Where your DNA places you among other people, and the studies behind it.
Not tailored to your result, and not medical advice
Quit or Avoid Smoking: Smoking is the most firmly established environmental risk factor for rheumatoid arthritis, and its effect falls almost entirely on the ACPA-positive form of the disease, in which the immune system attacks citrullinated proteins. In a Malaysian case-control study, ever-smokers had about four times the odds of ACPA-positive rheumatoid arthritis (OR 4.1), carriers of HLA-DRB1 shared epitope alleles about five times (OR 4.7), and people who both smoked and carried those alleles about 25 times the odds (OR 25.6) compared with non-smoking non-carriers. Neither smoking nor those alleles were associated with ACPA-negative disease. Of the two factors that multiply together in that study, smoking is the one that can be changed. Arthritis Research & Therapy (PMC)
Maintain a Healthy Body Weight: A dose-response meta-analysis of 11 studies found that, compared with normal weight, obesity was associated with a 31% higher risk of developing rheumatoid arthritis (RR 1.31, 95% CI 1.12 to 1.53) and overweight with a 15% higher risk (RR 1.15, 95% CI 1.03 to 1.29). Each 5-unit increase in BMI corresponded to roughly 3% higher risk. These are observational associations rather than proof of cause, and the effect sizes are modest next to smoking, but body weight is one of the few risk factors on this list that responds to everyday eating and activity habits. Arthritis Research & Therapy (PMC)
Look After Your Gums: People with rheumatoid arthritis have more gum disease than healthy controls, though the excess is modest: the review reports a relative risk of periodontitis of about 1.13. The mechanism behind the link is more striking than its size. Porphyromonas gingivalis, a periodontal bacterium, produces an enzyme called PPAD that converts arginine to citrulline, and inflamed gum tissue accumulates citrullinated proteins in patterns resembling those found in rheumatoid joints; citrullinated proteins are exactly what the antibodies of seropositive rheumatoid arthritis target. The authors are careful to note that these bacteria do not meet the formal Henle-Koch criteria for causing the disease, since they are neither present in every case nor specific to rheumatoid arthritis, and brushing, flossing and keeping up with dental care cost little regardless of how that question is eventually settled. Journal of Clinical Medicine (PMC)
Stay Physically Active: A meta-analysis of 13 randomized trials covering 967 people with rheumatoid arthritis found that aerobic exercise reduced pain (SMD -0.46), improved physical function on the HAQ-DI, and raised VO2max by about 2.4 ml/kg/min. Six of the trials specifically reported no adverse effects and no worsening of disease status, which speaks to the common worry that exercise accelerates joint damage. The same analysis found no clear effect on measured disease activity (DAS-28), so the benefit appears to be in how people function and feel rather than in the underlying inflammation. BMC Sports Science, Medicine and Rehabilitation (PMC)
Be Cautious About Diet Claims: A 2025 systematic review of nutrition in rheumatoid arthritis and related inflammatory arthritis reported that vegan, anti-inflammatory and Mediterranean eating patterns were associated with improvements in disease activity, inflammatory markers and quality of life. The same review found the studies too heterogeneous in design, intervention and outcome to pool statistically, and concluded that high-quality randomized trials are still needed to confirm any long-term benefit. Every study it covered looked at diet alongside existing care in people who already had the disease, so it says nothing about whether any eating pattern prevents rheumatoid arthritis in the first place. Eating well is worth doing on general health grounds, but the evidence does not support any diet as a way of preventing this condition. Frontiers in Medicine (PMC)
How much of this is genetic?
Genetics explains 60% of why people differ in this trait. The rest is environment, daily habits and chance.
Heritability estimate: MacGregor et al. 2000, Arthritis & Rheumatism
Background and further reading
Rheumatoid arthritis (RA) is a chronic autoimmune and inflammatory disease in which the immune system mistakenly attacks the synovium, the lining of the joints. It typically affects the small joints of the hands and feet in a symmetrical pattern, causing pain, swelling, stiffness (often worst in the morning), and, if uncontrolled, progressive joint erosion and deformity. RA affects roughly 0.5 to 1 percent of adults worldwide and is about two to three times more common in women than in men, often beginning between ages 30 and 60. Beyond the joints, RA is a systemic condition that can involve the lungs, blood vessels, eyes, and heart. There is no cure, but modern disease-modifying treatments can slow or halt joint damage in most patients when started early.
Genetic Basis: Twin and family studies estimate the heritability of RA at roughly 50 to 65 percent, with a stronger genetic contribution to the anti-CCP (ACPA) antibody-positive form of the disease. The single largest genetic contributor is the HLA-DRB1 locus in the major histocompatibility complex, where a set of similar sequences known as the shared epitope substantially raises risk. Many non-HLA genes have also been identified through genome-wide association studies, including PTPN22, STAT4, TRAF1-C5, CTLA4, PADI4, and TNFAIP3, most of which regulate T-cell activation, immune signaling, and the citrullination of proteins that the immune system targets in RA.
Environmental Factors: Environmental and lifestyle factors interact strongly with genetic susceptibility, and several are modifiable. Cigarette smoking is the best-established environmental risk factor and is especially potent in people carrying HLA shared-epitope alleles, where smoking and genetics multiply each other's effect on anti-CCP-positive disease. Other associated factors include obesity, periodontal (gum) disease linked to the bacterium Porphyromonas gingivalis, and possibly diet and the gut microbiome. RA is more common in women, and hormonal factors are thought to contribute. Not smoking, maintaining a healthy weight, and good dental hygiene are the main things known to lower risk or support better outcomes.
The published research behind your score, and the variants it draws on.
18 published scores from 6 studies
The rheumatoid arthritis score combines 18 polygenic scores drawn from 6 published studies.
These traits are influenced by some of the same genes and variants as this one
Content updated August 2026.
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