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From the Departments of Nutrition (Drs. Chen and Ascherio) and Epidemiology (Drs. Zhang, Hernán, and Ascherio), Harvard School of Public Health, Division of Preventive Medicine (Dr. Zhang) and Channing Laboratory (Dr. Ascherio), Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, and Department of Neurology (Dr. Schwarzschild), Massachusetts General Hospital, Boston.
Address correspondence and reprint requests to Dr. H. Chen, Department of Nutrition, Harvard School of Public Health, 665 Huntington Ave., Boston, MA 02115; e-mail: hchen{at}hsph.harvard.edu
Objective: To investigate whether greater physical activity is associated with a lower risk of Parkinson disease (PD).
Methods: The authors prospectively followed 48,574 men and 77,254 women who provided information on physical activity in 1986 or in early adulthood. During the follow-up, a total of 252 (male) and 135 (female) incident PD cases were identified.
Results: In men, greater baseline physical activity was associated with a lower PD risk; compared with the lowest quintile, the multivariate relative risk (RR) of PD for the highest quintile was 0.7 (95% CI 0.5 to 1.1; p value, test for trend = 0.007), and the inverse association was still present after excluding the first 10 years of follow-up (RR = 0.5; p value, test for trend = 0.02). Further, strenuous exercise in early adult life was also inversely related to PD risk in men: compared with men who regularly exercised 
2 months/year, those with 
10 months of strenuous exercise had a 60% lower PD risk (RR = 0.4; p value, test for trend = 0.005). In women, physical activity assessed at baseline was not related to PD risk, whereas strenuous exercise in early adulthood tended to be inversely related to PD risk later in life (highest vs lowest categories, RR = 0.5, 95% CI 0.2 to 1.4; p value, test for trend = 0.06).
Conclusion: This study suggests either that higher levels of physical activity may lower the risk of Parkinson disease (PD) in men or that men predisposed to PD tend to avoid strenuous physical activity in their early adult years.
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