By the way, doctor: Can even one fatty meal cause heart problems?
Q. I'm in good health and have a good lipid profile but occasionally have a yearning for brisket or corned beef. I recently read that even one meal heavy in fat could cause atherosclerosis. What do you think?
A. Unhealthy foods are not like poison. Arsenic is poisonous, and just one swallow could kill you, but it's not that way with the unhealthy saturated fats in brisket. What slowly makes atherosclerosis build up in your arteries is eating unhealthy fats week after week, year after year. The single meal heavy in "bad fats" (saturated fat and trans fat) makes only a tiny contribution toward atherosclerosis. So I never tell my patients to always avoid unhealthy foods. Life is too short. Celebrations and occasional culinary sins are a part of life. Besides, I'd have to take that advice myself — or be a terrible hypocrite.
But we're not quite off the hook. Most cases of sudden cardiac death and nonfatal heart attacks occur because blood flow through a coronary artery (the arteries that supply blood to the heart muscle) gets blocked suddenly. While atherosclerosis surely contributes to most of these cases, another factor is the tendency of the diseased artery to go into spasm, clamping down so that little if any blood can get through. And there's some evidence that the tendency for arteries to go into spasm is increased for a few hours after people eat a meal heavy in saturated fats.