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Much previous research relating to vegetarianism not only addresses motivations for adopting a vegetarian diet and a number of themes emerge addressing issues relating to health, and ethical and ecological concerns, but also brings to the fore other dyna


promoting access to White Rose research papers Universities of Leeds, Sheffield and York

This is an author produced version of a paper published in Social Science &
Medicine.

White Rose Research Online URL for this paper: http://eprints.whiterose.ac.uk/4074/
Published paper
Fox, N. and Ward, K.J. (2008) You are what you eat? Vegetarianism, health
and identity,
Social Science & Medicine, Volume 66 (12), 2585 -2595.


White Rose Research Online You are what you Eat?
Vegetarians, Health and Identity
Nick Fox and Katie Ward
University of Sheffield
Address for correspondence University of Sheffield Sheffield S1 4DA, UK [email protected] Abstract
This paper examines the views of ‘health vegetarians' through a qualitative study of an online vegetarian message board. The researcher participated in discussions on the board, gathered responses to questions from 33 participants, and conducted follow-up e-mail interviews with eighteen of these participants. Respondents were predominantly from the US, Canada and the UK. Seventy per cent were female, and ages ranged from 14 to 53, with a median of 26 years. This data is interrogated within a theoretical framework that asks, ‘what can a vegetarian body do?' and explores the physical, psychic, social and conceptual relations of participants. This provides insights into the identities of participants, and how diet and identity interact. It is concluded that vegetarianism is both a diet and a bodily practice with consequences for identity formation and stabilisation. Studies of vegetarians have found a range of secular motivations for their dietary choices (Beardsworth and Keil, 1991a, Povey et al., 2001). Personal health and animal welfare predominate (Beardsworth and Keil, 1991b; Hoek et al., 2004, p. 266; Lea and Worsley, 2001, p. 127), while emotional responses to eating flesh (Kenyon and Barker, 1998; Rozin et al., 1997; Santos and Booth, 1996), associations between meat and patriarchy (Adams 1990) or carnality and virility (Twigg, 1979, p. 17), and a range of personal, peer or family beliefs (Lea and Worsley, 2001, p. 128) have also been noted. Vegetarianism may also reflect concerns with the negative environmental impact of meat production (Gaard, 2002; Hoek et al., 2004, p. 265; Lindeman and Sirelius, 2001, p. 182). Rozin et al (1997) differentiate the moral bases for ‘health vegetarianism' and ‘ethical vegetarianism' 1, while Lindeman and Sirelius (2001) offer empirical data to support this distinction, arguing that they are grounded respectively in normative and humanist ideologies. Health vegetarians avoid meat in order to derive certain health benefits or lose weight (Key et al., 2006; Kim and Houser, 1999; Wilson et al., 2004), while ethical vegetarians wish to minimise harm to animals for food or other reasons (Fessler et al., 2003, p. 31; Whorton, 1994). Health vegetarians often make gradual ‘trial adoptions' of their new diet, while ‘ethical vegetarians' make more sudden changes to support their beliefs in animal welfare, and create consistency in their lives (Hamilton, 1993; Jabs et al., 1998). While substantial attention has thus been paid to the motivations behind vegetarianism and the ideological, practical and symbolic bases for this dietary behaviour, there is limited discussion of the consequences of adopting a vegetarian diet for a person's identity or sense of self, and how this may affect behaviour and beliefs over time (Beardsworth and Keil, 1997: 241). Vegetarianism is not only a cognitive or expressive response to food, it is also an embodied practice that can act as a cue to identity (Bisogni et al., 2002; Devine et al., 1999: 89; Twigg, 1979, p. 31). Recent work on embodiment suggests that the body may mediate many aspects of social order and organisation, and contribute to how people reflexively construct their identity (Buchanan, 1997; Fox and Ward, 2006; Giddens, 1991; Haraway, 1997; Negrin, 2002; Williams and Bendelow, 1998). In this paper, we explore the ways in which an embodied dietary practice may lead to the emergence of explicit identities. We focus specifically (though not exclusively) upon health vegetarianism, and draw out the ‘health identities' of those adopting a vegetarian diet. Health, Vegetarianism and Identity
Vegetarianism was associated historically with health in various notions of bodily and spiritual purity (Douglas, 1966, p. 47 ff.) or holism (Twigg, 1979). In the Victorian period, these ideas were given both a scientific and a spiritual spin, linking vegetarianism with the health of both body and spirit (Fraser, 2003, Whorton, 1994). In the modern period, vegetarianism has become an increasingly popular dietary choice, with meat consumption gradually declining (Beardsworth and Keil, 1991b). This has been linked to increased availability of meat-free products (Coveney, 2000: 141), association of a vegetarian diet with improved health (Bedford and Barr, 2005; Hoek et al., 2004; Kim and Houser, 1999; Key et al., 2006; Lea and Worsley, 2003; Phillips, 2005; Whorton, 1994), and a general social emphasis on ‘healthy eating' (Winter-Falk, 2001). Various studies have explored how reflexive constructions of the self affect the adoption and maintenance of vegetarianism. Jabs et al. (1998) found that most vegetarians