Plant-forward diets offer a potential solution to many of the health and ecological crises that we find ourselves facing today. A key barrier to the adoption and maintenance of plant-forward diets is ...an anticipated lack of support from family members, friends and romantic partners. The present study examined how relational climate (i.e., the cohesion and flexibility of a partnership) contributes to the tension individuals anticipate in their relationship when a member reduces their animal-product consumption, and their own openness to reducing. Four hundred and ninety-six coupled individuals took part in an online survey. Analyses revealed that couples with more flexible leadership styles anticipated less tension should they or their partner adopt a plant-forward diet. However, dimensions of relational climate were largely unrelated to openness to plant-forward diets. Romantic couples who perceived themselves to be matched in terms of dietary habits were less open to reducing their animal-product consumption than unmatched couples. Politically left-leaning couples and females were more open to plant-forward diets. The meat attachments of male partners were reported as a particular barrier to dietary goals, as were practical concerns about meal coordination, finance, and health. Implications for promoting plant-forward dietary transitions are discussed.
Adding to research on the form and content of anti-vegan sentiment, recent scholarship has identified a group of individuals who self-subscribe as “anti-vegan”. Here, we sought to determine whether ...anti-veganism might reflect a distinct dietarian identity with its own unique ideological profile. Two-hundred and fourteen vegans, 732 omnivores, and 222 self-identified “anti-vegans” were assessed using a survey methodology that included the Dietarian Identity Questionnaire and ideological markers related to dark humour, social dominance orientation (SDO), speciesism, male-role norms, moral relativism, and attitudes toward science. Our analysis revealed a dietarian identity unique to anti-vegans. The dietary patterns of anti-vegans were more central to their identity than for omnivores, though marginally lower than vegans. Like vegans, anti-vegans scored highly on dietarian measures of private regard and personal dietary motivations, and lower than omnivores on public regard. The diets of anti-vegans were more morally motivated than omnivores. However, anti-vegans scored higher than both omnivores and vegans on a number of ideological measures including dark humour, SDO, speciesism, male-role norms, moral relativism, and distrust of science. Somewhat surprising, anti-vegans held greater trust than omnivores in the science of plant-based nutrition. We discuss the unique dietarian identities of anti-vegans, considering both intra-group differences of omnivores and anti-vegans (e.g., in right-wing ideology), and inter-group similarities of vegans and anti-vegans (e.g., in diet centrality).
Despite the established health and ecological benefits of a plant-based diet, the decision to eschew meat and other animal-derived food products remains controversial. So polarising is this topic ...that anti-vegan communities — groups of individuals who stand vehemently against veganism — have sprung up across the internet. Much scholarship on veganism characterizes anti-vegans in passing, painting them as ill-informed, uneducated, or simply obstinate. However, little empirical work has investigated these communities and the individuals within them. Accordingly, we conducted a study using social media data from the popular platform, Reddit. Specifically, we collected all available submissions (∼3523) and comments (∼45,528) from r/AntiVegan subreddit users (N = 3819) over a five-year period. Using a battery of computerized text analytic tools, we examined the psychosocial characteristics of Reddit users who publicly identify as anti-vegan, how r/AntiVegan users discuss their beliefs, and how the individual user changes as a function of community membership. Results from our analyses suggest several individual differences that align r/AntiVegan users with the community, including dark entertainment, ex-veganism and science denial. Several topics were extensively discussed by r/AntiVegan members, including nuanced discourse on the ethicality and health implications of vegan diets, and the naturalness of animal death, which ran counter to our expectations and lay stereotypes of r/AntiVegan users. Finally, several longitudinal changes in language use were observed within the community, reflecting enhanced group commitment over time, including an increase in group-focused language and a decrease in cognitive processing. Implications for vegan-nonvegan relations are discussed.
Pledges are a popular strategy to encourage meat reduction, though experimental studies of their efficacy are lacking. Three-hundred and twenty-five participants from three different countries (UK, ...Germany, Australia) were randomly assigned to pledge 28 days meat-free or not, and their behavior was tracked via smartphones. Participants answered daily surveys regarding their eating behavior, meat cravings, and shared photos of their meals. Baseline data was collected prior to the pledge, after the 28 days, and one-month post-intervention. Participants assigned to the pledge condition ate less meat across the 28 days, compared to control participants. Meat reductions, observed at outtake, did not endure one-month post-intervention. Overall, German participants ate the least amount of meat, and showed the sharpest decrease in consumption when pledging. Meat cravings tended to increase among pledgers, relative to control participants. Pledgers who reported high starting intentions and conflict about meat tended to eat less meat and reported fewer cravings. All participants reported reduced meat-eating justifications one-month post-intervention. These findings provide experimental evidence that pledges can encourage meat consumers to reduce their intake, though additional mechanisms are needed to sustain commitments.
