Study links heavy meals to heart attacks
provided by The American Heart Association
e know gluttony is one of the seven deadly sins, but a new study suggests it may also trigger a potentially deadly medical complication, such as a heart attack.
Reporting at the American Heart Association's 73rd Scientific Sessions, a US Department of Veterans Affairs (VA) researcher finds that people at risk for heart disease were four times more likely than others to suffer a myocardial infarction (MI) soon after eating a big meal.
"To our knowledge, this study is the first to show overeating or having a heavy meal is a risk factor for triggering heart attacks," said Francisco Lopez-Jimenez, MD, MSc, a cardiology fellow with VA's Boston Health Care System in Brockton, Massachusetts. He is also on staff at Brigham and Women's Hospital and Harvard Medical School.
Dr. Lopez-Jimenez and colleagues interviewed nearly 2,000 patients at 45 different hospitals, including several VA medical centers, shortly after their heart attacks. The researchers asked about possible and proven triggers of heart attack, including "unusually heavy meals."
They found that 158 patients reported having an unusually heavy meal during the 26 hours preceding the MI. Twenty-five patients had the meal in the two hours before the attack, defined by the researchers as the "hazard" period, while only six patients reported a large meal the day before, defined by the team as the "control" period.
By comparing the two time slots -- 24 hours apart the study controlled for the possibility that time of day, and not the meal itself, was the trigger. The remaining patients in the group of 158 had their heavy meal at various other times in the 26 hours before the heart attack, but no other time period emerged as significant.
The researchers believe there are two possible explanations for how a heavy meal could bring on a heart attack. One, fatty meals may affect the function of the endothelium, the inner layer of the arteries, although details about what the patients ate were not recorded for this study. Secondly, eating increases the blood level of norepinephrine, a hormone that acutely raises blood pressure and pulse rate.
Despite the potential linkage of heavy meals to an MI, Lopez-Jimenez stressed the difference between risk factors for the development of coronary disease, such as obesity, hypertension, smoking and lack of exercise and possible triggers for an MI.
"Overeating should be considered as a heart attack trigger, much in the same way as extreme physical activities and severe anger episodes may cause an MI."
So what's the take home message for those with excessive or voracious appetites? The doctor advises exercising in moderation. "People at risk for a heart attack should be careful not only about the total caloric intake they eat every day, but the size of individual meals as well."
Collaborating with VA's Dr. Lopez-Jimenez on the study were Murray A. Mittleman, MD; Malcom Maclure, ScD; Geoffrey H. Tofler, MD; Jane B. Sherwood, RN; and James E. Muller, MD, all of Beth Israel Deaconess Medical Center in Boston. This study was funded by the National Heart, Lung and Blood Institute. VA research provides improved medical care for veterans, as well as the general population. Through its unique affiliation with medical schools, VA plays a crucial role in educating future physicians in research and clinically oriented areas.