adopted their new diet gradually as they became more aware of evidence concerning health or animal welfare, while others made a radical change. Among this latter group, life changes such as a divorce, change of career, going to university or experimenting with a new identity often provoked the sudden rejection of meat. Devine et al. (1998) have described the feelings, strategies and actions in relation to food choices that people adopt as ‘trajectories' that demonstrate persistence and continuity as circumstances alter. These trajectories are underpinned by values that determine what foods are chosen (Sobal et al., 2006, p. 9), and Lindeman and Sirelius (2001, p. 183) argue that alongside other lifestyle decisions, food choice has emerged as a further means for people to express their personal and philosophical commitments. Vegetarianism appears to be a fluid, subjective category that is ‘good to think' (Tambiah, 1969; Twigg, 1979, p. 31), with many people identifying themselves as vegetarian while continuing to eat foods other than plants (Lea and Worsley, 2003; American Dietetic Association, 2003; Hoek et al., 2004). In their study of dietary habits, Bedford and Barr (2005) found that vegetarians and vegans generated definitions to fit their own practices, and Willets (1997) described how a ‘lapse' from strict vegetarianism did not prevent a vegetarian or vegan from sustaining her/his self-definition. Conversely, the persistence over time of a vegetarian or vegan lifestyle (which may be hard to sustain practically and the subject of social opprobrium) suggests that reflexivity plays a part in their maintenance. Jabs et al (1998, p. 200) point to the importance of cognitive consistency (and the avoidance of cognitive dissonance) as factors in adopting a vegetarian diet, while there is evidence for convergence of beliefs over time between those who have adopted a vegetarian diet for health or ethical reasons (Beardsworth and Keil, 1991a), possibly to provide further cognitive support for a difficult life choice (Santos and Booth 1996, p. 204). Fox and Ward (in press) found that while environmentalism was not a primary motivator for vegetarianism among their respondents, ecological justifications for a meat-free diet may emerge over time as part of a subsequent generalisation of an original focus, perhaps as a consequence of rationalisations of behaviour, as adoptees of a minority dietary choice seek additional reasons for their decision, or as they are exposed to the views of others within a vegetarian ‘community of practice' (Bisogni et al., 2002; Jabs et al., 1998). There may also be convergence between the ‘deviant' behaviour of avoiding meat (Kenyon and Barker, 1998; Lea and Worsley, 2001) and other lifestyle commitments including energy conservation and waste reduction, which have until been recently regarded as radical or alternative. An interesting account of the relationship between eating and identity may be found in a study by Bisogni et al. (2002). Based on a qualitative study of eating behaviour, they argued that diet and identity were mutually constitutive, with identities both derived from and influenced by dietary choices. Identities were also affected by other personal characteristics, social and physical environment, reference groups and social categories, and were consequently both stable and highly individualised. Over time, dietary choices foster self-images and are an on-going cue for reflection and self- evaluation. These identity processes stabilise eating behaviours, establishing a feedback loop that is resistant to change (ibid., p. 131). Other studies support this reciprocal model. Devine et al. (1999, p. 89) found that respondents enacted their ethnic identities through dietary choices, and used food as an opportunity to bolster affiliations with their ethnic communities, or to reflexively sustain their identity in a strange environment. However, these approaches (in which ‘identity' appears to be an attribute bolted on to a prior human subject) highlight the problematic nature of identity in social theory. Most sociological models of identity foreground the role of social context in identity formation: identities are never prior, but ‘mobilised' in relation to (Bond et al 2003), or ‘constructed' from these contexts (Kiely et al., 2001; Turner and Oakes, 1997). Cultural formations may provide models (Connell, 1995) or discourses (Davies and Harre, 1998) for actors to appropriate, or mark out their distinctiveness from others (Vignoles et al., 2000). While identity exists in relation to a social context, Jenkins (2004: p. 18-19) has suggested that it should also be understood as inextricably linked to embodiment, the ‘canvas' upon which identity plays. The body is a reference point for identity, both in terms of continuity of the self and as a marker of similarity or difference (ibid., p. 19, Riley and Cahill, 2005, p. 263). Authors have suggested that the Deleuzian question ‘what (else) can a body do?' (Deleuze and Guattari, 1988, p. 257) offers a way to explore this relationship between embodied practice and identity (Buchanan, 1997; Fox, 2002; Fox, 2005; Fox and Ward, 2006; Potts 2004). Identities manifest from the reflexive interactions or ‘confluences' of the body with the physical, psychological, emotional and conceptual aspects of the environment, and are constituted within the totality of these relations (Fox, 2002). Health and illness, gender and sexuality, work, creativity, class, ethnicity, growth, maturation and ageing can all supply the relations for a reflexive