An American Blue Zones Diet: Loma Linda, California

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At midmorning on any given day, Ellsworth Wareham presides over a breakfast of biblical proportions. Spread out on the kitchen table before him at his home in Loma Linda, California, is a giant bowl of whole-grain cereal floating in soy milk, a cornucopia-like fruit bowl, a stack of whole-grain toast with nut butter, a large glass of full-pulp orange juice, and a handful of nuts. From his kitchen window he commands a view of orange groves and the waves of smoky brown foothills that ascend to the snowcapped San Jacinto Mountains.

Later in the day, around 4 p.m., Wareham will resume his place at the kitchen table. This time it will be to tuck into his second—and only other—meal of the day: mounds of beans, raw vegetables, cooked asparagus, cabbage, and broccoli, finished with a handful of nuts and dates for dessert—the exact diet, he might add, that God prescribed for the garden of Eden. And, as one of America’s largest and most robust epidemiology studies has shown, it’s also the healthiest diet for humankind today.

I first met Wareham in 2005, when I was researching an article about longevity for National Geographic magazine. I’d sought him out because he seemed to be an iconic Seventh-day Adventist, following a branch of Christianity whose members live longer than any other Americans. Seventh-day Adventists are conservative Protestants who distinguish themselves from other Christians in that they evangelize with health and celebrate the Sabbath on Saturday instead of Sunday. From sunset on Friday until sunset on Saturday, every week, Seventh-day Adventists create a “sanctuary in time,” spending most of the 24 hours in quiet contemplation or attending church and avoiding TV, movies, and other distractions. At midday on Saturday after church they join other Adventists for potluck lunches. Later in the afternoon, they strike out with friends and family on a nature walk for healthy doses of sunshine and fresh air. They shun smoking, drinking, and dancing.

It was a hot September afternoon, but Wareham was outside, hard at work, when I first walked into his yard to introduce myself. He’d been building a fence along a hillside, struggling to corkscrew a pole digger through the rocky soil. When he saw me he stood up, wiped his brow with his forearm, squeegeeing sweat down onto his clinging T-shirt and muscled pectorals. “Well, it’s a pleasure to meet you, Dan,” he said genteelly, extending a strong hand. He had erected two posts, each of which required digging a two-foot hole, pouring cement, and squaring off a forty-pound pole. Judging by the imposing pile of poles in the middle of the yard, he still had work to do. “It’ll get done in a few days,” he told me confidently.

Four days later Wareham was at his post in the operating room, assisting the lead cardiac surgeon. An early pioneer in open-heart surgery, he’d been working on people’s hearts for 47 years, performing three to four surgeries per week, some lasting up to six hours. In the late 1950s he’d started the cardiac surgery program at Loma Linda University and retired from there is 1985. Lately, he’d been making the four-hour round-trip each day in his compact Toyota to one of the two hospitals where he now assists. In fact, the epiphany that had led him to adopt the Adventist lifestyle had come to him when he was at work in an operating room.

“In the early days we’d need to connect the arterial line into the leg artery. Later it would be straight into the aorta,” he said. In his work clothes he’d looked like an affable grandpa, but now in scrubs he looked decidedly professorial. Tall and lean, he wore wide-rimmed glasses and had a mustache. “I observed when I was cutting down into the legs of these patients that those who were vegetarians had better arteries—smooth and supple.” Nonvegetarians, he said, tended to have a lot of heavy calcium and plaques in their arteries. “I began thinking about it. And I saw people getting their toes cut off or their feet cut off because of vascular disease, and that motivated me. At middle age, I decided to become a vegan. With the exception of an occasional piece of fish, all I eat are plants.”

GOD’S FOOD GUIDELINES

In support of a biblical diet of grains, fruits, nuts, and vegetables, Adventists cite Genesis 1:29: “And God said, Behold, I have given you every herb bearing seed, which is upon the face of all the earth, and every tree, in the which is the fruit of a tree yielding seed; to you it shall be for meat.” The Adventists encourage a “well-balanced diet” including nuts, fruits, and legumes, low in sugar, salt, and refined grains. Their diet prohibits foods deemed “unclean” by the Bible, such as pork or shellfish. The only beverage endorsed is water, at least six glasses a day.

