A large holiday meal on a table

How bad can overeating at holiday time really be for your health?

Most people get away with seasonal overindulgence without significant harm to their health. But for those with risk factors such as heart disease or high cholesterol, overeating can set off more serious medical problems. And any weight gained as a result might not be so easy to take off.

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In fact, both heart attacks and strokes tend to peak at this time of year. And during holiday time, Christmas Eve may carry the highest risk for a heart attack, followed by New Year's Day and Christmas Day—at least in Sweden, according to a large study published in The BMJ this week. 

Researchers looked at the timing of 283,014 heart attacks that occurred in Sweden between 1998 and 2013. They found that in comparison to the two weeks before and after Christmas, heart-attack risks were 37 percent higher on Christmas Eve—the main day of celebration there—20 percent higher on New Year's Day, and 15 percent higher on Christmas Day. 

Because this was an observational study, the authors drew no firm conclusions about cause and effect. But experts say that other research has provided clues about holiday heart hazards. 

Cold weather and the physical exertion of seasonal chores like snow shoveling may be factors, but "dietary indiscretion, too much alcohol, and family stress all play a role," says John A. Osborne, M.D., Ph.D., director of preventative cardiology and lipidology at State of the Heart Cardiology in Dallas and a spokesman for the American Heart Association. 

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Overeating and Heart Risks

Experts say that if you have coronary heart disease or are at risk for it, overeating (a big Christmas dinner can top 5,000 calories) can have dangerous consequences. 

In fact, one study of almost 2,000 heart-attack patients suggested that a single act of overeating could quadruple the chance of having a heart attack on the same day.

"The plaque that’s been forming has probably been forming for a long time," says Osborne. "But this could be the final trigger."

How? An unusually large meal can cause levels of triglycerides—a type of blood fat—to rise significantly, bringing inflammation that can lead to a heart attack

And so-called holiday-heart syndrome, marked by the abnormal heart rhythm of atrial fibrillation, or A-fib, can be brought on by overconsumption of alcohol. A-fib can cause a stroke, heart failure, and other heart problems.

Other Health Effects of Overeating

Here’s what else can happen when you stuff yourself, and how to handle the problems that crop up:

You may experience heartburn, which occurs when acidic gastric juices reflux into the delicate tissues of the esophagus. This can last for hours, though an over-the-counter antacid such as Tums may provide relief.

If you have gas and diarrhea after a sizable feast, try some bismuth subsalicylate (Pepto-Bismol and generic)—or just wait for it to work its way out, as it were.

The fat in your feast can also precipitate gall-bladder attacks. And if you’re susceptible to gout, the painful buildup of uric-acid crystals in your joints, go easy on alcohol and red meat. An overload of salty appetizers can result in swollen ankles for a few days.

Have a Healthier Holiday

Most of us can’t make it through a whole season of holiday parties without splurging a little. Here are a few ways to control your holiday food and drink intake:

  • Avoid going to a festive meal feeling famished. Eat a high-protein snack before, such as a slice of cheese, to take the edge off your hunger.
  • Be choosy about your hors d’oeuvres. Skip anything fried.
  • Eat slowly. Swallow each mouthful before taking the next and chat with a table mate between bites. Slow eaters tend to eat less food.
  • At a party buffet? Position yourself as far away from the table as you can.
  • Be mindful of alcohol. Binge drinking is usually associated with holiday heart syndrome, but the amount it takes to bring on an episode of A-fib varies from person to person, according to Osborne. "Some people can be very sensitive," he notes. "I've seen people have two to three drinks, and that can precipitate A-fib in them." Tip: At holiday gatherings, have a glass of sparkling water with a splash of cranberry juice between alcoholic drinks. It will seem festive and help you control your alcohol consumption.
  • Increase your regular exercise schedule to burn off some of those excess calories.
  • It's also important to reduce holiday stress, says Osborne. Stress can lead you to make poor eating choices. And mounting research suggests that difficult situations—arguments with relatives, for instance—can cause a surge in stress hormones that can damage your heart or lead to a heart attack (a condition known as broken heart syndrome, or Takotsubo syndrome).
  • Finally, if you end up overdoing it one night, don’t use it as an excuse to blow the rest of the season. Simply get back to your usual (and better) habits the next morning.