Physical activity and energy expenditure in rheumatoid arthritis patients and matched controls

Rheumatology (Oxford). 2012 Aug;51(8):1500-7. doi: 10.1093/rheumatology/kes067. Epub 2012 Apr 25.


Objectives: To compare daily energy expenditure between RA patients and matched controls, and to explore the relationship between daily energy expenditure or sedentariness and disease-related scores.

Methods: One hundred and ten patients with RA and 440 age- and sex-matched controls were included in this study. Energy expenditure was assessed using the validated physical activity (PA) frequency questionnaire. Disease-related scores included disease activity (DAS-28), functional status (HAQ), pain visual analogue scale (VAS) and fatigue VAS. Total energy expenditure (TEE) and the amount of energy spent in low- (TEE-low), moderate- (TEE-mod) and high-intensity (TEE-high) PAs were calculated. Sedentariness was defined as expending <10% of TEE in TEE-mod or TEE-high activities. Between-group comparisons were computed using conditional logistic regression. The effect of disease-related scores on TEE was investigated using linear regression.

Results: TEE was significantly lower for RA patients compared with controls [2392 kcal/day (95% CI 2295, 2490) and 2494 kcal/day (2446, 2543), respectively, P = 0.003]. A significant difference was found between groups in TEE-mod (P = 0.015), but not TEE-low (P = 0.242) and TEE-high (P = 0.146). All disease-related scores were significantly poorer in sedentary compared with active patients. TEE was inversely associated with age (P < 0.001), DAS-28 (P = 0.032) and fatigue VAS (P = 0.029), but not with HAQ and pain VAS.

Conclusion: Daily energy expenditure is significantly lower in RA patients compared with matched controls, mainly due to less moderate-intensity PAs performed. Disease activity and fatigue are important contributing factors. These points need to be addressed if promoting PA in RA patients is a health goal. Trial registration.,, NCT01228812.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Arthritis, Rheumatoid / complications
  • Arthritis, Rheumatoid / physiopathology*
  • Body Mass Index
  • Case-Control Studies
  • Cross-Sectional Studies
  • Energy Metabolism / physiology*
  • Exercise / physiology*
  • Fatigue / etiology
  • Female
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Pain Measurement
  • Sedentary Behavior
  • Severity of Illness Index
  • Surveys and Questionnaires

Associated data