2021 EULAR recommendations regarding lifestyle behaviours and work participation to prevent progression of rheumatic and musculoskeletal diseases

James M. Gwinnutt, Maud Wieczorek, Andra Balanescu, Heike A. Bischoff-Ferrari, Annelies Boonen, Giulio Cavalli, Savia de Souza, Annette Ladefoged de Thurah, Thomas E. Dorner, Rikke Helene Moe, Polina Putrik, Javier Rodríguez-Carrio, Lucia Silva-Fernandez, Tanja Stamm, Karen Walker-Bone, Joep Welling, Mirjana Zlatković-Švenda, Francis Guillemin, Suzanne M. M. Verstappen

Research output: Contribution to journalArticlepeer-review


Objectives: A EULAR taskforce was convened to review the literature and develop recommendations on lifestyle behaviours for RMDs.
Methods: Six lifestyle exposures (exercise, diet, weight, alcohol, smoking, work participation) and seven RMDs (osteoarthritis, rheumatoid arthritis, axial spondyloarthritis, psoriatic arthritis, systemic lupus erythematosus, systemic sclerosis, gout) were considered. The taskforce included health professionals in rheumatology, geriatricians, epidemiologists, public health experts, people with RMDs and exposure domain experts. Systematic reviews were conducted to gather available evidence, from which recommendations were developed.

Results: Five overarching principles and 18 specific recommendations were defined based on available evidence. The overarching principles define the importance of a healthy lifestyle, how lifestyle modifications should be implemented, and their role in relation to medical treatments. Exercise recommendations highlight the safety and benefits of exercise on pain and disability, particularly amongst people with osteoarthritis and axial spondyloarthritis. The diet recommendations emphasise the importance of a healthy, balanced diet for people with RMDs. People with RMDs and health professionals should work together to achieve and maintain a healthy weight. Small amounts of alcohol are unlikely to negatively affect the outcomes of people with RMDs, although people with rheumatoid arthritis and gout may be at risk of flares after moderate alcohol consumption. Smokers should be supported to quit. Work participation may have benefits on RMD outcomes and should be discussed in consultations.

Conclusions: These recommendations cover a range of lifestyle behaviours and can guide shared decision making between people with RMDs and health professionals when developing and monitoring treatment plans.
Original languageEnglish
JournalAnnals of the rheumatic diseases
Publication statusAccepted/In press - 4 Feb 2022


Dive into the research topics of '2021 EULAR recommendations regarding lifestyle behaviours and work participation to prevent progression of rheumatic and musculoskeletal diseases'. Together they form a unique fingerprint.

Cite this