Wednesday, November 24, 2010

Can Thanksgiving dinner cause a heart attack?

The Washington Post reported on 11/22 that one should be wary of eating a large meal because the risk of having a heart attack might be four times higher for the 2 hours after eating. They gloss over the fact that the science they are reporting is about 10 years old and was apparently presented in abstract form only at the American Heart Association's Scientific Sessions back in 2000. The first author, Francisco Lopez-Jimenez, has written quite a bit over the last several years, but I can't seem to find the abstract being referenced, or any full-text article about the research. I did find one other reference dated from 2000 in Medscape which describes the study as a case-control study of nearly 2,000 patients suggesting a correlation between large meals and heart attacks.

While this study design is useful, it cannot establish causation, only correlation. Furthermore, this is a classic example of the marked difference between relative risk and absolute risk. The RELATIVE risk of having a heart attack after a large meal may be quadrupled, however the ABSOLUTE risk of having a heart attack in any given 2 hour period is so vanishingly small. Let's say that your risk goes from a risk of one in a 1,000,000 to one in 250,000; this is technically a quadruple risk, but still negligible and not something to worry about.

So unless you are trying to get out of eating some foul dish that a family member is pushing you to eat, enjoy your feast and be thankful to have an over-abundance of food, and family to share it with. That, and go for a walk afterwards since Bloomberg is reporting that one half of Americans will have diabetes or prediabetes by the end of the decade!!!

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