For millennia, numerous faith traditions have encouraged adherents to limit eating meat, even if temporarily. The Seventh-day Adventist Church, which began in mid-nineteenth-century America explicitly linked theology and food to encourage a vegetarian lifestyle among present and potential believers. The Church also influenced the diet of non-members around the world through its ambitious organizational structure dedicated to education, health care, and the development and mass production of plant-based foods, such as meat analogues, breakfast cereals, and soy milk. Lastly, results of research conducted among vegetarian Adventists and at universities affiliated with the church have greatly contributed to the scientific understanding of the health effects of vegetarian diets and to dietary changes of the society at large.
Historians have noted that the religious and social upheaval of the Second Great Awakening of early to mid-nineteenth Century America produced movements such as Mormonism, Shakerism, and Millerism (Butler 1986
). When the Millerite prediction that the world would end in the early 1840’s did not come to pass, a handful from that movement went into a period of reflection and reassessment, resulting in a core group of ‘Adventists.’ This group increased from about 200 in 1850 to 3500 when the Seventh-day Adventist church was officially organized in 1863, having wide-ranging interests such as temperance, education, and religious liberty (Butler 1986
Historically, the SDA church began as a sect, marked by a high “state of tension” with the surrounding sociocultural environment due to factors such as prohibitions on diet and entertainment, observance of Saturday as the Sabbath, refusal to bear arms, and belief in the imminent end of the world (Lawson 1998
). Over time, the Adventist church reduced those tensions, in part as a result of the educational and healthcare institutions it developed and also through legal and political accommodations (Lawson 1998
In this review we will show the important role of diet within the theology and practice of Adventism, how the organizational and institutional structure of the church advances the Adventist perspective on diet—particularly in the marketplace, and how Adventists have used research and professional activities to advance vegetarianism in the broader society. Although this article focuses on efforts within the United States, there are examples of efforts across the world-wide church. We will be using the term ‘vegetarian’ as opposed to ‘plant-based’ to refer to the Adventist diet. However, there are also sub-groupings with this group such as vegan (no animal products), lacto-ovo-vegetarian (can include eggs and/or milk), pesco-vegetarian (can also include fish), and semi-vegetarian (eat red meat, poultry, and fish less than once per week and more than once per month) (Le and Sabate 2014
This review was not able to adequately cover the many individuals and organizations, both within the United States and throughout much of the world, who have worked or continue to work to advance the Adventist message on diet. However, we have introduced some of the key individuals in order to demonstrate the thesis of an Adventist global impact on diet. These include Ellen G. White who was instrumental in linking elements of the American diet reforms of the 1800’s to the theology and practice of a ‘remnant’ church. Another key individual was John Harvey Kellogg, who operationalized the Adventist message in a medically-oriented sanitarium. JH Kellogg and his family also worked to operationalize the Adventist message through a food industry. Mervyn G. Hardinge led an effort to demonstrate through research the health benefits of a vegetarian diet. Later Adventists were able to point to those research findings in making professional recommendations for a vegetarian diet. In addition to key historical figures, there are many organizations, such as food producers, schools, and health care facilities which together truly have a global impact on diet. Thus, the Seventh-day Adventist Church was able to incorporate and influence positive public health in society as well as play a role in the mainstream financial life of many nations.
Indeed, the Seventh-day Adventist Church is well-known for its healthcare and educational institutions spread around the globe, with a size and scope that belies its relatively small membership numbers compared to other major world religions. There is no doubt that these institutions have an influence on the lifestyle, including diet, of the millions of patients who are treated and on the millions of students who are educated, particularly those who live on campus and/or eat in school cafeterias. Unfortunately from an academic standpoint, there are surprisingly few peer-reviewed publications which address the impact of SDA healthcare and educational systems on population-level diet.
Particularly as a result of combining religion/health/medicine in the form of sanitariums, the SDA Church also began to produce vegetarian foods for the benefit of church members and the general public. Both the formal SDA Church and Adventists working independently of Church supervision, were heavily involved in developing and producing vegetarian food products in the 1900’s. Their involvement with food production resulted in the mass production of many different foods, including breakfast cereals, meat analogues, and soy milk. The fact that much of current production is no longer under control of the SDA Church, perhaps a disappointment for some within the faith, is a demonstration of the growing wide-spread acceptance of vegetarian foods and a function of substantial for-profit potential. However, the for-profit nature of the business has led to plant foods such as high sugar cereals, which are not as healthy. The simple processing of the late 1800’s has given way to more extensive processing and low nutritional value aspects, such as sugar, salt, stabilizing, texture, and flavoring additives. Though the movement of nutrition science and policy since the turn of the current century has been towards whole cereal grain consumption, the modern Kellogg company has generally not embraced that movement as much as other breakfast cereal companies. Regardless, it is appropriate to acknowledge the positive impact of developing several sectors of the food industry. Furthermore, the Adventist food industry has contributed financially towards research and advocacy, such as in supporting the International Congresses on Vegetarian Nutrition.
