Association of Healthy Lifestyle Behaviors and the Risk of Developing Rheumatoid Arthritis Among Women

Abstract

Objective. To investigate whether a healthy lifestyle, defined by a healthy lifestyle index score (HLIS), was associated with rheumatoid arthritis (RA) risk, overall and with seropositive/seronegative subtypes.Methods. We analyzed female nurses in the Nurses' Health Study (NHS, 1986(NHS, -2016 and NHSII (1991NHSII ( -2017. Lifestyle and medical information were collected on biennial questionnaires. Medical records confirmed incident RA and serostatus. The HLIS index includes 5 modifiable components: smoking, alcohol consumption, body mass index, physical activity, and diet. Cox regression, adjusted for confounders, modeled associations between HLIS and incident RA. The population attributable risk estimated the proportion of incident RA preventable if participants adopted ≥4 healthy lifestyle factors.Results. A total of 1,219 incident RA cases (776 seropositive, 443 seronegative) developed in 4,467,751 personyears. Higher (healthier) HLIS was associated with lower overall RA risk (hazard ratio [HR] 0.86 [95% confidence interval (95% CI) 0.82-0.90]), seropositive RA risk (HR 0.85 [95% CI 0.80-0.91]), and seronegative RA risk (HR 0.87 [95% 0.80-0.94]). Women with 5 healthy lifestyle factors had the lowest risk ). The population attributable risk for adhering to ≥4 lifestyle factors was 34% for RA.Conclusion. In this prospective cohort, healthier lifestyle was associated with a lower RA risk. A substantial proportion of RA may be preventable by a healthy lifestyle.

Seronegative rheumatoid arthritis: one year in review 2023

“…A correct lifestyle is important for preventing both seropositive and seronegative RA. A recent study conducted on 1,219 incident RA cases (776 seropositive, 443 seronegative) demonstrated that a high level of healthy lifestyle index score was associated with a lower RA risk, both in seropositive and seronegative RA, with hazard ratios of 0.85 and 0.87, respectively (18). The healthy lifestyle index analysed 5 different aspects of lifestyle: smoking, alcohol consumption, body mass index, physical activity, and diet; the higher the index, the healthier the lifestyle.…”

“…• Endogeneous and environmental factors contribute to disease pathogenesis, but specific risk factors could differ between seropositive and seronegative RA (18,19,22,23). • Differences in the pathogenic pathways between the two subsets of the disease can be partially captured from the analysis of the synovial tissue (29,30).…”

Lifestyle Factors and Their Influence on Rheumatoid Arthritis: A Narrative Review

“…The effect of a high EDII on RA risk mentioned above was attenuated after adjusting for BMI [ 12 ]. In addition, a recent analysis of the NHS cohort revealed that obesity had the most marked effect on RA risk [ 4 ], and after adjustment for the BMI, the AHEI 2010 did not contribute independently to the hazard ratio for RA [ 4 ]. By analyzing the data of 108,000 women who were followed-up prospectively between 1989 and 2017, the NHS demonstrated that weight gain from baseline was quantitatively associated with the risk for seropositive and seronegative RA.…”

“…Recently, the Nurses Health Study (NHS) cohorts were analyzed with respect to the impact of modifiable lifestyle factors (cigarette smoking, being obese, lacking physical activity and consuming unhealthy diets, as well as drinking alcohol in excess) on the risk of RA. A healthy lifestyle index score (HLIS) was developed to quantify these five factors [ 4 ]. In general, a higher (healthier) HLIS was associated with a lower hazard ratio (HR) for RA, most prominently in women with five healthy lifestyle factors (HR 0.42), which was even lower for seropositive RA (HR 0.24) [ 4 ].…”

“…A healthy lifestyle index score (HLIS) was developed to quantify these five factors [ 4 ]. In general, a higher (healthier) HLIS was associated with a lower hazard ratio (HR) for RA, most prominently in women with five healthy lifestyle factors (HR 0.42), which was even lower for seropositive RA (HR 0.24) [ 4 ].…”