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Eur J Epidemiol. 2016 Mar;31(3):255-66. doi: 10.1007/s10654-016-0119-9. Epub 2016 Mar 11.

Physical activity and risk of Amyotrophic Lateral Sclerosis in a prospective cohort study.

Author information

1
Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus - Norfolk Place, W2 1PG, London, UK. v.gallo@imperial.ac.uk.
2
Barts and the London School of Medicine, Centre for Primary Care and Public Health, Queen Mary, University of London, London, UK. v.gallo@imperial.ac.uk.
3
Italian National Institute of Health, Rome, Italy.
4
Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus - Norfolk Place, W2 1PG, London, UK.
5
National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
6
Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands.
7
Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands.
8
Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
9
Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
10
International Agency for Research on Cancer (IARC), Lyon, France.
11
Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå, Sweden.
12
Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
13
Division of Cancer Epidemiology, German Cancer Research Centre (DKFZ), Heidelberg, Germany.
14
Department of Community Medicine, Faculty of Health Sciences, The Artic University of Norway, Tromsö, Norway.
15
Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway.
16
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
17
Folkhälsan Research Center, University of Helsinki, Helsinki, Finland.
18
Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
19
Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy.
20
Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
21
Navarre Public Health Institute, Pamplona, Spain.
22
Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Madrid, Spain.
23
Epidemiology Department, Murcia Regional Health Council, Murcia, Spain.
24
Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology (ICO), L'Hospitalet de Llobregat, Barcelona, Spain.
25
Cancer Epidemiological Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
26
Andalusian School of Public Health, Granada, Spain.
27
Department of Neurology, Skåne University Hospital, Lund University, Malmö, Sweden.
28
Danish Cancer Society Research Center, Copenhagen, Denmark.
29
Ragusa Cancer Registry, Azienda Ospedaliera "Civile MP Arezzo", Ragusa, Italy.
30
Public Health Directorate, Asturias, Oviedo, Spain.
31
Hellenic Health Foundation, Athens, Greece.
32
First Department of Neurology, National and Kapodistrian University of Athens, Athens, Greece.
33
Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy.
34
Centre for Cancer Prevention (CPO-Piemonte), Turin, Italy.
35
Human Genetic Foundation (HuGeF), Turin, Italy.
36
Public Health Division of Gipuzkoa, Donostia-San Sebastian, Spain.
37
Department of Epidemiology, German Institute of Human Nutrition, Potsdam, Germany.
38
Inserm, Centre for Research in Epidemiology and Population Health, Institut Gustave-Roussy, Villejuif, France.

Abstract

Previous case-control studies have suggested a possible increased risk of Amyotrophic Lateral Sclerosis (ALS) with physical activity (PA), but this association has never been studied in prospective cohort studies. We therefore assessed the association between PA and risk of death from ALS in the European Prospective Investigation into Cancer and Nutrition. A total of 472,100 individuals were included in the analysis, yielding 219 ALS deaths. At recruitment, information on PA was collected thorough standardised questionnaires. Total PA was expressed by the Cambridge Physical Activity Index (CPAI) and analysed in relation to ALS mortality, using Cox hazard models. Interactions with age, sex, and anthropometric measures were assessed. Total PA was weakly inversely associated with ALS mortality with a borderline statistically significant trend across categories (p = 0.042), with those physically active being 33% less likely to die from ALS compared to those inactive: HR = 0.67 (95% CI 0.42-1.06). Anthropometric measures, sex, and age did not modify the association with CPAI. The present study shows a slightly decreased-not increased like in case-control studies-risk of dying from ALS in those with high levels of total PA at enrolment. This association does not appear confounded by age, gender, anthropometry, smoking, and education. Ours was the first prospective cohort study on ALS and physical activity.

KEYWORDS:

Amyotrophic Lateral Sclerosis; BMI; Cohort study; EPIC study; Physical activity; Vigorous physical activity

PMID:
26968841
PMCID:
PMC4820490
DOI:
10.1007/s10654-016-0119-9
[Indexed for MEDLINE]
Free PMC Article

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