In recent years, research in rheumatology has begun to look beyond prescriptions and lab results to explore how lifestyle choices and alternative therapies affect people living with rheumatic diseases. Studies are now examining everything from moderate alcohol use and rising cannabis consumption to the impact of diet, nutrition, and integrative treatments like Ayurveda. Together, these findings paint a more complex picture of disease management — one that blends science, behavior, and personal choice. Here I highlight key studies from the 2025 American College of Rheumatology Convergence conference that explore where evidence meets everyday life, helping patients and clinicians make informed decisions about what truly supports long-term health.
Light-to‐moderate drinking was associated with somewhat lower RA disease activity in this large study, but the finding is likely influenced by healthy user bias and other confounding factors. It’s not strong evidence to start drinking for disease benefit, and many other health risks of alcohol remain.
Researchers looked at data from adults with rheumatic and musculoskeletal diseases (RMDs) from 2020-2024 and found that the number of people using cannabis products in this group has roughly doubled. In 2020, about 32% reported ever using cannabis; by 2024 that was about 62%. Among those who used cannabis, 58% reported using products that contain THC (the part that can cause a “high”) and many used the products specifically to treat arthritis-related pain. The most common ways of use were ingestion (e.g., edibles) or topically, though smoking was more frequent among THC users. The authors conclude that with use rising sharply, doctors caring for people with RMDs should be aware and prepared to talk about cannabis—its effects, risks, and what we still don’t know.
Researchers analysed a large health-record database (about 229,000 matched people) to compare those who use cannabis versus those who don’t. They found that cannabis users had lower recorded rates of certain autoimmune diseases (for example, Hashimoto’s thyroiditis, Rheumatoid arthritis, type 1 diabetes, and Vitiligo).However, despite this, cannabis users had higher levels of inflammation (e.g., elevated CRP/ESR) and a higher risk of major cardiovascular events and death from any cause. The authors caution that the lower autoimmune-disease rates may be due to under-diagnosis or fewer doctor visits among users rather than a true protective effect. They emphasise that more research—including studies that follow people over time—is needed before drawing firm conclusions
This study looked at whether eating a healthy diet could lower the chances of developing rheumatoid arthritis (RA). Researchers reviewed results from 12 studies that included over 270,000 people. They found that people who followed overall healthy eating patterns — like the Mediterranean or DASH diet — were less likely to get RA. These diets are rich in fruits, vegetables, whole grains, fish, and healthy fats, and lower in processed foods and red meat. While the research can’t prove that diet alone prevents RA, it suggests that eating well may help reduce risk and support long-term joint and immune health.
Researchers surveyed over 1,200 U.S. adult patients with rheumatic diseases and 128 rheumatology clinicians. They found that many patients use complementary and alternative medicine (CAM) but often find it not very accessible (76% said so). Patients typically learned about CAM from the internet or social media (about 40%). Use varied by race/ethnicity and education level—e.g., Asian respondents reported higher daily use and Black respondents reported lower daily use. On the clinician side, a strong majority (95%) supported integrating CAM therapies into standard rheumatology care. The authors conclude that since CAM use is common but access and awareness are uneven, there’s an opportunity for rheumatology practices to develop structured, evidence-based CAM programs and education for patients.
Researchers ran a small, single-arm pilot study of a 10-week online lifestyle coaching program (called IMMUNE STRENGTH) aimed at adults with Psoriatic Arthritis (PsA) who met ACR criteria. Participants were recruited from a rheumatology clinic and a national advocacy group; the program included remote coaching focused on lifestyle interventions (e.g., diet, exercise, self-management). The aim was to test feasibility (can patients engage?) and preliminary efficacy (does it seem to help?). The pilot found that the program was feasible in this population (they were able to recruit, complete the sessions). As for efficacy: though details are limited (as this is conference‐abstract level), the findings suggest some positive signals that lifestyle coaching might help in PsA. The study emphasizes that lifestyle and behaviour-change tools could supplement standard medical therapy in PsA.
Researchers looked at a group of 613 patients with Rheumatoid Arthritis (RA) and measured both their nutritional status (using a tool called the CONUT score) and their physical function (using the HAQ-DI questionnaire). They found that patients with poorer nutrition—i.e., those whose CONUT score indicated “nutritional risk”—were significantly more likely to have worse physical function. Even when adjusting for age, how long they’d had RA, and their disease activity, being in the nutritional-risk group meant about 1.9 times higher odds of not reaching functional remission (HAQ-DI > 0.5).
Researchers in India studied about 140 people newly diagnosed with rheumatoid arthritis (RA) to see whether combining traditional Ayurvedic medicine with standard treatment could help. Everyone received methotrexate (MTX), the usual first-line RA drug, and half were randomly chosen to also take Ayurvedic medicines for 20 weeks. By the end of the study, both groups improved, but those taking Ayurveda plus MTX had greater reductions in pain, swelling, and inflammation scores, and more people met standard measures of improvement. The combination didn’t cause major side effects, and remission rates were slightly higher, though not significantly so. Overall, the results suggest that adding Ayurvedic therapy to methotrexate may help people with early RA—but larger studies are needed to confirm it.
