A season to be merry and remain healthy

‘Tis the season to be merry and to celebrate. But one’s merriment and joyous celebration need not turn sour because of a potentially serious event like a heart attack or stroke.

Some would look forward to the season as a time to let go of all of one’s strict health regimen for the year and binge on food and drinks. One month a year of unli food and drinks shouldn’t be that bad after 11 months of strict adherence to a healthy lifestyle, or so some mistakenly think. Some of them realize too late that such foolhardiness can cause them an untimely rush to the emergency room or intensive care unit.

Although not borne out of randomized controlled trials, the isolated reports are getting too frequent to ignore of individuals succumbing to a heart attack or stroke following even a single heavy meal.

Mechanistically, there appears to be a logic that such should happen. Looking at the pathophysiological events following a high carbohydrate, high fat, high salt diet, one can be easily convinced that the stage for a potentially catastrophic cardiovascular event is indeed set up. One study presented at the American Heart Association scientific sessions has shown that an eating binge can quadruple the risk of a heart attack within the next two hours of the meal.

The mechanism implicated is that after a large meal, an adverse shift in the circulation happens. Cardiac output increases and diverted to the intestinal circulation to aid digestion, and this can take up to six hours. Meanwhile, other organs, including the heart and brain, don’t get their fair share of the circulation which can render them relatively ischemic. If one already has significant coronary or cerebral atherosclerosis, this may be the final straw that can break the camel’s back leading to a cardiovascular event.

A heavy meal can also trigger more insulin release due to the heavy carbohydrate load; and since insulin is vasoactive, it can promote vasoconstriction which can aggravate the reduced circulation to the coronaries and cerebral arteries.

The post-prandial hypertriglyceridemia can also induce severe endothelial dysfunction with release of inflammatory cytokines which can lead to an atherosclerotic plaque rupture and an acute coronary syndrome.

Hopefully, we all realize that even a one-time pigging out can prove to be extremely risky.

Let’s all rejoice and be merry; but let’s eat and drink safe all year round. We wish you all a blessed and merry Christmas and a happy, healthy New Year.

Vital Signs Issue 82 Vol. 4, December 1-31 2015