Testing general sociocultural and coach-related appearance pressures as the factors associated with disordered eating in competitive female athletes participating in various sports.

The aim of the present study was to test the sociocultural Petrie and Greenleaf's (2007) model of disordered eating (DE) in competitive female athletes. Specifically, we tested a model of general sociocultural and coach-related pressures towards body weight and appearance of female athletes as the factors associated with athletes' DE through the mediators such as internalization of appearance ideals and overweight preoccupation. 515 athletes participated in this study. The mean age of the sample was 19.0 ± 5.9 years. Athletes were provided with study measures on general sociocultural and coach-related appearance and body weight pressures, internalization of appearance ideals, overweight preoccupation and DE. Path analyses showed that general sociocultural pressures were associated with DE directly and through internalization of appearance ideals and overweight preoccupation. Pressures from coaches were associated with DE through overweight preoccupation and through the internalization of appearance ideals and overweight preoccupation. The models were invariant across body weight sensitivity in sports and age groups. These results inform DE prevention for female athletes. It is important to increase resistance to sociocultural pressures and pressures from coaches in DE prevention programmes for female competitive athletes of all ages and participating in sports irrespective of sports group (weight-sensitive or less weight-sensitive).

Internalisation of stereotyped body appearance standards and body dissatisfaction in adolescent boys: Moderating role of sports participation.

The aim of this study was to test the moderating role of sport participation in the mediation model of media pressures, internalisation of appearance ideals and body dissatisfaction in adolescent boys. Five hundred and seventy adolescent boys (mean age 17.2 ± 0.45; range 15-19 years) participated in the cross-sectional study. Adolescents completed a questionnaire consisting of measures of attitudes towards sociocultural pressures on appearance, body dissatisfaction and sport participation (participation in achievement sport, leisure exercising and non-participation in any sports). Sports participation moderated the associations between the internalisation of stereotyped appearance ideals and body dissatisfaction. In athletes, the effect of internalisation of thin body ideals on body dissatisfaction was not significant, while the effect of internalisation of muscular/athletic body ideals was negative. In leisure exercisers, the effect of internalisation of muscular body ideals on body dissatisfaction was not significant, yet internalisation of thin body ideals had a significant effect on body dissatisfaction. The strongest associations between appearance ideals internalisation and body dissatisfaction were found in adolescent boys who reported no participation in sports. Sports participation might be an effective tool in decreasing the negative effect of internalisation of stereotyped appearance ideals on adolescent boys' body image.

Adolescent girls' participation in sports is associated with lower negative effects of internalization of thin body ideals on self-objectification: findings from a cross-sectional study.

PURPOSE: The aim of the present study was to test a partial sociocultural model of integrated tripartite influence and objectification theories in adolescent girls and to assess the moderating role of participation in sport. METHODS: This study is part of a larger research that involved a sample of adolescent girls and boys from the 11th grade. In the present study, data on 842 girls were analysed. The mean age of the sample was 16.9 ± 0.5 years. The adolescent girls completed online questionnaires assessing internalization of thin body ideals, disordered eating attitudes and behaviours, and self-objectification, as well as various aspects of participation in sports. To assess the primary hypotheses, moderated mediation models were tested. RESULTS: Self-objectification mediated associations between internalization of thin body ideals and disordered eating attitudes and behaviours in adolescent girls. Participation in an achievement sport moderated the association between internalization of thin body ideals and self-objectification, but not between the latter and disordered eating attitudes and behaviours. Internalization of thin body ideals was not significantly associated with self-objectification in girls participating in achievement sport. The association between internalization of thin body ideals and self-objectification was stronger in adolescent girls not involved in any sports activities than in leisure-time exercisers. CONCLUSION: It is important to promote involvement in sport for all adolescent girls, since it might help them to decrease the negative effect of internalization of thin body ideals on self-objectification and to value body functions over appearance. Decreasing self-objectification and teaching about body functionality might be an effective strategy in programmes aimed at decreasing disordered eating in adolescent girls participating in achievement sport. LEVEL OF EVIDENCE: Level of evidence V, cross-sectional descriptive study.

Effect of an education and mindfulness-based physical activity intervention for the promotion of positive body image in Lithuanian female students.

