{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:19:08Z","timestamp":1792790348613,"version":"4.5.0"},"posted":{"date-parts":[[2026,9,20]]},"group-title":"Cardiovascular Medicine","reference-count":69,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T00:00:00Z","timestamp":1789862400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"National Institute on Aging","award":["R01AG017644"],"award-info":[{"award-number":["R01AG017644"]}],"id":[{"id":"https:\/\/ror.org\/049v75w11","id-type":"ROR","asserted-by":"crossref"}]},{"name":"National Institute for Health and Care Research","award":["98_1074_03"],"award-info":[{"award-number":["98_1074_03"]}],"id":[{"id":"https:\/\/ror.org\/0187kwz08","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,9,20]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Religiosity and spirituality (R\/S) are generally associated with a more favourable cardiovascular risk profile, but longitudinal evidence is limited. We examined whether multidimensional R\/S predicts its future behavioural and biological components.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This prospective cohort study analysed 6,844 adults aged \u226550 (56% women; mean R\/S score 2.1; 20% weekly attenders; 81% Christian) from waves 4\u20137 of the English Longitudinal Study of Ageing (ELSA). Behavioural outcomes included smoking, exercise, alcohol intake, and fruit and vegetable consumption; biological outcomes included blood pressure (BP), haemoglobin A1c (HbA1c), and the inflammatory risk markers C-reactive protein (CRP) and fibrinogen. R\/S was assessed with four items from the Santa Clara Strength of Religious Faith Questionnaire. Hierarchical linear and logistic regressions adjusted for age, sex, wealth, education and ethnicity; biomarker models also adjusted for health behaviours and body mass index.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>\n                    Greater spirituality (\n                    <jats:italic>B<\/jats:italic>\n                    =\u22120.019; 95%CI[\u22120.036,\u22120.003]), daily prayer\/meditation (\n                    <jats:italic>B<\/jats:italic>\n                    =\u22120.017; 95%CI[\u22120.032,\u22120.002]), participation in organized religion (\n                    <jats:italic>B<\/jats:italic>\n                    =\u22120.017; 95%CI[\u22120.032,\u22120.002]), and importance of religious faith (\n                    <jats:italic>B<\/jats:italic>\n                    =\u22120.017; 95%CI[\u22120.033,\u22120.002]) were independently associated with lower fibrinogen levels. Daily prayer\/meditation also independently predicted higher fruit and vegetable intake (\n                    <jats:italic>B<\/jats:italic>\n                    =0.004; 95%CI[0.000,0.008]). However, frequent attendance (OR=0.846; 95%CI[0.730,0.982]), the significance of faith (OR=0.935; 95%CI[0.879,0.994]), and religious purpose (OR=0.939; 95%CI[0.884,0.997]) independently reduced the odds of meeting exercise recommendations. Similarly, frequent attendance was associated with higher HbA1c (\n                    <jats:italic>B<\/jats:italic>\n                    =0.002; 95%CI[0.000,0.005]). There were no independent associations with CRP or blood pressure.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>R\/S showed mixed prospective associations with the cardiovascular risk profile: favourable for fibrinogen and fruit and vegetable intake, unfavourable for physical activity and HbA1c.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>LAY SUMMARY<\/jats:title>\n                  <jats:p>\n                    We examined whether religious and spiritual involvement was related to later heart-related health behaviours and blood measurements in more than 6,800 English adults aged 50 and over. The associations ran in both directions, and the study cannot show that religion or spirituality causes these changes.\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>Stronger religious and spiritual involvement was associated with lower fibrinogen, a blood protein linked to clotting.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Daily prayer or meditation was associated with eating more fruit and vegetables.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Regular attendance at religious services was associated with less physical activity and higher blood sugar.