embodiment, and the possibilities and limits of identity emerge within the contexts of what (else) a body can do. New body technologies including body modification by cosmetic surgery (Negrin, 2002), pharmaceuticals (Monaghan, 2000; Potts, 2004), genetic therapies (Le Breton, 2004), tissue engineering and cloning (Petersen, 2002) alter and enhance what (else) bodies can do, and in a society increasingly focused on such potentials, we may expect identity to be constituted within the context and limitations of such health-related practices. In a series of studies, we have explored how ‘health identities' are grounded in the various physical, psychological and social relations associated with embodiment, for instance fitness and exercise, body modification, diet, illness, disability or growing old (Fox, 2002; Fox, 2005; Fox and Ward, 2006). Identities may be congruent with medicalised conceptions of health (for instance in weight loss programmes that encourage a identity constituted in relation to body mass), or emergent from a resisting sensibility to biomedicine such as the pro-anorexia movement or non- medical use of Viagra (ibid.). However, health identities are not static, but are associated with action and emerge from a ‘exercising' or ‘slimming' or ‘ageing' or ‘healthing' body. Might a dietary choice such as vegetarianism thus be a further embodied ‘identity practice', in other words, an action that contributes reflexively to a relatively stable sense-of-self? We set out to look at the ‘vegetarian-ing' body, to explore how the various relations that link health, diet and the body contribute to the identities of vegetarians. By asking what the vegetarian body can do, we will elucidate the physical, psychological, emotional and conceptual relations of the vegetarian(ing) body and consequently the relationship between diet, health and Research Design and Methods
We wished to obtain qualitative data to elucidate the relations within which vegetarians constituted both their dietary choices and their identity as non-meat- eaters. These relations may be material (for example with foodstuffs, animals or other vegetarians), experiential (taste, disgust, illness, allergies etc), emotional (reactions to animal welfare) or conceptual, for instance with beliefs concerning health or animal The study was based on ‘online ethnographic' work carried out in a web-based forum concerned with secular vegetarianism, which will be referred to here as the VegForum. The forum was selected because it attracted a high volume of users who posted regularly to the message boards, creating a lively website with a heavy flow of ‘traffic'. Message boards covered disparate topics, including advice to new vegetarians, health, animal rights and ecology. Participants ranged from strict vegans to those who ate dairy products or even fish. Glaser et al (2002, p. 189-190) suggest that the anonymity of the Internet is useful to research sensitive subjects, and Internet research is a cost-effective way to access small or hard to find groups who interact in specialist fora (Nosek et al., 2002; Illingworth, 2001). However, anonymity may increase intentional or unintentional deception (Glaser et al., 2002, p. 191) or identity manipulation (Hewson et al., 2003, p. 115, Nosek et al., 2002, p. 172). Participants need access to hardware, skills in typing and motivation to participate in what can be lengthy online interviews (Chen and Hinton, 1999), and so may under-represent poor and minority groups, although Hewson et al. (2003, p. 32) consider that this bias is disappearing with increasing Internet access. Thomsen et al. (1998) suggest that multi-method triangulation using textual analysis, prolonged participant observation and qualitative interviews can provide valid and reliable data, and we have used this approach in past studies (Fox and Ward, 2006). As with most qualitative approaches, we did not claim to be establishing a ‘representative' sample, but did apply a range of methods to gather data broadly and gain data saturation. It remains a limitation of the design, however, that participants in a forum such as this may under-represent sectors of the vegetarian To access the field of study, KW subscribed to the VegForum, announced her ‘presence', and explained that she was researching attitudes and beliefs about health among vegetarians. The research was carried out between August 2005 and February 2006 and comprised of three stages: • Participation in synchronous discussion within the VegForum. Permission was gained from participants to reproduce relevant posts from discussions. • A survey or ‘poll' of participants in one of the VegForum message boards known for its supportive and tolerant atmosphere, to which there were 33 responses. The survey contained open-ended questions designed to explore the health bases for participants' dietary choices and how these related to broader perspectives and life-style choices. Respondents were asked for their age and nationality, and were identified by their VegForum pseudonym. They were predominantly from the US and Canada, with some UK members. Seventy per cent were female, and ages ranged from 14 to 53, with a median • Respondents were invited to participate in asynchronous follow-up interviews, and 18 agreed to this. These were conducted using the VegForum's own private messaging system, providing confidentiality but permitting tracking of respondents from the earlier stages of data collection. These were unstructured interviews based on cues in respondents' answers to the survey questions, enabling