Healthy Food & Healthy Living by Dr. Ayala

Can gratitude really heal you?

Spiritual teachers of every religion, denomination, era and stripe pay much attention to gratitude. Science tends to agree: Practicing and feeling thanks – training it like a muscle – can make you feel better according to several studies, many of them observational. 

A recent review in the Journal of Positive Psychology looks at the connection between gratitude and health and focuses on experimental studies rather than observational ones – these can more accurately reflect causation. In these studies an intervention aimed at increasing gratitude takes place in a test group. There are several interventions that are commonly used. Gratitude journaling consists of writing regularly about what you’re grateful for. Writing a gratitude letter was devised by Martin Seligman – the father of Positive Psychology – participants are asked to write and deliver a letter of gratitude to someone in their lives whom they haven’t properly thanked. The Three Good Things exercise involves writing down three good things that occurred within a stated time period.

The definition of health is challenging. Complete absence of disease or disability, and total social and mental wellbeing, the World Health Association's definition, isn’t common in our society – we’re an aging society riddled with chronic diseases. Another definition of positive health is one proposed by Huber and others: “Health as the ability to adapt and to self-manage, in the face of social, physical and emotional challenges.” Does gratitude promote that ability to adapt and self manage?

When it comes to physical health, the reviewers found nine experimental articles testing gratitude’s effect on the cardiovascular system, inflammatory markers, pain and sleep. The results were inconclusive. The gratitude interventions seemed to have a positive effect on cardiovascular and inflammatory parameters, but no different from a distraction exercise.

The review studied 25 experimental articles that tested gratitude interventions and psychological wellbeing symptoms, such as depression, anxiety, stress, negative emotions and aggression. They found some evidence that gratitude may contribute to improvement in psychological well being.

Next, they gathered 32 interventional studies centered on emotional wellbeing: happiness, life satisfaction, quality of life, flourishing, etc. Overall, the vast majority of studies showed that gratitude practices increased emotional wellbeing.

A third aspect of wellbeing is the social one, consisting of social skills, contacts and relationships, and purposeful employment, and here, 19 experimental studies were identified. Practicing gratitude seems to maintain healthy relationships and to help in the formation of new ones.

Overall, the reviewers found that physical health showed less measured changes in response to gratitude interventions, however, "gratitude is beneficially, although modestly, linked to social well-being, emotional well-being and to a lesser extent psychological well-being.” 

Gratitude and wellbeing

“I would maintain that thanks are the highest form of thought, and that gratitude is happiness doubled by wonder” ~Gilbert K. Chesterton

Is physical health separate from mental health? The study may suggest that the body and the mind are different entities – I believe they are one unit. Medicine focused for too long on biological factors that affect disease, but it’s now pretty clear that wellbeing, disease prevention and longevity are affected by what goes in our mind, by our thoughts, and by our social ties. Psychological wellbeing and physical wellbeing are intertwined and affect each other deeply. If gratitude boosts happiness then it’s bound to advance health in the broader sense, even if we can’t prove it as of yet by the short term tests and measurable outcomes available to us in clinical studies.

And every time you concentrate on the positives you’re squeezing some negative thoughts – and the stress associated with them – out. 

Fall, traditional harvest time, is dedicated to giving thanks, and the Thanksgiving holiday is a wonderful celebration of this practice.

This Thanksgiving is bound to be special, and although life has not gone back to our pre-pandemic hugfest, getting together is especially sweet. I’m grateful for being among family and friends like never before. I adore the trees with their multitude of colors and their exposed branches, the crunch of the showy leaves under my feet, the air that’s crisp and clean. And then there’s food. Food, especially healthy food, is my constant reminder of how lucky I am, this holiday, and every single day, for the nourishing, delicious bounty of nature.

I’m thankful for you, dear reader. Wishing you health, gratitude and happiness this holiday and in the coming year.

Happy Thanksgiving, Dr. Ayala

The diet that keeps you young

Age’s just a number, goes the saying, years since birth don’t accurately predict ability, health or how much time’s left. 

Lifestyle often does. Eating well and being active are linked with lower incidence and later-in-life occurrence of chronic diseases such as heart disease, cancer, diabetes and stroke, and with greater likelihood of survival into old age.

How does food increase longevity? There are many mechanisms in which your diet can affect disease, as certain foods affect lipid profiles, sugar metabolism and inflammation, for instance, and all these play a role in disease onset and progression. 

Genetic makeup also predicts disease and lifespan.

Can food change our genes? Diet of course doesn’t change our coded DNA sequence, but diet can modify genes’ expression: which genes are more active and which are suppressed. This fascinating field of study is called epigenetics. Gene expression can be controlled through chemical changes such as methylation, the addition of a methyl group to the DNA chain in an area that doesn’t code for the gene itself. Methylation can occur in many places, and thousands of these sites are known to be correlated with aging, acting like “clocks”, which predict biological age, chronic diseases and mortality. People whose epigenetic age is older than their chronological age are thought to be biologically older and at greater risk of disease, while those with young epigenetic ages are at lower risk.

Diet and lifespan

A new study in the American Journal of Clinical Nutrition looks at the diet and at the methylation patterns of almost 2700 women. Diet quality was assessed in reference to four recommended healthy diet indexes, such as the DASH (Dietary Approaches to Stop Hypertension) and the Alternative Mediterranean Diet.

And the results: Higher diet quality was strongly inversely linked with two widely recognized epigenetic clocks that predict mortality – better diets predicting long lives and younger biological age. The authors conclude: “In summary, we found that healthy eating patterns are associated with some methylation-based measures of biological age. The benefits of healthy eating appear to accrue particularly in women reporting lower levels of physical activity. These findings support the hypothesis that a higher diet quality may slow aging and lower disease and mortality risks.”

Another recent study, including 2000 people, also looked at the overall diet quality using a DASH score, and at methylation profiles using 3 different verified epigenetic aging measures. The DASH score evaluates the intake of dietary components giving high scores for consuming more vegetables, fruit, nuts, legumes, whole grains and low-fat dairy, and for consuming less red and processed meat, sugary drinks, sweets and salt. The study demonstrated that higher diet quality was associated with slower aging according to the methylation epigenetic scores. What’s more, during the 10-year follow up in this study 297 participants died, and both a lower DASH score and the three epigenetic age acceleration measures were significantly associated with all-cause mortality. 

Several other studies look at how certain foods change methylation patterns, suggesting that high intake of plant-based foods slows the clock, that high intake of poultry predicts an accelerated aging, as does red meat. A study of 120 people aged 65-79 year showed slower epigenetic aging when people ate a Mediterranean-style diet for a year.

Anti-aging from within

Anti-aging skin care routines promise young looking skin (the most proven anti aging skin treatment however is ultraviolet radiation avoidance and blocking) and longevity supplements promise death defying miracles – without much evidential support.

But we actually know that certain habits are linked with delayed aging, disease and death. Chief among them are eating well, exercising, avoiding smoking and nurturing social ties. It’s not as  easy as taking a pill or a potion, and you need to stick to it long term.

What does eating well mean? There are very many ways to eat healthfully, and all of them center on emphasizing whole plant-based foods (vegetables, fruits, nuts, legumes, whole grains) and minimizing highly processed foods (fast-food, processed meats, sugary drinks). 

Dr. Ayala