Fascinating #ALS #MND study by @AmmarAlChalabi and @ShorterLab about the impact of exercise on ALS. What they found: 🔹Hard, strenuous exercise was linked to getting ALS appx 10 yrs earlier 🔹Highly active people Sx onset ≈ 54–58 years. 🔹Inactive people Sx onset ≈ 63–64 years. 🔹Exercise did not raise the chance of developing ALS 🔹Head injury was linked to higher ALS risk (about 1.7-fold), but not to earlier onset. This paper split people with ALS into three activity groups based on lifetime leisure exercise: highly active, active, and inactive. None were professional athletes—just recreational exercisers. After accounting for sex, C9orf72, and head injury, the highly active group ≈ 2.3–2.8x risk of earlier onset vs inactive people. But strenuous activity was not associated wth speed of progression or mortality. The authors treat strenuous exercise as a possible “accelerator” in age of onset in susceptible people, not a reason for the public to stop exercising. But for those at risk, it may justify the personalized approach to slow the age of disease onset. #endALS #fALS