Background/Purpose: There is a growing interest in the role of lifestyle in developing chronic diseases, such as rheumatoid arthritis (RA). Our aim was to investigate whether modifiable risk factors, such as an unfavorable lipid profile, smoking, obesity, diet, physical activity, and psycho-social factors, for example, education level, increase the risk of developing RA.

Methods: The register of patients with RA (1987 ACR criteria) at the Department of Rheumatology in the county of Västerbotten, northern Sweden, was co-analyzed with the register for the Västerbotten Intervention Project (VIP), which assembles data from clinical examinations in a community intervention program. Within this database, 146 patients (women, n=102, 70%) who had participated before onset of symptoms of disease and 438 controls matched for sex, were identified. Due to different versions of the food frequency questionnaire (FFQ) being used, the controls were also matched for FFQ version. From visits pre-dating the onset of symptoms, data on diet, physical activity, smoking, body mass index, serum levels of total cholesterol and triglycerides was retrieved from the database. The association between lifestyle factors and risk of developing RA was assessed by logistic regression analyses.

Results: Smoking and physically demanding work were associated with an increased risk of developing RA (OR=2.35 (1.54-3.59) and OR=1.17 (1.002-1.37), respectively), whilst higher education associated with a decreased risk (OR= 0.62 (0.39-0.98)). A median consumption of fish was 20 grams/day (IQR 11-28) and fruit/vegetables 150 grams/day (IQR 83-318) for the prediseased individuals was not significantly different from that of the controls. No significant associations for the risk of RA were found with the Healthy Diet Indicator score, or with food groups and macronutrients. Nor did body mass index and alcohol consumption affect the development of RA. Levels of serum cholesterol or triglycerides did not affect the risk, nor did the frequency of exercise.

Conclusion: In this nested case-control study no association between diet and risk for development of RA was observed. There was limited variability regarding dietary factors in the subject groups studied, which could reduce the detectibility within the populations studied. However, it can be concluded that smoking and the level of education, were more significant for the risk of developing RA than diet in this cohort of patients.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/diet-and-other-lifestyle-related-factors-and-the-risk-of-developing-rheumatoid-arthritis/