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One study discovered the more grateful you are, the lower your risk of heart attack. Is there a recipe for gratitude? Learn what highly grateful people do differently from the rest
"Gratitude opens the door to the power, the wisdom, and the creativity of the Universe" - Deepak Chopra
It is well known that mental and physical health are closely intertwined, but evidence suggests your attitude may have a major influence your heart attack risk. The latest science reveals that a "grateful heart" is a healthy heart.
Dr. Paul Mills of the University of California San Diego School of Medicine has been researching the connection between mental health and heart health for decades. A positive attitude is associated with lower heart disease risk because it reduces stress, anxiety and depression, all of which contribute to cardiovascular disease.
But what about gratitude and your heart? To answer this question, Mills designed a study. He recruited 186 men and women with heart disease and came up with a gratitude questionnaire.
What he learned was, the more grateful people are, the healthier they are. Mills also performed blood tests to measure inflammation levels. Inflammation strongly correlates with the buildup of arterial plaque and the development of heart disease. Interestingly, the most grateful individuals showed the lowest inflammatory markers.
Mills then dug in deeper with a follow-up study involving gratitude journaling. After two months, individuals with a history heart disease who kept gratitude journals enjoyed a decrease in their overall cardiac risk, whereas a non-journaling group did not. Mills isn't certain how gratitude helps the heart but believes the key may be reduced stress.
These results aren't surprising in light of previous studies linking negative emotional states with increased risk of heart attack and stroke. A 2012 review of 200 studies by the Harvard School of Public Health concluded that optimism and happiness do indeed reduce cardiovascular risk.
Gratitude Offers Benefits for Both Mind and Body
Robert A. Emmons heads up a long-term research project designed to create and disseminate scientific data on the nature of gratitude, its causes and potential consequences for human health and well-being.  Neuroscientist Emiliana Simon-Thomas, the science director of Greater Good Science Center (GGSC) at UC Berkeley, works alongside Emmons in the study of gratitude. Simon-Thomas reports:
"After eight weeks of practice, brain scans of individuals who practice gratitude have stronger brain structure for social cognition and empathy, as well as the part of the brain that processes reward."
Simon-Thomas has also seen gratitude relieve symptoms of post-traumatic stress and helps individuals with PTSD recover more quickly. Studies involving trauma survivors (Vietnam vets and 9/11) have found gratitude to be a significant factor in healing from trauma. 
In a blurb about the radio special The Science of Gratitude, UC Berkeley's online magazine Greater Good says the prescription for happiness can be distilled into one simple recommendation: Say thank you. But happiness is only the tip of the iceberg! Research reveals gratitude comes with an impressive array of benefits, including the following:56 
Improved personal and work relationships
Better physical health
Greater empathy, sensitivity, and connectedness with others
Higher self esteem
Better self care
Increased mental strength and resilience
Reduced stress and anxiety
Less focus on material goods
Is There a Recipe for a Grateful Heart?
I am particularly fond of the way editor Jeremy Adam Smith describes gratitude in a Greater Good article:
"Gratitude (and its sibling, appreciation) is the mental tool we use to remind ourselves of the good stuff. It's a lens that helps us to see the things that don't make it onto our lists of problems to be solved. It's a spotlight we shine on the people who give us the good things in life."
Believing he lacked a bit of discipline in the gratitude department, Smith put together a list of six traits he believes set "fantastically grateful people" apart from the rest:
1. Once in a while, they think about death and loss. Also known as "mental subtraction," this involves acknowledging what we do have by reflecting upon what might NOT have been. It's not about doom and gloom, but developing appreciation by looking at all possibilities.
2. They take the time to smell the roses. Savoring positive experiences makes them stick more in the brain. Have you ever noticed that the first sip of coffee tastes the best? We have a tendency to adapt to pleasurable things, enjoying them less over time--a phenomenon called "hedonic adaptation." The remedy is to temporarily give up the practice.
3. They take the good things as gifts, not birthrights. The opposite of gratitude is entitlement. A preoccupation with the self will quickly quash any feelings of thankfulness.
4. They're grateful for people, not just things. Expressing gratitude to others strengthens social bonds and increases trust, compassion and affection.
5. They mention the pancakes. Grateful people are very specific in their expressions of gratitude, which makes those expressions feel more authentic. For example, they would say, "I love you for making me pancakes on Saturday mornings when you know I've had a rough week," rather than, "I love you because you're wonderful."
6. They thank outside the box. This is not a denial of negativity, but rather a way of thinking about the world that turns obstacles into opportunities.
Ideas for Starting a Gratitude Practice
The practice of gratitude is about slowing down and looking deeply into your life--past, present and future. In addition to looking for gifts in the present, additional gratitude opportunities are cultivated by retrieving memories from the past and developing a positive outlook for the future. The following are a few suggestions for developing a gratitude practice:
Say thank you. Write short thank you notes often. For an even greater impact, write one detailed gratitude letter per month. Consider occasionally writing one to yourself
Thank someone mentally. Never underestimate the power of your thoughts.
Keep a gratitude journal. Before bed, spend a few minutes writing down things for which you are grateful. Once or twice a week is plenty. Focusing on interpersonal relationships, as opposed to material things, has been shown to be more impactful.
Create a gratitude jar. On a slip of paper, write down what you are grateful for each day, and place it in a jar. On a difficult day, pull out and reread a few as gratitude reminders.
Mealtime thankfulness. Practice sharing your daily gratitudes with your family during the evening meal.
Meditate or pray. It's much harder to tune in when you're doing, so set aside some time for just being. Meditation offers a panoply of benefits, including thinking more logically and clearly from multiple perspectives.
 NPR (November 23, 2015) "Gratitude Is Good For The Soul And Helps The Heart, Too"
 Castillo, S. (November 13, 2014) "The Science Of Gratitude: It Really Is The Little Things" Medical Daily
 Kashdan TB et al. "Gratitude and hedonic and eudaimonic well-being in Vietnam war veterans." Behav Res Ther. February 2006;44(2):177-99 PMID: 16389060
 Fredrickson BL. et al. "What Good Are Positive Emotions in Crises? A Prospective Study of Resilience and Emotions Following the Terrorist Attacks on the United States on September 11th, 2001" J Pers Soc Psychol. February 2003;84(2):365-376 PMCID: PMC275526
 EurekAlert! (August 26, 2014) "Gifts that generate gratitude keep customers loyal" Queensland University of Technology
 SPSP (January 19, 2013) "Surprising Connections Between Our Well-Being and Giving, Getting, and Gratitude"
 Quoidback J and Dunn EW. "Give It Up: A Strategy for Combating Hedonic Adaptation" Social Psychological and Personality Science September 2013;4(5):563-568 Doi: 10.1177/1948550612473489
 Castillo S. (August 9, 2014) "Materialism Makes People Unhappy: What To Focus On Instead" Medical Daily