Women and rheumatoid arthritis . . . and other storiesBMJ 2017; 358 doi: https://doi.org/10.1136/bmj.j4184 (Published 14 September 2017) Cite this as: BMJ 2017;358:j4184
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The relationship between breast feeding and rheumatoid arthritis is heterogenous. Although an association between breast feeding and rheumatoid arthritis could not be confirmed, more than 13 months' breast feeding lowers the risk ratio to 1 : 0,46. Not quantified "long practice of breast feeding" shows no effect with a risk ratio 1 : 1. Certainly a decreased risk ratio of 1 : 0,84 was observed for never, ever or past users of oral contraceptives. As interesting as these epidemiological studies are, they are not a guarantee that preventing the risk factors of a disease like rheumatoid arthritis, which affects about 1 percent of the population in Western countries, has an remarkable influence of countable cases.
More striking is the gradient of risk in matters of job. A nurse has a risk ratio of 1 : 1,3. A electrician shows a risk of 1 : 2,1. And the brick layer reaches the risk level of 1 : 2,9. This cannot be cut by even 3 or more drinks weekly, which reduces the risk by 1 : 0,84. That nicotine and other harmful substances damage the immune system is understandable. However, why people with a high school diploma twice as often (1 : 2,3) suffer from this autoimmune disease is more difficult to explain.
So I - a simple primary care doctor - learned from all these studies this good advice for my patients: Plan Your career, so that You won't have to work as a brick-layer. As well, as a medical doctor, You will earn good money in such a job, but Your joints will suffer from work and from inflammation. Beware practising too much, academic disciplines. Perhaps You'll become an epidemiologist, who has an easy job. These guys bear so many good factors, even without breast feeding.
Soon their recommendations will enlarge the treasure of knowledge of EULAR (10 recommendations), ACR (6 + 15 recommendations) and APLAR (40 recommendations).
Competing interests: No competing interests