Heavy Meals Linked to Heart Attacks

November 15, 2000

New York (MedscapeWire) Nov 15 — A new study suggests that gluttony may trigger a potentially deadly medical complication, such as a heart attack.

Reporting in New Orleans, Louisiana, 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 4 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 2000 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 2 hours before the attack, defined by the researchers as the "hazard" period, while only 6 patients reported a large meal the day before, defined by the team as the "control" period.

By comparing the 2 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 2 possible explanations for how a heavy meal could bring on a heart attack. One is that 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. Another explanation is that 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." Lopez-Jimenez advises exercising in moderation and said, "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."