Faith shapes how people eat, fast and decide, and your clinician should know

Key takeaways

• Adventist men in a large California study lived about 7.3 years longer than other Californians, and women about 4.4 years longer, though the studies can’t prove the lifestyle is the cause.
• Church-based weight-loss programs for Black adults produced real but modest weight loss across 15 studies, most of them small pilots.
• If you have diabetes and fast during Ramadan, International Diabetes Federation guidance says to break the fast if your blood sugar drops below 70 mg/dL or rises above 300 mg/dL.
• Some medicines contain animal-derived ingredients such as gelatin or pig-derived heparin, so ask your pharmacist about alternatives instead of skipping a dose.
• In a 2013 policy statement, the American Academy of Pediatrics said a parent’s religious objection must give way when a child could die or be permanently disabled without care.

Between 1983 and 2011, 322 Jehovah’s Witnesses had heart surgery at a single heart surgery center¹. Every one of them had said in advance that they would not accept a blood transfusion.

The surgical team planned around that choice. When researchers compared them with closely matched patients who did receive transfusions, the Witnesses had fewer heart attacks after surgery, fewer repeat operations for bleeding and shorter stays in intensive care¹. One year later, 95% of the Witnesses were alive, compared with 89% of the matched patients.

The study is a reminder that faith and medicine don’t have to collide. When patients say clearly what their beliefs require, care teams can often adapt.

Faith shapes health in many other ways: what people eat, when they fast, which medicines they take and who sits with them at the end of life. Sometimes it seems to add years. Sometimes, when a belief leads someone to refuse needed care, it can cost them.

This guide covers what research shows about faith-shaped habits, where faith and treatment can conflict, and how to bring your beliefs into the exam room. Evidence is rated on a four-level scale.

The Adventist studies began in 1958 and still shape nutrition research

Seventh-day Adventists are an unusual study group. In the second Adventist Health Study, only 1.1% were current smokers, and about half followed some kind of vegetarian diet⁴.

The research began in 1958 at Loma Linda University in California, with 22,940 California Adventists². Compared with volunteers in an American Cancer Society study, Adventist men had death rates about 34% lower, and women about 12% lower. Lung cancer deaths were 79% lower.

Not smoking explains part of that. When researchers compared only nonsmokers, the gap shrank to about 21% for men and 9% for women². That’s a useful lesson: a faith community’s health edge often runs through specific habits.

A later study, called AHS-1, put numbers on those habits³. Adventist men lived about 7.3 years longer than other Californians, and women about 4.4 years longer. Vegetarian Adventist men lived about 9.5 years longer, and vegetarian women about 6.1 years.

Five habits predicted longer life: never smoking, a lower body weight, regular exercise, a vegetarian diet and eating nuts often³. People with all five had about 10 more years of life expectancy than people with none.

The second study, AHS-2, enrolled about 96,000 Adventists in the U.S. and Canada between 2001 and 2007⁴. About 27% were Black. Diets varied widely: 8% were vegan, 28% were lacto-ovo vegetarian (eating dairy and eggs but no meat) and 48% were not vegetarian.

Vegans and lacto-ovo vegetarians were about half as likely as non-vegetarians to have type 2 diabetes, even after adjusting for income and lifestyle⁵. At age 55, vegans weighed about 30 pounds less than non-vegetarians of the same height.

Two cautions apply. These are observational studies of volunteers, and the study’s own website claims only that the evidence points to some protection, warning that statistics alone can’t prove cause². The research is also run by an Adventist university studying its own community, which deserves the same scrutiny you’d give any group studying itself.

The faith itself may matter, too. The Adventist Religion & Health Study, funded by the National Institute on Aging, surveyed 10,988 Adventists in 2006 and 2007⁶. People who saw the weekly Sabbath as a release from tension reported better mental health. Those who filled it with ordinary secular activities reported poorer physical health.

Church health programs help, but the gains so far are modest

Many congregations run health ministries: walking groups, blood pressure checks, cooking classes and weight-loss programs. The research on them is encouraging but early.

A 2024 review in the journal Obesity, led by Lovoria Williams, examined 15 studies of church-based weight-loss programs for Black adults, with 2,285 participants in all⁷. Most programs produced statistically significant weight loss, but the amounts were modest.