respondents to enlarge on their responses concerning their beliefs and attitudes, triggers and other factors that had led them to become vegetarian, and the effects of being vegetarian on their lives. These collection techniques will tend to supply somewhat different kinds of data. Asynchronous surveys and interviews may produce more measured responses, and on occasions, some of our data does give the impression of ‘sloganising'. This stands in contrast to the more ‘natural' synchronous discussion extracts, which provide more direct insight into the expressive aspects of respondents' views. Together, we believe these methods provide a richness to the data we have reported and increased internal validity and reliability (Thomsen et al., 1998). Data were analysed using the framework methodology for qualitative analysis. This is an approach to analysis that is appropriate to deductive research that addresses pre- set aims and objectives (Pope et al 2000), and enables data to be systematically collated and displayed within a spreadsheet or other software package, in order to address specific topic areas. Collated data can then be indexed and key findings extracted. All data from the case study have been reported in the ethnographic past tense, participants have been fully anonymised, and spellings have been corrected to Research Findings
In the following analysis, we consider first the relations that link diet with health for these vegetarians, and then examine how these contribute to the identities associated with dietary choices. Finally we examine contestations of identity among respondents, particularly in relation to ‘ethical' vegetarianism. Health and the Vegetarian Diet There was no shortage in our data of relations linking the vegetarian-ing body with ‘health'. For many respondents in the study, it had been the primary motivation for their decision to cease eating meat. Carol linked health to diet both experientially and Because I ate so much red meat before I went veggie, I practically lived off it so I wasn't very healthy at all and I hated feeling so unhealthy, and for a while I considered whether going veggie would improve my health, so I researched vegetarianism on the net and found out about the health benefits of being vegetarian such as having a stronger immune system and less likely to suffer high blood pressure (interview) Vegetarianism was cited variously by respondents as inherently associated with positive health and well-being. Diet was perceived as central to good health and longevity, while poor diet was linked to poorer health or specific diseases. Will suggested that ‘nothing affects your mind and quality of life as much as nutrition, while Ruby argued that ‘you can't expect your body to treat you right if you fill it full of crap all the time'. For June, the vegetarian diet was essential for her body I'm an active teenager, so I need lots of nutrients. I feel better knowing that I'm eating what my body needs (survey). Respondents offered a variety of types of evidence for this link between diet and health, ranging from the experiential to the ideological. For a few respondents, there had been a specific adverse health event that had prompted the move to a vegetarian diet. One said he had suffered from difficulties digesting meat, another from acne, while another adopted a vegetarian diet to counter high blood pressure. For some, the decision to become vegetarian had been motivated by a specific effort to improve health, for example to lose weight, ‘to cut down on my dairy for cholesterol reasons' or ‘to avoid high blood pressure and kidney stones'. The value of the diet was justified by some respondents by virtue of its positive effects on daily health To me- it is VERY important. If I eat crappy for even a week because I am away on business I feel horrible, tired, sluggish, and irritable (Mac, survey) Some participants contrasted their current healthy diets with previous or childhood food intakes, which they now perceived as unhealthy. The change to vegetarian diet was associated directly with an improvement in health I was overweight as a kid, I ate junk food, no veggies, and did not drink water. All of my liquid came from sodas. ALL of it. It was a long process to get out of that dietary sinkhole, and sometimes I am surprised that I did. Nowadays, typical dinners for me are home-cooked with plenty of whole foods. (Vinny, Others wished to avoid family health problems such as heart disease. In an interview, Lucy commented that her family has a history of breast/ovarian cancer and high cholesterol and I figured that eating the best possible diet of the most healthful foods (combined with exercise) would be the best thing I could do to prevent myself from developing these diseases as much as possible. Also most of my family is lactose-intolerant and though I didn't get sick when I ate dairy, I've noticed that when I DON'T eat it I feel better overall (interview) However, for some respondents in the study, the links between vegetarian diet and health were founded on ideologies, theories and perceptions, and a decision to change diet was based on this theoretical link. For Victor, veganism was an effective way to achieve good health and avoid a range of chronic diseases. Cancer, heart disease, later on stroke, osteoporosis. There are a lot of problems with a Western diet. It's very unfortunate that there is little profit in conveying these facts, but lots of profit in covering them up. A vegan diet done right is just about the healthiest diet you can have (survey) Ben argued that animal