URL of this page: http://www.nlm.nih.gov/medlineplus/podcast/transcript101414.html

NLM Director’s Comments Transcript

Exercise does not Increase ALS Risk: 10/14/2014

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Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

I'm Rob Logan, Ph.D. senior staff U.S. National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National Library of Medicine.

Here is what's new this week in MedlinePlus.listen

A meta-analysis of 37 studies suggests exercise is not a risk to develop Amyotrophic Lateral Sclerosis (ALS), finds a recent study published in the European Journal of Epidemiology.

ALS, or Lou Gehrig’s disease (as it is known in the U.S.), has received considerable attention this summer thanks to a novel ‘ice bucket challenge’ fund raising campaign — where persons who are doused in cold water challenge others to do the same and give funds for research.

Lou Gehrig, a hall-of-fame baseball player, (who ironically set a standard for consecutive games played that lasted for seven decades) died from ALS at age 37 in 1941.

Among all the American athletes and celebrities of the first third of the 20th century, Gehrig remains an exemplar probably because of his Greek tragedy journey from the pinnacle of sports to disability and death in just three years. Remarkably, Gehrig remains a symbol of personal courage and athletic excellence among generations of Americans who never saw him play baseball in person or on television.

Although it is eight decades since Gehrig’s death (and many illnesses/diseases of the 1930s are cured or less harmful), there still is no cure for ALS.  Hence, the efforts this summer to raise research funds, which some estimates suggest currently total about $100 million.

The study’s six authors explain ALS is a rare neurodegenerative disorder with what they describe (and we quote) as a ‘devastating course’ (end of quote). MedlinePlus.gov’s ALS health topic page continues the disease is fatal in about 90 percent of patients within three to five years. ALS patients lose their ability to control muscles, which means they lose their ability to use their arms and legs. Eventually, a person loses the ability to breathe when the disease spreads to one’s diaphragm and chest wall. Most persons with ALS die from respiratory failure.

The study’s authors explain earlier research that assessed an association between exercise, and playing specific sports such as soccer or American football, produced limited and sometimes conflicting results.

The authors write (and we quote): ‘An up-to-date critical appraisal of the epidemiological evidence is mandatory to enable research to progress’ (end of quote).

So, the authors compared results from 37 studies from around the world (from the past 50 years) to assess if different types of work that involve physical activity, playing specific sports, or level of exertion were statistically associated with a higher risk to develop ALS.

The study’s findings strongly suggest the risk of ALS’ development does not have a significant association with exertion from work or sport, or sport is not a risk for ALS.

However, the authors acknowledge the quality of the research they reviewed varies. For example, the authors found significant variation or heterogeneity in some measures of physical activity used in prior research studies.

The authors also found some past research did not account for potentially confounding variables, such as the degree athletes who developed ALS used legal or illegal medications, took dietary supplements, and were exposed to pesticides or other toxins on playing fields over time.

While the current findings seem to rule out physical activity as an ALS risk factor, the authors suggest more research is needed to determine if physical activity accelerates ALS’ development among persons who are genetically susceptible to the disease.

The authors also encourage more research on the ALS risk among soccer players — with unprecedented, rigorous controls for their genetic susceptibility to the disease, as well as a more complete evaluation of their lifestyle, diet, legal and illegal drug use, exposure to pesticides, and other factors.

Meanwhile, helpful background information about ALS (provided by the National Institute of Neurological Disorders and Stroke) is available in the ‘overviews’ section of MedlinePlus.gov’s ALS health topic page. The ALS Association describes the initial symptoms of ALS in the ‘diagnosis/symptoms’ section of MedlinePlus.gov’s ALS health topic page.

The ALS Association adds a guide for ALS caregivers within the ‘related issues’ section of MedlinePlus.gov’s ALS health topic page.

MedlinePlus.gov’s ALS health topic page additionally provides links to the latest pertinent journal research articles, which are available in the ‘journal articles’ section. Links to clinical trials that may be occurring in your area are available in the ‘clinical trials’ section. You can sign up to receive updates about ALS as they become available on MedlinePlus.gov.

To find MedlinePlus.gov’s ALS health topic page type ‘ALS’ in the search box on MedlinePlus.gov’s home page, then, click on ‘ALS (National Library of Medicine).’

While the lack of progress in curing ALS is sobering, let’s hope some of the funds raised this summer provide a turning point. At least, the current study rules out a long suspected link between ALS and exertion. Now, let’s see if evidence for other predictors of ALS can be identified.

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It was nice to be with you. I look forward to meeting you here next week.