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:p>\n                  <jats:fig id=\"ufig1\" position=\"float\" orientation=\"portrait\" fig-type=\"figure\">\n                    <jats:caption>\n                      <jats:title>GRAPHICAL ABSTRACT<\/jats:title>\n                    <\/jats:caption>\n                    <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"26362903v1_ufig1\" position=\"float\" orientation=\"portrait\"\/>\n                  <\/jats:fig>\n                <\/jats:sec>","DOI":"10.64898\/2026.09.14.26362903","type":"posted-content","created":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T22:05:18Z","timestamp":1789941918000},"source":"Crossref","is-referenced-by-count":0,"title":["Matters of the Heart and Soul: The Mixed Impact of Religiosity and Spirituality on the Cardiovascular Risk Profile Over Time"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9199-9689","authenticated-orcid":false,"given":"Vinicius","family":"Vieira Neves","sequence":"first","affiliation":[{"name":"Brown University Mindfulness Center, Department of Epidemiology, School of Public Health, Providence, Rhode Island, United States of America"},{"name":"University College London, Department of Behavioural Science and Health, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesar","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"University College London, Department of Epidemiology and Public Health, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"LaPrincess C.","family":"Brewer","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, United States of America"},{"name":"Center for Clinical and Translational Science, Mayo Clinic, Rochester, Minnesota, United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ione","family":"Jayce Ceola Schneider","sequence":"additional","affiliation":[{"name":"Federal University of Santa Catarina, Department of Health Sciences, Florianopolis, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Steptoe","sequence":"additional","affiliation":[{"name":"University College London, Department of Behavioural Science and Health, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2026092308205759000_2026.09.14.26362903v1.1","doi-asserted-by":"publisher","DOI":"10.5935\/1678-9741.20130015"},{"key":"2026092308205759000_2026.09.14.26362903v1.2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2014.9427"},{"key":"2026092308205759000_2026.09.14.26362903v1.3","doi-asserted-by":"publisher","DOI":"10.5935\/abc.20190204"},{"key":"2026092308205759000_2026.09.14.26362903v1.4","doi-asserted-by":"publisher","DOI":"10.1159\/000190791"},{"key":"2026092308205759000_2026.09.14.26362903v1.5","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.11086"},{"key":"2026092308205759000_2026.09.14.26362903v1.6","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2016.1615"},{"key":"2026092308205759000_2026.09.14.26362903v1.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2013.02.007"},{"key":"2026092308205759000_2026.09.14.26362903v1.8","unstructured":"Koenig H , King D , Carson VB . Handbook of religion and health: Oup Usa; 2012."},{"key":"2026092308205759000_2026.09.14.26362903v1.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2013.03.002"},{"key":"2026092308205759000_2026.09.14.26362903v1.10","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/146214"},{"key":"2026092308205759000_2026.09.14.26362903v1.11","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0339676"},{"key":"2026092308205759000_2026.09.14.26362903v1.12","doi-asserted-by":"publisher","DOI":"10.1007\/s10943-018-0663-6"},{"key":"2026092308205759000_2026.09.14.26362903v1.13","doi-asserted-by":"publisher","DOI":"10.1093\/abm\/kay001"},{"key":"2026092308205759000_2026.09.14.26362903v1.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2011.11.004"},{"key":"2026092308205759000_2026.09.14.26362903v1.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2012.02.020"},{"key":"2026092308205759000_2026.09.14.26362903v1.16","doi-asserted-by":"publisher","DOI":"10.1097\/01.psy.0000160482.89163.e8"},{"key":"2026092308205759000_2026.09.14.26362903v1.17","doi-asserted-by":"publisher","DOI":"10.2337\/dc19-1586"},{"key":"2026092308205759000_2026.09.14.26362903v1.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jash.2015.04.003"},{"key":"2026092308205759000_2026.09.14.26362903v1.19","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.879973"},{"key":"2026092308205759000_2026.09.14.26362903v1.20","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dys168"},{"key":"2026092308205759000_2026.09.14.26362903v1.21","unstructured":"Banks J , Marmot M , Blundell R , Lessof C , Nazroo J. Health, wealth and lifestyles of the older population in England: the 2002 English Longitudinal Study of Ageing. In: Institute for Fiscal Studies; 2003."