farming was ‘a breeding ground for antibiotic-resistant bacteria and viruses, which can spread to humans' (survey). Jane supported her ideological claims with personal experiences, which she suggested justified the If you want to live a longer life, then eating healthy is key. Eating unhealthy foods can really change your personality. When you switch to a healthy diet from an unhealthy diet you get this sudden spring in your step, so to speak. Every day that I wake up, I feel so much healthier and alive than I used to. It's so awesome to feel awake and alive (survey) For another respondent, Cath, health was not just physical, it was also an aspect of her spiritual link to nature I see vegetarianism as a way to reduce my harmful impact on the Earth. I've seen my change in diet have a positive impact on my body (which relates back to respect) and my sense of well-being (interview) In summary, there are many relations concerning health for the vegetarian-ing body. These include the physical effects of meat and vegetarian diets, the cognitive association of diet with physiology, the experiential aspects of a vegetarian diet, family or personal histories and conceptual relations between diet and health. These relations variously motivated people to stop eating meat, or to sustain a vegetarian diet once adopted. Negative Consequences of the Vegetarian Diet Not all the relations between the vegetarian-ing body and health were positive, as health can be problematic for strict vegetarians and vegans. In Sneijder and te Molder's (2004) study of veganism, respondents de-emphasised the potential health problems associated with their dietary commitment, and argued that it was a matter of personal responsibility and integrity to avoid ‘health problems' within a vegan lifestyle. This issue was raised by our respondent Solomon I do think that vegans have a responsibility to watch their health - dead vegans make horrible advocates, especially when they die from something like a heart attack. However, I also think that we should make vegan foods seem exciting, accessible and fun - not a boring chore that we have to force ourselves through Some participants were conscious of the dangers of a diet low in certain essential I am still pretty new to this kind of diet, so I still enter all my food eaten into a computer program I have and look at how my nutrition stacks up against the RDAs [recommended daily amount]. It has been hard to get the RDA of protein without eating a load of tofu everyday (Mark, survey) One strategy used by some participants was use of nutritional supplements, grounded in careful research I take a woman's daily multi a few times a week (when I remember). I also that a B-complex when I feel stressed, vitamin C when I feel like I'm starting to get sick, and calcium-magnesium when I've been working hard and might get leg cramps. Otherwise I try to get as much from my diet as I can (Cath, survey) However, some of our respondents regarded supplements as an inferior source of nutrition and advocated a comprehensive diet as an alternative. When asked whether she took any supplements, Jane replied No. I don't feel like I need to. I feel better than I did when I was an omnivore, and so I know that I must be doing something right. I get my iron checked twice a year just in case. It is going up over time. My nutritionist tries to get me to take multi[vitamin]s, but I avoid them because the vegan ones are so expensive. I would also rather get nutrients and [suchlike] from a resource other then popping a pill (survey) Despite the negative associations between vegetarianism and health, these relations may still be highly significant for the emergence and sustaining of a vegetarian identity, as the last extract indicates. In the next section, we look more closely at how these positive and negative relations contribute to a vegetarian identity. Elaborating a Vegetarian Identity Within the Deleuzian model, reflexive identity emerges from the limits of ‘what (else) a body can do', based on the sum of a body's physical, psychical, social and conceptual relations. The range of relations and the links to emergent identity can be seen among the vegetarians in this study. Most of our respondents described vegetarianism as not only a diet, but also a way to confirm personal commitments or the validity of a broader lifestyle orientation. Will's diet encompassed various I try to eat primarily organic. Being where I live cost of organic food isn't really an issue. I try to eat as few processed foods as possible and eliminate added sugars. For the most part all of the above are working (Will, survey) Sometimes these dietary choices were one element within a range of bodily practices. Simon's diet, for example, appeared to be part of a general ‘de-toxification' of his life I feel better, cleaner. I also quit smoking and went back to biking, walking and trying not to travel by automobile. Physically I know that my diet is better (Simon, interview) For other participants in the forum, vegetarianism was emblematic of a broader sense of personal responsibility for health … people should be more involved in their own health rather then completely relying on a physician or whoever. I also think that our culture neglects healing through whole foods and I support it 100%. Since most herbal remedies consist of inert chemicals … potential harm is minimal. (Gail, forum) I have one friend in particular who gets a cold, goes to the doctor, gets meds and proceeds to go about her day miserable and ill doesn't even go to bed early. Plus she eats