Will Being Optimistic Lower Your Cholesterol Level?
Abstract & Commentary
By Harold L. Karpman, MD, FACC, FACP
Clinical Professor of Medicine, UCLA School of Medicine
Dr. Karpman reports no financial relationships relevant to this field of study.
Synopsis: Optimism is associated with a significantly healthier lipid profile than is present in less optimistic persons, possibly due to healthier behaviors and lower body mass indices, which are found with increased frequency in optimistic individuals.
Source: Boehm JK, et al. Relation between optimism and lipids in midlife. Am J Cardiol 2013;111:1425-1431.
Lipid levels are in part influenced by health behav-iors such as eating a healthy diet, exercising, and consuming no more than a moderate amount of alcohol and, since being optimistic probably contributes to a healthier lifestyle, it has been hypothesized that being optomistic may result in a improved lipid panel.1-4 The Midlife in the United States (MIDUS) study was started in 1995 to better understand the connections between psychosocial factors, aging, and health in men and women aged 29-74 years.5 The authors from the Harvard School of Public Health decided to test the hypothesis that greater levels of optimism would be associated with a healthier lipid profile.
The MIDUS study obtained data from 4000 subjects who were first recruited by either random digit dialing or oversampling of select metropolitan areas.5 The population was increased to 7108 individuals by recruiting twin pairs and siblings of the randomly selected participants. Boehm and colleagues investigated a subsample of respondents from the psychosocial and biomarker projects consisting of 990 participants who were able to engage in a telephone interview and successfully complete self-administered questionnaires. Optimism was assessed by self-reporting using the Life Orientation Test. The 990 participants were mostly Caucasian men and women who were, on average, 55.1 years old with complete data obtained on optimism, lipid levels, potential confounders, and pathway variables. Results revealed that after adjusting for covariates, greater optimism was associated with higher high-density lipoprotein (HDL) cholesterol and lower triglyceride levels. However, optimism was not associated with significant differences in the low-density lipoprotein or total cholesterol levels.
COMMENTARY
It is not surprising that optimism and lipid levels were found to be associated because optimism had been linked to healthier behavior patterns such as eating a balanced diet, exercising, and consuming none or only moderate amounts of alcohol.1-4 Although the effect of optimism on raising HDL levels and lowering triglyceride levels were small, they were determined to be significant and nontrivial.6,7 The benefits of optimism were observed not only on the lipid panel, but were also associated with a beneficial smoking status, decreased alcohol consumption, and improved dietary intake and exercise patterns.1-4 Also, other relevant factors for explaining the clinical improvement noted in optimistic individuals may have been the positive effects of optimism on inflammation8,9 and metabolic dysfunction.10 Finally, optimistic individuals might be better equipped than their less optimistic subjects to meet the challenges of engaging in healthy behavior and maintaining a healthy body mass index.11
In summary, for very many reasons, optimistic individuals do better from an overall health perspective including the relatively minor but significant improvements that appear to be present in the lipid profile in this select group of subjects.
References
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5. Radler BT, et al. Who participates? Accounting for longitudinal retention in the MIDUS National Study of Health and Well-Being. J Aging Health 2010;22:307-331.
6. Gordon DJ, et al. High-density lipoprotein cholesterol and cardiovascular disease: Four prospective American studies. Circulation 1989;79:8-15.
7. Kodama S, et al. Effect of aerobic exercise training on serum levels of high-density lipoprotein cholesterol: A meta-analysis. Arch Intern Med 2007;167:999-1008.
8. Ikeda A, et al. Optimism in relation to information and endothelial dysfunction in older men: The VA Normative Aging Study. Psychosom Med 2011;73:604-671.
9. Roy B, et al. Association of optimism and pessimism with information and hemostasis in the Multi-Ethnic Study of Atherosclerosis (MESA). Psychosom Med 2010; 72:134-140.
10. Hotamisligil GS. Inflammation and metabolic disorders. Nature 2006;444:860-867.
11. Rasmussen HN, et al. Self-regulation processes and health: The importance of optimism and goal adjustment. J Pers 2006;74:1721-1747.