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Heavy Meals, Vigorous Exercise Linked to Heart Attack and Stroke


WebMD Health News
Reviewed by Gary D. Vogin, MD

Nov. 14, 2000 (New Orleans) -- Before you work out -- or pig out -- be forewarned: If you normally spend more time on the sofa than the Stairmaster, you could be setting yourself up for a deadly heart attack or stroke. New research shows that sedentary individuals are much more likely to die suddenly after eating a heavy meal or exercising vigorously. But before you use these latest research findings as another excuse to skip the gym, bear in mind that regular, moderate exercise is still what experts advise.

In a study that lasted four years, Francisco Lopez-Jimenez, MD, MSc, and colleagues at Brigham and Women's Hospital in Boston, conducted in-depth interviews with nearly 2,000 patients, within a few days of their hospitalization for a heart attack. "We found that patients who'd had what they described themselves as an unusually large meal were more likely to have a heart attack. This basically confirms the popular belief that a very large meal may start the process," he tells WebMD.

So just how risky is that belt-busting Thanksgiving dinner? "The [risk is] probably similar to that of sexual activity," says Lopez-Jimenez -- real, but "not tremendous." Still, he says, "this is important now, because restaurant meals are getting bigger and bigger." What people begin to see as a normal amount of food could actually be dangerous.

According to Lopez-Jimenez, the risk could be due to the effects of fat on the cells that line our arteries, or perhaps the rush of hormones released into the bloodstream during digestion. "It's similar to what happens during heavy exercise," he explains. Also, the sharp rise in blood sugar levels after a big meal can change the way arteries function, he says. This is especially important in women dieters, who tend to skip breakfast and lunch and then "binge" on a too-large dinner, potentially putting themselves at risk.

Whatever the mechanism, "the findings open a whole new research area," says Lopez-Jimenez, who presented his findings here Tuesday at a meeting of the American Heart Association. Future work, he says, will investigate specific foods, timing of meals, and other factors that could affect risk.

"As with many things in life, moderation is the key," Lopez-Jimenez tells WebMD. "Those people with a history of heart disease, or with risk factors such as diabetes or smoking, really need to watch the size of meals, not only the content."

A similar message of moderation -- this time for exercise -- can be taken from two other studies. "The risk of exercise -- meaning the risk of dying during or immediately after exercise -- is very low," says Barry Franklin, MD, director of cardiac rehabilitation at William Beaumont Hospital in Royal Oak, Mich. "It's the infrequent exerciser -- the one who decides to go out and get all their exercise in one day -- who's at the greatest risk." That is, the "perfectly healthy guy" who drops dead without warning while shoveling his driveway or after eating a big holiday meal was almost certainly overweight, sedentary, and already well on his way to that heart attack.

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