The authors flagged real limits⁷. Most studies were small pilots, and most participants were well-educated women. Only one program offered personal attention beyond texts or emails.

That doesn’t make health ministries a poor choice. A congregation offers a weekly gathering and people who notice when you’re missing, and a well-designed program can build on both.

Five questions to ask about a church health program

• Who designed it, and has a version of it been tested in a study?
• Does a nurse, dietitian or other trained person help lead it?
• Are your weight and blood pressure results kept private, not shared with the group?
• Does it encourage you to keep seeing your own clinician?
• Is anyone selling supplements or products through it?

Fasting for faith: keeping Ramadan safe with diabetes

Fasting is part of many faiths, and Ramadan draws close medical attention. About 50 million people with diabetes fast during Ramadan worldwide, according to a 2017 review in the Cleveland Clinic Journal of Medicine⁸. In one 13-country study, 94.2% of Muslim patients with diabetes fasted for at least 15 days.

Fasting from dawn to sunset can push blood sugar to dangerous levels. The review cited earlier research finding that the risk of low blood sugar during Ramadan was about 4.7 times higher in type 1 diabetes and 7.5 times higher in type 2⁸. Severe high blood sugar was also several times more likely.

The International Diabetes Federation’s patient guide sorts people into three groups⁹:

• Very high risk: must not fast. This includes people who had severe or repeated low blood sugar in the three months before Ramadan, diabetic ketoacidosis (a dangerous buildup of acids in the blood), poorly controlled type 1 diabetes, pregnancy, heart problems or a sudden illness.
• High risk: should not fast. This includes poorly controlled type 2 diabetes, insulin use, kidney problems and physically demanding jobs.
• Moderate or low risk. This means well-controlled type 2 diabetes managed with lifestyle, pills or injectable medicines. The decision depends on your doctor’s judgment and how well you handle fasting.

People in every group should see a doctor before Ramadan, the guide says⁹. The timing, dose or type of medicine may need to change.

The guide’s stop signs are clear⁹. End the fast if your blood sugar falls below 70 mg/dL (3.9 mmol/L) or rises above 300 mg/dL (16.6 mmol/L), or if you feel unwell. Checking your blood sugar and injecting insulin do not break the fast.

The guide points to the Qur’an’s exemption for people who are ill or traveling, who can make up missed days later, and frames Ramadan’s rules around ease rather than hardship⁹.

Keeping another religious fast, such as Lent or Yom Kippur? The same steps apply: see a clinician first, ask about your medicines, and know your stop signs.

Your medicine cabinet may hold ingredients your faith avoids

Medicines can contain animal products, which matters if you keep halal, kosher, vegetarian or other dietary rules. An April 2026 guidance document from Gloucestershire Hospitals NHS Foundation Trust in England lists common examples¹⁰:

• Standard heparin, a blood thinner, is made from pig intestine.
• Gelatin is used in most capsule shells, some vaccines and many calcium and vitamin D products.
• Lactose, a sugar from milk, is a filler in many tablets.
• Pancreatin, a digestive enzyme product, comes from pigs.
• Premarin, a hormone product, comes from horses.

U.S. brands and formulas may differ from these British examples, so check before you assume.

The guidance notes that some religions may allow gelatin when no easy alternative exists, or when it’s used in a non-food form such as a capsule shell¹⁰. Alternatives may exist, such as a tablet in place of a capsule or a gelatin-free vaccine.

It also tells clinicians to record a patient’s wishes, offer an alternative where one exists, and explain the risks when none does¹⁰. Don’t stop a prescribed medicine on your own. Ask your pharmacist, who can check the label and the manufacturer’s information.

When faith and treatment pull in different directions

Faith communities can be a lifeline during serious illness. They can also shape choices in ways patients may not expect.

In a 2013 study in JAMA Internal Medicine, researchers led by Tracy Balboni of Dana-Farber Cancer Institute followed 343 people with advanced cancer until death¹¹. About 43% said their religious community supported their spiritual needs very well.

Those patients were less likely to use hospice and more likely to receive aggressive care near death, such as intensive care, breathing machines or resuscitation¹¹. They had about five times the odds of dying in an ICU. Their quality of life near death was no different.

