Association of Family History, Life-Style Related Factors, Dietary Patterns, and Psychological Status with <i>Amavata</i> (~Rheumatoid Arthritis) among the Population of Jamnagar, India: A Matched Case-Control Study

Abstract

Background: The modern medical community now recognises Amavata as a condition that can lead to Rheumatoid Arthritis (RA) due to a combination of genetic predisposition, poor dietary habits, altered lifestyle, disturbed sleep, disturbed psychological condition, etc. Amavata’s origins are said to be two thousand years old, but there is no rigid evidence to support this. Aim: To evaluate the association of family history, different dietary patterns and lifestyle related risk factors such as Vyayama, improper bowel movements, disturbed/irregular sleep patterns, psychological stress, etc., in the pathology of Amavata (~RA). Materials and Methods: A matched case-control study was conducted from 18 April 2018 to 09 January 2020, containing 150 cases (patients of Amavata), and 150 controls (healthy volunteers), matching in age (between 18-50 years), and both the sexes (1:1 ratio) selected from Jamnagar district. After receiving written informed permission, data were obtained using CRF (Case Record Form). An open-ended questionnaire through the one-to-one interview was used to obtain data on eating habits, psychological and emotional circumstances previous to sickness, lifestyle features such as sleep, Vyayama (physical activity), and bowel patterns. Chi-square tests and Odds Ratios (OR) were computed. Results: The statistical analysis revealed that positive family history (χ2 = 63.021, p<0.001), Avyayama (lack of physical activity) (OR = 7.43, χ2 = 79.95, p<0.001), Diwaswapna (day time sleep) (OR = 12.86, χ2 = 93.048, p<0.001), disturbed night sleep (OR = 44.25, χ2 = 159.61, p<0.001), constipation (OR = 85.17, χ2 = 144.10, p<0.001), Atishrama (occupational stress)(OR = 22.86, χ2 = 96.989, p<0.001), disturbed psychological status (p<0.001) and faulty dietary patterns (p<0.001) were found to have statistically significant association with Amavata (~RA). Conclusion: Strong positive associations were found between positive family history, Avyayama (lack of physical activity), Diwaswapna (daytime sleep), disturbed night sleep, constipation, disturbed psychological status, Atishrama (occupational stress), and faulty dietary patterns (Adhyashana, Vishamashana, Viruddhashana) with Amavata which are statistically significant and they can be considered as the potential risk factors for the incidence of Amavata (~RA).