Participants: Don Mckintosh (Host), John Kelly
Series Code: HFAL
Program Code: HFAL000165
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00:50 Hello, I'm Don Mackintosh,
00:52 and this is HEALTH FOR A LIFETIME 00:53 We're glad you've joined us today. 00:54 Today we're going to be talking about research. 00:57 Wait a minute - research is a good thing! 00:59 It's not something that makes us go to sleep. 01:01 It's something that might document why we go to sleep, 01:04 but it's something that today I think will wake you up 01:07 because it's good news research, 01:10 and joining us to talk about this 01:12 research is a researcher from from Loma Linda University, 01:15 Dr. John Kelly. 01:17 He has been a physician since 2000 and actually he went to 01:21 school a little bit later in life, didn't you Dr. Kelly? 01:25 Yes, Don, I started school at Loma Linda when I was 48 01:29 48! People out there are probably gasping! 01:33 Was that planned? 01:35 Well, you certainly don't go to medical school by accident! 01:40 It was planned! 01:42 No, actually I wanted to go to medical school. I first 01:45 thought about it when I was 28 but I was told I was too old 01:49 because I had dropped out of college and I needed to go 01:53 back and do four years of college, 01:54 and I was told you know when you're over 30 it's hard to get 01:57 through medical school. 01:58 So I spent 20 years doing and believing that and doing health 02:02 education and getting acquainted with some of 02:06 God's health principles, 02:07 and then in '96 I guess God decided time to send me to 02:11 medical school. 02:13 You went through medical school and not only that you 02:16 came out with a MPH in epidemiology and research, 02:19 and you got to be involved in primary research right away. 02:24 Yes, that's true, I'm very fortunate, 02:27 but I also have a very specific objective in mind. 02:32 I didn't get distracted in medical school with lots of, 02:35 there's so many interesting specialties and things that you 02:38 learn, but I knew I wanted to do lifestyle medicine and 02:43 it fairly quickly was obvious that lifestyle research was 02:46 something for me. 02:48 Actually, I started my first research during my last 02:53 year of residency. 02:54 In fact one of the studies we're going to talk about today, 02:57 I collected the data during my last year of residency. 03:00 Is that right? So you knew 03:02 exactly why you were there, what you were doing, and the 03:05 Lord had given you just a real, laser beam like focus. 03:08 Yes, I knew from the very first day of medical 03:12 school I wanted to do lifestyle medicine. 03:14 You know this is a great time to be talking about 03:16 lifestyle medicine. 03:18 Just recently there was a National Geographic article 03:22 that we have a graphic showing that looked at Adventists 03:27 and here it is, you brought it with you: 03:42 That National Geographic article is directly an outgrowth of 03:47 the research that has been done showing the benefits to the 03:52 lifestyle principles that we have as a people and as 03:55 a church. 03:56 So it was over the last 20- 30 years that, is this 04:01 right or wrong, that the Adventist Health Study 1 04:06 was being conducted? 04:07 Yes. 04:08 And it was because of that research that that article like 04:11 National Geographic and then many other news networks 04:14 all over the place were picking up on this. 04:16 It's because of that research that these articles are able to 04:19 be published. 04:20 That is correct. 04:21 There's a number of studies that... the medical literature 04:28 is literally replete now with results from Adventist Study. 04:33 We've got the Adventist Health Study 2 is even larger, bigger 04:36 study that Dr. Gary Frasier is working the lead, 04:38 principle investigator. 04:41 The Lifestyle Research and Adventists is just growing and 04:47 mushrooming. 04:48 You mentioned Dr. Frasier and I think he also recently published 04:51 a book a couple years ago from Oxford University Press that has 04:55 a listing of all the different scientific studies that have 04:58 been done on Seventh-day Adventists. 04:59 How many is there about? 05:02 I don't know just how many. 05:05 I know this, I know of personally of seven or eight 05:09 that have been done, 05:10 but many of those early ones were quite small. 