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Holidays - Your Heart and Your Weight

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Addiction Medicine FYI

Holidays - Your Heart and Your Weight

Strike a balance between celebration and health.

Is it true that more alcohol is consumed over vacations? Is drug use also increased? Can this use affect the heart?

Students who vacationed with friends during spring break dramatically increased their alcohol use.  In contrast, students who stayed home or vacationed with parents during spring break were at low risk for excessive alcohol use according to research done by Grekin et al (J Stud Alcohol Drugs.2007; 68(5):681-8).  There findings highlight the need for targeted drinking interventions geared specifically toward students taking trips with friends and for further research into both personal and environmental variables that predict increases in drinking during spring break.

Studies about drug use and holidays are scant, however, there was a study done in Australia on the effects of backpacking holidays on alcohol, tobacco and drug use. (Bellis et al BMC Public Health. 2007; 7:1) found that the  use of alcohol and other drugs by  backpackers visiting Australia was common with use of illicit drugs being substantially higher than in peers of the same age in their home country. Individuals showed a significant increase in frequency of alcohol consumption in Australia compared to their behavior in their home country with the proportion drinking five or more times per week rising from 20.7% to 40.3%. The study noted that relatively few individuals were recruited into drug use (3.0%, cannabis; 2.7% ecstasy; 0.7%, methamphetamine).  However, over half of the sample (55.0%) used at least one illicit drug when backpacking.  Risk factors for illicit drug use while backpacking included being a regular club goer, being male, being based in Sydney, travelling without a partner or spouse, having been in Australia more than four weeks, Australia being the only destination on their vacation and drinking or smoking 5 or more days a week.

Holidays are good times, but they can also be a time that impacts your cardiac system greatly.  One specific disorder related to alcohol and the holidays is “Holiday Heart Syndrome”. It has long been recognized that alcohol consumed in large quantities for many years can induce an alcoholic cardiomyopathy, whereby the muscle of the heart is damaged and the heart does not function in a normal manner. 

In 1978, Ettinger et al conducted a study evaluating 32 separate episodes of irregular heart rates in 24 patients.  These patients consumed alcohol heavily and regularly; in addition, they took part in a weekend or holiday drinking binge immediately prior to evaluation.  Based on the results of this study, the term holiday heart syndrome was coined. It was defined as an acute cardiac rhythm and/or conduction disturbance, most commonly supraventricular tachyarrhythmia, associated with heavy ethanol consumption in a person without other clinical evidence of heart disease.  Typically, this resolved rapidly with spontaneous recovery during subsequent abstinence from alcohol use.

The most common rhythm disorder is atrial fibrillation, which usually converts to normal sinus rhythm (normal beating of the heart) within 24 hours.  The clinical course is benign, and specific  therapy is usually not indicated. Interestingly, even modest alcohol intake can be identified as a trigger in some patients with paroxysmal (intermittent) atrial fibrillation. Several mechanisms are theorized to be responsible for the occurrence of this irregular heart rate caused by alcohol.  The possible etiologies include an increased secretion of epinephrine and norepinephrine, a rise in the level of plasma free fatty acids, and an indirect effect through acetaldehyde, the primary metabolite of alcohol.

Recently, similar reports indicated that recreational use of marijuana may have similar effects.

What about your weight and the holiday season?

Hull et al (Nutr J 2006; 5:29) stated that “more people than ever are considered obese and the resulting health problems are evident.  These facts highlight the need for identification of critical time periods for weight gain”.  They investigated the changes that occur in weight during the Thanksgiving holiday break in college students. 94 college students were recruited and a significant (P < 0.05) increase in body weight was found between pre (72.1 kg) and post (72.6 kg) Thanksgiving holiday. When gender and class standing were looked at,  a significant (P < 0.05) increase in body weight was observed between the pre and post Thanksgiving holiday in males (0.6 kg), females (0.4 kg) and graduate students (0.8 kg). When participants were classified as normal or as overweight/obese, a significant 1.0 kg BW gain was found (P < 0.05) in the overweight/obese group compared to a non significant 0.2 kg gain in the normal group. Thus, data indicated that participants gained a significant amount of body weight (0.5 kg) during the Thanksgiving holiday.  While an increase in body weight of half a kilogram may not be cause for alarm, the increase could have potential long-term health consequences if participants retained this weight gain throughout the year.

Yanovski et al (N Engl J Med 2000; 342(12):861-7)stated that “it is commonly asserted that the average American gains 5 lb (2.3 kg) or more over the holiday period between Thanksgiving and New Year's Day”.  They set out to get an actual holiday-related weight variation in a sample of 195 adults.  The results showed that the mean weight increased significantly during the holiday period (gain, 0.37+/-1.52 kg; P<0.001), but not during the preholiday period or the post-holiday period.  The average holiday weight gain was less than commonly asserted but this gain was not reversed during the spring or summer months: the net 0.48-kg weight gain in the fall and winter was there to stay.