In addition to eating your greens and working out daily, carve out some time in your day to sit down and write thank you notes, call your friends and family, or simply journal about the positive things in your life. Do this without fail, no matter how difficult your life may be.

That’s because, according to a new study out of the American Psychological Association, gratitude may be the key to a healthier heart — and a healthier lifestyle, in general. The study, which analyzed 186 men and women who had been diagnosed with asymptomatic (Stage B) heart failure for 3 months, focused on the positive effects of both gratitude and spirituality on overall health.

“We found that more gratitude in these patients was associated with better mood, better sleep, less fatigue and lower levels of inflammatory biomarkers related to cardiac health,” Paul J. Mills, a professor of family medicine and public health at the University of California, San Diego, and an author of the study, said in the press release.

Stage B patients have structural heart disease, but don’t show the symptoms of heart disease. It’s also a point in the disease where patients can drastically improve their lifestyle and make a difference before reaching Stage C heart failure.

The researchers used standard psychological tests to score patients’ levels of gratitude and spirituality. They compared them to the patients’ scores in depressive symptoms, sleep quality, fatigue, self-efficacy, and inflammation; they found that more gratitude in life was linked to improved mood, sleep quality, self-esteem/self-efficacy, and less inflammation.

The fascinating result was that it wasn’t necessarily overall spirituality — like the belief in God or a greater power — that assisted in improving health (which has been shown to be the case in other studies on the health benefits of religion and spirituality). Instead, it seemed to be the gratitude in particular, or the ability to focus on the positive things, that made the biggest difference: “We found that spiritual well-being was associated with better mood and sleep, but it was the gratitude aspect of spirituality that accounted for those effects, not spirituality per se,” Mills said in the press release.

In another experiment, the researchers asked the patients to write down 3 things they were grateful for, nearly every day, for 8 weeks. They found that “those patients who kept gratitude journals for those eight weeks showed reductions in circulating levels of several important inflammatory biomarkers, as well as an increase in heart rate variability while they wrote,” Mills noted. “Improved heart rate variability is considered a measure of reduced cardiac risk.”

So today, sit down and make a list of all the good things in your life. It could be that new job, your best friend, or it can be as simple as a cup of coffee or a scarf on a windy day. Write your friends thank you notes for their recent gifts, visits, or just for fun. Focusing on the good things will reduce your stress and make you realize that things aren’t so bad after all; and this will benefit your cardiovascular health.

“It seems that a more grateful heart is indeed a more healthy heart, and that gratitude journaling is an easy way to support cardiac health,” Mills states.

Source: Mills P, Redwine L, Wilson K, Pung M, Chinh K, Greenberg B. “The Role of Gratitude in Spiritual Well-Being in Asymptomatic Heart Failure Patients.” Spirituality in Clinical Practice, 2015.