05:13 Research is like anything else, it starts off and grows 05:20 slowly in magnitude and so some of those early 05:22 studies that we did with the American Cancer Society 05:26 as one of our control groups that we compared Adventists 05:30 to and so forth 05:31 The Adventist Mortality Study and others were quite small. 05:34 Now were doing a study of 125 thousand 05:37 Seventh-day Adventists. 05:38 That's huge! 05:39 So you're involved in what you call the 05:42 Adventist Lifestyle Intervention Research Project. 05:46 That's correct. 05:47 I don't actually work directly with Dr. Frasier and the team 05:51 on the Adventist Health Study. 05:52 I appreciate its work and I value it greatly but I'm 05:56 actually trying to build, am building on that research, doing 06:00 intervention research to test some of the hypotheses. 06:05 You know we found out for example that those folk who 06:09 ate more nuts per week had a reduced risk of heart disease. 06:14 So that could lead to a question "Would it be that you could 06:18 improve your heart disease risk if you were to eat nuts?" 06:22 Now that may seem like an obvious thing but in research 06:26 those are two different questions. 06:27 One was an observation that people who ate more nuts 06:30 had less risk of heart disease. 06:32 That does not prove that if a person with high risk started 06:35 eating nuts it would reduce their risk, but 06:37 Dr. Sabetae has done studies that show that was the case. 06:43 So now what we're saying, "Let's test many of these other 06:47 principles. " 06:48 And is a natural place to study those is at the Adventist 06:52 lifestyle centers that are using these very principles 06:56 to treat disease. 06:57 So what are some of those principles? 06:59 Let's talk about where they are, what they're called 07:02 and let's just go through that. 07:04 Well, let me just do it by talking about the 07:08 data that we collected. 07:09 I mentioned when I was in my last year of residency 07:11 collecting some data at various lifestyle centers. 07:14 Let me just mention the Battle Creek Lifestyle Health Center, 07:18 the Lifestyle Center of America, that's in Oklahoma, 07:22 Uchee Pines Institute and Wellness Center, that's in 07:26 Alabama, Weimar Institute in California, and 07:31 Wildwood Hospital and Lifestyle Center in Georgia. 07:34 Any of these names if you put in your search engine 07:35 on your web it will come right up. 07:38 Yes, they all have web sites. 07:40 I think actually the Battle Creek Lifestyle Health Center 07:44 that one has closed down. 07:47 All the others are there and functioning. 07:49 I collected data on patients from 30 or more at each 07:57 one of those centers, so it was a multi-center study. 08:00 It's technically what we call a retrospectively collected data 08:04 but it was perspective data. In other words, at the time 08:05 they were collecting the measures on these patients, 08:08 they did not know they were going to be in a study, and I 08:11 came along later collected what had happened. 08:15 The type of intervention, you asked... what did they do. 08:20 What we found was that there are differences 08:23 between these five centers, but the differences 08:27 were relatively minor... negligibly small. 08:31 There were minor differences overall and we were able to 08:35 pool all the subjects. 08:39 So we had 183 subjects that we could put in our study. 08:43 That were largely, you say, pooling, they were largely 08:46 being treated the same way, just minor differences. 08:47 Right. 08:49 And the reason they were being treated the same was why? 08:52 They were all receiving the same kind of intervention. 08:56 Let me just read here what the a typical intervention would be 09:01 at these centers. 09:02 They all received a plant based, high fiber, low fat, cholesterol 09:07 free, calorie restricted diet. 09:10 In fact some of the centers used fasting, especially with 09:14 diabetics or some other obesity patients. 09:18 Do they all exercise? 09:19 They all do, that's everyone. 09:21 They all received regular graded exercise 09:24 and strength building exercise. 09:27 They also all used health education classes - cognitive 09:32 training. 09:33 Educate, educate, educate. 09:35 And typically that would include knowledge about the physiology 09:40 of their illness, about the connection between their 09:43 lifestyle and their disease, knowledge about nutrition 09:47 and the effect of nutrition, and cooking classes, etcetera, 09:50 stress management. 