Numerous reports in recent years have focused on the influence of environmental factors on rheumatoid arthritis. This article provides an overview of the current study situation on the influence of modifiable environmental factors on the development and course of rheumatoid arthritis. Lifestyle factors, such as cigarette smoking, diet, exercise and body weight can be individually influenced. Factors such as air pollution and socioeconomic status can be influenced by environmental and sociopolitical measures at apublic level. Epidemiological studies have identified nicotine abuse, an unhealthy diet and obesity as well as alow level of education and social status as risk factors for the development of rheumatoid arthritis. Numerous factors are also associated with apoorer response to treatment and aworse prognosis. As randomized interventional studies on most environmental factors are hardly feasible, the causal relationship of the individual factors to the incidence and progression of rheumatoid arthritis is difficult to quantify. Nevertheless, the current evidence already enables the provision of appropriate counselling to patients with rheumatoid arthritis with respect to ahealthy lifestyle including abstaining from cigarette smoking, maintaining ahealthy diet, physical activity and avoiding obesity.
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