Research finds link between military service, Lou Gehrig's disease
BY JOHN FAUBER
Milwaukee Journal Sentinel
SAN FRANCISCO - (KRT) - A large new study has found a puzzling link between Lou Gehrig's disease and men who served in the U.S. military throughout most of the 20th century. The research, presented in San Francisco on Wednesday, is the second large study in the last year to find an unexplained connection between military service and amyotrophic lateral sclerosis, a rare but invariably fatal neurological disorder.
In 2003, a large study of members of the military who were deployed in the Persian Gulf region during the Gulf War showed that they had a substantially higher risk of getting ALS than service members who were not deployed in the region. However, the new study focused on men who served in all settings throughout the 20th century, including World Wars I and II, Korea and Vietnam, but not the Gulf War. It was presented at the annual meeting of the American Academy of Neurology.
The study found that men who served in the military, overall, were 60 percent more likely to develop ALS than those who did not. Those who served in the Navy had somewhat higher risk than those who served in the Air Force, Army and National Guard. "This study shows that the increased risk of ALS among military personnel does not appear to be specific to service during the Gulf War," said lead author Marc Weisskopf, an epidemiologist with the Harvard School of Public Health.
The whole issue of military service and ALS has become a controversial topic. Studies finding a heightened risk have been questioned about whether the link is real, but they continue to pile up. Part of the problem is that none of the studies, including the one presented Wednesday, offers any real insight into what about military service may be causing the risk. The cause of ALS has eluded neurologists for decades. Among military personnel, there has been speculation about a number of possibilities, including some chemical or environmental agent such as lead, vaccinations or viral infections, extreme physical exertion and stress.
"It is very difficult with ALS," said Steven Albert, an ALS researcher and associate professor of clinical public health at Columbia University's College of Physicians and Surgeons. "Nobody has found any toxin or environmental exposure ... (that causes ALS)." About 20,000 Americans have the disease, according to the National Institutes of Health. Each year about 5,000 new cases are diagnosed. Men are about 1.5 times as likely to get the disease as women. The vast majority of cases are sporadic, but about 1 in 20 cases are caused by a gene mutation.
In the general population, the risk of getting the disease is 1 to 2 per 100,000 people each year. It generally is diagnosed when patients reach their 40s and 50s. ALS is a motor neuron disease. It causes nerve cells in the brain stem and spinal cord to die, resulting in a progressive loss of voluntary muscle control, eventually leading to paralysis and death. The Harvard study looked at a vast database of about 1 million people originally devised to study cancer prevention. The study looked at 268,258 men who entered the military between 1906 and 1982 and compared their ALS rates to 126,414 men who did not serve in the military. A total of 274 ALS deaths between 1989 and 1998 were found.
"There really does appear to be this increased risk among people who served in the military," Weisskopf said. "We can't say much further than that." However, Weisskopf acknowledged that while the link was strong, there may be another explanation. He said it is possible that veterans receive a type of medical care that makes it more likely for them to be properly diagnosed with ALS than the general public. Jasper Daube, a neurologist and ALS specialist with the Mayo Clinic, said the Harvard study is exciting and adds to what is known about the disease. However, he added: "We don't have the answers. Is it because of stress or exercise or things we haven't thought of?
"I would not suggest to any of the patients and families I see that they have ALS because they were in the service." In another study, the same Harvard researchers found that regular vitamin E users had substantially lower risk of developing ALS. Men and women who were regular users, those who took the supplement at least 15 times a month, had 62 percent less chance of getting the disease if they took vitamin E for more than 10 years, compared with those who did not take vitamin E at all.
Less frequent use also seemed to provide some protection.
Oxidative stress is thought to contribute to ALS as well as many other diseases.
"Vitamin E is probably good for a lot of things," Weisskopf said.
Vitamin E is an anti-oxidant that may help stabilize free radicals, unstable oxygen-bearing molecules that contribute to oxidative stress.
No significant protection was found among those who used vitamins A or C or multivitamins.