09:51 They also then, I found they have very similar intervention. 09:58 They were drinking water, and at each center 09:59 the patients were not only encouraged to drink 10:03 water... in many of the centers they actually had a simple way 10:07 unobtrusively of counting the amount of water, glasses of 10:11 water, and giving them containers with the amount 10:13 of water they were supposed to drink for the day. 10:15 They had spiritual exercises which were voluntary. 10:18 All of them were voluntary? 10:20 Yes. 10:21 They would have hydrotherapy treatments - hot and cold for 10:25 their limbs, for example. 10:26 I learned something wonderful, I had never seen in a clinical 10:29 setting before, and that was getting rid of 10:32 diabetic neuropathy pain by the use of hot and cold contrast to 10:38 the lower limbs, and it was highly effective. 10:42 They had massage, and the physician visits 10:45 on a regular basis, medications were adjusted, 10:48 to be reduced as the lifestyle therapies exerted their effect, 10:56 and some of them used supplements. That was the one 10:58 area that varied the most was supplements 11:02 or herbs, you know this kind of thing. 11:05 But everything else was really minor, so you could pool 11:09 these all together and have a much larger study then any 11:13 one could do on their own. 11:14 That's correct. 11:15 It gave us a lot more power to find out what the 11:18 real effect was. 11:19 So what did you find? 11:20 You're going to talk about that a little bit more in the second 11:23 half but start on it now. 11:24 What did you find? 11:25 Well we found in a nutshell was that the... we did a case 11:30 control analysis where we were looking at diabetics. 11:34 As you know, diabetes is a epidemic and growing world 11:38 wide, unfortunately, and the question was, would lifestyle 11:43 be as effective in a diabetic or is it less effective? 11:47 Because, after all, they're having problems with lifestyle, 11:50 and this is a reasonable question. We compared 11:54 the reduction of cardiac risk in patients that 11:59 were diabetic to concurrent controls that did not 12:02 have diabetes. 12:03 So these were non-diabetic concurrent controls, meaning 12:07 the controls got the exact same treatment that the 12:09 diabetic cases did, and we 12:11 compared them, these two groups, and found that the 12:16 diabetics had as good or better outcomes, risk reduction, from 12:22 lifestyle intervention as the non-diabetic controls did. 12:26 In other words, it works! 12:28 It works and it works maybe even better in diabetics. 12:31 Is that right? 12:33 So this has been published? 12:36 This will be published, it has not yet been published 12:38 The manuscript I hope to have submitted here shortly. 12:41 And that will be in what they call a peer review? 12:44 Peer review, yes, one of major diabetes journals, yes. 12:48 And then if that happens, which we hope it does, that just gives 12:54 more credibility to some very good things that are happening 12:57 in lifestyle centers around the nation. 12:59 Yes, especially I'm looking, of course, at Adventist lifestyle 13:03 centers, but we have compared some of the results that we 13:09 find in the Adventist lifestyle centers to published outcomes 13:13 from other studies like the DASH Diet, which has been 13:17 recognized for lowering blood pressure, and the portfolio diet 13:22 been shown to reduce cholesterol and we made some comparison 13:27 to those, which I will talk about if we have time. 13:31 All right. 13:32 We're talking with Dr. John Kelly. 13:35 He's a researcher from Loma Linda University 13:37 and he's looking at the lifestyle centers around the 13:40 country that largely are operated by 13:43 Seventh-day Adventists. 13:44 In this particular study all of them where, and 13:46 those studies are found in Oklahoma - the Lifestyle Center 13:50 of America, or Weimar in Northern California, or 13:53 Uchee Pines in Alabama, Wildwood in Georgia and 13:57 there may be others as well. 13:59 We encourage you to get in touch with these places. 14:02 They really are helping people. 14:04 Dr. Kelly is doing the research that documents what really is 14:08 happening. 14:09 When we come back we'll look more closely 14:11 at what he's been finding. 14:12 We hope that you can join us. 14:16 Have you found yourself wishing that you could 14:17 shed a few pounds? 