},{"key":"2026092308205759000_2026.09.14.26362903v1.22","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.13304"},{"key":"2026092308205759000_2026.09.14.26362903v1.23","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.121.007868"},{"key":"2026092308205759000_2026.09.14.26362903v1.24","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1007\/BF02230993","article-title":"The Santa Clara strength of religious faith questionnaire","volume":"45","year":"1997","journal-title":"Pastoral Psychology"},{"key":"2026092308205759000_2026.09.14.26362903v1.25","unstructured":"Koenig HG , Futterman A. Religion and health outcomes: A review and synthesis of the literature. Methodological Approaches to the Study of Religion, Aging, and Health, National Institute on Aging, Bethesda, MD , March 1995;1617."},{"key":"2026092308205759000_2026.09.14.26362903v1.26","first-page":"34","article-title":"Quality control of blood, saliva and urine analytes","volume":"2","year":"2004","journal-title":"Health survey for England"},{"key":"2026092308205759000_2026.09.14.26362903v1.27","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000052939.59093.45"},{"key":"2026092308205759000_2026.09.14.26362903v1.28","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-010-1785-x"},{"key":"2026092308205759000_2026.09.14.26362903v1.29","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2008.02197.x"},{"key":"2026092308205759000_2026.09.14.26362903v1.30","unstructured":"Koenig HG . Spirituality and health research: Methods, measurements, statistics, and resources: Templeton Foundation Press; 2012."},{"key":"2026092308205759000_2026.09.14.26362903v1.31","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1107477"},{"key":"2026092308205759000_2026.09.14.26362903v1.32","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1080\/13607863.2024.2335390","article-title":"The association between religious beliefs and values with inflammation among Middle-age and older adults","volume":"28","year":"2024","journal-title":"Aging & mental health"},{"key":"2026092308205759000_2026.09.14.26362903v1.33","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2014.08.030"},{"key":"2026092308205759000_2026.09.14.26362903v1.34","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1007\/s10865-020-00146-1","article-title":"Perceived racism, affectivity, and C-reactive protein in healthy African Americans: Do religiosity and racial identity provide complementary protection?","volume":"43","year":"2020","journal-title":"Journal of behavioral medicine"},{"key":"2026092308205759000_2026.09.14.26362903v1.35","doi-asserted-by":"crossref","first-page":"kaae082","DOI":"10.1093\/abm\/kaae082","article-title":"Exploring novel determinants of exercise behavior: a lagged exposure-wide approach","volume":"59","year":"2025","journal-title":"Annals of Behavioral Medicine"},{"key":"2026092308205759000_2026.09.14.26362903v1.36","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2018.09.009"},{"key":"2026092308205759000_2026.09.14.26362903v1.37","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyaa120"},{"key":"2026092308205759000_2026.09.14.26362903v1.38","doi-asserted-by":"publisher","DOI":"10.1093\/poq\/nfw016"},{"key":"2026092308205759000_2026.09.14.26362903v1.39","doi-asserted-by":"publisher","DOI":"10.1111\/1468-4446.12205"},{"key":"2026092308205759000_2026.09.14.26362903v1.40","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.024974"},{"key":"2026092308205759000_2026.09.14.26362903v1.41","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnr156"},{"key":"2026092308205759000_2026.09.14.26362903v1.42","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/gbaf125"},{"key":"2026092308205759000_2026.09.14.26362903v1.43","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-017-0296-1"},{"key":"2026092308205759000_2026.09.14.26362903v1.44","doi-asserted-by":"publisher","DOI":"10.5993\/AJHB.38.2.4"},{"key":"2026092308205759000_2026.09.14.26362903v1.45","doi-asserted-by":"publisher","DOI":"10.1002\/pon.4852"},{"key":"2026092308205759000_2026.09.14.26362903v1.46","unstructured":"Peters NA . Identifying Associations between Religious Commitment and Preventive Health Behaviors in a Southeastern Rural County. 