Understanding the connection between spiritual well-being and physical health: an examination of ambulatory blood pressure, inflammation, blood lipids and fasting glucose Julianne Holt-Lunstad • Patrick R. Steffen • Jonathan Sandberg • Bryan Jensen Received: May 31, 2010 / Accepted: March 29, 2011 / Published online: April 13, 2011 Ó Springer Science+Business Media, LLC 2011 Abstract Growing research has demonstrated a link be- tween spiritual well-being and better health; however, little is known about possible physiological mechanisms. In a sample of highly religious healthy male and female adults (n = 100) ages 19–59 (m = 28.28) we examined the influence of spiritual well-being, as measured by the Functional Assessment of Chronic Illness Therapy- Spiritual Well-Being (FACIT-Sp-Ex), on physiological risk factors for heart disease. Specifically we examined 24-h ambulatory blood pressure (BP), inflammation (hs-C- reactive protein), fasting glucose, and blood lipids. Regression analyses reveal that higher levels of spiritual- wellness (total FACIT-Sp-Ex score) was significantly related to lower systolic ambulatory BP (b =-.345; P \ .001), diastolic ambulatory BP (b =-.24; P = .02), hs-C-reactive protein (b =-.23; P = .04), fasting glucose (b =-.28; P = .006), and marginally lower triglycerides (b =-.21; P = .09) and VLDL (b =-.21; P = .10) controlling for age, gender, and church attendance. Results remained generally consistent across the Meaning, Peace, Faith and Additional Spiritual Concerns subscales of the FACIT-Sp-Ex. Spiritual well-being may be cardio protective. Keywords Spiritual Á Religiosity Á Heart disease Á Blood pressure Á Fasting glucose Á Inflammation Á Cholesterol Introduction Religiosity and spirituality have been related to better health across a number of studies (McCullough et al., 2000). Church attendance in particular has been studied extensively, with frequent attendees having better physical and mental health outcomes. Among 21,204 adults from the National Health Interview Survey, those who attended church weekly or more had increased longevity compared to those who attended church less than weekly (Hummer et al., 1999). It was also noted that several factors appear to play a role in the religiosity and longevity relationship, with those attending church more frequently having stronger social ties and better health behaviors. However, controlling for these and other health factors did not completely eliminate the relationship between church attendance and longevity in this sample. Oman and Reed (1998), in a sample of 1,931 older adults found similar results, with those attending church more frequently having lower mortality rates as compared to those attending less frequently. As before, controlling for health factors, social ties, and psychological well-being only accounted for part of the relationship. Although church attendance is related to health, it may fail to capture the spiritual factors that influence health. Sloan (2007), discussing the difficulties in using church attendance as a measure of religiosity, quoted Garrison Keillor who stated ‘‘anyone who thinks sitting in church makes you a Christian must also think that sitting in a garage makes you a car (p. 493).’’ Focusing in on spiritu- ality in general and spiritual well-being specifically is one way to address this issue. A National Institute of Health- care Research panel of experts defined spirituality as ‘‘the feelings, thoughts, experiences, and behaviors that arise from a search for the sacred’’ (Larson et al., 1997, p. 21). J. Holt-Lunstad (&) Á P. R. Steffen Á B. Jensen Department of Psychology, Brigham Young University, 1024 Spencer W. Kimball Tower, Provo, UT 84602-5543, USA e-mail: julianne_holt-lunstad@byu.edu J. Sandberg Department of Marriage & Family Therapy, Brigham Young University, Provo, UT, USA 123 J Behav Med (2011) 34:477–488 DOI 10.1007/s10865-011-9343-7