Background/Purpose: Although available evidence supports the benefits of lifestyle interventions in SLE, the prevalence of lifestyle and integrative health behaviors and their association with health-related quality of life (HRQoL) in real world practice are not well understood. We describe the association of physical activity (PA), diet, and integrative health behaviors with HRQoL in women with SLE and other connective tissue disease (CTD) at a single tertiary care musculoskeletal center.

Methods: We included women aged 18-65 years evaluated by a Hospital for Special Surgery rheumatologist ≥2 times who enrolled in the Rheumatology Women’s Reproductive Health and Wellness Cohort from 12/2022-5/2024. The current cross-sectional analysis includes women with SLE and other CTD (identified by ≥2 ICD-10 codes ≥7 days apart) who shared type and frequency of PA, dietary quality, and integrative health practices and responded to questions on HRQoL reflecting 4 domains (life satisfaction, life worthwhile, happiness, anxiety, each scored on a 0-10 scale, with 0 “not at all” and 10 “completely”) from the United Kingdom Office for National Statistics. We performed descriptive analyses to summarize self-reported demographic and clinical characteristics, diet, PA, and integrative health practices. Logistic regression models were built using each of the 4 HRQoL domains (dichotomized) as outcomes, with lifestyle and integrative health behaviors as independent variables. Adjusted models controlled for age, race, ethnicity, and immunosuppressive medication use.

Results: Of 255 women (mean age 46.8 ±12.1 years), 180 (71%) reported exercising ≥1-3 times per week, and 105 (41%) rated their diet as very good or excellent; 166 (65%) participants were pursuing ≥1 integrative health practice at survey completion (Table 1). In unadjusted models, participants who reported never engaging in PA were less likely to report life satisfaction (odds ratio [OR] 0.18, 95% confidence interval [CI] 0.03-0.81] and happiness (OR 0.21, 95% CI 0.04-0.90) compared to those who exercised >3x/week while participants with a poor diet had lower odds of reporting life worthwhile (OR 0.17, 95% 0.03-0.94) and higher odds of reporting anxiety (OR 6.75, 95% 1.42, 39.68) compared to those with an excellent diet (Table 2). In adjusted models, participants who reported never engaging in PA were less likely to report life satisfaction (OR 0.19, 95% CI 0.03-0.90) and happiness (OR 0.20, 95% CI 0.04-0.88) compared to those who exercised >3x/week while participants with a poor diet had lower odds of reporting life worthwhile (OR 0.15, 95% 0.03-0.85) and higher odds of reporting anxiety (OR 8.19, 95% 1.62, 51.18) compared to those with an excellent diet (Table 3); any exercise was potentially associated with life worthwhile (high/very high versus medium/low).

Conclusion: In this sample, engagement in lifestyle and integrative health behaviors was common in SLE and other CTD. Lack of PA and poor diet were generally associated with decreased HRQoL. Interventional strategies promoting PA and healthy diet may improve wellbeing in this population alongside disease-directed therapies.

Table 1. Characteristics of 255 women with SLE and other CTD who enrolled in the Hospital for Special Surgery Women’s Reproductive Health and Wellness Cohort and completed Health-Related Quality of Life Questionnaires

Table 2. Logistic regression models relating lifestyle and integrative health practices to health-related quality of life (life satisfaction, life worthwhile, happiness, and anxiety) in participants with SLE and other CTD

Table 3. Adjusted * logistic regression models relating lifestyle and integrative health practices to health-related quality of life (life satisfaction, life worthwhile, happiness and anxiety) in participants with SLE and other CTD

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/association-of-lifestyle-and-integrative-health-practices-with-health-related-quality-of-life-in-women-with-systemic-lupus-erythematosus-and-connective-tissue-disease/