Summary
The National Osteoporosis Guideline Group (NOGG) has revised the UK guideline for the assessment and management of osteoporosis and the prevention of fragility fractures in postmenopausal ...women, and men age 50 years and older. Accredited by NICE, this guideline is relevant for all healthcare professionals involved in osteoporosis management.
Introduction
The UK National Osteoporosis Guideline Group (NOGG) first produced a guideline on the prevention and treatment of osteoporosis in 2008, with updates in 2013 and 2017. This paper presents a major update of the guideline, the scope of which is to review the assessment and management of osteoporosis and the prevention of fragility fractures in postmenopausal women, and men age 50 years and older.
Methods
Where available, systematic reviews, meta-analyses and randomised controlled trials were used to provide the evidence base. Conclusions and recommendations were systematically graded according to the strength of the available evidence.
Results
Review of the evidence and recommendations are provided for the diagnosis of osteoporosis, fracture-risk assessment and intervention thresholds, management of vertebral fractures, non-pharmacological and pharmacological treatments, including duration and monitoring of anti-resorptive therapy, glucocorticoid-induced osteoporosis, and models of care for fracture prevention. Recommendations are made for training; service leads and commissioners of healthcare; and for review criteria for audit and quality improvement.
Conclusion
The guideline, which has received accreditation from the National Institute of Health and Care Excellence (NICE), provides a comprehensive overview of the assessment and management of osteoporosis for all healthcare professionals involved in its management. This position paper has been endorsed by the International Osteoporosis Foundation and by the European Society for the Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases.
Barrett's oesophagus (BE) is the premalignant condition associated with the development of oesophageal adenocarcinoma (OAC). Diagnostically, p53 immunohistochemistry remains the only biomarker ...recommended clinically to aid histopathological diagnosis. The emerging mutational profile of BE is one of highly heterogeneous lesions at the genomic level with many mutations already occurring in non-dysplastic tissue. As well as point mutations, larger scale copy-number changes appear to have a key role in the progression to OAC and clinically applicable assays for the reliable detection of aneuploidy will be important to incorporate into future clinical management of patients. For some patients, the transition to malignancy may occur rapidly through a genome-doubling event or chromosomal catastrophe, termed chromothripsis, and detecting these patients may prove especially difficult. Given the heterogeneous nature of this disease, sampling methods to overcome inherent bias from endoscopic biopsies coupled with the development of more objective biomarkers than the current reliance on histopathology will be required for risk stratification. The aim of this approach will be to spare low-risk patients unnecessary procedures, as well as to provide endoscopic therapy to the patients at highest risk, thereby avoiding the burden of incurable metastatic disease.
Recent studies show that aneuploidy and driver gene mutations precede cancer diagnosis by many years
. We assess whether these genomic signals can be used for early detection and pre-emptive cancer ...treatment using the neoplastic precursor lesion Barrett's esophagus as an exemplar
. Shallow whole-genome sequencing of 777 biopsies, sampled from 88 patients in Barrett's esophagus surveillance over a period of up to 15 years, shows that genomic signals can distinguish progressive from stable disease even 10 years before histopathological transformation. These findings are validated on two independent cohorts of 76 and 248 patients. These methods are low-cost and applicable to standard clinical biopsy samples. Compared with current management guidelines based on histopathology and clinical presentation, genomic classification enables earlier treatment for high-risk patients as well as reduction of unnecessary treatment and monitoring for patients who are unlikely to develop cancer.
Osteoporosis is a common disease diagnosed primarily by measurement of bone mineral density (BMD). We undertook a genome-wide association study (GWAS) in 142,487 individuals from the UK Biobank to ...identify loci associated with BMD as estimated by quantitative ultrasound of the heel. We identified 307 conditionally independent single-nucleotide polymorphisms (SNPs) that attained genome-wide significance at 203 loci, explaining approximately 12% of the phenotypic variance. These included 153 previously unreported loci, and several rare variants with large effect sizes. To investigate the underlying mechanisms, we undertook (1) bioinformatic, functional genomic annotation and human osteoblast expression studies; (2) gene-function prediction; (3) skeletal phenotyping of 120 knockout mice with deletions of genes adjacent to lead independent SNPs; and (4) analysis of gene expression in mouse osteoblasts, osteocytes and osteoclasts. The results implicate GPC6 as a novel determinant of BMD, and also identify abnormal skeletal phenotypes in knockout mice associated with a further 100 prioritized genes.
