Dr. Yan Yeung
Rheumatologist, Waterloo Rheumatology
Exercise and mindfulness can help people with rheumatoid arthritis manage their disease and improve heart health.
Carrie Barnes has always been active. She used to play volleyball regularly and jog up to 10 kilometres a day. When she developed rheumatoid arthritis (RA), Barnes had to find other activities that weren’t as hard on her most affected joints. She has played in a ball hockey league, trained for and participated in several extreme trail runs, walks or bikes to work, and logs hundreds of kilometres a year of cross-country skiing and hiking. “When you’re diagnosed with a chronic illness, it can be quite overwhelming,” she says. “What helps me is being active, eating well, and having strong relationships with the people around me. This helps me remember that I’m so much more than the fact that I have RA.” While these habits help Barnes feel better in her daily life, they’re also beneficial for her long-term health, says Dr. Yan Yeung, a rheumatologist in Waterloo, Ont.
RA increases your risk of heart attack
“Managing cardiovascular health is crucial in patients with RA. RA increases your risk of heart attack, perhaps to the same degree as having diabetes,” Dr. Yeung says. “The best way to avoid that higher risk is to take your medication, because that controls the added inflammation. But we also have to address lifestyle factors to improve cardiovascular health and RA.”
RA is an autoimmune disease in which the body’s immune system mistakenly attacks the lining of the joints. It’s an inflammatory disease that can affect multiple joints in the body. The same inflammation that causes pain, stiffness, swelling, and joint damage also increases the risk of heart disease. This risk increases further in people with RA who smoke, are overweight, or have high blood pressure. Dr. Yeung recommends that people with RA eat a diet rich in fruits, vegetables, whole grains, beans, nuts, and seeds — for example, a Mediterranean diet, which may improve cardiovascular health. He also suggests practising meditation or taking short mindfulness breaks. “It’s about learning to just stop and take a breath or a moment to reflect,” he says. “This can reduce stress.” Smoking cessation is also important for improving your cardiovascular health. “There’s also higher risk of lung cancer in RA and there are connections between smoking and RA,” Dr. Yeung says.
“Smoking has been shown to possibly increase your risk of getting RA and once you get it, smoking can make it more difficult to control your disease.” Dr. Yeung also recommends regular exercise. If new to exercise, he suggests starting with short walks a few days a week. “In addition to cardiovascular health, exercise has benefits for RA,” he says. “Strength training can improve the structures around the joints, so that they’re not so easily strained. Walking or cycling can enhance cartilage integrity. Mobility exercise, like tai chi and yoga, can improve the range of motion of your joints.”
“The fact that I keep moving keeps me moving”
Barnes, who has completed several 100 Mile Wilderness challenges, says people sometimes worry that so much activity might make her RA worse. “I tell them, the fact that I keep moving keeps me moving,” she says. “It maintains the strength around my joints and improves my stability. It keeps my weight down and it keeps my heart healthy.”
Dr. Yeung says lifestyle changes can be difficult. “It requires a lot of persistence, but my patients who make these changes seem to be happier,” he says. “They’re more active and live with less pain. There’s less missed work and they can do more things around the house and more activities with friends and family. Medications are important, but lifestyle changes help improve overall function, happiness, and quality of life.”
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