title: Long-term physical activity: an exogenous risk factor for sporadic amyotrophic lateral sclerosis?
abstract: To conduct a geographically defined, UK-based case-control study, to examine any association between physical activity (PA) and amyotrophic lateral sclerosis (ALS).
  
  
  
  A novel historical PA questionnaire was designed, validated, and subsequently administered in individual face-to-face interviews of 175 newly diagnosed sporadic ALS cases and 317 age- and sex-matched community controls. Historical PA energy expenditure and time spent in vigorous-intensity PA were derived from questionnaire data and compared between cases and controls.
  
  
  
  Participation in an extra 10kJ/kg/day of PA (equivalent to approximately 45minutes brisk walking) was consistently associated with an increased risk of ALS, with the strongest association observed for adulthood exercise-related PA (OR 1.47, 95% CI 1.10-1.97). An extra 10mins/day of vigorous PA was also associated with the odds of ALS (OR 1.03, 95% CI 1·01-1·05). Results were slightly attenuated following adjustment for smoking and educational attainment.
  
  
  
  To our knowledge this is the first study to demonstrate a positive association between ALS and PA participation using a specifically designed and validated historical PA questionnaire. Despite the well-established health benefits of PA, a high activity lifestyle may also be associated with elevated risk of ALS. Large-scale prospective studies in the future may help to confirm this association.
authors.affiliation: a Academic Neurology Unit, Sheffield Institute for Translational Neuroscience (SITraN), Department of Neuroscience, Faculty of Medicine, Dentistry and Health , University of Sheffield , 385A Glossop Road , Sheffield , S10 2HQ , UK and.
authors.forename: Ceryl A
authors.initials: CA
authors.lastname: Harwood
authors.affiliation: b Medical Research Council Epidemiology Unit , University of Cambridge, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus , Cambridge , CB22 0QQ , UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Westgate
authors.affiliation: a Academic Neurology Unit, Sheffield Institute for Translational Neuroscience (SITraN), Department of Neuroscience, Faculty of Medicine, Dentistry and Health , University of Sheffield , 385A Glossop Road , Sheffield , S10 2HQ , UK and.
authors.forename: Sue
authors.initials: S
authors.lastname: Gunstone
authors.affiliation: b Medical Research Council Epidemiology Unit , University of Cambridge, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus , Cambridge , CB22 0QQ , UK.
authors.forename: Soren
authors.initials: S
authors.lastname: Brage
authors.affiliation: b Medical Research Council Epidemiology Unit , University of Cambridge, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus , Cambridge , CB22 0QQ , UK.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Wareham
authors.affiliation: a Academic Neurology Unit, Sheffield Institute for Translational Neuroscience (SITraN), Department of Neuroscience, Faculty of Medicine, Dentistry and Health , University of Sheffield , 385A Glossop Road , Sheffield , S10 2HQ , UK and.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: McDermott
authors.affiliation: a Academic Neurology Unit, Sheffield Institute for Translational Neuroscience (SITraN), Department of Neuroscience, Faculty of Medicine, Dentistry and Health , University of Sheffield , 385A Glossop Road , Sheffield , S10 2HQ , UK and.
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Shaw
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000690:Amyotrophic Lateral Sclerosis / Q000453:epidemiology* / Q000503:physiopathology*; D016022:Case-Control Studies; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D006113:United Kingdom
keywords: Amyotrophic lateral sclerosis; Epidemiology; Gene-environment interaction; Physical Activity; Risk factor