{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T18:42:14Z","timestamp":1790448134795,"version":"4.1.0"},"reference-count":32,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2017,2,1]],"date-time":"2017-02-01T00:00:00Z","timestamp":1485907200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"The Western Norway Regional Health Authority","award":["n. 911421\/2008 to M. Pugliatti"],"award-info":[{"award-number":["n. 911421\/2008 to M. Pugliatti"]}]},{"name":"The Western Norway Regional Health Authority","award":["n. 911474\/2009 to KM. Myhr"],"award-info":[{"award-number":["n. 911474\/2009 to KM. Myhr"]}]},{"name":"The Western Norway Regional Health Authority","award":["n. 912020\/2015 to K. Wesnes"],"award-info":[{"award-number":["n. 912020\/2015 to K. Wesnes"]}]},{"name":"Fondazione Italiana Sclerosi Multipla, FISM,","award":["n. 2007\/R\/14 to M. Pugliatti"],"award-info":[{"award-number":["n. 2007\/R\/14 to M. Pugliatti"]}]},{"name":"Fondazione Italiana Sclerosi Multipla, FISM,","award":["n. 2008\/R\/19 to M. Pugliatti"],"award-info":[{"award-number":["n. 2008\/R\/19 to M. Pugliatti"]}]},{"name":"the Multiple Sclerosis Society of Canada","award":["N\/A, 2011-2013 to C. Wolfson"],"award-info":[{"award-number":["N\/A, 2011-2013 to C. Wolfson"]}]},{"name":"the Canadian MS Scientific Research Foundation","award":["N\/A, 2009-2010 to C. Wolfson"],"award-info":[{"award-number":["N\/A, 2009-2010 to C. Wolfson"]}]},{"DOI":"10.13039\/100008272","name":"Novartis Pharmaceuticals Corporation","doi-asserted-by":"publisher","award":["N\/A, unrestricted grant 2015 to K.Wesnes"],"award-info":[{"award-number":["N\/A, unrestricted grant 2015 to K.Wesnes"]}],"id":[{"id":"10.13039\/100008272","id-type":"DOI","asserted-by":"publisher"}]},{"name":"the Norwegian MS society","award":["N\/A, 2011 to T. Riise"],"award-info":[{"award-number":["N\/A, 2011 to T. Riise"]}]},{"name":"The University of Bergen, Norway","award":["N\/A, 2007 to T. Riise"],"award-info":[{"award-number":["N\/A, 2007 to T. Riise"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The lifestyle factors smoking and obesity have been associated with the risk of multiple sclerosis (MS). Physical activity (PA) may also be of importance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To examine the association between PA and MS risk in Italy, Norway, and Sweden and to evaluate the possible influence by established risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In this case\u2013control study, 1904 cases and 3694 controls were asked to report their average weekly amounts of light and vigorous PA during adolescence on a scale ranging from none to more than 3\u2009hours activity. We used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) and adjusted for potential confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Vigorous PA was inversely associated with MS risk in the pooled analysis ( p-trend\u2009&lt;\u20090.001) with an age- and sex-adjusted OR of 0.74 (95% CI: 0.63\u20130.87) when comparing the highest and lowest levels. Adjusting for outdoor activity, infectious mononucleosis, body size, and smoking yielded similar results. The association was present in all countries and was not affected by exclusion of patients with early disease onset. Light PA was not associated with the risk of MS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our findings suggest that vigorous PA can modify the risk of developing MS independent of established risk factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1352458517694088","type":"journal-article","created":{"date-parts":[[2017,2,21]],"date-time":"2017-02-21T08:18:12Z","timestamp":1487665092000},"page":"150-157","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":61,"title":["Physical activity is associated with a decreased multiple sclerosis risk: The EnvIMS study"],"prefix":"10.1177","volume":"24","author":[{"given":"Kristin","family":"Wesnes","sequence":"first","affiliation":[{"name":"Department of Clinical Medicine, University of Bergen, Bergen, Norway\/The Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kjell-Morten","family":"Myhr","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, University of Bergen, Bergen, Norway\/The Norwegian Multiple Sclerosis Registry and Biobank, Department of Neurology, Haukeland University Hospital, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trond","family":"Riise","sequence":"additional","affiliation":[{"name":"Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway\/The Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Cortese","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, University of Bergen, Bergen, Norway\/The Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maura","family":"Pugliatti","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Specialty Surgical Sciences, Section of Clinical Neurology, University of Ferrara, Ferrara, Italy\/Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inger","family":"Bostr\u00f6m","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Clinical and Experimental Medicine, University of Link\u00f6ping, Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Marie","family":"Landtblom","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Clinical and Experimental Medicine, Link\u00f6ping University, Link\u00f6ping, Sweden\/Department of Neuroscience\/Neurology, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Wolfson","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada\/The Research Institute of the McGill University Health Centre, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kjetil","family":"Bj\u00f8rnevik","sequence":"additional","affiliation":[{"name":"Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway\/The Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,2,1]]},"reference":[{"key":"bibr1-1352458517694088","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24009"},{"key":"bibr2-1352458517694088","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2012.198"},{"key":"bibr3-1352458517694088","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181c0d6e0"},{"key":"bibr4-1352458517694088","doi-asserted-by":"publisher","DOI":"10.1177\/1352458513513968"},{"key":"bibr5-1352458517694088","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2010.1"},{"key":"bibr6-1352458517694088","doi-asserted-by":"publisher","DOI":"10.1097\/HJR.0b013e3282f55e09"},{"key":"bibr7-1352458517694088","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.051351"},{"key":"bibr8-1352458517694088","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1144"},{"key":"bibr9-1352458517694088","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003980.pub2"},{"key":"bibr10-1352458517694088","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD009956.pub2"},{"key":"bibr11-1352458517694088","doi-asserted-by":"publisher","DOI":"10.1016\/j.brainres.2009.06.063"},{"key":"bibr12-1352458517694088","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1177\/1352458515578770","volume":"21","author":"Cortese 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