Exercise and diet are keys to a healthier life, as many studies show, but a heart specialist also recommends something more.

“One, two, three — twirl.”

Kendra Martin is taking photographs of three little girls in chiffon dresses. As they twirl, Martin tells them to smile.

“All right, big smiles!”

“I tell people to fake laugh, and they feel stupid doing it, but the result is theyʼre laughing, and it turns into a genuine smile,” Martin said.

And, in this case a giggle.

Big grins and giggles pay off on camera. The girls may be too young to have heart problems, but the smiles can promote heart health.

Brain rewiring

Dr. Anand Chockalingam is a heart specialist at the University of Missouri Health Care who tells his patients to smile.

“When we smile, the brain wiring gets altered. The chemicals that are released are more positive,” he said.

Chockalingam’s advice is supported by a number of studies. He says smiling is a first step in fighting stress and its ill health effects.

When you feel stressed, your body releases a surge of hormones, including adrenaline and cortisol.

Adrenaline increases your heart rate and blood pressure. Cortisol, the primary stress hormone, increases sugars in the bloodstream. If you are truly in danger, these hormones can help, but too much of these stress hormones too frequently can lead to heart disease and stroke.

​Bad habits arise

People who are stressed look for ways to cope. The American Heart Association says smoking, overeating or drinking alcohol as a way to reduce the stress can harm your heart and other organs.

“Once people smile, they are relaxing,” Chockalingam said. “This relaxation directly lowers blood pressure, improves sugar levels in the blood.”

Chockalingam tells his patients to smile 20 times an hour. It might seem like a lot, but it doesn’t involve drugs or have any negative side effects.

“If we are smiling, we are breaking that link between stress and health,” he said.

Smiling is something Martin does to improve her photography.

“Waking up in the morning with a smile on my face, you know, itʼs gonna put everybody in a better mood,” she said.

And it provides a little boost to everyone’s heart health.

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