Factors influencing mortality in ALS are clearly multifactorial.  The ability to determine these factors and subsequently modify them could be of therapeutic significance in ALS.  The large EPIC cohort recently established that a higher body mass index may be neuroprotective, i.e. reduce mortality in ALS, which was evident in both males and females.  This association could be explained by hypermetabolism.  Namely ALS patients  and SOD-1 mice seem to exhibit a hyper-metabolic state.  Perhaps the link to sport may also have a similar etiology?  Is this a chance association only?  What do you think??

Gallo V et al. Prediagnostic body fat and risk of death from amyotrophic lateral sclerosis: The EPIC cohort. Neurology. 2013;80:829-838.