Last week, I spoke at a two-day Lifestyle Medicine and Wellness Coaching Immersion conference at Harvard Medical School. I was invited by my friend and colleague, Dr. Beth Frates, a faculty member at HMS and the Past President of the American College of Lifestyle Medicine (ACLM). Beth is widely known for her publications and contributions to the field of LM. The principles of LM align with the strength-based approach I use, including prevention, personal control, physical and emotional well-being, and resilience. The title of my talk was “Lessening Stress and Nurturing Resilience in Ourselves and Others.” The photo to the right was taken while I was speaking with the group.
I’ve previously written about LM, including in my two articles about the “Upstream Parable” posted in April and May, 2024. The ACLM was founded in 2004 and has identified Six Pillars to follow for leading a healthier, longer life. The Six Pillars include: connections with others, nutrition, physical activity, stress management, restorative sleep, and avoidance of risky substances.
What made the conference even more meaningful for me was that the attendees represented many different professional disciplines and, in addition to the United States, came from throughout the world, including Canada, the Dominican Republic, Brazil, Argentina, Greece, France, Italy, Romania, the UK, Thailand, the Philippines, and I’m certain from other countries as well.
Since “selfies” were encouraged, I had the opportunity to meet, even briefly, many of the attendees and to speak at length with several of them. In a divisive world marked by animosity and anger, and often by a lack of empathy and trust, it was a pleasure to be in a conference room with people from different backgrounds and countries who enjoyed interacting with and learning from one another. What they all shared was an interest in furthering their knowledge of LM and enriching their own lives and those of others in their communities.
From Intervention to Prevention: A Challenging Task
As I’ve noted in earlier articles, the principles of LM focus on activities that increase the likelihood of emotional and physical well-being. Stated differently, they serve a preventive function by reducing the likelihood of problems. A shift from intervention to prevention is a major goal of LM. I heard many examples of this shift at last week’s conference, especially from Beth, who reviewed research demonstrating the positive outcomes of practices that support the Six Pillars.
Although there is a growing body of research supporting the benefits of adopting the Six Pillars in our daily lives, from personal experience I know it is not always easy. I have observed two main obstacles that are two sides of the same coin. One appears when someone has unrealistic expectations and wants to change every aspect of their lifestyle at once. When they cannot meet these expectations, they give up. The other occurs when individuals view making lifestyle changes as a Herculean undertaking, becoming so overwhelmed that they don’t begin at all. Both obstacles require a similar approach that may seem obvious but is often difficult to execute—start with small, realistic goals. Each success builds on the last and serves as motivation to move forward.
Small Successes
I have been impressed by how even small successes can contribute to significant improvements in our well-being. I was reminded of this again when I read two articles this past week, one by Maya Brownstein titled “Optimism May Lower Dementia Risk” and the other by Karon Miller titled “Could a Shift in Attitude Affect Your Dementia Risk?” Both articles cited the findings of a recently published 14-year study of more than 9,000 individuals conducted by Sade Stenlund and other members of the Harvard T.H. Chan School of Public Health. An in-depth description of the study and the methods used to assess optimism and dementia may be found in the article published in the Journal of the American Geriatrics Society.
Brownstein noted that previous studies have found a link between optimism and cognitive longevity. However, questions about causality remained; that is, did declining cognition contribute to declining optimism, or did optimism lower the risk of dementia? In fact, Stenlund’s study found the latter, and the researchers noted, “These findings identify optimism as a protective psychosocial factor and highlight the potential value in supporting healthy aging.”
Stenlund and her colleagues added, “Although optimism is a complex construct, and it is not clear exactly how it might translate in terms of future dementia initiatives, this is an area which merits future research.”
Davide Cappon, a psychologist and director of neuropsychology at Tufts Medical Center in Boston, is quoted in Miller’s article, saying, “This is one of the strongest studies I’ve seen on dementia and optimism. It helps answer a big ‘chicken-or-egg’ question, suggesting a lack of optimism isn’t just an early symptom of dementia—it may actually be linked to risk in a more meaningful, potentially upstream way.”
Components of Optimism
Other professionals cited by Miller explained that optimistic people use effective coping strategies, engage in activities that stimulate the brain, and maintain strong, positive social connections, a well-known factor in living longer and healthier lives. Stenlund observed, “Optimistic people are likelier to exercise and practice healthier behaviors, manage stress well, be cognitively engaged, and maintain strong social connections—all habits that can help protect brain health.”
Reflecting on the findings of this study of the connection between optimism and dementia, one might ask, “What can I do to become more optimistic?” While some aspects of optimism may be inborn, for example, influenced by our temperament, this does not mean, as my colleague Sam Goldstein and I expressed in our book Tenacity in Children: Nurturing the Seven Instincts for Lifetime Success, that optimism cannot be nurtured as we grow and develop.
As one example, Stenlund noted a technique that others have also highly recommended, namely, writing down three things each day for which we are grateful. This helps to foster a more realistic, optimistic attitude.
Cappon supported this view. “The encouraging part is that optimism isn’t fixed—it can be trained. Optimism-focused interventions can lead to meaningful, sustained changes in biological markers, including those tied to cardiovascular health.” One intervention involved “keeping a gratitude habit, pausing to reset perspective in stressful moments and staying socially connected.”
In a similar way, I have advocated that we not only consider the things for which we are grateful but also express gratitude to others. I emphasize that a focus on gratitude does not imply that we minimize or deny the challenges in our lives. Rather, it helps us be more effective in meeting these challenges, since thoughts of gratitude foster positive emotions and greater confidence.
Clinicians have advised that other ways to promote optimism include reframing stressful events by preparing for them, planning how to cope, and visualizing success. I have often suggested that strengthening our capacity for personal control is an important component of resilience and that we focus our time and energy on situations over which we have some control rather than trying to change situations we cannot influence. If we attempt to change what we cannot change, the likely outcomes are frustration, anger, and pessimism.
Another behavior that reinforces optimism, and one that I have written extensively about is kindness (as one example, please see my June, 2023 column.). I have often cited engagement in “contributory” or “charitable” activities as a major component of well-being and resilience.
Brownstein published an article last year about this theme titled “Kindness Linked to Better Physical Health and Longevity.” She cited studies that “found a link between volunteerism and charitable activities and lower levels of physical pain.” She also wrote that regular volunteering was found to “lower the risk of mortality and increase physical functioning into old age.”
Laura Kubzansky, on the faculty at Harvard T. H. Chan School of Public Health, observed that volunteerism can serve as an antidote to loneliness and a “buffer against stress.” Immaculata De Vivo, also on the faculty of the School of Public Health, emphasized the importance of following the Six Pillars to manage stress (and, I might add, to promote optimism and longevity) when she remarked that “habits such as exercise, a healthy diet, and sleep—as well as activities based in kindness, empathy, compassion, and other attitudes reduce stress.”
Concluding Thoughts
There is growing evidence that guidelines and practices, such as those represented by LM, are designed to help us be more optimistic and resilient throughout our lives. Although most of us are aware of these guidelines and practices, it is often challenging to adopt and maintain them consistently. Let us practice self-compassion when some of our goals are not met, viewing each setback as an opportunity to learn. As I noted, it is important to start with small, realistic steps within our control. We should also keep in mind that each small accomplishment can provide the confidence to continue on a journey filled with optimism and well-being.