Looking on the bright side of heart health

If you’ve ever seen the Monty Python’s Life of Brian, you’ll no doubt vividly recall the final scene of the film, in which Eric Idle attempts to cheer up a despairing Brian (played by Graham Chapman) and other fellow crucifixion victims by belting out a rousing rendition of “Always Look on the Bright Side of Life”.

I guess you have to be a Python fan to truly appreciate this apotheosis of optimism. But according to a study just published on JAMA Network Open, titled ‘Association of Optimism With Cardiovascular Events and All-Cause Mortality: A Systematic Review and Meta-analysis‘, cultivating the glass-half-full outlook may be at least as good for your heart health and overall longevity as regular exercise. (Although there’s no guarantee that it will save you from a grisly death by crucifixion.)

The meta-analysis – a statistical procedure for combining data from multiple studies – drew on data from 15 studies conducted in the US, Australia, Israel and Europe, involving over 200 000 participants in total.

The studies were all prospective, that is, they enrolled participants, assessed them using validated questionnaires for their degree of optimism – broadly defined as “the tendency to think that good things will happen in the future” – and then followed them for an average of almost 14 years.

And what did crunching the data from all those studies reveal? In their own words:

“The findings suggest that optimism is associated with a lower risk of cardiovascular events and all-cause mortality.”

Or in plain language, the more optimistic you are, the less likely you are to develop angina, have a heart attack and to die before your time.

The researchers pointed out that there is already a substantial body of evidence that “more optimistic individuals are more likely to succeed at work and in school, sports, politics, relationships, and other forms of life endeavors” and that optimism has also been associated with a range of favourable physical health outcomes.

However, studies linking optimism/pessimism to heart health are thinner on the ground.

Important questions are raised by this type of research:

  1. What is the mechanism of action by which optimism influences health?
  2. How can we measure an individual’s optimism/pessimism more accurately?
  3. Do interventions that promote optimism and reduce pessimism in individuals have as large an impact as naturally-occurring optimism?

Let’s look at each of these questions in turn.

Firstly, research on other psychosocial risk factors, such as loneliness and hostility, suggests that they influence health in 2 ways: indirect behavioral mechanisms (that is, influencing the choices people make with regard to their self-care) and direct physiologic mechanisms (such as elevating blood pressure and clotting factors).

For example, if I am optimistic about my prospects for a long life, I might be more inclined to eat a healthier diet and exercise regularly, so that I can enjoy better health and mobility in my old age. On the other hand, if I pessimistically assume that I’ll die young, just like my father, I might choose to smoke, eat junk and be sedentary – after all, I’m doomed by my genes no matter what I do.

And indeed, numerous studies have indicated that people with higher levels of optimism do tend to eat healthier diets and maintain regular exercise habits.

As yet, there is no blood test that will reveal how optimistic or pessimistic you are, but future research will no doubt identify biomarkers associated with mental outlook.

On the second question, a number of different research instruments were used to measure participants’ optimism/pessimism, but the most commonly utilised scale was the Life Orientation Test–Revised (LOT-R), which has been validated across a number of different clinical settings.

If you’re curious to assess your own degree of optimism, here are the key questions from the LOT-R:

  1. In uncertain times, I usually expect the best.
  2. If something can go wrong for me, it will.
  3. I’m always optimistic about my future.
  4. I hardly ever expect things to go my way.
  5. I rarely count on good things happening to me.
  6. Overall, I expect more good things to happen to me than bad.

The scoring system is a little complex, but here goes:

For items 1, 3 and 6, score your answers as follows:

0 = strongly disagree, 1 = disagree, 2 = neutral, 3 = agree, and 4 = strongly agree.

For items 2, 4 and 5, score your answers as follows:

4 = strongly disagree, 3 = disagree, 2 = neutral, 1 = agree, and 0 = strongly agree.

There is no defined cut-off point for defining either optimism or pessimism, but you might like to invite your loved ones to take the quiz, and compare your scores with theirs.

On the third question, optimism and pessimism are generally thought of as traits that is, relatively fixed aspects of personality, presumably with a fairly substantial genetic component.

However, numerous studies have demonstrated that pessimism can be reduced and optimism boosted using cognitive behavioral therapy and positive psychological techniques. My own clinical experience suggests that the use of Emotional Freedom Techniques (EFT) has the same effect.

While it’s not yet clear whether ‘learned optimism’ is as health-promoting as innate optimism, optimistic people have been found to possess more effective goal setting, problem solving and coping skills – all of which are directly relevant to the adoption of a healthy lifestyle.

Hence, interventions that nurture optimism and assuage pessimism have enormous potential for helping people make better decisions when it comes to diet, exercise and other elements of self-care.

The bottom line: if a long, healthy life free of cardiovascular disease and other chronic conditions is your aim, you need to pay as much attention to your mindset as to your food choices and exercise routine. If you’re naturally optimistic, good for you! If you tend toward pessimism, it would serve you well to work on your mindset as diligently as you work out your body.

Pessimism is not your lot in life! To discover effective tools for shifting mindset, apply for a Roadmap to Optimal Health Consultation today.

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