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Long term alcohol intake and risk of rheumatoid arthritis in women: a population based cohort study

BMJ 2012; 345 doi: (Published 10 July 2012) Cite this as: BMJ 2012;345:e4230
  1. Daniela Di Giuseppe, PhD student1,
  2. Lars Alfredsson, professor2,
  3. Matteo Bottai, professor3,
  4. Johan Askling, associate professor4,
  5. Alicja Wolk, professor1
  1. 1Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Box 210, 171 77, Stockholm, Sweden
  2. 2Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institute
  3. 3Division of Biostatistics, Institute of Environmental Medicine, Karolinska Institute
  4. 4Clinical Epidemiology Unit, Department of Medicine, Karolinska Hospital, Stockholm
  1. Correspondence to: A Wolk Alicja.Wolk{at}
  • Accepted 15 May 2012


Objective To analyse the association between alcohol intake and incidence of rheumatoid arthritis in women.

Design Prospective cohort study with repeated measurements.

Setting The Swedish Mammography Cohort, a population based cohort from central Sweden.

Participants 34 141 women born between 1914 and 1948, followed up from 1 January 2003 to 31 December 2009.

Main outcome measures Newly diagnosed cases of rheumatoid arthritis identified by linkage with two Swedish national registers. Data on alcohol consumption were collected in 1987 and 1997.

Results During the follow-up period (226 032 person years), 197 incident cases of rheumatoid arthritis were identified. There was a statistically significant 37% decrease in risk of rheumatoid arthritis among women who drank >4 glasses of alcohol (1 glass = 15 g of ethanol) per week compared with women who drank <1 glass per week or who never drank alcohol (relative risk 0.63 (95% confidence interval 0.42 to 0.96), P=0.04). Drinking of all types of alcohol (beer, wine, and liquor) was non-significantly inversely associated with the risk of rheumatoid arthritis. Analysis of long term alcohol consumption showed that women who reported drinking >3 glasses of alcohol per week in both 1987 and 1997 had a 52% decreased risk of rheumatoid arthritis compared with those who never drank (relative risk 0.48 (0.24 to 0.98)).

Conclusion Moderate consumption of alcohol is associated with reduced risk of rheumatoid arthritis.


  • Contributors: All authors participated in the study design and in writing the manuscript, interpreted the data and critically reviewed the paper, and read and approved the final manuscript. DDG and AW performed the data collection. DDG analysed the data and wrote the manuscript under the supervision of AW. AW is the guarantor of the study.

  • Funding: The study was supported by research grants from the Swedish Research Council’s Committee for Research Infrastructure for maintenance of the Swedish Mammography Cohort, and from the Karolinska Institute’s Award for PhD students (KID-funding).

  • Competing interests: All authors have completed the ICMJE uniform disclosure form at (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years, no other relationships or activities that could appear to have influenced the submitted work.

  • Ethical approval: This study was approved by the Regional Research Ethics Board at the Karolinska Institute, and all participants gave their informed consent.

  • Data sharing: No additional data available

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