Saturday, November 17, 2018
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Medical Files

Coping with holiday stressors

It’s less than a week before Christmas, but the holiday season is far from over. In our country, the season usually extends to at least another week after New Year’s Day.

We may not realize it, but Christmas and the New Year—the most anticipated holiday season of the year—can also be the most stressful. I guess this is part of the yin-yang balance in life. As Lao Tzu wrote in his book “Tao Te Ching”: “All things (and occasions) carry the yin while (embracing) the yang. Neutralizing energy brings them into harmony.”


There is always that yin-yang dualism in almost all aspects in life. And this can be noted in the holiday season, too. It’s the season to be merry, to have fun, to enjoy all the bonuses and Christmas gifts one receives, and to attend all the parties and partake generously of the good food and drinks that come with them. But it’s also the season when one’s stress level can be so high; and if one is not careful about it, it can shoot through the roof and could lead to a period of grief instead of merriment.

Montrous traffic


First on the list of stressors is the monstrous traffic the holiday season brings. With all the shopping malls we have and everyone’s busy activities requiring road travel, the traffic can be so bad and can make a trip to the office party or family reunion seem like a long-haul flight.

As one receives gifts, one must also give; and just thinking of what gifts to buy for each family member, close family friends and other people included in one’s list and find the time and not-too-crowded mall to buy them is enough to rev up one’s sympathetic nervous system to hyperdrive. The resulting surge in adrenaline in one’s circulation is certainly not good for one’s health.


The countless parties and get-togethers can also be occasions that can serve as risk factors particularly for those who are already high-risk to start with; hence, physicians must be able to identify these patients way in advance and forewarn them of the danger that awaits them if they don’t watch out what and how much they’re eating and drinking during the holidays.

Even physicians would certainly not enjoy being called to the emergency room in the middle of the night due to an admission of a patient who just had a heart attack, an exacerbation of heart failure or a stroke. And the immediate trigger? Well, the patient just came from a party where he/she binged or pigged out.

Chink in the armor

Binge eating and drinking during the holidays remain a chink in the armor even of those who are religiously following a healthy lifestyle regimen in the preceding months or years. With a somewhat distorted thinking, some would look forward to the season as a time to let go of all of one’s strict health regimen for the year and binge on food and drinks. Many realize too late that such foolhardiness can cause them an untimely rush to the ER or the intensive care unit.


Although not borne out of extensive research or clinical trials, there are already quite a volume of reports of individuals succumbing to a heart attack or stroke following a single heavy, fat-laden meal.

What? A single meal could immediately trigger a heart attack? Well, in high-risk, predisposed individuals, many of whom don’t realize they are at risk, there appears to be enough reason for this to happen. Looking at the pathophysiological events following a high-carbohydrate, high-fat, high-salt diet, one can be easily convinced that the stage for a potentially catastrophic heart attack or stroke is indeed ominously set up. One study presented at the American Heart Association scientific sessions has shown that an eating binge can quadruple the risk of a heart attack within the next two hours of the meal.

Adverse shift

The mechanism implicated that after a large meal, an adverse shift in the circulation happens. The blood circulation is diverted to the intestines to aid digestion, and this can take up to six hours. Meanwhile, other organs, including the heart and brain, don’t get their fair share of the circulation which can render them relatively ischemic or lacking in nutrients and oxygen. If one already has significant narrowing of the heart and brain arteries, this may be the final straw that breaks the camel’s back, leading to a potentially catastrophic event.

A heavy meal can also trigger more insulin release due to the heavy carbohydrate load and since excessive insulin makes the arteries constrict, it can aggravate the reduced circulation to the coronaries (heart) and cerebral (brain) arteries.

The dangerous elevation in the blood cholesterol and triglycerides following a binging episode can also release bad hormones called inflammatory cytokines into the circulation, which can trigger a heart attack or a stroke.

The key, of course, is moderation in everything we do during the holidays; and a conscious effort to prevent ourselves from being unnecessarily exposed to these heart-attack stressors and triggers.

The best person

How does one know if one is at risk? One’s family physician should be the best person who could tell. But if one already has a previous history of heart attack, stroke (or even just transient ischemic attacks, aka “warning stroke”); cardiovascular risk factors like diabetes, high blood pressure, high cholesterol and triglyceride levels, obesity, smoking; family history of heart attack, stroke or sudden death, one has to exert caution and must constantly remind oneself that it’s better to be safe than sorry.

After all, the yin-yang balance is supposed to lead to harmony, bliss and good health—and not catastrophe.

Wishing you all a merry Christmas and a joyous, healthy New Year.

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TAGS: christmas, column, health and science, holiday stress, new year, rafael r. Castillo, yin-yang
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