PURPOSE: The aim of this study was to test the effectiveness of an 8-week classroom education and mindfulness-based physical activity intervention for the promotion of positive body image in female students. METHODS: A quasi-experimental study was carried out with 110 Lithuanian female students (mean age 21.5 ± 3.5, range 19-35 years). Thirty students voluntarily participated in the intervention programme and 80 students volunteered in the assessment-only control group. The intervention comprised five cognitive behavioural therapy classroom education sessions and mindfulness-based exercise (one exercise workout per week). The intervention group was evaluated with a pre-test and post-test and the control group completed measures at parallel times. RESULTS: Compared with the control group participants, the intervention group participants reported greater improvements in positive body image and a reduction in body dissatisfaction and drive for thinness and internalisation of stereotyped beauty ideals, with medium to large effects. There were significant time × group interactions for pre-test to post-test changes in internalisation of beauty ideals, body area satisfaction, body dissatisfaction and body appreciation. In all cases, the interaction reflected greater pre-test to post-test changes in the intervention group compared with the control group, whose scores remained stable. A decrease in appearance orientation, overweight preoccupation, disordered eating and physical activity was observed in the control group, but the effect sizes were low. CONCLUSION: The preliminary findings of this study support the efficacy of cognitive behavioural therapy methods and mindfulness-based exercise intervention aimed to promote positive body image in student-aged women. Future studies should test the efficacy of the introduced programme in larger randomised samples of young women. LEVEL IV: Evidence obtained from multiple time series with or without an intervention.

Changes in sociocultural attitudes towards appearance, body image, eating attitudes and behaviours, physical activity, and quality of life in students before and during COVID-19 lockdown.

BACKGROUND: The coronavirus pandemic resulted in national lockdowns that are associated with a rise in important macro-stressors for populations worldwide. The aim of the present study was to assess the impact of the COVID-19-related lockdown period on the sociocultural attitudes towards appearance, body image, eating attitudes and behaviours, physical activity, and quality of life of Lithuanian university-aged students of both genders. METHOD: A total of 1850 students completed the body image, health-related behaviour and quality of life assessments three months before the first lockdown, of which 959 provided consent and an e-mail to be contacted by for further surveys. Of these 959, 230 completed the same questionnaire during the second lockdown providing the informed consent for the participation in the COVID-19-impact for the lifestyle study and use their first round data for the comparison with the lockdown. The age of the participants was 23.9 ± 5.4 years. Independent comparisons were used to test lifestyle and body image differences between men and women before and during the lockdown. Paired-sample statistics were conducted to evaluate any changes in the male and female groups separately with Cohen's d employed to represent effect sizes. RESULTS: No body image or disordered eating changes were found, however, body appearance evaluation increased in women (effect size 0.15). Significant increases in media pressures (in women, effect size 0.16) and the internalization of thin/low body fat beauty ideals (effect size 1.18-1.46) were observed during the lockdown when compared to baseline. No changes in quality of life were evident for men, however, for women, an increase in general and psychological domain was observed (effect size 0.17). We observed a significant decrease in physical activity (in men, effect size 0.46), an increase in internet browsing time (effect size 0.52-0.8), a decrease in unhealthy eating habits (effect size 0.49-0.60), an increase in sleep duration (in women, effect size 0.40) and lower self-rated health (in men, effect size 0.42) during the lockdown when compared to baseline. CONCLUSIONS: These findings suggest that the majority of students cope with lockdown-related situation well. However, based on the Tripartite influence model, we can speculate that a drastic increase in the internalization of stereotyped thin/low body fat ideals might trigger body image concerns and increase disordered eating after the lockdown. Specific interventions helping students to decrease internalization of stereotyped body ideals, to promote positive body image and physical activity may be beneficial during and after the COVID-19-related lockdown.

An exploration of the tripartite influence model of body image in Lithuanian sample of young adults: does body weight make a difference?

PURPOSE: The present study aimed to test the sociocultural Tripartite Influence Model (TIM) that helps to explain the associations between the sociocultural pressures to achieve stereotyped body ideals and disordered eating in young Lithuanian women and men of different body mass. METHODS: A mixed-gender sample of students (n = 1850, 58.8% female, the mean age of men was 20.4 (SD = 3.1) years, of women 22.4 (SD = 5.8) years) filled in series of questionnaires including the social attitudes towards appearance, body image, disordered eating and drive for muscularity. Mediation analyses were performed to estimate the size of total, direct, and indirect effects of variables in the models. RESULTS: For women of different body weight, the TIM model was fully replicated. For men of normal weight, internalization of the muscular/athletic ideal, drive for muscularity and greater investment towards appearance mediated the relationships between peers' pressures and disordered eating. For overweight men, internalization of the thin and muscular/athletic ideals, poorer body image mediated associations between pressure from the peers and disordered eating. However, the internalization of the muscular/athletic ideal and the greater appearance evaluation mediated the associations between sociocultural pressures and disordered eating for overweight and obese men. CONCLUSION: The TIM was replicated in women of different body weight. However, internalization of the thin/low fat ideal was not relevant for men of normal body weight and internalization of the muscular ideal had different outcomes for men of different body mass index. The implications of the results for practice are discussed. LEVEL OF EVIDENCE: V, Cross-sectional descriptive study.

