Preventing Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic autoimmune condition. Your body attacks its own cells, causing pain and inflammation. While RA can affect a number of tissues and organs, it mostly targets joints. The specific cause of RA remains a mystery, but a number of risk factors and lifestyle choices may play a role.

Some of the known risk factors for RA include:

  • Increasing age, with most cases beginning in the 60s
  • Female sex, especially those who have never given birth
  • Genetics, specifically people with human leukocyte antigen (HLA) class II genotypes
  • Smoking
  • People whose mothers smoked during pregnancy, or who were exposed to early secondhand smoke
  • Lower income groups
  • Obesity

While it's not possible to prevent RA entirely, there are ways you can reduce your chance of getting the disease.

X-ray of knee - osteoarthritis and rheumatoid arthritis

Peter Dazeley / Getty Images

Stop Smoking

Smoking and exposure to cigarette smoke is a major risk factor in the development of rheumatoid arthritis. One study found that the risk of developing RA was approximately twice as high for smokers than for non-smokers. For female smokers, the risk was approximately 1.3-times higher than for non-smokers.

Smoking can affect the immune system by increasing oxidative stress on the body, affecting apoptosis (cell death), and causing inflammation, among others. Quitting smoking and avoiding secondhand smoke can therefore be helpful in preventing the development of RA.

The Centers for Disease Control and Prevention offers a number of resources that can help if you want to quit smoking. These include live quitlines, medications, text messages, a free smartphone app, support groups, and help making a quit plan.

To make a quit plan:

  • Set a specific date to start
  • Tell friends and family what you are trying to do so they can help keep you accountable
  • Get rid of items and habits that remind you of smoking
  • Develop new routines that help you avoid triggers for smoking
  • Keep a written list of reminders for why you want to quit
  • Identify a support system
  • Find ways to cope with cravings
  • Identify rewards for when you reach milestones

Limit Alcohol

Alcohol doesn't have to be completely off the table for people with RA, but limiting your intake can help promote a healthy lifestyle and prevent a number of diseases. Long-term moderate alcohol drinking has been linked to lower RA risk in women.

The concern with alcohol when it comes to RA is the possible interaction with any medications you may be taking and the risk of liver damage. Some medications used to treat RA, like methotrexate, can be damaging to the liver. Alcohol use, which can also hurt the liver, would only increase that risk. Talk to your doctor about your alcohol consumption and any medications you are taking.

Minimize Bone Loss

Joint damage and joint pain are hallmarks of RA, and the inflammation cause by the disease can lead to bone loss and osteoporosis. The glucocorticoid medications often prescribed for the treatment of rheumatoid arthritis can trigger significant bone loss. Pain and loss of joint function caused by the disease can result in inactivity, further increasing osteoporosis risk. 

You can help prevent or slow down bone loss caused by RA by:

  • Making sure your diet is rich in calcium or vitamin D
  • Taking supplements for bone health is these nutrients aren't in your diet
  • Controlling your RA with the help of a doctor to avoid progression
  • Avoiding the use of glucocorticoids, or using it in short-term doses when needed

Improve Oral Health

Certain bacterial or viral infections have been linked to the development of some autoimmune diseases, and RA is one of them. A 2017 study at Johns Hopkins University found that some bacteria that cause gum disease, such as Aggregatibacter actinomycetemcomitans, releases a toxin that creates tiny holes in white blood cells, leading to the production of antibodies. These antibodies were found in 62% of people with chronic periodontitis and 43% of people with RA, suggesting that both conditions may be triggered by the same bacterial process.

To help prevent RA, keep your teeth and gums in good shape, and see a dentist regularly to prevent chronic oral health problems or infections.

Increase Fish Intake

Fish is rich in a number of nutrients, particularly omega-3 fatty acids and vitamins A and D. Eating fish regularly is a good idea for anyone, but fish oil has been shown to be especially helpful for people with inflammatory diseases and various types of arthritis, including RA. Some guidance suggest eating fish several times each week may be protective against RA.

Maintain a Healthy Weight

A healthy diet can help prevent a host of diseases, but may be especially beneficial when it comes to RA. Obesity has been linked to the development of rheumatoid arthritis, so it's important to maintain a healthy weight to reduce your risk of RA. Additionally, there are a number of vitamins and minerals—like vitamin D and calcium—that can help to keep RA from progressing.

There is also some evidence that anti-inflammatory diets can help fight RA and other inflammatory diseases. These diets typically rely on elements of a vegetarian, gluten-free, and Mediterranean diets. While these diets don't have a significant effect on disease development or progression, eating or avoiding certain foods seems to help some patients with RA alongside other therapies.

Key aspects of these diets include:

  • Fish—mostly salmon—three to four times each week
  • Vegetarian meals with legumes one to two times each week
  • Potatoes
  • Whole-grain cereals
  • Low-fat dairy
  • Five or more servings of fruit and vegetables each day
  • Probiotics

Super foods for an anti-inflammatory diet include:

  • Tomatoes
  • Olive oil
  • Spinach
  • Kale
  • Almonds
  • Walnuts
  • Salmon
  • Tuna
  • Strawberries
  • Blueberries
  • Cherries
  • Oranges

Foods best avoided or limited include:

  • Meats no more than three times per week
  • Processed meats
  • Red meats
  • Margarine
  • Lard
  • Shortening
  • Refined carbohydrates like white breads
  • Fried foods
  • Sodas

Stay Active

Regular exercise—even low-impact exercise—can help with chronic disease prevention. Exercise improves bone health, heart health, oxygenation throughout your body, mental health, and more. Even with joint pain in RA and other forms of arthritis, exercise is helpful.

All types of exercise—aerobic, weight training, stretching, and yoga—can also be protective against diseases like RA or help slow progress and relieve symptoms of the disease. Yoga, in particular, is helpful for its impact on pain, inflammation, stress and mental health, balance, and strength development.

Some of the best examples of exercises for people with RA include:

  • Stretching
  • Walking
  • Yoga and Tai Chi
  • Aquatic exercise
  • Biking
  • Strength training

The important thing when exercising with RA or other chronic conditions is to listen to your body. Be mindful of pain and body positioning. You should also be sure to use the right equipment, like supportive shoes, to get the greatest benefit from your efforts.

Reduce Exposure to Environmental Pollutants

Environmental pollutants like toxic chemicals and harsh cleaners are good for some things, but your health is not one of them. Chemicals used in cleaning and manufacturing can pollute air, water, and soil. These chemicals not only hurt the environment, but they have also been shown to trigger a host of health problems—especially in people with certain genes.

The HLA gene has been tied to the development of RA, and studies have found that pollutants like dioxin and cigarette smoke are associated with disease development in people with this gene. New medications are being investigated to block these actions, but avoidance of harmful chemicals is best when possible.

Take Early Action

Rheumatoid arthritis is a chronic, progressive disease that can lead to disabling joint damage. There are many conditions that come with joint pain and inflammation, but suspicions should be raised for RA when morning stiffness that resolves in about an hour. If you think you have RA, or are at risk of developing RA, talk with your doctor. Early and aggressive treatment with medications that help stop inflammation and put RA into remission are key to preventing severe joint damage or damage to other organs.

RA Treatment: Window of Opportunity

Getting an accurate diagnosis and treatment early is the key to fighting rheumatoid arthritis. The worst joint damage comes about two years into the disease, and you will have the best outcomes if your diagnosis and treatment begins within six months of your symptoms starting.

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Article Sources
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