In time-to-first-event analyses, icosapent ethyl significantly reduced the risk of ischemic events, including cardiovascular death, among patients with elevated triglycerides receiving statins. These ...patients are at risk for not only first but also subsequent ischemic events.
Pre-specified analyses determined the extent to which icosapent ethyl reduced total ischemic events.
REDUCE-IT (Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial) randomized 8,179 statin-treated patients with triglycerides ≥135 and <500 mg/dl (median baseline of 216 mg/dl) and low-density lipoprotein cholesterol >40 and ≤100 mg/dl (median baseline of 75 mg/dl), and a history of atherosclerosis (71% patients) or diabetes (29% patients) to icosapent ethyl 4 g/day or placebo. The main outcomes were total (first and subsequent) primary composite endpoint events (cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, coronary revascularization, or hospitalization for unstable angina) and total key secondary composite endpoint events (cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke). As a pre-specified statistical method, we determined differences in total events using negative binomial regression. We also determined differences in total events using other statistical models, including Andersen-Gill, Wei-Lin-Weissfeld (Li and Lagakos modification), both pre-specified, and a post hoc joint frailty analysis.
In 8,179 patients, followed for a median of 4.9 years, 1,606 (55.2%) first primary endpoint events and 1,303 (44.8%) subsequent primary endpoint events occurred (which included 762 second events, and 541 third or more events). Overall, icosapent ethyl reduced total primary endpoint events (61 vs. 89 per 1,000 patient-years for icosapent ethyl versus placebo, respectively; rate ratio: 0.70; 95% confidence interval: 0.62 to 0.78; p < 0.0001). Icosapent ethyl also reduced totals for each component of the primary composite endpoint, as well as the total key secondary endpoint events (32 vs. 44 per 1,000 patient-years for icosapent ethyl versus placebo, respectively; rate ratio: 0.72; 95% confidence interval: 0.63 to 0.82; p < 0.0001).
Among statin-treated patients with elevated triglycerides and cardiovascular disease or diabetes, multiple statistical models demonstrate that icosapent ethyl substantially reduces the burden of first, subsequent, and total ischemic events. (Reduction of Cardiovascular Events With Icosapent Ethyl-Intervention Trial REDUCE-IT; NCT01492361).
Age-disparate sexual relationships with older men may drive high rates of HIV acquisition in young women in sub-Saharan Africa, but evidence is limited. We investigate the association between ...age-disparate relationships and HIV incidence in Manicaland, Zimbabwe.
A general-population open-cohort study (six surveys) (1998-2013).
A total of 3746 young women aged 15-24 years participated in consecutive surveys and were HIV-negative at the beginning of intersurvey periods. Last sexual partner age difference and age-disparate relationships intergenerational (≥10 years age difference) and intragenerational (5-9 years) versus age-homogeneous (0-4 years) were tested for associations with HIV incidence in Cox regressions. A proximate determinants framework was used to explore factors possibly explaining variations in the contribution of age-disparate relationships to HIV incidence between populations and over time.
About 126 HIV infections occurred over 8777 person-years (1.43 per 100 person-years; 95% confidence interval = 1.17-1.68). Sixty-five percent of women reported partner age differences of at least 5 years. Increasing partner age differences were associated with higher HIV incidence adjusted hazard ratio (aHR) = 1.05 (1.01-1.09). Intergenerational relationships tended to increase HIV incidence aHR = 1.78 (0.96-3.29) but not intragenerational relationships aHR = 0.91 (0.47-1.76). Secondary education was associated with reductions in intergenerational relationships adjusted odds ratio (aOR) = 0.49 (0.36-0.68). Intergenerational relationships were associated with partners having concurrent relationships aOR = 2.59 (1.81-3.70), which tended to increase HIV incidence aHR = 1.74 (0.96-3.17). Associations between age disparity and HIV incidence did not change over time.
Sexual relationships with older men expose young women to increased risk of HIV acquisition in Manicaland, which did not change over time, even with introduction of antiretroviral therapy.
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