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Epidemiological evidence that physical activity is not a risk factor for ALS

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Abstract

To elucidate whether physical activity (PA) and sport increase the risk of developing amyotrophic lateral sclerosis (ALS), a literature review of epidemiological studies was conducted according to the Meta-analysis of Observational Studies in Epidemiology guidelines. Six databases (Pubmed, Scopus, ScienceDirect, IngentaConnect, Refdoc and the Cochrane database) were searched to April 2014. Experts were asked to identify studies in press. Studies of interest were examined for their level of evidence and synthetized using Armon’s classification for exogenous risk factors for ALS. Of 37 epidemiological works included in the review, two (5.5 %) provided class I evidence, and five (13.5 %) class II. Others offered evidence of class III (n = 8, 21.6 %), IV (n = 16, 43.2 %) and V (n = 6, 16.2 %). Results were stratified according to type of exposure: (1) PA related to sport and work (n = 14), (2) soccer and American football (n = 9), (3) occupation (n = 12), (4) proxies of PA (n = 2). Among articles which considered “PA related to sport and work”, two class I studies and one class II study concluded that PA is not a risk factor for ALS. This evidence establishes (level A) that PA is not a risk factor for ALS. As regards “occupational related activity” a level of evidence of U was obtained (it is unknown whether the professional category “physical worker” is a risk factor for ALS). Football/soccer may be considered as a possible risk factor for ALS (level C) and there is a need for further research taking into account the numerous confounding factors that may arise in this field.

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Abbreviations

ALS:

Amyotrophic lateral sclerosis

EEDC:

El escorial diagnostic criteria

MeSH:

Medical subject headings

MET:

Metabolic equivalents

PA:

Physical activity

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Acknowledgments

We thank Prof Ettore Beghi, Chairman of EURALS consortium (pan-European consortium for the epidemiological study of ALS) for his opinions as an expert in the field and for his comments on the manuscript. We thank William Françis for reviewing the manuscript in English. Hamidou Bello is sponsored by a scholarship from the Regional Council of Limousin Region and Inserm.

Conflict of interest

We confirm that there is no conflict of interest associated with this publication.

Author information

Authors and Affiliations

  1. INSERM UMR1094, Tropical Neuroepidemiology, Faculté de Médecine, 2 rue du Dr Marcland, 87025, Limoges Cedex, France

    Bello Hamidou, Philippe Couratier, Cyril Besançon, Marie Nicol, Pierre Marie Preux & Benoit Marin

  2. Univ Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France

    Bello Hamidou, Philippe Couratier, Cyril Besançon, Pierre Marie Preux & Benoit Marin

  3. CHU Limoges, Service de Neurologie, Centre SLA, Limoges, France

    Philippe Couratier & Marie Nicol

  4. CEBIMER, CHU Limoges, Limoges, France

    Pierre Marie Preux & Benoit Marin

Authors
  1. Bello Hamidou
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  2. Philippe Couratier
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  3. Cyril Besançon
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  4. Marie Nicol
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  6. Benoit Marin
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Corresponding author

Correspondence to Benoit Marin.

Additional information

The Groupe « Bibliographie de la coordination des centres SLA français ».

Appendix: Groupe « Bibliographie de la coordination des centres SLA français »

Appendix: Groupe « Bibliographie de la coordination des centres SLA français »

  • Biologists

    • Séverine Boilée (Paris)

    • Luc Dupuis (Strasbourg)

    • Franck Letournel (Angers)

    • Stéphanie Millecamps (Paris)

  • Epidemiologist

    • Benoît Marin (Limoges)

  • Clinicians

    • Pneumologists

      • Jésus Gonzalez (Paris)

      • Capucine Morelot (Paris)

      • Thierry Perez (Lille)

    • Neurologists

      • Sharam Attarian (Marseille)

      • Jean-Philippe Camdessanché (St-Etienne)

      • Laurence Carluer (Caen)

      • Pascal Cintas (Toulouse)

      • Philippe Corcia (Tours)

      • Véronique Danel-Brunaud (Lille)

      • Andoni Echaniz-Laguna (Strasbourg)

      • Nathalie Guy (Clermont Ferrand)

      • Nadine Le Forestier (Paris)

      • Julien Cassereau

      • Pierre-François Pradat (Paris)

      • Marie-Hélène Soriani (Nice)

      • Nadia Vandenberghe (Lyon)

      • Annie Verschueren (Marseille)

      • Sophie Pittion (Nancy)

      • Raoul Morales (Montpellier)

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Hamidou, B., Couratier, P., Besançon, C. et al. Epidemiological evidence that physical activity is not a risk factor for ALS. Eur J Epidemiol 29, 459–475 (2014). https://doi.org/10.1007/s10654-014-9923-2

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  • DOI: https://doi.org/10.1007/s10654-014-9923-2

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