The concerns raised by Sturges are quite valid. In our study,1 we did not obtain specific data on meat consumption or meat contact, and, consequently, we cannot be certain that our Seventh-Day Adventist participants did not eat or handle meat. However, assuming that a substantial percentage of the Seventh-Day Adventists were adherent to a strict vegetarian diet (a not unreasonable assumption, as blood samples were collected from church attendees at the close of Sabbath services), we would have expected to see some evidence of decreased seroprevalence if meat consumption was a significant risk factor for Helicobacter pylori infection. We would also have expected to find a greater degree of heterogeneity in the responses of the Seventh-Day Adventists compared with their meateating neighbors (ie, if meat consumption was a risk factor, and there were both meat eaters and strict vegetarians within our group of Seventh-Day Adventists, the range
Hopkins RJ, Wasserman SS, Morris JG. Helicobacter pylori in Seventh-Day Adventists?-Reply. Arch Intern Med. 1991;151(8):1672–1674. doi:10.1001/archinte.1991.00400080152039
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