Question
allan
Posted on Wed, Apr. 28, 2004
Research finds link between military service, Lou Gehrig's disease
BY JOHN FAUBER
Milwaukee Journal Sentinel
SAN FRANCISCO - (KRT) - A large new study has found a puzzling link between Lou Gehrig's disease and men who served in the U.S. military throughout most of the 20th century. The research, presented in San Francisco on Wednesday, is the second large study in the last year to find an unexplained connection between military service and amyotrophic lateral sclerosis, a rare but invariably fatal neurological disorder.
In 2003, a large study of members of the military who were deployed in the Persian Gulf region during the Gulf War showed that they had a substantially higher risk of getting ALS than service members who were not deployed in the region. However, the new study focused on men who served in all settings throughout the 20th century, including World Wars I and II, Korea and Vietnam, but not the Gulf War. It was presented at the annual meeting of the American Academy of Neurology.
The study found that men who served in the military, overall, were 60 percent more likely to develop ALS than those who did not. Those who served in the Navy had somewhat higher risk than those who served in the Air Force, Army and National Guard. "This study shows that the increased risk of ALS among military personnel does not appear to be specific to service during the Gulf War," said lead author Marc Weisskopf, an epidemiologist with the Harvard School of Public Health.
The whole issue of military service and ALS has become a controversial topic. Studies finding a heightened risk have been questioned about whether the link is real, but they continue to pile up. Part of the problem is that none of the studies, including the one presented Wednesday, offers any real insight into what about military service may be causing the risk. The cause of ALS has eluded neurologists for decades. Among military personnel, there has been speculation about a number of possibilities, including some chemical or environmental agent such as lead, vaccinations or viral infections, extreme physical exertion and stress.
"It is very difficult with ALS," said Steven Albert, an ALS researcher and associate professor of clinical public health at Columbia University's College of Physicians and Surgeons. "Nobody has found any toxin or environmental exposure ... (that causes ALS)." About 20,000 Americans have the disease, according to the National Institutes of Health. Each year about 5,000 new cases are diagnosed. Men are about 1.5 times as likely to get the disease as women. The vast majority of cases are sporadic, but about 1 in 20 cases are caused by a gene mutation.
In the general population, the risk of getting the disease is 1 to 2 per 100,000 people each year. It generally is diagnosed when patients reach their 40s and 50s. ALS is a motor neuron disease. It causes nerve cells in the brain stem and spinal cord to die, resulting in a progressive loss of voluntary muscle control, eventually leading to paralysis and death. The Harvard study looked at a vast database of about 1 million people originally devised to study cancer prevention. The study looked at 268,258 men who entered the military between 1906 and 1982 and compared their ALS rates to 126,414 men who did not serve in the military. A total of 274 ALS deaths between 1989 and 1998 were found.
"There really does appear to be this increased risk among people who served in the military," Weisskopf said. "We can't say much further than that." However, Weisskopf acknowledged that while the link was strong, there may be another explanation. He said it is possible that veterans receive a type of medical care that makes it more likely for them to be properly diagnosed with ALS than the general public. Jasper Daube, a neurologist and ALS specialist with the Mayo Clinic, said the Harvard study is exciting and adds to what is known about the disease. However, he added: "We don't have the answers. Is it because of stress or exercise or things we haven't thought of?
"I would not suggest to any of the patients and families I see that they have ALS because they were in the service." In another study, the same Harvard researchers found that regular vitamin E users had substantially lower risk of developing ALS. Men and women who were regular users, those who took the supplement at least 15 times a month, had 62 percent less chance of getting the disease if they took vitamin E for more than 10 years, compared with those who did not take vitamin E at all.
Less frequent use also seemed to provide some protection.
Oxidative stress is thought to contribute to ALS as well as many other diseases.
"Vitamin E is probably good for a lot of things," Weisskopf said.
Vitamin E is an anti-oxidant that may help stabilize free radicals, unstable oxygen-bearing molecules that contribute to oxidative stress.
No significant protection was found among those who used vitamins A or C or multivitamins.
© 2004, Milwaukee Journal Sentinel.
Visit JSOnline, the Journal Sentinel's World Wide Web site, at http://www.jsonline.com
Distributed by Knight Ridder/Tribune Information Services.
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