Self-perception of physical activity and fitness is related to lower psychosomatic health symptoms in adolescents with unhealthy lifestyles.

The general aim of the present study was to examine how physical activity, participation in sports, and beliefs about personal physical activity and physical fitness are associated with adolescents' psychosomatic health complaints (PHC) in relation to their lifestyles. METHODS: A total of 3284 11-19-year-old adolescents (average age 14.9 ± 2.0; 48.6% male) participated in the population-based cross-sectional study. Self-administered questionnaires addressed lifestyle, sports participation, physical activity, physical fitness perception, and PHC. RESULTS: Female gender (OR = 1.92; 95% CI = 1.57-2.35), smoking (OR = 1.31; 95%PI = 1.01-1.68), alcohol consumption (OR = 1.60; 95%PI = 1.30-1.97), unhealthy foods (OR = 1.14; 95%PI = 1.04-1.26), hours of internet use (OR = 1.14; 95%PI = 1.07-1.21), and poor personal fitness perception (OR = 1.60; 95% CI = 1.27-2.02) were associated with PHC in adolescents. Lower physical activity and self-perceived insufficient physical activity, perception of physical fitness as being poor, and not participating in sports were associated with greater somatic and psychological complaints controlling for age, gender, and BMI. Participation in sports and physical activity did not change PHC in adolescents involved in unhealthy behaviour. However, a positive perception of one's own physical activity and physical fitness decreased PHC in adolescents who reported an unhealthy lifestyle. CONCLUSIONS: Adolescents demonstrating poorer health-related behavioural profiles showed higher PHC. Physical activity and sports participation were related to lower PHC. Positive physical activity and physical fitness perception changed the associations between PHC and unhealthy lifestyle: adolescents perceiving themselves as sufficiently physically active and those evaluating their physical fitness as good showed lower PHC, despite the presence of unhealthy habits (high screen time, drinking alcohol, smoking, and consuming unhealthy foods). It is important to study cognitive factors when exploring the associations between adolescent lifestyles and PHC. These results are important for health promotion and education programmes aimed at improving healthy lifestyle and psychosocial well-being in adolescents.

HMG-coenzyme A reductase inhibition, type 2 diabetes, and bodyweight: evidence from genetic analysis and randomised trials.

BACKGROUND: Statins increase the risk of new-onset type 2 diabetes mellitus. We aimed to assess whether this increase in risk is a consequence of inhibition of 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR), the intended drug target. METHODS: We used single nucleotide polymorphisms in the HMGCR gene, rs17238484 (for the main analysis) and rs12916 (for a subsidiary analysis) as proxies for HMGCR inhibition by statins. We examined associations of these variants with plasma lipid, glucose, and insulin concentrations; bodyweight; waist circumference; and prevalent and incident type 2 diabetes. Study-specific effect estimates per copy of each LDL-lowering allele were pooled by meta-analysis. These findings were compared with a meta-analysis of new-onset type 2 diabetes and bodyweight change data from randomised trials of statin drugs. The effects of statins in each randomised trial were assessed using meta-analysis. FINDINGS: Data were available for up to 223 463 individuals from 43 genetic studies. Each additional rs17238484-G allele was associated with a mean 0·06 mmol/L (95% CI 0·05-0·07) lower LDL cholesterol and higher body weight (0·30 kg, 0·18-0·43), waist circumference (0·32 cm, 0·16-0·47), plasma insulin concentration (1·62%, 0·53-2·72), and plasma glucose concentration (0·23%, 0·02-0·44). The rs12916 SNP had similar effects on LDL cholesterol, bodyweight, and waist circumference. The rs17238484-G allele seemed to be associated with higher risk of type 2 diabetes (odds ratio [OR] per allele 1·02, 95% CI 1·00-1·05); the rs12916-T allele association was consistent (1·06, 1·03-1·09). In 129 170 individuals in randomised trials, statins lowered LDL cholesterol by 0·92 mmol/L (95% CI 0·18-1·67) at 1-year of follow-up, increased bodyweight by 0·24 kg (95% CI 0·10-0·38 in all trials; 0·33 kg, 95% CI 0·24-0·42 in placebo or standard care controlled trials and -0·15 kg, 95% CI -0·39 to 0·08 in intensive-dose vs moderate-dose trials) at a mean of 4·2 years (range 1·9-6·7) of follow-up, and increased the odds of new-onset type 2 diabetes (OR 1·12, 95% CI 1·06-1·18 in all trials; 1·11, 95% CI 1·03-1·20 in placebo or standard care controlled trials and 1·12, 95% CI 1·04-1·22 in intensive-dose vs moderate dose trials). INTERPRETATION: The increased risk of type 2 diabetes noted with statins is at least partially explained by HMGCR inhibition. FUNDING: The funding sources are cited at the end of the paper.

