Environment and Lifestyle: Their Influence on the Risk of RA

Abstract

Background: Rheumatoid arthritis (RA) is a complex disease in which environmental agents are thought to interact with genetic factors that lead to triggering of autoimmunity. Methods: We reviewed environmental, hormonal, and dietary factors that have been suggested to be associated with the risk of RA. Results: Smoking is the most robust factor associated with the risk of RA, with a clear gene–environment interaction. Among other inhalants, silica may increase the risk of RA in men. There is less evidence for pesticides, pollution, and other occupational inhalants. Regarding female hormonal exposures, there is some epidemiological evidence, although not consistent in the literature, to suggest a link between hormonal factors and the risk of RA. Regarding dietary factors, available evidence is conflicting. A high consumption of coffee seems to be associated with an increased risk of RA, whereas a moderate consumption of alcohol is inversely associated with the risk of RA, and there is less evidence regarding other food groups. Dietary pattern analyses (Mediterranean diet, the inflammatory potential of the diet, or diet quality) suggested a potential benefit of dietary modifications for individuals at high risk of RA. Conclusion: To date, smoking and silica exposure have been reproducibly demonstrated to trigger the emergence of RA. However, many other environmental factors have been studied, mostly with a case-control design. Results were conflicting and studies rarely considered potential gene–environment interactions. There is a need for large scale prospective studies and studies in predisposed individuals to better understand and prevent the disease and its course.

Causal Association of Coffee Consumption and Total, Knee, Hip and Self-Reported Osteoarthritis: A Mendelian Randomization Study

“…Single nucleotide polymorphism sites (SNPs) are randomly assigned at conception, bias from reverse causation, and residual confounding is avoided ( 22 ). Although observational studies found the association between coffee intake and bone health, such as bone mass index, fracture, rheumatoid arthritis, and osteoarthritis ( 12 , 23 , 24 ), data are limited for the relationship of genetically predicted habitual coffee intake concerning the bone disease. One MR analysis support that coffee intake is causally associated with an increased risk of OA ( 25 ).…”

Is Rheumatoid Arthritis Related to Coffee Consumption in Korea? A Nationwide Cross-Sectional Observational Study

“…Third, although this study classified coffee consumption based on the number of cups of coffee consumed per day, cup size, strength, and concentration of coffee may vary considerably. Fourth, there has been no investigation of other foods that may affect the risk of RA, such as fish, fruit, vegetables, and tea [27]. Finally, the small number of RA patients in our study may not have revealed the significant relationship; thus, a larger-scale study is needed.…”

The Traditional Chinese Medicine Compound Huangqin Qingre Chubi Capsule Inhibits the Pathogenesis of Rheumatoid Arthritis Through the CUL4B/Wnt Pathway

“…RA is an autoimmune disease mainly characterized by chronic inflammation of synovium, which can cause joint swelling and pain, and then lead to narrowing of joint space, destruction of cartilage, joint deformity, and finally different degrees of disability (Maden, 2020;Salliot et al, 2020). According to statistics, RA has been worldwide incidence, the average incidence rate is 1%, the prevalence rate of China is 0.3-0.4%.…”