Rheumatoid arthritis is an autoimmune disorder that can cause disabling joint destruction and deformation. Treatment involves the use of drugs designed to modify the body’s autoimmune response in order to diminish symptoms and slow the progression of the disease. However, not everyone responds to the medications, and the drugs are not without serious side effects.
Researchers continue to seek better drug treatments, or even a cure. But is it possible to prevent RA altogether?
[See: How to Practice Yoga When You Have Arthritis or Another Chronic Condition.]
The short answer is no. There is no available vaccine or other intervention that can prevent RA. One of the reasons for this is because no one knows why some people develop RA, and the disease appears to have several triggers.
“Different pathways lead to the development of RA,” says Dr. Kristen Demoruelle, a rheumatologist specializing in RA in Denver, Colorado.
Research has shown that several characteristics are known to increase the likelihood of developing RA. According to the Centers for Disease Control and Prevention, the main risk factors are:
— Age. RA can begin at any age, but chances of developing the disease increase with age, and most new cases are diagnosed in adults in their 60s.
— Gender. RA is about three times more prevalent in women than in men.
— Genetics. There can be a genetic predisposition to RA, particularly in people who have a first-degree relative — parent, sibling or child — with the disease.
— Smoking. Multiple studies show that cigarette smoking increases a person’s risk of developing RA and can make the disease worse.
— Early exposure. Early exposure may also be a factor. For example, one study found that the children of mothers who smoked had twice the risk of developing RA as adults.
— Childbearing history. Women who have never given birth may have a greater chance of developing RA than women who have given birth.
— Obesity. Obesity can increase the risk of developing RA, and the more overweight one is, the higher the risk.
[See: 9 Ways to Boost Your Immune System.]
The likelihood of developing RA appears to be greater in people who have a combination of risk factors, such as smokers with a family history of the disease, but many people with RA have none of these predisposing characteristics. To further complicate the issue, there is also evidence that infection with certain viruses and bacteria may trigger the disease in some individuals.
Because so many different factors may cause the immune system to malfunction and turn on itself, it’s impossible to predict who will develop RA.
“This makes it difficult to individualize or personalize recommendations [for prevention],” says Demoruelle, who is an assistant professor of medicine at the University of Colorado.
Demoruelle believes that studies looking at the earliest phases of the disease may be key to improving our understanding of RA and perhaps eventually developing reliable methods of predicting who will get it. For example, researchers have found that there is a preclinical phase of the disease in which biomarkers for RA, such as rheumatoid factor antibodies, are present in the blood years before symptoms appear and the disease is diagnosed.
A handful of preliminary clinical trials are investigating whether drug therapy during this preclinical phase can delay the development of RA or even prevent it altogether, but it’s too early to draw any conclusions.
“In the future it may be possible to use milder interventions to ‘reset’ the immune system before RA develops, but more research is needed,” says Demoruelle.
A growing body of evidence also indicates that it may be possible to decrease the odds of developing RA by making lifestyle changes to modify your risk factors.
“There is plenty of evidence that lifestyle affects the immune system,” says Dr. Leonard Calabrese, a rheumatologist and immunologist in clinical practice at the Cleveland Clinic in Ohio.
Unhealthy habits, such as a high-sugar diet, have been found to increase the incidence of RA. A study cited in the journal Nutrition & Diabetes found that young adults between the ages of 20 and 30 who drank five or more high-sugar beverages each week — including apple juice and sodas and fruit drinks sweetened with sugar or high fructose corn syrup — had three times the incidence of any arthritis than those who drank fewer, or no, sugary drinks.
In contrast, a healthy diet has been shown to decrease the risk of RA, according to Calabrese, who is also the Director of Clinical Immunology at the Cleveland Clinic Lerner College of Medicine. A study of people with a first-degree relative with RA found a lower incidence of the disease in individuals who followed a low-protein Mediterranean-type diet that includes plenty of vegetables, fruits and fats enriched with omega-3 fatty acids, as compared with those who ate less-healthy diets.
Stress also impacts overall immune system functioning. Stress causes the release of cytokines, molecules responsible for inflammation and pain in RA. And the more stressed you are, the more cytokines your body produces.
“Biobehavioral approaches, such as mindfulness meditation, have been proven to be very effective in combating stress,” says Calabrese, who recommends it to all of his patients with an autoimmune disease.
So although science has yet to find a cure for RA and there are no sure-fire ways to prevent the disease, you can make some positive changes that can potentially reduce your chances of getting RA, or delay its onset. If you do get RA or have already been diagnosed, these changes may also decrease the severity of your symptoms.
If you smoke, quit. “Smoking has been shown to be the most important risk factor for developing RA,” Demoruelle says. And if possible, limit your exposure to other environmental toxins. For example, if your job requires you to work with chemical solvents, make sure you have the best, most up-to-date protection available.
[See: 12 ‘Unhealthy’ Foods With Health Benefits.]
“If you’re obese, lose weight.” Calabrese advises. Even if you’re not overweight, eat a healthy, low-sugar diet that includes healthy omega-3 fats and plenty of vegetables and fruits, and adopt a moderate exercise routine.
And if you have a family history of RA, pay careful attention to your body and see a rheumatologist the moment you feel any joint pain or discomfort, advises Demoruelle. Early treatment increases the odds that you’ll slow RA’s progression and have milder symptoms overall.
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How to Prevent the Onset of Rheumatoid Arthritis originally appeared on usnews.com
