A healthy lifestyle is associated with decreased rheumatoid arthritis (RA) risk when compared with a non-healthy lifestyle, according to a study published in Arthritis Care & Research. Karen H. Costenbader, MD, MPH, and colleagues used the healthy lifestyle index score (HLIS)— which measured five modifiable components: smoking, alcohol consumption, BMI, physical activity, and diet—to assess the link. A higher HLIS was associated with lower overall RA risk (HR, 0.86) and lower risk for RA subtypes (HRs for seropositive RA and seronegative RA, 0.85 and 0.87, respectively). The lowest risk was seen among women with five healthy lifestyle factors (HR, 0.42). Each additional healthy lifestyle behavior decreased RA risk by 13%. For adhering to four or more lifestyle factors, the population attributable risk was 34%. “Our finding that a high proportion of RA risk in the general female population is attributable to the confluence of modifiable lifestyle factors represents something of a paradigm shift in thinking about RA and autoimmune disease risk,” the authors wrote.