14:19 Have you been on a diet for most of your life? 14:21 But not found anything that will really keep the weight off? 14:24 If you've answered yes to any of these questions, then we 14:28 have a solution for you that works. 14:30 Dr. Hans Diehl and Dr. Aileen Ludington 14:33 have written a marvelous booklet called, 14:35 Reversing Obesity Naturally, and we'd like to send it to you 14:38 free of charge. 14:40 Here's a medically sound approach successfully used 14:43 by thousands who are able to eat more 14:45 and loose weight permanently without 14:46 feeling guilty or hungry through lifestyle medicine. 14:50 Dr. Diehl and Dr. Ludington have been featured on 3ABN, 14:54 and in this booklet they present a sensible approach to eating, 14:57 eating, nutrition, and lifestyle changes that can help you 15:01 prevent heart disease, diabetes, and even cancer. 15:03 Call or write today for your free copy: 15:16 Welcome back. 15:17 We're talking with Dr. John Kelly. 15:18 We're talking about research as it relates to lifestyle and 15:22 avoiding America's killer diseases. 15:24 And Dr. Kelly we're just glad that you can join us today. 15:27 Thank you, Don, it's good to be here talking about research. 15:31 What you've discovered is that the things that we're learning 15:35 in the Adventist Health Study, which now have taken a 15:38 national theater, the National Institute of Health are giving 15:42 a lot of money to study that, 12 million dollars I believe, 15:45 this last study, what you're finding is those same 15:49 principles, the same things they've learned, really are 15:52 things that need to studied on a intervention level. 15:56 In other words, does it work in these lifestyle centers that 16:01 you've mentioned. 16:02 You've found some preliminary results that are very 16:05 encouraging. 16:06 Yes, yes, we were just talking about how we compared 16:09 the effect in folks that have diabetes to concurrent controls, 16:16 meaning people who were there at the same time but did not 16:19 have diabetes, and found that the benefits were as great or 16:23 greater in the diabetics as the non-diabetics, 16:27 but what I want to talk about next is how we have compared 16:32 the outcomes from the centers to published results 16:36 in other studies. 16:37 You may be aware that Dean Ornish has done some 16:41 landmark studies... 16:42 He's that famous, Harvard trained cardiologist, now living 16:46 I think in California somewhere? 16:47 Yes, I understand he's one of President Clinton's physicians 16:52 and friend. 16:53 So he's a well known researcher. He's 16:55 done some of the pioneering work looking at the effect of 17:01 diet on heart disease and especially regression of 17:07 coronary artery blockages. 17:09 The lifestyle heart trial was first published, 17:13 one year results, was published in Lancet in 1990. 17:17 Which is a very reputable magazine. 17:19 This is probably one of the best in the world. 17:22 What he found was that in this study they compared a low fat 17:30 diet with stress reduction techniques, meditation 17:33 techniques that were used, to the recommended at the 17:38 time the standard of care for dietary recommendations for a 17:42 person who had heart disease. 17:44 So in other words, American Heart... 17:47 Yes, the step one, step two diet, and 17:49 what he found that one year was that there was 17:56 about.4 risk. 17:59 In other words there was a tremendous risk reduction 18:01 less than half the risk of events, heart attack or other 18:08 angina chest pain in the treatment group compared 18:11 to the controls that were getting standard care. 18:14 But probably the most amazing thing was when they looked at 18:18 the blockages, you know we can do an angiogram, we can do an 18:22 image of the heart vessels and we can see if its narrowed, 18:26 we can see what's called the lumen, the opening of where 18:28 the blood flows, and see the blockage, and this is what most 18:32 people that have ever had a stint they've got one of these 18:34 done and it showed this real narrow spot and the doctor 18:37 put a little tube, little piece of metal in there. 18:39 Ok, well they did these studies before and after and found that 18:45 even though the radiologist were blinded, they did not 18:48 know who was who, they found that there was a significant 18:52 difference in this that on the control group blockages were 18:56 actually continuing to get worse. 