Today the Adventist diet in its current interpretation is demonstrably yielding the healthiest Americans. It is a plant-based diet that emphasizes nuts, whole grains, beans, and soy products. It’s also very low in sugar, salt, and refined grain. It includes small amounts of meat, dairy, and eggs, and discourages coffee and alcohol. A new study has found that adherents have the nation’s lowest rates of heart disease and diabetes and very low rates of obesity. They also live up to a decade longer than the rest of us.

Gary Fraser, of Loma Linda University, probably understands the Adventists’ lifestyle better than anybody else alive. Trained as a cardiologist and epidemiologist, and an Adventist himself, he has for the past 12 years directed the Adventist Health Studies, an enormous project entailing several studies that has tracked tens of thousands of Adventists for decades. In simple terms, the study asks scores of questions about what people eat, and then follows them long enough until they develop heart disease, cancer, or die. Looking back on the data, Fraser can see which diets are associated with shorter or longer life spans. He can also cite the cause of death, whether it’s heart disease, cancer, diabetes, or stroke.

The first Adventist Health Study, the AHS-1, funded by the National Institutes of Health, followed 34,000 Adventists in California for 14 years. In that study, Fraser calculated that Adventists who most strictly followed the religion’s teachings lived about ten years longer than people who didn’t. The practices most likely to yield that longevity? Fraser winnowed them down to five, each adding about two years to life expectancy:

•  Eating a plant-based diet with only small amounts of dairy or fish

•  Not smoking

•  Maintaining medium body weight

•  Eating a handful of nuts four to five times per week

•  Doing regular physical activity

Think about this for a moment. These are Americans. They live among us, drive by the same fast-food restaurants, shop in the same grocery stores, breathe the same air, and work in the same jobs we do. But they’re living up to a decade longer than the rest of us!

In 2002 Fraser and his colleagues launched a second, even more ambitious study. The Adventist Health Study 2 (AHS-2) recruited 96,000 men and women of all ethnicities. It asked each participant at least 500 questions about their health histories, eating habits, and physical activity, among other topics. To figure out how diet impacted how long people lived, Frazer and his colleagues broke the study subjects into four general categories: (1) vegans, (2) ovo-lacto vegetarians (vegetarians who consume eggs and dairy, (3) pesco-vegetarians (vegetarians who eat fish and very little meat), and (4) nonvegetarians.

They gleaned several insights. Meat-eaters, for one thing, tended to consume more soda pop, desserts, and refined grains than vegetarians. They also tended to be fatter. If you were to take two men of equal height, one a meat-eater and the other a vegan, the meat-eater was likely to weigh an extra 20 pounds. The meat-eater was also likely to die sooner.

Although vegans tended to weigh less, they didn’t live the longest, the study found. That distinction went to pesco-vegetarians, or pescatarians, those who ate a plant-based diet with up to one serving of fish per day.

TYPICAL DAILY DIET OF SEVENTH-DAY ADVENTISTS

When a prominent medical journal published the results of Fraser’s study, I phoned Wareham. I was interested in his take on the article, but mostly I wondered how he, as a practitioner of the Adventist diet, had managed to stick with it for more than half a century. Most diets fail after nine months.

“All human tastes, except mother’s milk, are acquired,” he told me from his kitchen phone. He was now 99 years old and, although he had given up surgery, he was still in perfect health. “You start by eating a little bit of plant-based food and grow with it. You keep eating it and pretty soon you start to enjoy it.”

Typical Daily Diet of Seventh-Day Adventists (Percentage of daily intake in grams)

This chart represents the average intake of various food groups for the Adventists participating in Adventist Health Study 2. The data tables included 513 in the white cohort and 414 in the black cohort. The averages used for this table were weighted proportionally in combining the data to reflect a more accurate average for the total population.