The twist came next. Among well-supported patients, those who also got spiritual support from their medical team used hospice more and had fewer aggressive treatments¹¹. The medical team’s willingness to talk about faith seemed linked to a different course of care.

That’s a reason to raise faith early, as the Witness heart patients did¹. Aggressive care is right for some people. What matters is that the choice reflects your values and full information.

Children are where doctors and the law draw a harder line

For children, the stakes and the rules are different. In a 1997 statement, the American Academy of Pediatrics (AAP) asked pediatricians to be sensitive and flexible about families’ religious practices and to seek shared decisions¹². It also said that no child should be denied medical care because of a parent’s religious beliefs.

The AAP’s Committee on Bioethics went further in a 2013 policy statement, as reported by the trade journal Contemporary Pediatrics¹³. Parents’ wishes deserve great respect, the committee said, but withholding care on religious grounds becomes medical neglect when a child could die or be permanently disabled. In those cases, pediatricians should step in and report the situation to child protective services.

The same statement urged states to repeal religious exemptions in their child abuse and neglect laws¹³. It also said public health dollars should not pay for unproven religious or spiritual healing. Contemporary Pediatrics noted that this would end Medicaid and Medicare payments for care at Christian Science sanatoria and similar institutions.

Those exemptions were once nearly universal. In 1997, the AAP counted 46 states with religious exemption clauses in child abuse and neglect laws¹².

Federal policy helped create them. After the 1974 Child Abuse Prevention and Treatment Act, federal officials read the law as requiring faith-healing exemptions from states that wanted grants, and most states complied, according to ProPublica’s 2026 reporting¹⁴. After a 1983 federal change, several states rolled theirs back, and Colorado restored prosecution in 2001.

Idaho kept its shield, which dates to a 1971 rewrite of its criminal code¹⁴. ProPublica reported in August 2026 that congregations of one faith-healing church, the Followers of Christ, saw 15 preventable child deaths in Idaho from 2015 to 2025. State lawmakers have turned down one attempt after another to narrow the exemption.

State laws vary and change, and this is not legal advice. The medical point is simpler. A seriously ill child needs medical care now, and prayer can continue alongside it. If you suspect a child is being denied needed care, you can contact your state’s child protective services.

How to bring your faith into the exam room

Tools exist to help clinicians ask. One, called FICA, was developed in 1996 by Christina Puchalski, MD, and colleagues, and is offered through the George Washington University Institute for Spirituality and Health¹⁵. It guides a clinician through four areas: your faith or sources of meaning, how much they matter and shape your decisions, your community, and how you want them handled in your care.

The institute suggests raising spirituality early, such as at a new-patient visit or annual exam¹⁵. You don’t have to wait to be asked.

A faith-and-health card for your next appointment

Fill this out and bring it, or keep it on your phone. Every example below is hypothetical.

Topic	What to note	Example
Fasting	Dates and hours of any religious fasts	Ramadan, dawn to sunset; I use insulin
Food rules	Dietary laws that affect medicines	Halal; please check capsules for pork gelatin
Treatments	Anything you won’t accept, and what you will consider	No blood transfusions; please discuss alternatives
Decisions	Who you want involved in big choices	My daughter and my pastor
Rituals	Prayers, objects or rites you want honored	Prayer before surgery; a visit from my priest

What to say

• “My faith shapes how I make health decisions. Before we choose a plan, I want to tell you about my fasting, food rules or a treatment I don’t accept.”
• “Can we look for an option that respects my beliefs and still treats the problem?”
• “If we can’t find one, I’d like to talk with the chaplain or my faith leader before I decide.”

Rating the evidence on faith and health

Claim	Evidence level	What the research shows
The Adventist lifestyle is linked to longer life	Strong evidence	Decades of large cohorts; years gained tie to specific habits; cause not proven23
Vegetarian diets are linked to less type 2 diabetes in Adventists	Promising but early	Large cohort with adjusted data; observational5
Church-based weight-loss programs help Black adults lose weight	Promising but early	Modest losses across 15 mostly small studies7
Spiritual support from the medical team steers end-of-life care toward hospice	Promising but early	One cohort of 343 patients11
Heart surgery without transfusion can go well with blood-saving planning	Promising but early	Matched observational data from one center1
Fasting with high-risk diabetes is safe without a medical plan	Evidence says no, or unsafe	Sharply higher risk of low and high blood sugar89
Prayer alone can replace care for a seriously ill child	Evidence says no, or unsafe	ProPublica documented 15 preventable child deaths in one Idaho faith community14

Faith and natural health share deep roots

Many values natural-health readers hold, such as whole food, rest, fasting and community, also live in faith traditions. The Adventist research shows those habits, kept over a lifetime, track with years of added life³. The Sabbath findings hint that rest with meaning may matter for mental health⁶.

