Women who were regularly exposed to secondhand smoke as children might be at slightly increased risk of rheumatoid arthritis, a new study hints.
Rheumatoid arthritis is an autoimmune disease in which the immune system mistakenly attacks the lining of the joints. Researchers believe that a mix of genes and certain environmental factors conspire to cause the disease. And a number of studies have linked smoking to a heightened risk of RA.
The new study, published Aug. 14 in the journal Rheumatology, looked at whether childhood exposure to secondhand smoke might be a risk factor for RA, too.
The answer, researchers found, is “maybe.”
Among more than 71,000 French women followed for two decades, those exposed to secondhand smoke as kids were at somewhat higher risk of rheumatoid arthritis, versus other women. That was true of women who currently smoked, and those who’d never smoked.
But those differences were not quite significant in statistical terms. That means the association between secondhand smoke and RA risk could be a chance finding.
So while the results are “provocative,” further research is necessary, one U.S. expert said.
“It’s hard to definitively say from the data what role secondhand smoke exposure in childhood plays in RA development,” said Dr. Tamar Rubinstein, a pediatric rheumatologist at Children’s Hospital at Montefiore in New York City.
Rubinstein, who is also a member of the American College of Rheumatology, was not involved in the study.
She called the findings “interesting,” and noted that there is a “growing” body of research finding links between childhood health and environmental exposures and the risks of disease later in life.
Plus, Rubinstein said, it’s biologically plausible that secondhand smoke exposure in childhood could contribute to rheumatoid arthritis later in life.
As the study authors explain it, secondhand smoke may affect immune system development in a way that makes RA more likely to develop — particularly in kids who are genetically susceptible to the arthritic disease.
Future studies should look at whether the relationship between RA and childhood smoke exposure is stronger in people who carry RA-linked genes, according to lead researcher Dr. Marie-Christine Boutron-Ruault, from the Gustave Roussy Institute in Villejuif, France.
For now, the findings “highlight the importance of children — especially those with a family history of this form of arthritis — avoiding secondhand smoke,” Boutron-Ruault said in a news release from the journal.
The findings are based on 71,248 middle-aged women who were followed for over 20 years. During that time, 371 women were diagnosed with rheumatoid arthritis.
In line with past studies, smokers showed a higher RA risk. Women who had ever smoked, but had no childhood exposure to secondhand smoke, were 38 percent more likely to develop RA than lifelong nonsmokers.
The risk appeared somewhat higher among smokers who were regularly exposed to tobacco smoke as kids. They were 67 percent more likely to develop RA than nonsmokers were.
However, the difference between smokers who were or were not exposed to smoking as kids was not statistically significant.
There was a similar pattern among women who’d never smoked: If they were regularly exposed to smokers as children, their risk of RA was 43 percent higher.
But again, that finding was just shy of statistical significance. And only an association was seen, not a cause-and-effect link.
“That doesn’t mean that there isn’t an association in reality,” Rubinstein said. “But it suggests we need to study this further to better understand it.”
The American College of Rheumatology has more on rheumatoid arthritis.
SOURCES: Tamar Rubinstein, M.D., assistant professor, pediatric rheumatology, Children’s Hospital at Montefiore, New York City; Aug. 14, 2018, Rheumatology, online
While people typically associate osteoporosis with women, men aren’t immune.
Osteoporosis commonly leads to weakening of the skeleton and fractures. According to the U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases, by the age of 70, men and women are losing bone mass at about the same rate.
The institute mentions these factors that raise a man’s chances of developing osteoporosis:
- Having a chronic disease affecting the kidneys, lungs, stomach or intestines.
- Taking certain medications regularly.
- Having low testosterone.
- Smoking, drinking alcohol excessively, getting insufficient calcium or failing to get enough exercise.
- Getting older.
Exercise can help prevent many chronic illnesses as well as make it easier to manage health conditions, from diabetes to joint pain.
In terms of prevention, aim for the recommended 150 minutes of exercise, like brisk walking or cycling, each week. Along with eating a healthy diet, this can cut your risk of diabetes by more than a third, plus increase your level of good cholesterol. Exercise also lowers body weight, blood pressure and triglycerides, thus reducing key risk factors for heart disease.
If you’re already managing a chronic illness, exercise may improve symptoms and reduce the amount of medication you need to take. It builds muscle, which helps you move more easily, and reduces stress, which can aggravate many health conditions. Back pain and arthritis improve with the right stretching and exercise plan. If you have diabetes, exercise can improve blood sugar control.
Exercise’s health effects on:
Heart disease: Regular aerobic exercise and interval training in particular are heart-healthy, boosting cardiovascular fitness.
Back pain: Core exercises strengthen the muscles around your spine, creating better support for your spine.
Arthritis: Exercise enhances the muscles that support your joints, making movement easier; it also eases stiffness.
Diabetes: Exercise helps you use insulin more effectively and lower your blood sugar level.
Asthma: Exercise can help control attacks.
If you’re managing an illness and haven’t been active, talk to your doctor about what exercises are safe, any precautions to take, what kind of discomfort is normal, and what are signs to stop, like feeling dizzy, short of breath or chest pain.
Working with your doctor is especially important when you have diabetes. Because exercise can affect blood sugar, you’ll need to take precautions to prevent blood sugar from becoming too low during workouts.
In terms of intensity, start off slow — that means you should be able to talk, but not sing, when working out.
The Cleveland Clinic has detailed tips on exercising with a chronic condition to help you get started safely.
Obesity may accelerate and amplify the crippling symptoms of rheumatoid arthritis, new research suggests.
Conversely, the researchers also found that unexplained weight loss might also signal problems for these patients, because it could mean that they’re at greater risk for disability.
“While patients and rheumatologists may be focused mostly on disease activity, we should also consider this common condition [obesity], which can contribute to problems that are usually attributed to the arthritis itself,” said study author Dr. Joshua Baker.
“In addition, unintentional weight loss should alert us that the patient may be becoming frail and is at risk for developing new disability,” he added. Baker is an assistant professor of medicine at the University of Pennsylvania’s Perelman School of Medicine.
Rheumatoid arthritis is an autoimmune condition. It develops when immune cells that normally fight germs attack the lining of the joints, or cartilage. This causes the joints to swell and the surrounding bones, ligaments and muscles to gradually erode. Rheumatoid arthritis worsens over time, often leading to disability.
For the study, Baker and his colleagues looked at the effects of obesity on the progression of rheumatoid arthritis in just over 25,000 people with the disease.
The investigators found that the disease advanced more quickly among those who were very obese. This was true regardless of the level of inflammation in their joints.
In addition, people who were thin but lost weight without trying also became disabled more quickly.
The study was published April 30 in the journal Arthritis Care & Research.
“So, this study suggests that patients with rheumatoid arthritis and obesity would benefit from intentional weight loss through a comprehensive management strategy,” Baker said in a journal news release.”
“However, when we see that someone is losing weight without trying, it’s probably a poor prognostic sign, especially if they are already thin,” he added.
Although the study could not prove a cause-and-effect link, the researchers suggested that new treatments and strategies to help people maintain a healthy weight might help prevent disability among people with rheumatoid arthritis.
And, Baker’s team noted, the findings could help doctors recognize signs of frailty among their rheumatoid arthritis patients who may benefit from strength training and physical therapy.
The Arthritis Foundation has more about obesity and rheumatoid arthritis.
SOURCE: Arthritis Care & Research, news release, April 30, 2018