If you are reading this, you have already dodged 2/3 of the bullet.
I read a sobering statistic this week that heart attacks are more prevalent in December and January than any other time of year in the U.S. More specifically, if you are seeking to experience the full religious effect of Christmas, you have a great chance of seeing God personally on that day since December 25th is one of the three most common days of the year to die of a heart attack. If the heart attack doesn’t kill you on Christmas proper, don’t despair; you will have an equally good chance to watch year-end football from inside the Pearly Gates since the next two most common heart attack death days are December 26th and New Year’s Day. Place your Rose Bowl bets early and hand the ticket off to a loved one just in case. Prediction: Badgers make Oregon quack like a duck.
Doctors don’t have a full understanding of why the heart decides not to go on during these specific days, but they have several hypotheses. Much to my surprise, none of them include:
- The shock of having a fat guy in red break and enter your house while you are snoozing on the living room couch
- The desperate desire to do anything to avoid taking your teenage girl to the mall on December 26th
- The natural reaction to seeing that big a number on your bathroom scale
- The devastating heart break that comes from the Cal Bears once again missing the Rose Bowl cut
- The realization that there are few other legitimate excuses for not returning to work on January 2nd
Nope. Rather, actual doctors say that these holiday heart attacks are the product of some toxic combination of stress (and the resulting hormonal load on the body), cold weather, food and alcohol overindulgence, snow shoveling and denial.
Let’s tick off the easy ones first. Every year you read about the guy in Cleveland or Buffalo or Milwaukee who meets his maker shoveling snow in his driveway. A recent study in Canada found that 7% of holiday heart attack deaths were the result of snow shoveling. Okay, listen closely now. Don’t shovel snow this week. Unless you want the last person you see to be Frosty the Snowman, just leave the damn snow where it is. Okay, that should save 7% of you.
Cartoonist Bill Watterson (Calvin & Hobbes) was once quoted as saying, “It’s not denial. I’m just selective about the reality I accept.” Perfect for this time of year, as another heartbreaker is getting lax about taking one’s normal prescription medicines, particularly when traveling and you forget them back at home. Similarly, despite the fact that their left arm is burning and you feel like they’re going to die, many people don’t go to the hospital to get obvious heart attack signs checked out because, hey, it’s almost turkey time. It seems people don’t want to make a fuss when their family is around and/or they blame that fire in their chest on having had one too many roasted chestnuts; denial is a powerful emotion. Personally, I think the fact that you might need medical attention seems like a great excuse to get a few moments away from the family…just think how relaxing it will be to wait alone in the Emergency Room at a busy time where no one will pay attention to you—downright bliss. Might be worth going to the hospital even if you feel fine just to get a few moments of peace. Anyway, the lesson here is: don’t be a schmuck; take your meds and go to the hospital if you feel any heart attack signs.
It gets a little harder as you head down the list. Physicians know that cold temperature itself increases heart attack risk. Apparently cold weather makes blood vessels constrict, blood pressure rise and the heart work harder, particularly when we are dehydrated from too much salty food. According to Dr. Tracy Stevens, a cardiologist at Saint Luke’s Health System in Kansas City, Missouri, cold might also trigger changes in the blood that produce clotting and inflammation. Just walking outside and taking an icy breath can “create a crisis,” she says. “That sudden exposure can cause constriction of the coronary arteries or lung constriction, which creates shortness of breath and puts a strain on the heart.” I know I’m not a medical professional, but here is my professional advice on this one: stay warm. Listen to your mom and wear a sweater. Don’t overexert yourself outside in the cold (this means YOU, snow-shovelers). And furthermore, stay hydrated so your blood vessels stay nice and open. FYI, egg nog is not a legitimate hydration cure.
