title: Lifetime physical activity and the risk of amyotrophic lateral sclerosis.
abstract: BACKGROUND
  It has been hypothesised that physical activity is a risk factor for developing amyotrophic lateral sclerosis (ALS), fuelled by observations that professional soccer players and Gulf War veterans are at increased risk. In a population based study, we determined the relation between physical activity and risk of sporadic ALS, using an objective approach for assessing physical activity.
  
  
  METHODS
  636 sporadic ALS patients and 2166 controls, both population based, completed a semistructured questionnaire on lifetime history of occupations, sports and hobbies. To objectively compare the energy cost of a lifetime history of occupational and leisure time physical activities and to reduce recall bias, metabolic equivalent scores were assigned to each activity based on the Compendium of Physical Activities.
  
  
  RESULTS
  ALS patients had significantly higher levels of leisure time physical activity compared with controls (OR 1.08, 95% CI 1.02 to 1.14, p=0.008). No significant difference was found between patients and controls in the level of vigorous physical activities, including marathons and triathlons, or in occupational activity. Cumulative measures of physical activity in quartiles did not show a dose-response relationship.
  
  
  CONCLUSIONS
  An increased risk of ALS with higher levels of leisure time physical activity was found in the present study. The lack of association with occupational physical activity and the absence of a dose-response relationship strengthen the hypothesis that not increased physical activity per se but rather a genetic profile or lifestyle promoting physical fitness increases ALS susceptibility.
authors: Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors: Mark H B
authors: MH
authors: Huisman
authors: Meinie
authors: M
authors: Seelen
authors: Sonja W
authors: SW
authors: de Jong
authors: Kirsten R I S
authors: KR
authors: Dorresteijn
authors: Perry T C
authors: PT
authors: van Doormaal
authors: Anneke J
authors: AJ
authors: van der Kooi
authors: Marianne
authors: M
authors: de Visser
authors: Helenius Jurgen
authors: HJ
authors: Schelhaas
authors: Leonard H
authors: LH
authors: van den Berg
authors: Jan Herman
authors: JH
authors: Veldink
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology; D000465:Algorithms; D000690:Amyotrophic Lateral Sclerosis / Q000453:epidemiology* / Q000378:metabolism; D016022:Case-Control Studies; D003627:Data Interpretation, Statistical; D004522:Educational Status; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007899:Leisure Activities; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D009426:Netherlands / Q000453:epidemiology; D016272:Occupational Health; D011153:Population; D012306:Risk; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D016019:Survival Analysis; D055815:Young Adult
keywords: ALS; MOTOR NEURON DISEASE