Doctors tell us. Medicare tells us. Our insurance companies tell us.

Watch your waistline, exercise, keep your mind active, socialise, go for your medical checkups.

But there's something else, less cited, that apparently can add years to our lives: our attitude.

Attitude counts

A couple of Harvard publications suggest that practicing gratitude and optimism might benefit us about as dramatically as taking our blood pressure pills or joining a water aerobics class.

The first publication, a press release from Harvard's T.H. Chan School of Public Health, tells how researchers from the school found gratitude was associated with greater longevity among seniors.

Harvard scientist Ying Chen, the lead researcher, said earlier studies had already shown an association between gratitude and a lower risk for mental distress, as well as greater emotional and social well-being.

A new study, published in JAMA Psychiatry in July, demonstrated a positive link to physical health.

"Our study provides the first empirical evidence on this topic," Chen is quoted as saying.

Chen and colleagues used data from the Nurses' Health Study to assess levels of gratitude and mortality among almost 50,000 older women, whose average age was 79.

The women completed a gratitude questionnaire measuring their agreement or disagreement with statements such as, "I have so much in life to be thankful for," and, "If I had to list everything that I felt grateful for, it would be a very long list."

Four years later, the researchers followed up, looking at deaths from all causes among the women. Participants whose gratitude scores were in the highest one-third of the group had a 9 percent lower incidence of death than those who scored in the bottom one-third.

Gratitude, the scholars said, appeared to protect against every cause of mortality. The results were controlled for demographics, prior health issues and lifestyle factors such as social participation, religion and even optimism, which is closely related to gratitude.

The other piece I saw was a 2019 Harvard Medical School blog by David R. Topor, then a clinical psychologist on the medical school's faculty.

"Plenty of research suggests optimistic people have a reduced risk of heart disease, stroke, and declines in lung capacity and function," his blog entry began. "Optimism is also associated with a lower risk of early death from cancer and infection. And now a new study links optimism to living a longer life."

That study found highly optimistic people had longer lives and also a greater chance of achieving "exceptional longevity" — living past 85.

It controlled for diseases such as high blood pressure or high cholesterol and for health behaviors such as smoking or alcohol use.

Granted, the first thing I learned in my graduate-school courses in research methods is that correlation is not causation. The fact that two things are linked doesn't automatically mean one caused the other.

We might find — I'm making this up — that 97 percent of drivers involved in fatal car wrecks are wearing shoes at the time of their accidents. That wouldn't mean shoes cause car crashes.

Similarly, discovering that grateful and/or optimistic people often live longer than ungrateful and/or sour people doesn't necessarily prove either group's attitudes are causing their outcomes.

Still. These studies and basic common sense suggest that our attitudes do play a role in our physical and mental health, not to mention our very will to live.

Fortunately, as Topor said, all of us can take steps to improve our disposition and with it, perhaps our long-term health.

Among other things, he suggested practicing the half-smile, a technique to cope with sad feelings. You practice smiling a few minutes each day. If you can't force a full smile, a half-smile will do. Then you note how your thoughts and mood change.

He suggested setting aside time to focus on the positive. At a set time each day, think about the day's positive aspects. What went well? What made you happy or proud?

Self-help tactics

I'm not naturally a Dr. Pangloss. But as I've aged I've worked on myself.

A trick I do when I'm experiencing what my dad used to call "the mulligrubs": I force myself to make a mental list of things I'm grateful for. It's like the old hymn said, "Count your blessings, name them one by one." I do that and, hey, it works. I feel better despite myself.

Another tactic: I remind myself that everybody has setbacks, failures, fears. Often it's not so much what happens to us that determines our lot, but what we do with what happens. We can be discouraged or we can look for opportunities to grow and conquer.

As Hamlet put it, "There is nothing either good or bad, but thinking makes it so."

Will my efforts to focus on the positive earn me bonus years? Who knows?

But this I do know. I feel better when I count my blessings instead of cursing my woes, and when I expect the best instead of assuming the worst.

• First published in the Herald Leader; republished by Religion Unplugged
• Paul Prather is a rural Pentecostal pastor in Kentucky and writes a regular column about faith and religion for the Herald-Leader

Yet, while it may seem normal to be verbally appreciative at certain times and with specific people, there's much more that you can get out of gratitude at other times.