18:58 Their disease was continuing to progress. 19:01 And these were the ones on normal medication and normal 19:04 American Heart Diet? 19:06 Yes, 30% of calories from fat or less and so forth. 19:10 The treatment group which was on a low fat diet or 10% less 19:14 of calories from fat, which is quite low, and exercise, and 19:19 meditation, and stress reduction, group support, etc. 19:22 This group had actual reversal, the blockages were going away. 19:27 Wow! 19:29 So this is more powerful than the normal treatment you 19:32 normally would hear about. 19:33 Absolutely, and not only that what was amazing to a lot of 19:36 folk was that in the treatment group they were not on 19:38 on medication, and so of course this was an unusual study. These 19:43 were people who of course agreed to this intervention. 19:46 Sometimes I asked folk, "Would you be willing to do that?" 19:49 Well, ahead of time we might say, "I'm not so sure," but now 19:52 looking back you would want to be in a treatment group because 19:55 the five year results were published in 1998 in the 19:58 Journal of American Medical Association and they showed 20:02 that there was almost a 28% worsening of the blockage. 20:07 They were getting 28% worse and the treatment group, 20:13 they had reversed by almost 8%. They had opened up 20:16 by about 8% in 5 years. 20:20 So lifestyle intervention is much more effective than the 20:24 traditional approach is what you're finding out? 20:26 That's what he showed clearly and there have been others. 20:30 Dr. Caulrel Estergen Jr. has done some work on using diet 20:34 and lifestyle to treat coronary artery disease with similar 20:37 results and so has John McDougal. 20:40 There's a number of doctors that have done this work 20:43 and actually had even studies of the flow of the blood to 20:47 the heart. 20:48 This is an objective measure. 20:49 This is not just looking at "Did your cholesterol go down?" but 20:53 "Did the blockages open up or not?" 20:56 Same thing's true of the CHIP program that they have 20:58 some studies showing that. 20:59 Yes, yes, I understand that Hans Diehl's coronary health 21:02 improvement project that has been documented to improve 21:07 circulation of the blood to the heart. 21:09 The modern techniques we have we can actually look at 21:12 and see how well the heart muscle is being "profused" with 21:16 blood and we can see a significant difference from 21:20 these lifestyle programs. 21:21 You had another study as well looking at diet that you want... 21:24 Yes, you know there was an amazing study published by 21:28 Dr. David Jenkins. 21:29 He's head of eccrinology at University of Toronto. 21:34 And this was published, I believe, in 2003 in the 21:39 Journal of American Medical Association. What he did was, 21:41 he took a group of patients that had very high 21:45 cholesterol, what we call hyperlipidemics, 21:47 cholesterol over 250, and he put... this was a randomized 21:53 trial, he put one group on a diet that was... he called it 22:01 Portfolio Diet because it consisted of pieces of things 22:04 that have been shown in the literature to reduce 22:06 cholesterol... soy protein, viscous fiber, almonds, etc., 22:12 so you call it a portfolio. 22:14 And another group we put on Lovastatin, 20 mg a day. 22:19 This is a typical starting dose, as you may know, for a statin 22:23 which lowers cholesterol. 22:25 That's the drug you get from your doctor when you have 22:27 high cholesterol, right? 22:28 Yes, that's one of the older ones. 22:29 You might not get Lovastatin these days, but it's about 22:31 the similar to the others. 22:33 Then there was a third group, as a control group, and they had 22:36 no change, they didn't get any special intervention. 22:39 And what we found was that there was a highly significant 22:44 reduction in cholesterol in two groups. 22:47 The Lovastatin and the Portfolio Diet both reduced cholesterol. 22:54 Which is more? 22:55 Well, the one that seemed to be a little bit more may have been 22:59 Lovastatin depending on what numbers you look at, 23:02 LDL vs. the ratio, etc. 23:05 But what we did find there was no statistically significant 23:08 difference between the Portfolio Diet without medication or the 23:12 Lovastatin without diet. 23:14 So what this is telling us is that his studies show that 23:19 lifestyle alone can be as effective as a beginning dose 23:24 of a statin. 