Food overindulgence is particularly tough to avoid this time of year. You think you had peer pressure in high school? Try eating only a salad when the rest of the family is holding a fork in each hand. Unfortunately, eating too many salty, sugary high carb, lipid-raising calories can contribute to the Big One. This is particularly the case for those who already have congestive heart failure, high blood pressure or diabetes. According to Dr. Robert Lustig of UC San Francisco, burning the carbohydrates found in the dense, high-energy holiday food can generate body heat, which helps mitigate the negative heart effects of the cold weather, but these foods can also cause too much insulin, leading to dangerously low sugar levels that can cause the body to crash. Lustig adds, “When you don’t have happiness and when you have stress you opt for simple pleasures, one of which is eating,” Lustig said. “The problem is the more you eat, the more your dopamine levels go down, which can make you want to eat more to keep feeling good.”
According to that all-knowing source, Wikipedia, Dopamine is commonly associated with the rewards system of the brain, providing feelings of enjoyment and reinforcement to motivate a person to perform certain activities. In other words, people find the Christmas Eve motivation to put together that 749 piece toy for their kid by promising themselves that they can have one more piece of pumpkin pie when they’re done. This one’s a very slippery slope, as The Journal of the Norwegian Medical Association recently reported that sugary foods stimulate the vagus nerve which makes you feel less full and thus makes you think that, actually, you could have two pieces of pie as a reward for building that damned toy. “Shouldn’t I get some sort of prize,” you think to yourself, “for digging that piece of lego out of my Achilles tendon?” The bummer here is, of course, that you will end up doing yourself more harm than good. When they wheel you into the catheterization lab at the hospital, it would be very embarrassing to find that the thing blocking the blood flow to your heart is an entire Buche de Noel.
Winning the food wars during the holidays is tough, but it may mean the difference between having a heart that flutters from joy and one that flutters from atrial fibrillation. “The best rule of thumb for holiday eating is to eat in moderation,” the Cleveland Clinic’s Dr. Leslie Cho says. “Try to avoid going to parties hungry. Watch your portion size, try to avoid eating foods that are too salty, and choose your beverage wisely.” And by wisely, I do not think she means choose premium brands over well drinks, good as that sounds right about now.
The last culprit in the list of holiday heart attack suspects is stress. Holiday stress comes from everything from family encounters to parking at the mall to being unable to get the TIVO to work when the Grinch That Stole Christmas comes on. Holiday stress is daunting to many and very hard to avoid entirely. For some people just the thought of the holidays makes their hearts race–and not in a George Clooney kind of way.
You may not be working over the holidays, but according to Dr. Lustig, the stress hormone cortisol works overtime this time of year. And since the Christmas holidays now seem to start in August, the sustained stress is hard to manage. Cortisol is not your friend, as it can increase sugar production in the liver to power the muscles, which in turn increases blood pressure and thus stress on the heart. Dr. Lustig adds that stress can also suppress the immune system and bring on colds and flu. And the mixture of stress, temptation and the near-freezing temperatures can get us reaching for the reindeer-shaped sugar cookies, adding to the stress on our heart. All in all, it’s a toxic combination dressed up in fruitcake form. Beware the fruitcake.
The big bummer, of course, is that the ways many of us deal with stress this time of year are correlated with the ways we make our heart explode: drinking too much, eating crappy foods, even exercising if it’s done out in the cold. If you live in, say, Northern California or the Amsterdam, you can consider herbal remedies to calm your nerves, but that brings its own risks, a key one being the risk of increased Twinkie cravings.
The best things you can do for yourself this time of year are to ensure you get some time to yourself, set some personal ground rules about eating, take your prescribed medications, get some exercise in a warm place and do whatever you can to manage your stress: get a massage, meditate, surf the Internet, whatever. I always find that laughter is your best friend this time of year. Nothing beats the blues like watching the movie Bad Santa…so wrong it’s right, particularly the advent calendar with candy corn and aspirin in it (beware: video swear word alert).
And just remember, with New Year’s Day only 5 days away, you’re almost in the clear. Happy Holidays everyone!