Next week’s Spring Festival will already be my sixth here in Beijing, and Spring Festival Eve is always one of the highlights of my year. My wife and I spend a wonderful evening with our Chinese in-laws, and all two dozen of us will gorge for hours on endless rounds of dumplings and snacks, drink all types of alcohol and juices, and happily shout at the TV screen as another awful performer lip syncs yet another tacky ballad. Just before midnight we will all rush to the rooftop and spend the next hour in awe at the lightshow and sound spectacular coming from every corner of Beijing. It’s difficult to describe to people back in the US just how impressive Spring Festival is. It’s like a combination of American Thanksgiving, Christmas and the Fourth of July — only much, much more intense, and lingering for a couple weeks, fading away with one last blast on Lantern Festival.
One of the major connections, unfortunately, between Chinese Spring Festival and the American holidays is the habit of ending these festive days slightly heavier and more unhealthy than when we started. So let’s continue another annual tradition: news media filled with warnings by nerdy doctors like myself lecturing their readers to not have any holiday fun. So I now shall try the difficult task of balancing health advice while not ruining your party. I could just say “everything in moderation!” and send you on your way to the supermarket, but I would like to make a couple points first. So please bear with me, and I’ll reward you with a cookie at the end. Or maybe just a sticker.
I think it’s important to step back a bit and make sure everyone realizes that the main killers and causes of disability across both China and the USA are cardiovascular disease, especially heart attacks and strokes. And for many reasons, the situation in China is more serious, according to the World Bank’s fascinating report from 2011 regarding the global burden of disease in China. They report that the average Chinese person can expect to live only 66 “healthy years” (years free from disease and disability), which is ten years less than in some leading G-20 countries. Strokes, in particular, have “the largest health and well-being impact on an individual.
I find these statistics alarming, but in my talks with my Chinese patients, most have no idea about this data. Nor do they know about the report’s other warnings that Chinese eat an astonishingly dangerous amount of salt every day, more than 12 grams on average, which is more than twice the recommended maximum amount. The World Bank calls excess salt, “by far, the most prevalent modifiable risk factor for non-communicable disease in China.” Too much salt is one of the major causes of high blood pressure and strokes, and lowering salt intake across China would probably be one of the quickest and most cost effective measures that public health groups could tackle. Most of this salt comes from processed foods such as instant noodles as well as the incredible variety of sauces in China.
How does all this tie in to Spring Festival Eve? The great majority of us survive the holiday fun just fine, but what I mostly worry about are the well documented spikes in heart attacks and strokes after classically large meals such as American Thanksgiving and Chinese Spring Festival Eve. Emergency room doctors in both countries report spikes in patients during these holidays, for a multitude of illnesses mostly traced back to indulgence with food and drink. Many of these high salt foods are eaten in abundance during the Spring Festival revelries. A large dose of salt can easily raise your blood pressure and lead to strokes and heart attacks in those of us at most risk for heart disease. Also, this salt infusion makes all of us retain water, which inevitably leads a few people into congestive heart failure, heart attacks and strokes.
One of the great tragedies of these holiday parties is that all of us are trying to relax and have a great time with our families and loved ones, and the last thing we want to do is to ruin the party. Therefore, some people may actually be having a heart attack during the meal, and they will ignore the pain so as not to upset the others, trying to wait until after the party is over to get some help. Another group will feel the chest pain but mistake it for a stomach problem such as indigestion or heartburn, and they will show up the next day in the doctor’s office or the emergency room with “really bad heartburn” which actually is a half-day old heart attack.
So if you have to absorb just one party-pooping take-home message from me today, it’s this: if you feel pressure or pain around your left chest during the party, especially if this pain radiates into your jaw or left arm, please do not ignore it until the next day. I’m deadly serious: if you truly are having a heart attack, then you need to be having emergency treament at your local hospital within 90 minutes to three hours, otherwise your survival rate starts to drop dramatically. Time is crucial with heart attacks, and your heart’s muscles are being starved of oxygen and need treatment ASAP, otherwise the muscle tissue may die forever — and so may you. Trust me, your relatives would much rather have you ruin the party and stay alive than be the life of the party now but dead tomorrow.
OK, everyone, go have fun! Here, have some more Coke with your third plate of dumplings. Don’t worry, these ones are vegetarian.
Perhaps I should have stopped earlier when I told everyone the horrible cliche, “everything in moderation”, because that actually is the obvious answer to avoiding this above dilemma. Hopefully the people cooking the holiday foods can try to use healthier oils and lower salt sauces, especially soy sauce, which is probably the easiest to find. And maybe the host can put out their smallest kitchenware, since it’s been proven many times that people eat less and feel more full when they use smaller plates, bowls and cups.
Otherwise, the rest is up to each of us and our self control when faced with bounty. I’d like to add some tips from my family medicine colleage Dr Liang Lijun (梁立筠), who also has a masters degree in nutrition and public health:
On the day of a big evening gathering, wake up at a reasonable time, eat a satisfying breakfast, and exercise so that you are not so hungry by dinner time. If you really want to be health-conscious, survey the table, choose a colorful palette of foods to eat, and try to eat the healthier foods first. This way you leave less room for oily, rich foods that are sure to tip the bathroom scale. Also, be wary of drinks, which can contain a lot of hidden calories. Try to make sure you prepare some tea (flower tea is best) to drink, or choose wine over cocktails and beer. And, perhaps most importantly, eat slowly, pause often to enjoy the conversations flowing around you, and do your best to remove yourself from the table when you’re full.
I will be the first to admit that I’m terrible at self control, and it takes me weeks to work off the excess holiday weight — an increasingly losing battle. And if I added up my total calories from my usual Thanksgiving meal, I’d probably have a heart attack just from the sticker shock. But I hope some of these recommendations can help some of you to take action, ensuring that you continue to enjoy Spring Festival with your loved ones for many more years.
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