The researchers found that women with five healthy lifestyle factors had the lowest risk of developing RA and that the population-attributable risk (i.e, the incidence of RA in the population that would be eliminated if exposure were eliminated) for adhering to four or more of the five lifestyle factors was 34%, with the population-attributable risk for each individual factor ranging from 1% for physical activity to 17.3% for healthy BMI.
The investigators concluded from this that a substantial proportion of RA may be preventable by following a healthy lifestyle, and they emphasize in their paper the importance of this message for not only individuals at risk for RA by virtue of family history, but also the general population. That message includes the implication that even if a patient has reduced their risk of developing RA in in one category, such as not smoking, a patient has several other opportunities to further lower that risk.
“Healthy lifestyle behaviors are good for the prevention of many different diseases, and now RA is one of them,” says senior author Karen H. Costenbader, MD, MPH, a rheumatologist at Brigham and Women’s Hospital, Boston. “RA and chronic autoimmune diseases are traditionally thought of as mainly genetic diseases, and there is not much you can do about that. As it turns out, RA, like many chronic diseases, is related to environmental exposures and health behaviors.”
She describes this as a “paradigm shift in thinking about RA as a preventable disease.”
Implications for RA Outcomes
While acknowledging that the study does not specifically address outcomes, Dr. Costenbader notes that because “healthy lifestyle behaviors are strongly related to the risk of RA, it makes sense they [may also be] associated with outcomes from RA.”
Lara C. Pullen, PhD, is a medical writer based in the Chicago area.
References
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- Zaccardelli A, Friedlander HM, Ford JA, et al. Potential of lifestyle changes for reducing the risk of developing rheumatoid arthritis: is an ounce of prevention worth a pound of cure? Clin Ther. 2019 Jul;41(7):1323–1345.
- Stampfer MJ, Hu FB, Manson JE, et al. Primary prevention of coronary heart disease in women through diet and lifestyle. N Engl J Med. 2000 Jul 6;343(1):16–22.
- Chiuve SE, Rexrode KM, Spiegelman D, et al. Primary prevention of stroke by healthy lifestyle. Circulation. 2008 Aug 26;118(9):947–954. Epub 2008 Aug 12.
- Li Y, Schoufour J, Wang DD, et al. Healthy lifestyle and life expectancy free of cancer, cardiovascular disease, and type 2 diabetes: Prospective cohort study. BMJ. 2020 Jan 8;368:l6669.