He told me that eating only two meals a day helps him to keep his weight down. “I love to eat,” he said. “When I eat, I eat a lot, and I really enjoy it. So twice daily is enough.” He almost never eats out at restaurants unless he gets a hankering for salmon. Nuts are usually part of the menu. “I know walnuts are supposed to be good, but I also enjoy peanuts and cashews and almonds. Purists will tell you to eat them raw but salted is okay too—whatever is handy,” he said. “And you know I’m very much against sugar except natural sources like fruit, dates, or figs. I never eat refined sugar or drink sodas.”

Wareham prefers to drink water, a beverage he claims keeps the weight off. He drinks at least two glasses when he first gets up. “I want to make sure before I get busy and forget,” he said. Then he keeps drinking water throughout the day. “One of my little rituals is to never pass a water fountain without having a little drink.”

As Wareham described his diet, I was thinking that it sounded pretty bland, the type of food that might excite a rabbit, and I told him so. “Once you get used to being a vegetarian, the very idea of eating a cow’s secretion or an animal’s muscle is much less appealing,” he replied.

I asked him if he ever thought about mortality, about dying. “Well, Dan, I do,” he said. “When we first met, I remember you asking me if I would ever get to age 100 and now I’m pretty sure I will. I feel good. My mind is sharp. I still mow the lawn. If I have any problems, I’m not aware of them.”

I told him I was writing a new book and asked him how I should describe how he feels to readers.

“Tell them I still feel like I’m 20,” he said

TOP ADVENTIST LONGEVITY FOODS

  • AVOCADOS: High in potassium and low in salt, avocados may help reduce blood pressure and the risk of stroke. Ounce for ounce, an avocado contains 30 percent more potassium than a banana, a dietary staple for many people with high blood pressure.
  • SALMON: The longest-lived Adventists are pesco-vegetarians. They eat plant-based food and up to one serving offish per day, most often salmon, well known for its heart-healthy properties. Researchers at the Harvard School of Public Health recently concluded that people who eat one to two three-ounce servings weekly of fish rich in omega-3 fatty acids—the oil that collects in the fatty tissue of cold-water fish—reduced their chance of dying from a heart attack by a third. To play it on the safest side, look for wild-caught Alaska salmon, which contains the least contaminants and the most omega-3 fatty acid–rich oils.
  • NUTS: A study during the 1990s found that Adventists who ate a handful of nuts at least five times a week lived two to three years longer than people who didn’t eat any nuts. More research since then found links between nut-eaters and lower rates of cholesterol, blood pressure, chronic inflammation, diabetes, and myriad other troubles that add up to cardiovascular disease.
  • BEANS: For vegetarian Adventists, beans and other legumes such as lentils and peas represent important daily protein sources. There are at least 70 varieties of beans to choose from and an infinite number of ways to prepare them.
  • WATER: Ellen G. White, founder of the Adventist Church, prescribed six to eight glasses of water daily. Apart from its well-known hydrating and toxin-flushing benefits, water consumption promotes better blood flow and less chance of clotting, some studies have suggested. Beyond their health value, six glasses of water a day likely pushes diet sodas, fruit juices, and other sugar-sweetened or artificially sweetened beverages out of the diet.
  • OATMEAL: A staple for Adventists, slow-cooked oatmeal is frequently mentioned as the breakfast for American centenarians everywhere. It provides a balanced portion of fats, complex carbohydrates, and plant protein, along with good doses of iron and B vitamins. Its high fiber content makes it filling, and nuts and dried fruits can add fiber, flavor, and variety.
  • WHOLE WHEAT BREAD: Like other Americans, Adventists often find themselves eating lunch at school, at work, or on the go. Slices of 100 percent whole wheat bread are convenient and healthy “packaging” for protein and vegetable fillings, such as avocado or nut butters. True 100 percent whole wheat breads add only 70 calories per slice to the sandwich plus small amounts of a wide variety of nutrients. The high fiber content minimizes the need for mid-afternoon snacking, which is often less than healthy.
  • SOY MILK: Adventists use real soy milk (not the sweetened, flavored variety) as a topping for breakfast cereals, a whitener for herbal teas, and an all-around healthy alternative to dairy. High in protein and low in fat, soy milk contains phytoestrogens that may protect against certain types of cancer. Because it’s so versatile, it can figure into daily breakfast, lunch, and dinner.

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