Biomarkers of oxidative stress and redox status in a short-term low-dosed multivitamin and mineral supplementation study in two human age groups.

A 60-day intervention study was conducted in which the participants took a low dose of a multivitamin and mineral supplement. The study consists of a final number of 66 volunteers (30 males and 36 females), divided into two age groups of 30-35 and 60-65 years. For 30 days they took a multivitamin and mineral supplement with 1× the recommended daily intake (RDI) followed by another 30 days with 2× the RDI. The aim of the study was to monitor oxidative stress and redox status of both young and old age groups. In serum, the expected increase of the water-soluble vitamins folate and vitamin B12 was observed with a concomitant decrease in homocysteine. Serum biomarkers of oxidative stress, the reactive oxygen metabolites, of the antioxidant status, the biological antioxidant potential did not change. However, the total thiol levels in serum, biomarker of the redox status, decreased significant, only in both groups of elderly after 60 days. In erythrocytes, there was a change in the glutathione metabolism as observed by an increase in glutathione reductase and to a lower extend in glutathione peroxidase, indicating an increase in oxidative stress in all groups. It is concluded that a low-dosed multivitamin and -mineral supplementation have different effects on the redox status in young versus old. It remained to explain why a low dose of a multivitamin and -mineral supplement cause increased oxidative stress.

Accessibility and use of urban green spaces, and cardiovascular health: findings from a Kaunas cohort study.

BACKGROUND: The aims of this study were to explore associations of the distance and use of urban green spaces with the prevalence of cardiovascular diseases (CVD) and its risk factors, and to evaluate the impact of the accessibility and use of green spaces on the incidence of CVD among the population of Kaunas city (Lithuania). METHODS: We present the results from a Kaunas cohort study on the access to and use of green spaces, the association with cardiovascular risk factors and other health-related variables, and the risk of cardiovascular mortality and morbidity. A random sample of 5,112 individuals aged 45-72 years was screened in 2006-2008. During the mean 4.41 years follow-up, there were 83 deaths from CVD and 364 non-fatal cases of CVD among persons free from CHD and stroke at the baseline survey. Multivariate Cox proportional hazards regression models were used for data analysis. RESULTS: We found that the distance from people's residence to green spaces was not related to the prevalence of health-related variables. However, the prevalence of cardiovascular risk factors and the prevalence of diabetes mellitus were significantly lower among park users than among non-users. During the follow up, an increased risk of non-fatal and fatal CVD combined was observed for those who lived ≥629.61 m from green spaces (3rd tertile of distance to green space) (hazard ratio (HR) = 1.36), and the risk for non-fatal CVD-for those who lived ≥347.81 m (2nd and 3rd tertile) and were not park users (HR = 1.66) as compared to men and women who lived 347.8 m or less (1st tertile) from green space. Men living further away from parks (3rd tertile) had a higher risk of non-fatal and fatal CVD combined, compared to those living nearby (1st tertile) (HR = 1.51). Compared to park users living nearby (1st tertile), a statistically significantly increased risk of non-fatal CVD was observed for women who were not park users and living farther away from parks (2nd and 3rd tertile) (HR = 2.78). CONCLUSION: Our analysis suggests public health policies aimed at promoting healthy lifestyles in urban settings could produce cardiovascular benefits.

The relationship of green space, depressive symptoms and perceived general health in urban population.