crappy food. I haven't had a cold in forever but when I did start to feel poorly I would get extra rest and eat well, increase my liquids, etc, etc. and tried to limit activities as much as possible (Petal, forum) In her study, Twigg (1979) noted that vegetarianism was often associated with ‘alternative' lifestyles or holistic or mystical practices. Our respondents similarly reported a range of behaviours unrelated to diet that suggests their vegetarianism was located in a broader nexus of relations (although with a 21st century emphasis) that contributed to reflexive identity. Participants suggested environmental commitments in which they were involved, including saving energy, using public transport, re- cycling, composting, tree-planting and picking up litter. Naomi commented (survey) that she was ‘considered the recycle queen, totally obsessed-reduce, reuse, recycle', while Lucy commented (survey) that she was ‘fairly environmentally friendly - public transit, composting, gardening, canvas bags instead of paper or plastic'. Like Babs, who tried to walk whenever possible, Andy had cut his energy consumption I telecommute, so I'm not burning gas sitting in rush hour traffic every day. I bought a less luxurious car than my previous one because it gets 50% better mileage. I keep my thermostat at 65 during the cold season and don't heat rooms that aren't used much, including my guest bedroom. I don't heat my master bath[room] since I only use it about 15 minutes a day (Andy, survey) These data indicate the elaborating relations of the vegetarian-ing body. Health may be a motivation for vegetarianism, or a justification for this dietary option, but once adopted, a vegetarian diet can become an end in itself, or one of a set of bodily practices that reflect a range of relations, not only with the materialities of physiology or biochemistry, but with ideological and philosophical commitments that may extent beyond health. Particularly for vegan participants, both human and animal health were located within this nexus of concerns with a lifestyle that contributes positively to the environment, while other environmental concerns were also important drivers of a broader lifestyle within which vegetarianism was one element. This can have consequences for reflexive sense of sense. For Michael, the extent of his responsible behaviours had led him to be perceived as different by some friends. I recycle, try and cut down waste, conserve energy. … Most of my friends think I'm weird because in addition to the above, I also refuse to eat anything with e- numbers or hydrogenated oils and also boycott animal testing companies (survey) Mark refused to adopt a label, preferring to construct an identity around health rather When eating a vegan diet my symptoms go away and I feel great. I never call myself a vegan or vegetarian. I tell people that I have food allergies and I have to eat like this for my health. I feel so much healthier when I eat vegan meals However, our study also found that the relations surrounding vegetarianism could be problematic for identity. This can be discerned within a debate on the VegForum during the period of this research, in which participants divided themselves into two categories: ‘health vegetarians' whose principle aim was to improve their own health or prevent disease, and ‘ethical vegetarians', who saw animal rights as the most important motivator. The latter group was sometimes critical of health vegetarians, as personal health was regarded as a selfish motivation, as enunciated by Diana. Now, about health vegans. I certainly don't jump for joy just because ‘one less animal is killed'. If people only care about themselves and their health, that shows they are selfish and egotistical. … I find their motivations for being vegan boring and selfish. There's nothing wrong with wanting to stay healthy. … But there are lots and lots of healthy people who eat meat and/or fish every day of their lives and they live till they're 100. (forum) Another VegForum participant responded to this as follows: I think everyone can agree the less meat people eat the better. Making a difference in general is difficult and pointing fingers about who makes more of a difference doesn't help anybody's cause. I consider myself a health vegetarian for the most part. I do agree with a lot of AR [animal rights] causes, and so I see both sides of the story (Caroline, forum) In summary, we can see that the embodied practice of vegetarian diet is located in a myriad of relations, which together constitute not only a practice that manifests at mealtimes, but may elaborate a range of other commitments, and a consequent reflexivity about their embodied, choice-making lived experience. Few of our respondents were pure ‘health vegetarians', and many had adopted environment concerns that contributed reflexively to their lifestyle and identity. The fault-line within the VegForum over health and ethical motivations demonstrates how the relations that surround an embodied practice such as vegetarianism, especially when imbued with moral value, are much more than simply dietary. Rather they contribute to a reflexivity that invests an identity, and what is ‘simply' a bodily practice also becomes an identity practice. Discussion
