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Higher body mass index (BMI) and weight gain are linked to a reduced risk of developing amyotrophic lateral sclerosis (ALS) decades later. This association strengthens over time, showing a significant protective effect up to 50 years post-measurement.

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Area of Science:

  • Neurology
  • Epidemiology
  • Public Health

Background:

  • Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease with multifactorial etiology.
  • Understanding modifiable risk factors like body mass index (BMI) and weight change is crucial for prevention strategies.

Purpose of the Study:

  • To examine the long-term temporal relationship between prediagnostic body mass index (BMI), weight fluctuations, and the subsequent risk of developing amyotrophic lateral sclerosis (ALS).

Main Methods:

  • Utilized data from a large Norwegian cohort (nearly 1.5 million individuals) with objectively measured BMI from 1963-1975.
  • Tracked ALS cases through national registries until 2017, employing Cox hazard and flexible parametric survival models for analysis.
  • Collected additional data on weight change and lifestyle factors from participants in later health surveys.

Main Results:

  • A significant inverse association was observed between prediagnostic BMI and ALS risk; a 5-unit increase in BMI correlated with an 17% reduction in ALS risk (HR 0.83).
  • The protective effect of higher BMI against ALS risk increased over time, reaching a hazard ratio of 0.69 (95% CI 0.62-0.77) after 50 years.
  • Individuals experiencing substantial weight gain exhibited a lower risk of ALS compared to those with minimal weight change (HR 0.63).

Conclusions:

  • Elevated prediagnostic BMI and significant weight gain are associated with a decreased risk of developing ALS, with effects persisting for several decades.
  • The protective association between BMI and ALS risk is cumulative, strengthening considerably up to 50 years following BMI assessment.