AIMS: To assess the relationship between green space proximity, use of green space and depressive symptoms and perceived general health among a random sample men and women. METHODS: Cross-sectional study of a population-based sample of 6,944 45-72 year old Kaunas city residents. Self-reported questionnaires provided information on sociodemographic variables, health behaviours, depressive symptoms and poor and very poor perceived general health. Residential proximity to green spaces was defined as living less than 300 m, within interval of 300-999 m, and equal or more than 1 km from a park. The use of the park was divided into two categories: no park use or use <4hrs/week and use of the park ≥4 h/week. The study received approval from the Kaunas Regional Research Ethics Committee. Multiple logistic regression assessed the associations controlling for confounding variables. RESULTS: The prevalence of depressive symptoms and poor and or very poor perceived general health was higher in women than in men. The association between the use of the park and residential proximity to the park revealed that women living >300 m from a green space and who used the space ≥4 h/week showed higher odds 1.92 (1.11-3.3) and 1.68 (0.81-3.48) of depressive symptoms and poor and very poor perceived general health as compared to those who used the park <4 hrs/week and residential proximity was >300 m. CONCLUSIONS: The results of our study confirmed an association between use of the green space, residential proximity, and depressive symptoms and poor and very poor perceived general health among women only.

Correlates of depressive symptoms in urban middle-aged and elderly Lithuanians.

PURPOSE: The study aimed to examine the prevalence of depressive symptoms and their correlates in urban middle-aged and elderly Lithuanian adults. METHODS: Data from the survey was collected within the framework of the international project HAPIEE (Health, Alcohol and Psychosocial Factors in Eastern Europe). A random sample of 7,115 individuals aged 45-72 years was screened in 2006-2008. RESULTS: Depressive symptoms were differently associated with independent variables by sex. In men, deprivation (OR 1.85, 95 % CI 1.54-2.17), being divorced (OR 2.34, 95 % CI 1.61-3.39) or widowed (OR 3.64, 95 % CI 2.40-5.52), physical inactivity (OR 1.30, 95 % CI 1.02-1.65), having a history of spine and joint disease (OR 1.72, 95 % CI 1.36-2.17), average perceived health (OR 2.14, 95 % CI 1.55-2.95), poor perceived health (OR 5.13, 95 % CI 3.39-7.76), average quality of life (OR 2.0, 95 % CI 1.55-2.95), or poor quality of life (OR 8.86, 95 % CI 5.19-15.13) were significantly associated with depressive symptoms. In women, deprivation (OR 1.28, 95 % CI 1.15-1.43), being widowed (OR 1.52, 95 % CI 1.23-1.88), mean dose of alcohol per occasion 40-79.9 g (OR 1.65, 95 % CI 1.18-2.30) and more than 80 g (OR 2.09, 95 % CI 1.14-3.82), physical inactivity in leisure time (OR 1.27, 95 % CI 1.04-1.57), having a history of spine and joint disease (OR 1.26, 95 % CI 1.06-1.51), average perceived health (OR 2.56, 95 % CI 1.89-2.72), poor perceived health (OR 5.07, 95 % CI 3.62-7.11), average quality of life (OR 2.27, 95 % CI 1.89-2.72), or poor quality of life (OR 7.21, 95 % CI 4.73-11.00) were significantly associated with depressive symptoms. CONCLUSIONS: Health status and lifestyle factors are associated with depressive symptoms. Associations between depressive symptoms and long-term health problems are partially mediated by self-rated quality of life and self-rated health.

Trends of myocardial infarction morbidity and its associations with weather conditions.

