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Intense exercise can give higher risk of mnd

Discussion in 'off topic' started by hifinutt, Jun 11, 2021.

  1. Woodface

    Woodface pfm Member

    It is probably just bad reporting from the media
     
  2. Bob McC

    Bob McC Living the life of Riley

    If you’d avoided rowing and rugger your knees might have survived longer…?
     
    narabdela likes this.
  3. Vinny

    Vinny pfm Member

    Maybe. As ever, the devil is in the detail (probably) - it is a major reason that lunatic theories proliferate abut everything and more.
     
  4. gustav_errata

    gustav_errata pfm Member

    That would have fallen under 'walking for pleasure' ;)

    But in all seriousness, I think the problem lies in the reporting and, really, with some of the wording used by the researchers. Throughout the meat of the article they refer to the effects of "SSOE" on ALS, where "SSOE" stands for "strenuous sport" and "other exercise", but then they go on to use the word "intense" to describe the exercise. That word then makes it into the lay reporting. Since this was a questionnaire, it's very likely that what people defined as "other exercise" probably varies greatly from person to person. But, and this is the important "but": that's why we use statistics. We need statistics to help account for the variance in the questionnaire responses and in the genetic results. By accounting for and trying to explain that variance, we can arrive at general patterns that can then be followed up for more precise effects.

    Here their statistics were (IMO) fairly weak, but they were suggestive enough to merit follow-up by the medical community. Basically, if you have one of these genetic variants, it is possible that practically any form of real exercise (let's say enough to build up a sweat) can potentially increase your risk of developing motor neurone disease.

    Edit: the kind of outcome I can foresee from something like this is a) following genetic sequencing, you can then seek out medical advice to moderate your exercise habits and/or b) pre-screening of professional athletes in order to communicate risk early in their careers.
     
  5. Joe Hutch

    Joe Hutch Mate of the bloke

    I liked rugger even less than cross-country. If my school had offered proper football I'd have been in like Flynn, but because it was a poncey grammar school we got rugby union, the most boring sport known to humanity. Indeed, it embodies Schopenhauer's quote that life 'swings like a pendulum backward and forward between pain and boredom.'
     
  6. Seanm

    Seanm pfm Member

    I remember speculation that athletes might be more susceptible 25 years ago, when my dad developed it (he was himself quite athletic, as it happens). It would account for Lou Gehrig anyway. (Sick MND joke [Dennis Leary?]: "Poor Lou Gehrig, he should really have seen that one coming.")
     
  7. gustav_errata

    gustav_errata pfm Member

    Indeed. The journal where these researchers published has a nice thing where they make the authors put the research in context, including "Evidence before this study", which leads with this bit:

    The role of physical activity as a risk factor for ALS was evaluated in a systematic review of 26 studies performed by Lacorte et al. in 2016. The authors concluded that there was insufficient evidence to draw a firm conclusion and highlighted limitations of previous studies relating to heterogeneous classification of both physical activity and ALS. They noted that none of the published literature achieved the highest quality rating in the Newcastle Ottawa Scale, which they attribute to methodological challenges posed by the rarity and severity of the disease.
    So it does sound like there has been a suspicion for some time, but the rarity of the disease previously precluded robust analysis. Data sets like the UK Biobank are very powerful in that regard.
     
    Seanm likes this.
  8. gustav_errata

    gustav_errata pfm Member

    Side note: I have almost nothing useful to add to threads about audio gear compared to the other people here so I had to latch onto the first computational molecular biology thread that crossed my path. :cool:
     
    darrenyeats, Seanm and Vinny like this.
  9. doctorf

    doctorf left footed right winger

    I’m no epidemiologist, but that figure of 1 in 300 is complete bollocks. More like 2/100,000 per year in the uk, which means about 5000 people living with the disease at any one time.
     
    hifinutt and sean99 like this.
  10. Vinny

    Vinny pfm Member

    And very welcome it is too :)
     
    gustav_errata likes this.
  11. Bob McC

    Bob McC Living the life of Riley

    Same for me.
    My loathing for union has not diminished in 55 years.
     
  12. gintonic

    gintonic 50 shades of grey pussy cats

    now I see my wife is protecting me when she says slowdown, after a couple of hours or so.
     
    Rob998 likes this.
  13. sean99

    sean99 pfm Member

    I was thinking the same (but with no knowledge until google served this up):

    https://n.neurology.org/content/96/8/e1227

    "We identified 7,992 MND cases, reflecting an incidence of 2.64 (95% confidence interval [CI] 2.62–2.67) per 100,000 person-years and a prevalence of 9.5 (95% CI 9.1–10.0) per 100,000 persons."

    Given the vastly overstated risk, and (according to Gustav - thank you) the vastly overstated correlation with exercise it seems the original BBC article is scaremongering click-bait.
     
    hifinutt likes this.
  14. gustav_errata

    gustav_errata pfm Member

    It was likely a press release from the university. The Guardian had a similar article.

    BTW that 1 in 300 figure came from a charity linked in the BBC article. I didn't dig to find the source though. Seems high indeed. I wonder if it's for a much more general condition.
     
  15. hifinutt

    hifinutt hifinutt

    yes glad you sad that ,I thought it was a bit odd
     
  16. sean99

    sean99 pfm Member

    I think I figured it out. If the risk of MND is 3 per 100,000 per person per year then over 70 years a person's risk would be (70 x 3) / 100000, which equates to 1 in 476.

    So an apparently very low annual incidence risk (3 in 100k) can, over the years, lead to a non-negligible lifetime risk (1 in 476).

    However cancer and heart disease have a lifetime risk of something like 1 in 3 and both are reduced via exercise, so I think even if MND is 1 in 300 it's still pretty rare.
     
  17. sean99

    sean99 pfm Member

    Intense exercise (or HIIT as it's commonly known) offers benefits over "just exercise". It's not for everyone, but it has its place.

    https://www.medicalnewstoday.com/articles/327474

    Not only is it more time efficient (not everyone can take a 2 hour walk every day), but it also offers physiological advantages vs longer duration lower intensity exercise. In fact the latest thinking is that moderate exercise is the least effective, and that for optimum results about 80% of your exercise should be at a relatively easy intensity and about 20% at high intensity.
     
    Linds likes this.
  18. davidsrsb

    davidsrsb pfm Member

    The much greater incidence of heart disease (and other obesity related conditions) means that simply living longer from not being a lazy slob increase the ending up with something unusual
     
  19. sq225917

    sq225917 Bit of this, bit of that

    What a piece of shit meta analysis.

    The threshold for intense exercise seems a little low. To anyone who does intense exercise. They should subset for competitive rowers, runners, cyclist and squashes.
     
  20. gustav_errata

    gustav_errata pfm Member

    It wasn't a meta-analysis at all.

    Sufficient data almost certainly isn't available for elite athletes, given the rarity of the condition. Something like this could only reliably e done with something like UK Biobank, and even then statistical power was wanting.
     

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