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    Heavy Meals, Vigorous Exercise Linked to Heart Attack and Stroke


    "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.

    Franklin and colleagues collaborated with Bally's Total Fitness health clubs to determine just how often people die during or just after working out, and who's most likely to do so. "When you walk into one of these clubs, your membership card is swiped. That provides a record of the number of visits for each member," he says. They analyzed the records at 320 clubs, where "between 1997 and 1998, there were approximately 182 million visits made by 3 million members."

    In all, 61 men and 10 women had died at the clubs; the victims were an average of 53 years old. "That translates to one death out of every 2.57 million workouts," Franklin says. "This study indicates that among the general population, at least among members of commercial fitness facilities, the risk is extremely low."

    When they looked more closely at precisely who had died and why, they found that "a third had a history of cardiovascular disease or known risk factors." Half had exercised less than once, and three-quarters less than twice per week in the months prior to dying. In fact, only three had been regular exercisers who hit the gym five times each week. "More than half of the people who died were engaged in some sort of aerobic exercise -- probably extremely vigorous -- when they died," Franklin says.

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