Respect for faith includes honesty about where it can conflict with health. Traditions often make room for both, as Ramadan’s exemption for illness shows⁹. Your clinician can work with your beliefs, but only if you share them.

Questions readers ask

The bottom line

Faith shapes health in real, measurable ways. Adventist habits track with longer life, church programs can help people lose some weight, and many people can keep religious fasts with a medical plan and clear stop signs. Faith can also lead to choices that need careful thought, from aggressive end-of-life care to refusing a child’s treatment.

The common thread is conversation. Tell your clinicians what your faith asks of you, ask them to find options that respect it, and bring in a chaplain or faith leader when the choices get hard.

Related reading

• Your right to refuse treatment, and its real limits
• How medical decisions are supposed to get made with you
• What to bring, write down and ask before a doctor visit
• What happens when you don’t tell your doctor about supplements
• The symptoms that mean call 911 now

Sources

1. American College of Cardiology. “Outcome of Patients Who Refuse Transfusion After Cardiac Surgery: A Natural Experiment With Severe Blood Conservation.” Journal Scan, July 3, 2012. acc.org
2. Adventist Health Study, Loma Linda University. “Adventist Mortality Study.” Accessed October 2026. adventisthealthstudy.org
3. Adventist Health Study, Loma Linda University. “Findings for Longevity” (Adventist Health Study-1). Accessed October 2026. adventisthealthstudy.org
4. Adventist Health Study, Loma Linda University. “Adventist Health Study-2.” Accessed October 2026. adventisthealthstudy.org
5. Adventist Health Study, Loma Linda University. “Findings for Lifestyle, Diet & Disease” (Adventist Health Study-2). Accessed October 2026. adventisthealthstudy.org
6. Adventist Health Study, Loma Linda University. “Adventist Religion & Health Study.” Accessed October 2026. adventisthealthstudy.org
7. Williams LB, Abu Farsakh B, Karle ER, Almogheer ZS, Coughlin S, Kim Yeary KH. “How effective are church-based weight-loss interventions among Black adults? A systematic review.” Obesity, 2024. scholars.uky.edu
8. Raveendran AV, Zargar AH. “Diabetes control during Ramadan fasting.” Cleveland Clinic Journal of Medicine, 2017. ccjm.org
9. International Diabetes Federation. “Diabetes and Ramadan: A Guide to a Safe Fast.” International Diabetes Federation, PDF posted 2024 (no publication date given). international-diabetes-federation.s3.eu-west-1.amazonaws.com
10. Gloucestershire Hospitals NHS Foundation Trust. “Drugs of Animal Origin Guidance.” NHS, approved April 2026. gloshospitals.nhs.uk
11. Balboni TA, Balboni M, Enzinger AC, et al. “Provision of Spiritual Support to Patients With Advanced Cancer by Religious Communities and Associations With Medical Care at the End of Life.” JAMA Internal Medicine, 2013 (copy hosted by Harvard). rshm.hsites.harvard.edu
12. American Academy of Pediatrics. “Religious Objections to Medical Care.” News release via Newswise, February 15, 1997. newswise.com
13. Contemporary Pediatrics. “Religion is no ground for refusing lifesaving care” (on the AAP Committee on Bioethics policy statement, Pediatrics, 2013). Contemporary Pediatrics, November 5, 2013. contemporarypediatrics.com
14. Dutton A. “Idaho law protects faith-healing parents. It wasn’t always that way.” ProPublica, with The Oregonian/OregonLive, August 26, 2026. propublica.org
15. George Washington University Institute for Spirituality and Health. “Clinical FICA Tool.” GW School of Medicine and Health Sciences, accessed October 2026. gwish.smhs.gwu.edu