The data in this study supports previous findings that health is a significant motivator for vegetarians (Beardsworth and Keil, 1991; Rozin et al., 1997; Lindeman and Sirelius, 2001), both because of perceived health benefits or to prevent or counter disease. Respondents in the study offered a range of health-related reasons for a vegetarian diet, and these provided a context for the dietary choices they made. However, it was clear that this association between diet and health also entailed lifestyle choices that were not simply concerned with individual health. For many respondents, the health benefits of vegetarianism had connections to other beliefs, values and commitments, predominantly in relation to environmental concerns. For some, health was something to be sustained in spite of a self-denying diet selected for ethical reasons. And, as we saw in the final section of the findings, these relations influence the reflexive identities of those within this vegetarian community. While for health vegetarians, their dietary choice was linked to positive values associated with health, for the ethical vegetarians, these values were turned on their heads, to suggest selfishness and a lack of concern by health vegetarians with the victims of meat-eating: animals. We wish to focus here on the ways in which the relations that cluster around vegetarianism contribute to a reflexive identity. Readers will recall that we introduced earlier the Deleuzian question 'what can a body do?, and in this context we can ask more specifically what (else) can a non-meat-eating body do? In proposing that this question is of interest, Buchanan (1997) argued that the answer is not to be found in terms of functions, but grounded in the possibilities and limits consequent upon the psychological, emotional and physical engagements of that body. In this anti-essentialist perspective, a body is the capability to form new relations, and the desire to do so (ibid., p. 83). From this perspective, our analysis suggests that the non-meat eating body is much more than simply a physical entity unsullied by animal protein, it is constituted from these physical engagements but also from a myriad of cognitive, emotional, cultural, social and philosophical relations. ‘Health vegetarians' in this study had relations not only to meat and vegetables, but also to diseases and symptoms, and to notions of purity, holism, integrity and so forth. However, various respondents also described a further set of relations: to animals, the environment, industrialisation, globalisation and so on. Identities emerge from these constellations of relations that contextualise the practice of vegetarianism. Identity is thus an outcome of embodied practice within the context of the ‘physical and cultural worlds which impinge and limit, yet also make possible' (Fox, 2002, p. 349). By mapping these relations, we can learn more about the identities that emerge around these confluences of bodies and their We noted earlier Bisogni et al.'s (2002) model of reciprocity between diet and identity, which accounts both for a stability in dietary choices, and the ways in which dietary choices can be markers for identity and distinctiveness. While this model recognises the part a practice such as vegetarianism can play in identity-formation and stabilisation, the inherent essentialism of that account, in which it appears that a prior human agency consciously accretes identity upon itself, limits its sociological appeal. The Deleuzian approach adopted in this paper, while similarly acknowledging the mutuality of practice and identity, resists the problem of a prior human subject. Here the focus is on the confluences between bodies and the physical, psychic, social and conceptual relations that emerge from bodily practice, and the stabilisation of consequent possibilities and limits for reflexive identification. Our data tells us that because every vegetarian's relations are both myriad and consequential upon personal history, background and so forth, so also the emergent identity will be highly individualised. While ‘health vegetarian' or ‘ethical vegetarian' can serve as a headline for this identity, reflecting a set of embodied practices (what the body can do), we have seen the variety of relations, and the continuities between these categories. On the other hand, we also see how these categories can serve as exclusivities, such that ‘ethical vegetarianism' may be defined at least in part in opposition to a health-motivated dietary practice. By exploring relations, we can thus learn much more about identities associated with embodiment It is methodologically possible to impose some second-order patterning upon this bewildering variety of vegetarian identities. Elsewhere we have described the kinds of identities that people construct from different health practices, including weight loss, use of viagra and anorexia (Fox and Ward, 2006). Among these ‘health identities', we mapped out a dimension ranging from expert patient to resisting consumer, which we summarised as autonomy/dependence. This provided explanatory power to understand a range of health identities and the kinds of care that would be appropriate and effective. A similar analysis of the individuals in this study might yield further dimensions that could then offer insights into how vegetarians understand health and illness, or to predict health behaviour. We can take the relations that Simon or Jane have with their lived worlds and ask what else their bodies can do. This is not a question about functionality, but about the limits that relations impose on active, choice-making, embodied ‘vegetarian-ing' selves. Such an approach would enable understanding of individual choices concerning practices that can influence health and illness. However it also reminds us to be cautions about generalisation, because of the