Investigating the influence of lifestyle factors on the development and progression of Rheumatological conditions: systematic review

Abstract

Moamen Abdelfadil Ismail*, Abdullatif Mohammed Alhussain, Abdulmohsen Emad Al Mulhem, Waleed Khalid Moosa, Seham Salem Almohammadi, Hanin ali Aseeri, Mohammad Haitham Derbas, Alaa Mohammad Zaher Mohammad, Elhussein Hashim Mahmoud, Lojain Mazkar M. Alsharif, Ethabah Abdulrazaq Al Drees

Background: Rheumatological conditions, including rheumatoid arthritis (RA), osteoarthritis (OA), and ankylosing spondylitis (AS), are multifactorial diseases influenced by genetic, environmental, and increasingly acknowledged, lifestyle-related factors. Modifiable behaviours such as smoking, diet, physical activity, sleep, and stress have been implicated in altering the course and severity of these conditions. Understanding how these factors affect disease development and progression is vital for guiding preventive and therapeutic strategies.

Objectives: This systematic review aims to evaluate and synthesize existing empirical evidence on the role of modifiable lifestyle factors in the development and progression of rheumatologically diseases in adult populations.

Methods: A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and Embase databases, identifying peer-reviewed articles published from 2010 to 2024. Studies included were observational or interventional in design and investigated the effects of lifestyle factors on disease incidence, activity, or progression in patients with RA, OA, AS, or related conditions. A narrative synthesis was employed to interpret findings due to heterogeneity in study designs and outcomes.

Results: Fifteen high-quality studies met inclusion criteria. Findings consistently indicated that smoking, poor diet, sedentary behaviour, and elevated body mass index were associated with increased disease risk and severity. In contrast, physical activity, adherence to anti-inflammatory diets, stress reduction, and adequate sleep were linked with reduced inflammation, lower disease activity, and improved patient-reported outcomes.

Conclusions: Lifestyle factors play a substantial and modifiable role in the trajectory of rheumatological diseases. Integrating Behavioral interventions with pharmacologic treatments may offer synergistic benefits.These findings highlight the need for patient-centered, multidisciplinary care models that include lifestyle counselling as a core component of disease management.