Here's a look at how gratitude can affect your physical and psychological well-being.

Gratitude promotes positive mind-sets and reduces stress

A 2017 study published in Scientific Reports looked at the effects of gratitude meditation and resentment and mental well-being.

Using functional magnetic resonance imaging (fMRI) and heart rate at three intervals - before, during, and after interventions - researchers suggest that gratitude interventions modulate heart rhythms in a manner that enhances mental health.

Gratitude intervention, said researchers, improves both emotional regulation and self-motivation by modulating resting state functional connectivity (rsFC) in brain regions involving emotion and motivation.

Furthermore, researchers pointed to the potential use of gratitude interventions in treating those with mood disorders or post-traumatic stress disorder (PTSD).

Gratitude related to better sleep, mood, less fatigue and inflamation

Mills et al. (2015), in a study of patients with asymptomatic heart failure, found that an "attitude of gratitude" was related to better moods and sleep, less fatigue, reduced inflammation, and better cardiac-specific self-efficacy.

Authors said this is important because depressed mood and poor sleep are both associated with a worse prognosis in heart failure patients, as well as in other cardiac condition populations.

Thus, researchers said, the simple, low-cost efforts to help heart failure patients increase gratitude may have clinical value and be a potential target in treatment to improve patients' well-being.

Gratitude predicts lower depression rates in patients with chronic illness

Sirois and Wood (2017) examined longitudinal associations of gratitude to depression in two chronic illness samples, one with inflammatory bowel disease, and the other with arthritis.

The study included two time points: completion of online survey at start of study (T1), and completion of a follow-up study at 6 months (T2).

There were assessments of gratitude, depression, perceived stress, social support, illness cognitions, and disease-related variables at both time points.

Study results showed that T1 gratitude was a "unique" and "significant" predictor of T2 depression in both sample groups.

Authors noted that gratitude has relevance and potential benefits as an intervention for adjusting to chronic illness.

Various elements of well-being associated with gratitude

A white paper on the science of gratitude prepared for the John Templeton Foundation by the Greater Good Science Center at UC Berkeley highlights a number of studies showing possible connections between gratitude and various elements of well-being in those with self-reported higher dispositional gratitude.

These include life satisfaction, happiness, positive affect, optimism, and subjective well-being.

Authors also mention studies of university students self-reporting higher-order gratitude also reporting increased life satisfaction and positive affect.

Examples of higher-order gratitude include thanking God, appreciating life's hardships, cherishing the present, thanking others, and cherishing blessings. Continue reading

Earlier this year, in Northern California, producer Kate Olson sat in on just such an event.

Jack Kornfield is a prominent Buddhist leader.

David Steindl-Rast is a well-known Christian, a Benedictine monk. Their topic was living gratefully.

Brother David Steindl-Rast: Gratefulness is there from the very beginning, because it is always a loving listening to whatever comes your way, and if you lovingly listen to it, you are grateful for it.

It has these three steps that we have talked about many times: the stopping, the looking — opening your heart in every respect — and then the doing, the responding.

And all three must come together.

Jack Kornfield: A couple of years ago, the Washington Post hired the world-famous violinist Joshua Bell to take his Stradivarius and play in the Washington subway, in the metro, play these amazing Bach pieces during rush hour.

He was playing Lincoln Center that night for two hundred dollars a ticket or something.

Put out his hat, and after an hour he got fourteen dollars, and no one stopped except for children.

Everybody else was on their way and the only people who stopped to hear this extraordinary music, "I'm sorry, I've got to get somewhere," were the children who tugged on their parents' arms and said, "Wait, there's something going on here worth paying attention to."

It's not an easy thing, actually, to listen.

Because also there are the barriers.

We have the unfinished business of the heart, and when people start to get quiet and listen, sometimes what happens is the tears come, because they have to grieve something that they've been too busy to feel, or some longing, or something that's in there.

My friend Anne Lamott says, "The mind is like a bad neighborhood; I try not to go there alone." Continue reading

Sources

• PBS Religion & Ethics Newsweekly
• Image: By Way of Beauty