contingent nature of identity as grounded in the multiplicity of relations of individual vegetarians. Rather than undertake an individualised analysis of that type here, we wish to limit ourselves to some more general reflections on an identity approach to an embodied health practice such as vegetarianism. The existing literature has sought to explain vegetarianism in terms of triggering factors such as a divorce or going to university (Jabs et al. (1998), values that determine what foods are chosen (Sobal et al., 2006, p. 9), or as an expression of personal and philosophical commitments (Lindeman and Sirelius, 2001). Asking what a body can do addresses these aspects in a somewhat different way, regarding them all as relations that may enable or constrain, setting limits on what is possible or creating possibilities that may affect actions and practices. However these are not simply independent variables that act on people to determine their behaviours. Rather, these relations are ‘confluent' with the active sense-making of human actors. Importantly, these relations serve not as the determinants of action, but as contributors to a reflexive and on-going identity, whose limits determine what (else) a body can do. The literature has also acknowledged the role that a practice such as vegetarianism has in enabling a person to define themselves in a particular way (Devine et al., 1999; Twigg, 1979). A range of studies have suggested that vegetarianism is a moveable feast, capable of being interpreted flexibly to incorporate fish and poultry consumption (Bedford and Barr, 2005; Hoek et al., 2004; Lea and Worsley, 2003), and ‘lapses' (Willets, 1997). On the other hand, there is evidence that once adopted, vegetarians demonstrate persistence and continuity over time (Devine et al., 1998). Once again the Deleuzian approach is helpful, providing insight into the power of embodied practice to generate reflexivity. Bolstered by the relations that mediated a turn from meat, consumption of a vegetarian diet accretes further relations that sustain and may deepen the commitments to vegetarianism over time, indeed vegetarians may cultivate such relations actively. This helps to explain the elaborations of health vegetarians' practices around a range of environmental commitments, but also the antipathy between health and ethical vegetarians. The ‘healthy-eating, responsibility- taking, disease-avoiding' body of the health vegetarian has different relations from that of the ‘animal-loving, self-denying, proselytising' body of the ethical vegetarian, though both may elaborate their practices with environmental commitments (Fox and Ward, in press). Like other embodiment practices, diet thus has the potential to contribute to the identities of their proponents. However, as we have sought to show in this final section, body and identity are not linked in a simple causal relationship. Identity is neither an assertion of individuality nor a socially-constructed attribution, but an embodied, reflexive process grounded firmly upon practice and the relational context within which it takes place. What (else) a body can do is a way of reflecting on both practices and identity: a practice such as vegetarianism, which may or may not be a ‘health behaviour', is also a contributor to identity. It is the latter that, in turn, will underpin and create regularity in behaviour over time. Behaviour is thus indirectly mediated by the myriad relations of a body that constitute reflexive identity. This way of understanding body, identity and health has relevance for the explorations of health behaviour and ‘healthy' living. It opens up a dietary practice like vegetarianism to a form of analysis that links behaviour, social context and the active processes of sense-making that constitute what else a body can do. In this way it confirms the importance of identity in determining both present and future behaviour. Vegetarianism is both a practice and an identity for its proponents. 1. Our data indicates that this classification is also used by vegetarians 2. Some participants used the word veg*n to refer to both vegetarians and References
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Long chain polyunsaturated fatty acids are requiredfor efficient neurotransmission in C. elegans Giovanni M. Lesa1,*,‡, Mark Palfreyman2, David H. Hall3, M. Thomas Clandinin4, Claudia Rudolph5,Erik M. Jorgensen2 and Giampietro Schiavo11Molecular Neuropathobiology Laboratory, Cancer Research UK, London Research Institute, Lincoln's Inn Fields Laboratories, 44 Lincoln's InnFields, London WC2A 3PX, UK2Department of Biology, University of Utah, Salt Lake City, Utah 84112-0840, USA3Center for C. elegans Anatomy, Department of Neuroscience, Albert Einstein College of Medicine, Bronx, New York 10461, USA4Nutrition and Metabolism Research Group, University of Alberta, Edmonton, Alberta, T6G 2P5, Canada5EleGene AG, Am Klopferspitz 19, 82152 Martinsried, Germany*Present address: MRC Laboratory for Molecular Cell Biology, University College London, Gower Street, London WC1E 6BT, UK‡Author for correspondence: (e-mail: [email protected])

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Musculoskelet Surg (2010) 94:59–61 Primary hydatid cyst of the biceps femoris M. F. Hamdi • B. Touati • A. Abid Received: 14 September 2009 / Accepted: 18 January 2010 / Published online: 4 February 2010Ó Springer-Verlag 2010 which generally involves the liver and the lungs. Primarymuscle hydatidosis is an uncommon finding. The authors A 25-year-old woman living in a rural area consulted for a