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February 15, 1995

Physical Activity and Risk of Gastrointestinal Hemorrhage in the Elderly-Reply

Author Affiliations

National Institutes of Health Bethesda, Md

JAMA. 1995;273(7):522. doi:10.1001/jama.1995.03520310013011

In Reply.  —Dr Phinney raises an interesting and important issue related to the mechanisms underlying GIH. He suggests that low levels of arachidonic acid may be associated with an increased risk of GIH. Such a hypothesis is clearly supported by experimental data in rats showing that modifications of arachidonate metabolism predispose to gastric bleeding,1 and that a diet rich in arachidonic acid provides protection from ethanol-induced gastric hemorrhage.2However, the pathway by which low arachidonate could lead to a low level of physical activity is tenuous. Phinney suggests that low levels of arachidonate in the muscle membranes, by causing insulin resistance, lead to a decrease of glycogen deposition in the muscles, which in turn would not allow the older persons to exercise. Such a causal pathway conflicts with evidence provided by the current literature.3 The link of physical activity with insulin resistance proceeds in the opposite direction:

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