OBJECTIVE: The aim of this study was to assess the trends of myocardial infarction (MI) morbidity and evaluate the associations with some meteorological factors. MATERIALS AND METHODS: Data on MI morbidity were collected from Kaunas ischemic heart disease registry and information about meteorological factors from Kaunas meteorological station was collected. RESULTS: The overall morbidity rates of acute MI among men aged 25-64 increased by 2.0%/yr. (P=0.02), whereas among women did not change significantly (+1.2%/yr., P=0.2) during 1995-2007. Among men aged 65-84 the overall morbidity rates of MI were without significant changes (-1.0%/yr., P=0.3) and among women decreased significantly by -1.7%/yr. (P=0.03). During 1995-2000, a weak inverse significant correlation between atmospheric air temperature and morbidity of MI (r=-0.05, P=0.019) was documented (in women and the elderly r=-0.045 and -0.048, respectively, P<0.05). Weak correlation between atmospheric air wind speed and MI morbidity in women (r=-0.042, P=0.05) and in population of older age (r=-0.056, P=0.099) was determined. In men and in elderly population a direct weak correlation between atmospheric pressure and MI morbidity was found (r=0.114 and 0.166, respectively, P<0.01). In this study monthly and seasonal variation of MI rates were observed. In winter period MI rates were higher to compare with other seasons (χ(2)=18.682, df=3, P<0.0001). CONCLUSIONS: The overall morbidity rates of MI increased among Kaunas men aged 25-64 and tended to increase among women, whereas among men aged 65-84 MI morbidity trends were without statistically significant changes and significantly decreased among women during 1995-2007. Weak inverse correlations between atmospheric air temperatures, rainfall level and direct correlation between air wind speed, atmospheric pressure and MI morbidity were established. Months/seasonal variations during analyzed period were observed.

Mindful monitoring and accepting the body in physical activity mediates the associations between physical activity and positive body image in a sample of young physically active adults.

Introduction: The study aimed to extend research on the possible mechanisms that explain the associations between physical activity (PA), mindfulness during PA and positive body image. In the present study, we tested the mediating role of state mindfulness during PA in the association between PA and trait body appreciation. We also explored the moderating roles of sex and body mass index (BMI) in these associations. Methods: In total, 759 students participated in the study but after applying the inclusion criteria 539 questionnaires were approved for analysis, with a mean age of 23.3 ± 7.2 years (49.7% were women). Study participants completed the online survey, which included sociodemographic details, PA data, the State Mindfulness Scale for Physical Activity 2 (SMS-PA-2) and the Body Appreciation Scale 2 (BAS-2). Results: Monitoring and accepting the body during exercise mediated the association between PA and body appreciation. BMI moderated the association between accepting the body during exercise and body appreciation: for heavier individuals with BMI > 24.99 kg/m2, the associations between accepting the body during exercise and body appreciation were higher (B = 0.53, p < 0.001) compared to those whose body weight was in the normal range (B = 0.21, p < 0.001). Conclusion: Strengthening mindfulness and promoting mindful body acceptance during exercise might enhance a positive body image, especially in individuals with a higher BMI.

The interleukin-6 receptor as a target for prevention of coronary heart disease: a mendelian randomisation analysis.

BACKGROUND: A high circulating concentration of interleukin 6 is associated with increased risk of coronary heart disease. Blockade of the interleukin-6 receptor (IL6R) with a monoclonal antibody (tocilizumab) licensed for treatment of rheumatoid arthritis reduces systemic and articular inflammation. However, whether IL6R blockade also reduces risk of coronary heart disease is unknown. METHODS: Applying the mendelian randomisation principle, we used single nucleotide polymorphisms (SNPs) in the gene IL6R to evaluate the likely efficacy and safety of IL6R inhibition for primary prevention of coronary heart disease. We compared genetic findings with the effects of tocilizumab reported in randomised trials in patients with rheumatoid arthritis. FINDINGS: In 40 studies including up to 133,449 individuals, an IL6R SNP (rs7529229) marking a non-synonymous IL6R variant (rs8192284; p.Asp358Ala) was associated with increased circulating log interleukin-6 concentration (increase per allele 9·45%, 95% CI 8·34-10·57) as well as reduced C-reactive protein (decrease per allele 8·35%, 95% CI 7·31-9·38) and fibrinogen concentrations (decrease per allele 0·85%, 95% CI 0·60-1·10). This pattern of effects was consistent with IL6R blockade from infusions of tocilizumab (4-8 mg/kg every 4 weeks) in patients with rheumatoid arthritis studied in randomised trials. In 25,458 coronary heart disease cases and 100,740 controls, the IL6R rs7529229 SNP was associated with a decreased odds of coronary heart disease events (per allele odds ratio 0·95, 95% CI 0·93-0·97, p=1·53×10(-5)). INTERPRETATION: On the basis of genetic evidence in human beings, IL6R signalling seems to have a causal role in development of coronary heart disease. IL6R blockade could provide a novel therapeutic approach to prevention of coronary heart disease that warrants testing in suitably powered randomised trials. Genetic studies in populations could be used more widely to help to validate and prioritise novel drug targets or to repurpose existing agents and targets for new therapeutic uses. FUNDING: UK Medical Research Council; British Heart Foundation; Rosetrees Trust; US National Heart, Lung, and Blood Institute; Du Pont Pharma; Chest, Heart and Stroke Scotland; Wellcome Trust; Coronary Thrombosis Trust; Northwick Park Institute for Medical Research; UCLH/UCL Comprehensive Medical Research Centre; US National Institute on Aging; Academy of Finland; Netherlands Organisation for Health Research and Development; SANCO; Dutch Ministry of Public Health, Welfare and Sports; World Cancer Research Fund; Agentschap NL; European Commission; Swedish Heart-Lung Foundation; Swedish Research Council; Strategic Cardiovascular Programme of the Karolinska Institutet; Stockholm County Council; US National Institute of Neurological Disorders and Stroke; MedStar Health Research Institute; GlaxoSmithKline; Dutch Kidney Foundation; US National Institutes of Health; Netherlands Interuniversity Cardiology Institute of the Netherlands; Diabetes UK; European Union Seventh Framework Programme; National Institute for Healthy Ageing; Cancer Research UK; MacArthur Foundation.

