title: Lifestyle factors and risk of amyotrophic lateral sclerosis: a case-control study in Japan.
abstract: OBJECTIVE
  We examined the associations between lifestyle factors and the risk of amyotrophic lateral sclerosis (ALS) using a case-control study in Aichi Prefecture, Japan.
  
  
  METHODS
  The study comprised 183 ALS patients diagnosed by the El Escorial World Federation of Neurology criteria as well as 366 gender- and age-matched controls randomly selected from the general population with the use of the basic register of residents. Detailed information on lifestyle factors was obtained through a mailed self-administered questionnaire. The strength of association between ALS and a potential risk factor was assessed by calculating odds ratios (ORs) and 95% confidence intervals (CIs).
  
  
  RESULTS
  Vigorous physical activity, self reported stress, a type A behavior pattern, and less frequent intakes of green-yellow vegetables were significantly associated with increased risk of ALS, whereas smoking and drinking habits were not. The greatest effect on risk for ALS was posed by the combination of a type A behavior pattern and less frequent intakes of green-yellow vegetables (adjusted OR, 11.2; 95% CI, 3.8 to 33.0).
  
  
  CONCLUSIONS
  These data suggested that imbalances between excessive productions of oxidants as patient-specific factors and a diminished or missing antioxidant defense system in motor neurons may increase the risk of ALS.
authors.affiliation: Department of Public Health, Aichi Prefectural College of Nursing and Health, Kamishidami, Nagoya, Japan. okamoto@aichi-nurs.ac.jp
authors.forename: Kazushi
authors.initials: K
authors.lastname: Okamoto
authors.forename: Tameko
authors.initials: T
authors.lastname: Kihira
authors.forename: Tomoyoshi
authors.initials: T
authors.lastname: Kondo
authors.forename: Gen
authors.initials: G
authors.lastname: Kobashi
authors.forename: Masakazu
authors.initials: M
authors.lastname: Washio
authors.forename: Satoshi
authors.initials: S
authors.lastname: Sasaki
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Yokoyama
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Miyake
authors.forename: Naomasa
authors.initials: N
authors.lastname: Sakamoto
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Inaba
authors.forename: Masaki
authors.initials: M
authors.lastname: Nagai