a spiritual history be taken on every patient admitted to the hospital, acute care hospital, a nursing home, or seen by a home health agency.

So every patient is supposed to have a spiritual history done.

It doesn't specify your offices, But a lot of times as things develop, if it goes in 1 place, it ultimately ends up in another.

And a lot of organizations are trying to get accredited by JCO.

So this is very interesting that they require that.

And then going along with this as well, 66 to 81 percent of patients say they would have greater trust in their physician if he or she asked about their religious or spiritual beliefs.

And you combine that along with this next statement, other research has shown a significant improvement in the doctor-patient relationship when the physician does do that spiritual history.

And even just doing that, just the minimum of asking, are you religious?

Some studies have shown that that in and of itself, if you did nothing else, has improved outcomes.

It's because they patients, it's thought because patients perceive that you care more when you care about what they believe as well.

So religious and coping, religious coping and depression.

Medically ill patients who rely on religion to cope adapt more quickly to illness than those who do not.

Patients who depend on religion are less likely to develop depression and if they do become depressed are more likely to recover quickly from depression than patients who are less religious.

What about other aspects of spiritual care?

Praying with patients is certainly a part of spiritual care and a very important part and could also in some ways be a spiritual intervention for you as well.

This being said, there's quite a wide difference between some people's opinions, if you go from Dr.

Levy and some of you who pray with every patient to some who raise the concern that a health care provider should not pray with anybody.

You know, it should only be initiated by the patient and never by the health care provider.

Illinois study, 160 primary care physicians.

1 third of them believe that patients might want to pray with them and then put along with that older patients in the same area where this study was done said when they were asked if they would like their physician to pray with them, 53% yes, very much so.

29% said yes, somewhat, and only 5% said no.

Other studies in medical populations have reported between 28 to 67% have positive attitudes towards prayer.

So there is a large part of the population that appreciate prayer and spiritual.

How do you go about doing it and maintaining appropriate boundaries?

So the best times, some of the best times when you first meet the patient.

You know, if you start off with a spiritual tone, they're more likely to accept it and feel more comfortable with it when you do that.

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