After presenting the health message for many decades based largely on the writings of Ellen G. White, the Church dedicated resources to scientifically study the health benefits of the SDA lifestyle, especially diet. With the passage of half a century, during which Adventist researchers were able to secure millions of dollars of funding from the National Institutes of Health, there is now a large body of peer-reviewed publications and the broader society generally accepts that there are benefits of vegetarianism, independent of any religious message. It has been argued that a paradigm shift has occurred within the professional world, from a model which viewed a vegetarian diet primarily in terms of deficits compared to a meat-based diet, to a model in which a vegetarian diet is perceived as most healthful and a meat-based diet has deficits, such as in phytochemicals and fiber (Sabate 2003
). As noted by Hardinge, societal “attitudes toward vegetarian diets have progressed from ridicule and skepticism to condescending tolerance, to gradual and sometimes grudging acceptance, and finally to acclaim” (Johnston 1999
). Furthermore, there is also scientific evidence of a synergistic benefit of religion and diet/lifestyle.
The Adventist Health Studies were designed as prospective cohort research studies. As outlined in epidemiology textbooks, there are strengths and weaknesses associated with any study design (Gordis 2014
). Cohort studies are especially good at exploring associations between exposures (such as diet) and multiple outcomes (such as disease and mortality). Drawbacks include cost (need to enroll many subjects) and long time period needed to observe health outcome (since subjects do not have a disease at beginning of study). Indeed, many cohort studies must be maintained for decades to yield meaningful results. Cohort studies are not strong for describing a population (best to use a cross-sectional study design) or in proving a relationship between two variables (best to use randomized controlled trial study design, although often this is not practical or ethical). Potential biases in cohort studies include selection biases, such as differential non-response and follow-up loss, information biases, and as true of any study design, bias in analysis by the researchers and statisticians if they have strong preconceptions (Gordis 2014
). However, it is important to note that most Adventist research has compared Adventists to other Adventists who have somewhat different lifestyles, beliefs, or adherences. Cost is not a trivial issue, as Loma Linda University has needed to continue funding the Adventist Health Studies even during periods when there was not funding from the National Institutes of Health.
Although cohort studies generally do not need to represent a particular population, some have questioned how well the Adventist Health Study represents Adventists in the United States, particularly African Americans. It has been observed that there are regional differences in church involvement, notably AHS participants in the southern US tend to be longer-time church members and also more involved with church activities compared to California participants (Lampkin et al. 2009
). However, it is unlikely that such variations would invalidate observed relationships between diet and health status. Furthermore, recruitment into all health-oriented studies can be influenced by broader social forces such as racism and individual’s perception of health care and perceived sense of control over their health (Lampkin et al. 2009
The Adventist Church has been successful in presenting the personal health and spiritual benefits of a lifestyle which includes a vegetarian diet. However, it can do more with regards to diet. For example, future research could better quantify the costs and benefits at the society level of vegetarians’ longer life. Greater organizational effort could be placed into advancing a “stewardship” model of population diet, which would include examining and mitigating the environmental impacts of modern food systems and more forcefully articulating the ethical and moral problems of a meat-based diet within the context of global poverty and food shortages.
In summary, during the 1800’s the SDA church ultimately combined an evolving vegetarian perspective, an active evangelistic agenda, and a health ministry program, such that a vegetarian lifestyle was presented in many places around the world in a package that promoted a whole person and good health. As concluding exemplars, the Blue Zone books sponsored by National Geographic highlighted a handful of cities around the world in which a relatively large number of residents live to be at least 100 years of age, extensive information is available on their website (https://www.bluezones.com
). The Blue Zones identified in the initial book (Buettner 2008
) were: Sardinia, Italy; Okinawa, Japan; Nicoya Peninsula, Costa Rica; Icaria, Greece; and Loma Linda, California. Loma Linda made that list as a representative of Adventists, who have been demonstrated though research to have a longer and healthier life. Per the website, lessons learned from Loma Linda include the importance of a healthy social circle, social engagement, family, faith, moderate physical activity, and no smoking or alcohol. Food-specific lessons include plant-based diet, and consuming plenty of legumes, including soy, whole grains, and nuts. Finally, The Adventists Trilogy, three films produced by Martin Doblmeier which aired on PBS stations, presented not only on Adventist education and global health missions; but started by showing how the biblically-based approach to health and wholeness led to members living an extra 7–10 years longer than others. Thus, not only does the Adventist perspective on diet emphasize the wholeness of mind and body; it is difficult to present the Adventist message on diet without also presenting the whole Adventist “package” of theology, worship, health ministry, and education.