title: Physical activity and risk of alcohol use disorders: results from a prospective cohort study.
abstract: OBJECTIVE
  To examine the effect of physical activity on risk of developing alcohol use disorders in a large prospective cohort study with focus on leisure-time physical activity.
  
  
  METHODS
  Data came from the four examinations of the Copenhagen City Heart Study (CCHS), performed in 1976-1978, 1981-1983, 1991-1994 and 2001-2003. Information on physical activity (classified as Moderate/high, low or sedentary) and covariates was obtained through self-administered questionnaires, and information on alcohol use disorders was obtained from the Danish Hospital Discharge Register, the Danish Psychiatric Central Research Register and the Winalco database. In total, 18,359 people participated in the study, a mean follow-up time of 20.9 years. Cox proportional hazards model with delayed entry was used. Models were adjusted for available covariates (age, smoking habits, alcohol intake, education, income and cohabitation status) including updated time-dependent variables whenever possible.
  
  
  RESULTS
  A low or moderate/high leisure-time physical activity was associated with almost half the risk of developing alcohol use disorder compared with a sedentary leisure-time physical activity. This translates into a 1.5- to 2-fold increased risk of developing alcohol use disorder (Hazard ratios for men 1.64; 95% CI 1.29-2.10 and women 1.45; 1.01-2.09) in individuals with a sedentary leisure-time physical activity, compared with a moderate to high level. However, when stratifying by presence of other psychiatric disorders, no association was observed in women with psychiatric comorbidity. Residual confounding may have been present in this study, especially according to rough measures of income and education.
  
  
  CONCLUSIONS
  In both men and women, being sedentary in leisure time was a risk factor for developing an alcohol use disorder.
authors.affiliation: National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, København K 1399, Denmark.
authors.forename: Louise Kristiansen
authors.initials: LK
authors.lastname: Ejsing
authors.affiliation: National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, København K 1399, Denmark Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Kettegårds Allé 30, Hvidovre DK-2650, Denmark becker@dadlnet.dk.
authors.forename: Ulrik
authors.initials: U
authors.lastname: Becker
authors.affiliation: National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, København K 1399, Denmark.
authors.forename: Janne S
authors.initials: JS
authors.lastname: Tolstrup
authors.affiliation: Unit of Medical Psychology, Institute of Public Health, University of Copenhagen, Øster Farimagsgade 5A, København K 1399, Denmark.
authors.forename: Trine
authors.initials: T
authors.lastname: Flensborg-Madsen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007899:Leisure Activities; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D009043:Motor Activity; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D055815:Young Adult