The Comparison of Disordered Eating, Body Image, Sociocultural and Coach-Related Pressures in Athletes across Age Groups and Groups of Different Weight Sensitivity in Sports.

The aim of the present study was to compare disordered eating (DE), body image, and sociocultural and coach-related pressures between athletes of different age groups (adolescents and adults) and between athletes participating in weight-sensitive (WS) and less WS groups. A total of 1003 athletes participated in this study. The age range of the sample was 15 to 44 years, and the mean age was 18.9 ± 5.8 years (51.3% were female). Athletes who voluntarily agreed to participate in the study were provided with the study measures on DE, body image and sociocultural attitudes towards appearance. Vomiting, laxative misuse and excessive exercise were more prevalent in adolescent female athletes than adults, while dietary restraint was more common in adult male athletes than adolescents. Adolescent female athletes experienced higher sociocultural (family, peers) and sport-related (coach) pressures and a less positive body image compared with adult female athletes. Adult male athletes experienced higher overweight preoccupation, more DE and unhealthy eating habits, and engaged in more frequent self-weighing behaviour compared with adolescent males. When the effect of weight sensitivity in sports was tested, a higher prevalence of DE and overweight preoccupation, more frequent self-weighing, and higher body-image-related pressure from coaches were observed in female athletes participating in aesthetic weight-sensitive (WS) sports as compared with those participating in less WS sports. No differences in positive body image were observed in female WS and less WS sports. Special DE prevention and positive body image promotion programs are necessary for female competitive athletes and parents of adolescent female athletes, especially those participating in aesthetic ones. For adult male athletes, special programs aiming to promote healthy eating should be implemented to prevent DE and body image concerns. Special education about DE prevention is compulsory for coaches who train female athletes.

Mindfulness, Physical Activity and Sports Participation: Validity Evidence of the Lithuanian Translation of the State Mindfulness Scale for Physical Activity 2 in Physically Active Young Adults.

The aim of the present study was to examine the psychometric properties of the Lithuanian translation of State Mindfulness in Physical Activity (SMS-PA-2) in a sample of physically active students. A total sample of 539 students from universities and colleges (50.3% men; mean age 23.3 ± 7.2 years) were asked to provide demographical data, report physical activity (PA) and PA habits and fill in measures of trait awareness, autonomous motivation in physical activity, trait body appreciation, trait body functionality appreciation and disordered eating attitudes and behaviours and self-esteem via an online anonymous survey. Students also provided information about their participation in organized team sports, organized individual sports, recreational sports and home exercise. Results. The SMS-PA-2 replicated the original four-factor structure, with good internal consistency (except for the Accepting Mind subscale). Invariance analyses across sex groups revealed an acceptable fit of the configural, metric and scalar models. However, in the multi-group analysis, metric invariance and scalar invariance were not confirmed. The SMS-PA-2 was positively associated with leisure-time PA, PA habits, more self-determined motivation for exercise, trait awareness, trait body appreciation, trait body functionality appreciation and self-esteem. A negative association was observed between the SMS-PA-2 and disordered eating attitudes and behaviours. Home exercisers and students engaged in team sports demonstrated lower levels of state mindfulness in PA than those engaged in organized individual and recreational sports. The Lithuanian version of the SMS-PA-2 is a reliable and valid instrument for measuring state mindfulness in PA. This instrument is recommended for researchers who aim to investigate the role of state mindfulness in the PA in Lithuanian-language-speaking samples of young adults. Future studies should explore the Lithuanian version of the SMS-PA-2 by asking participants to fill questionnaires in immediately after the PA session, and measurement invariance between sexes should be further tested.

