Investigating healthy lifestyle and mortality in osteoarthritis

Healthy lifestyles are thought to reduce mortality in the general population, but it is not known whether the same is true in osteoarthritis. Fan and colleagues present new data on the topic at the 2023 annual congress of EULAR—the European Alliance of Associations for Rheumatology.

In this work, data from the UK Biobank were used to investigate the association of both individual and combined healthy lifestyle factors with the risk of all-cause and cause-specific mortality among 104,142 people with osteoarthritis.

The researchers gave each person a score for their lifestyle, based on their body mass index (BMI) and self-reported diet, sleep duration, physical activity, sedentary time, social connection, smoking, and alcohol drinking—all factors thought to be associated with health.

Overall, there were 9,915 deaths recorded after the first 2 years' follow-up. Models showed a variety of associations between people's lifestyle and mortality. Sleep duration had a U-shaped relationship, while moderate physical activity was L-shaped, and BMI and vigorous activity were J-shaped—a trend that starts with a sharp drop and is followed by a dramatic rise.

For sleep, the ideal seems to be 7 hours a night, while the turning point for moderate physical activity was 550 minutes per week, and 240 minutes per week for vigorous physical activity. The J-shaped turning point for BMI was 28 kg/m².

In multivariable models, each lifestyle factor was significantly associated with all-cause mortality, as well as mortality associated with cancer, cardiovascular, digestive, and respiratory diseases.

This study could be important in helping to identify a healthy lifestyle pattern that could significantly reduce the risk of mortality in people with osteoarthritis. Indeed, EULAR has recently published recommendations on lifestyle behaviors and work participation to prevent progression of rheumatic and musculoskeletal diseases, including osteoarthritis.

The overarching principles define the importance of a healthy lifestyle, how lifestyle modifications should be implemented, and their role in relation to medical treatments.1 It seems now this could possibly benefit mortality as well as disease outcomes.