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Why Higher Levels of Physical Activity Are Important in Preventing Chronic Diseases
By Julie Gould
According to recent study findings published online in Arthritis & Rheumatology, higher levels of physical activity reduced the risk of rheumatoid arthritis (RA).
In order to evaluate long-term physical activity and subsequent risk for RA among an all-female study population, a team of researchers examined 113,366 women and identified 506 incident RA cases. According to the research team, “increasing cumulative average total hours of recreational physical activity was associated with reduced RA risk.” Further, the team found that the “proportion of the effect between physical activity and RA mediated by updated BMI was 14.0% for all RA and 20.0% for seropositive RA.”
First Report Managed Care spoke with researcher, Jeffrey Sparks, MD. Dr Sparks discussed why high levels of physical activity are important and explained why he suspects physical activity has beneficial effects on the immune system and also lowers systemic inflammation.
Please tell us a little about yourself and your research interests.
I am a rheumatologist performing epidemiologic and patient-oriented research related to rheumatoid arthritis (RA) etiology and outcomes. I have a particular interest in understanding the lifestyle factors that are related to development of autoantibodies and autoimmune diseases such as RA. I am an Assistant Professor of Medicine at Brigham and Women's Hospital and Harvard Medical School.
Can you highlight what past research implies regarding physical activity and RA risk? How does your study support past findings?
Our group has performed several studies related to smoking, excess body weight, and dietary intake for RA risk. We found that metabolic factors seem to be very important to the development of RA perhaps related to systemic inflammation. Therefore, we decided to investigate long-term physical activity and RA risk. Only a few studies had investigated physical activity and RA risk before.
Can you briefly discuss why physical activity lowers the risk of rheumatoid arthritis? Why is physical activity a good preventative measure for patients at risk of developing RA?
The reason that physical activity lowers RA risk will need further investigation. However, we designed our study in such a way that physical activity changes occurring as early RA manifestations were less likely to explain our findings. We also had rich data on other RA risk factors such as smoking, diet, and obesity so we think these factors are unlikely to explain the association. I suspect that physical activity has beneficial effects on the immune system and also lowers systemic inflammation.
How does an increase in physical activity among patients lower health care utilization as well as in-office visits as a result? Does this lower the overall cost of care?
Our study's outcome was related to RA diagnosis and we did not study health care utilization or costs. However, if high levels of physical activity were able to prevent a chronic disease, it is likely this would also result in lower health care utilization and cost of care.
At what age should clinicians begin to encourage increased activity among this patient population?
Our study investigated working women who were ages 27-54 at the baseline of analysis. Since we studied long-term levels of physical activity, people would likely have best results if this was a lifelong lifestyle change.
Due to a reduced risk of RA with higher levels of activity, what can clinicians as well as payers learn from your study findings?
Our study offers evidence for another lifestyle factor that might alter the risk for RA. Clinicians could give this advice to people at risk for developing RA through family history or presence of RA-related autoantibodies.
Reference:
Liu X, Tedeschi SK, Lu B, et al. Long‐term physical activity and subsequent risk for rheumatoid arthritis among women: A prospective cohort study [published online March 28, 2019]. Arthritis Rheum. https://doi.org/10.1002/art.40899