Body appreciation around the world: Measurement invariance of the Body Appreciation Scale-2 (BAS-2) across 65 nations, 40 languages, gender identities, and age.

The Body Appreciation Scale-2 (BAS-2) is a widely used measure of a core facet of the positive body image construct. However, extant research concerning measurement invariance of the BAS-2 across a large number of nations remains limited. Here, we utilised the Body Image in Nature (BINS) dataset - with data collected between 2020 and 2022 - to assess measurement invariance of the BAS-2 across 65 nations, 40 languages, gender identities, and age groups. Multi-group confirmatory factor analysis indicated that full scalar invariance was upheld across all nations, languages, gender identities, and age groups, suggesting that the unidimensional BAS-2 model has widespread applicability. There were large differences across nations and languages in latent body appreciation, while differences across gender identities and age groups were negligible-to-small. Additionally, greater body appreciation was significantly associated with higher life satisfaction, being single (versus being married or in a committed relationship), and greater rurality (versus urbanicity). Across a subset of nations where nation-level data were available, greater body appreciation was also significantly associated with greater cultural distance from the United States and greater relative income inequality. These findings suggest that the BAS-2 likely captures a near-universal conceptualisation of the body appreciation construct, which should facilitate further cross-cultural research.

All-cause and cardiovascular mortality risk estimation using different definitions of metabolic syndrome in Lithuanian urban population.

OBJECTIVE: The objective of the study was to assess mortality risk in the subjects with diagnosed metabolic syndrome (MS) using National Cholesterol Educational Program (NCEP-ATPIII), American Heart Association and National Heart Lung and Blood Institute (AHA/NHLBI) International Diabetes Federation (IDF) and Joint Interim Societies (JIS) definitions. METHODS: Two random samples aged 35-64 years were examined in 1992-2002 in the framework within the Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) study (N=2455). The follow-up was carried out in terms of the end points reached from the baseline health examinations until December 31, 2009. RESULTS: Cox regressions demonstrated that MS defined by IDF and JIS definitions remained the only significant determinants for all-cause mortality (RR=1.48 and RR=1.41; p<0.05) and cardiovascular disease (CVD) mortality in men (RR=1.81 and RR=1.66; p<0.05). In men (without previous CVD) the NCEP-ATPIII definition had increased mortality risk from CVD (RR=1.98; p=0.012), than in men with identified MS by the IDF and the new JIS definition. In women the MS was not associated with risk of mortality from CVD. CONCLUSION: The MS definitions according to the IDF and JIS criteria appear to be a slightly better predictor of all-cause mortality and mortality from CVD; MS according to the NCEP-ATPIII criteria appears to be a better predictor of mortality from CVD in men.

Cardiovascular risk factors and cognitive function in middle aged and elderly Lithuanian urban population: results from the HAPIEE study.

BACKGROUND: The purpose of this study was to examine associations between cardiovascular risk factors and cognitive ability in middle aged and elderly Lithuanian urban population. METHODS: Data from the survey performed in the framework of the HAPIEE (Health, Alcohol, Psychosocial Factors in Eastern Europe) study were presented. A random sample of 7,087 individuals aged 45-72 years was screened in 2006-2008. RESULTS: The scores of immediate recall and delayed verbal recall, cognitive speed and attention were significantly lower in men than in women; yet numerical ability scores were higher in men. Significant associations between lowered cognitive functions and previous stroke (in male OR = 2.52; 95% CI = 1.75-3.64; in female OR = 2.45; 95% CI = 1.75, 3.64) as well as ischemic heart disease history (among male OR = 1.28; 95% CI = 1.03-1.60) have been determined. Higher level of physical activity in leisure time (among female OR = 1.32; 95% CI = 1.03-1.69), poor self-rated health (among male OR = 1.57; 95% CI = 1.15-2.14) and poor quality of life (in male OR = 1.67; 95% CI = 1.07-2.61; in female OR = 2.81; 95% CI = 1.92-4.11) were related to lowered cognitive function. CONCLUSIONS: The findings of the study suggest that associations between cardiovascular risk factors and lowered cognitive function among healthy middle-aged and elderly adults strongly depend on gender.