2017."},{"key":"2026092308205759000_2026.09.14.26362903v1.47","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1007\/s10865-016-9736-8","article-title":"Religiosity, dietary habit, intake of fruit and vegetable, and vegetarian status among Seventh-Day Adventists in West Malaysia","volume":"39","year":"2016","journal-title":"Journal of behavioral medicine"},{"key":"2026092308205759000_2026.09.14.26362903v1.48","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980023001866"},{"key":"2026092308205759000_2026.09.14.26362903v1.49","doi-asserted-by":"publisher","DOI":"10.5888\/pcd9.120001"},{"key":"2026092308205759000_2026.09.14.26362903v1.50","doi-asserted-by":"publisher","DOI":"10.1177\/0898264314529333"},{"key":"2026092308205759000_2026.09.14.26362903v1.51","unstructured":"How CB , Ming KE , Chin CY . Does religious affiliation influence glycaemic control in primary care patients with type 2 diabetes mellitus? Mental health in family medicine 2011;8:21."},{"key":"2026092308205759000_2026.09.14.26362903v1.52","doi-asserted-by":"publisher","DOI":"10.1097\/01.nmd.0000253801.18367.a5"},{"key":"2026092308205759000_2026.09.14.26362903v1.53","doi-asserted-by":"publisher","DOI":"10.1097\/01.NNR.0000313497.10154.66"},{"key":"2026092308205759000_2026.09.14.26362903v1.54","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2021.09.012"},{"key":"2026092308205759000_2026.09.14.26362903v1.55","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0319002"},{"key":"2026092308205759000_2026.09.14.26362903v1.56","doi-asserted-by":"publisher","DOI":"10.1093\/abm\/kax012"},{"key":"2026092308205759000_2026.09.14.26362903v1.57","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-4679(200004)56:4<519::AID-JCLP6>3.0.CO;2-1"},{"key":"2026092308205759000_2026.09.14.26362903v1.58","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.161.15.1881"},{"key":"2026092308205759000_2026.09.14.26362903v1.59","doi-asserted-by":"publisher","DOI":"10.3109\/09540261.2014.899999"},{"key":"2026092308205759000_2026.09.14.26362903v1.60","doi-asserted-by":"crossref","unstructured":"Rosmarin DH , Koenig HG . Handbook of spirituality, religion, and mental health: Academic Press; 2020.","DOI":"10.1016\/B978-0-12-816766-3.00003-3"},{"key":"2026092308205759000_2026.09.14.26362903v1.61","doi-asserted-by":"crossref","unstructured":"Krentzman AR . Longitudinal differences in spirituality and religiousness between men and women in treatment for alcohol use disorders. Psychology of religion and spirituality 2017;9:S11.","DOI":"10.1037\/rel0000096"},{"key":"2026092308205759000_2026.09.14.26362903v1.62","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2024.02.012"},{"key":"2026092308205759000_2026.09.14.26362903v1.63","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0223095"},{"key":"2026092308205759000_2026.09.14.26362903v1.64","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.122.028712"},{"key":"2026092308205759000_2026.09.14.26362903v1.65","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwz222"},{"key":"2026092308205759000_2026.09.14.26362903v1.66","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1093\/ajh\/hpz199","article-title":"Religious Service Attendance, Educational Attainment, and Hypertension at Baseline of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)","volume":"33","year":"2020","journal-title":"American Journal of Hypertension"},{"key":"2026092308205759000_2026.09.14.26362903v1.67","doi-asserted-by":"publisher","DOI":"10.2190\/75jm-j234-5jkn-4dqd"},{"key":"2026092308205759000_2026.09.14.26362903v1.68","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1007\/s11739-018-1791-4","article-title":"Correlation between religion and hypertension","volume":"14","year":"2019","journal-title":"Internal and emergency medicine"},{"key":"2026092308205759000_2026.09.14.26362903v1.69","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2015.06.006"}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.64898\/2026.09.14.26362903","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T15:21:24Z","timestamp":1790176884000},"score":1,"resource":{"primary":{"URL":"http:\/\/medrxiv.org\/lookup\/doi\/10.64898\/2026.09.14.26362903"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,20]]},"references-count":69,"URL":"https:\/\/doi.org\/10.64898\/2026.09.14.26362903","relation":{},"subject":[],"published":{"date-parts":[[2026,9,20]]},"subtype":"preprint"}}