23:25 I'm excited because a number of studies are being done 23:29 continually now showing that lifestyle intervention is 23:33 as or more effective than medication for many of 23:36 these diseases. 23:37 So you're planning to put all these studies... you've 23:40 reviewed the literature, it's obvious, you've reviewed one on 23:44 heart disease, you've reviewed one on diet here, and what 23:49 you're hoping to show, or maybe a scientist would say that, what 23:54 you expect to find perhaps, you'll be surprised if you don't 23:57 these lifestyle centers will be just as effective as a statin 24:03 and even more effective when you look at the side effects. 24:05 Yes, in fact what we have done I've taken that same data that 24:08 we got from these five centers that we mentioned earlier 24:12 and we have looked at the results from those subjects 24:18 comparing them to these published results. 24:20 And what we've found is that really the 24:23 lifestyle intervention is as effective as these published 24:31 studies are showing. 24:32 So in other words, we don't just think this, we have some 24:35 objective data, some objective analyses to indicate that yes 24:40 the typical patient going through a lifestyle center 24:43 is having as good or better risk reductions as those that 24:49 are in these published studies. 24:50 What we want to do is we want to now do a longer term 24:56 prospective longitudinal study. 24:59 In other words, these are looking at three weeks results. 25:02 Month long. 25:05 And so we need to look at what happens at one year, five years 25:10 just like the Dean Ornish study did. 25:12 And that will then document that not only are they effective 25:16 on the short term but also in the long term. 25:18 Do you expect to find a difference in those groups 25:21 between those that respond to the spiritual component 25:25 vs. those that do not? 25:27 You know, Don, I'm actually very excited in what we will find 25:31 in looking to ferret out, what are the predictors of who does 25:38 well and stays with the program and vs. who doesn't. 25:41 One of the things that Dean Ornish showed in his study was 25:43 that there was a regression in only 82% of the subjects. 25:50 In other words reversal or whatever. 25:52 Yes. 25:53 So I ask myself why didn't everybody? 25:55 And he showed that the amount of regression correlated to 26:00 the adherence to the program. 26:03 The greater that they followed the program, 26:05 the greater the regression. 26:07 So, yes, you're right, it will be very interesting to see 26:10 if there's a predictor and what is the predictor? 26:14 Many of us think that it will be those who take their personal 26:19 health as a steward, looking at themselves as a steward, 26:23 as opposed to an owner. 26:25 Do you have that in your study that you're planning? 26:27 Do you have those kind of questions so you can look at 26:30 that spiritual component? 26:31 Yes, we will definitely be doing spiritual history, 26:36 if you will, or spiritual measures. 26:38 We'll be looking at a lot of things. 26:40 We'll be looking at depression for example. 26:41 It's been thought perhaps depression factors may 26:44 play into this. 26:45 We'll be looking at spirituality. 26:47 Be looking at the attitude, 26:50 the change in the attitude itself. 26:52 We're probably going to find things that we don't even 26:55 anticipate. 26:56 Right. 26:57 You know, I've always wanted someone to do the very study 27:00 that you're doing. 27:01 I really believe that's a study for this time. I have 27:04 said in my church and other churches around the nation are 27:10 now becoming more energized in trying to be kind of 27:13 lifestyle centers themselves. 27:15 Churches, that what I've seen antidotally, those people that 27:20 make the spiritual connection really have more effective 27:25 results in the long haul. 27:27 You told me that church leaders are really endorsing what 27:31 you're doing - Mark Finley, a well known Adventist evangelist 27:36 and others are really backing this up. 27:39 Thank you so much for joining us today. 27:42 Thank you, Don, I appreciate being here. 27:44 Thank you for joining us on Health for a Lifetime. 27:47 There's good news out there and it maybe just as close 27:50 as your nearest Seventh-day Adventist Church. 27:52 Check them out, check a lifestyle out and you'll have 27:55 health that lasts for a life time. |
Revised 2014-12-17