WEDNESDAY, Jan. 30 (HealthDay News) -- If you plan on watching the Super Bowl on Sunday, you might want to stay cool and calm if the referee makes a bad call, especially if you have known risk factors for heart disease.

New research suggests that when serious sports fans are watching their team play in a big game, they face more than twice the risk of suffering a heart attack. While the study focused on the 2006 World Cup soccer matches in Germany, American football fans would be wise to take note of the findings.

"Viewing a stressful soccer match more than doubles the risk of an acute cardiovascular event," wrote the German researchers who conducted the study. "In view of this excess risk, particularly in men with known coronary heart disease, preventive measures are urgently needed."

Does this mean American football fans should give up watching Sunday's showdown between the New England Patriots and the New York Giants?

It depends on whom you ask.

Dr. Stephen Siegel, a cardiologist at New York University Medical Center, said fans just need to remember it's only a game. "It's a game and it's great to be involved and excited, it just needs to be toned down. Don't let your emotions get the better of you," he advised.

While some doctors might recommend people with known risk factors or a history of heart disease skip the stress of watching the game, Dr. Shukri David, chief of cardiology at Providence Hospital in Southfield, Mich., said he thinks the stress of not witnessing an important game could be just as harmful for some people.

For the study, published in the Jan. 31 issue of the New England Journal of Medicine, the German researchers compared the number of cardiac events that occurred during World Cup matches held between June 9, 2006, and July 9, 2006, to three control periods when no soccer matches were played. They also looked for effects on the days the German team was playing versus days the team was resting.

The researchers found that during six of the seven German games, there was an increase in the number of reported cardiovascular events. That effect was even more pronounced when the Germans were involved in a dramatic match where the winning goal was scored during the last minute.

On days when the German team was playing, the proportion of cardiac patients who were male jumped to an average of 71.5 percent, while men only accounted for 56.7 percent of cardiac care during the no-play period.

Overall, the incidence of cardiac emergencies in men increased 3.26 times the average of the control period when the German team was playing. For women, the increase was 1.82 times higher than the control period.

"It appears you have to be vested in some way in the outcome," explained Siegel. "I would definitely expect there to be an increase in heart attacks in New York and New England this weekend if it's a close game."

David added that sports fans can create "the perfect storm for heart attacks" by leading a sedentary lifestyle, eating junk food, smoking, drinking excessive alcohol, and getting stressed out by the game.

He said that if you've got known risk factors for heart disease and you know you get worked up when viewing sports, but you just can't tear yourself away from the games, you should talk with your doctor about whether a temporary treatment to keep your blood vessels relaxed would be helpful.

"There are people who have lots of heart irregularities when they have to do public speaking, and we treat them with medications called beta blockers. Maybe we should treat stressed-out sports fans with beta blockers also," he suggested.

Both David and Siegel added that it's not only the stress of sporting events that can trigger cardiac problems. Financial woes, losing a loved one and natural disasters can all cause stress that may harm your heart.

More information

The American College of Cardiology offers advice on preventing heart disease  .

MONDAY, Jan. 28 (HealthDay News) -- New research suggests the caffeine in those daily cups of java might spell blood sugar trouble for diabetics.

In a small group of 10 diabetics, glucose levels rose by 8 percent when participants took pills filled with the level of caffeine found in four cups of coffee.

"There's reason to believe that caffeine consumption -- and coffee is the most common source of caffeine -- may be harmful to people with type 2 diabetes and make it more difficult for them to keep their glucose levels under proper control," said study author James Lane, a professor of medical psychology at Duke University.

While some research has suggested that the antioxidants in coffee could prevent diabetes in women, laboratory tests have questioned whether caffeine disrupts the body's ability to process blood sugar. "We want to demonstrate that what we've seen in the lab takes place in the real world when people are living their normal lives," Lane said.

In the new study, researchers inserted a small sensor into the abdomens of 10 patients who had diabetes but didn't take insulin. The sensor kept track of blood sugar levels for up to 72 hours.

Over several days, the patients -- all coffee drinkers -- alternated between taking placebos and 500 milligrams of caffeine a day in capsule form. That level of caffeine is equal to four eight-ounce cups of coffee.

The findings appear in the February issue of Diabetes Care.

On days when they consumed the caffeine pills, the blood sugar levels of the patients went up by 8 percent compared to when they took placebos. Glucose also rose after meals, most notably after dinner when blood sugar levels grew by 26 percent.

There are a couple possible explanations, according to Lane. In one, caffeine may interfere with the transfer of glucose from blood into the cells of the body, boosting blood sugar levels. Another possibility, he said, is that caffeine may stimulate the liver to release glucose when it's not needed.

A researcher who studies coffee said the new study has some limitations. For one, it looks at effects over one day, rather than over the long term, said Rob van Dam, a research scientist at Harvard School of Public Health. For another, "it should be noted that effects of caffeine in capsules cannot be directly translated to effects of caffeinated coffee, as studies have previously found less pronounced effects of caffeinated coffee on blood glucose levels as compared with caffeine in isolation," he added.

What to do? Keep coffee consumption under control, Lane suggested. "It would be worthwhile for people with diabetes who drink coffee to try quitting for a time and see if their glucose improves," Lane said. "It's a simple thing that might make their diabetes better."

Decaf may also do the trick. Indeed, van Dam said a previous study showed decaffeinated coffee actually reduced spikes in glucose levels after people ate sugary food. "It may thus be useful for persons with diabetes to try switching from caffeinated to decaffeinated coffee and see whether this improves their glycemic control, he said.

More information

Learn more about diabetes from the National Institutes of Health.

THURSDAY, Jan. 24 (HealthDay News) -- Just by strapping on a step-counting pedometer, overweight or obese "couch potatoes" who start a daily walking regimen can expect to lose at least a modest amount of weight -- even in the absence of any special diet, new research reveals.

The review of data from nine studies found that patients who used a pedometer to track and motivate their walking achieved a loss of about a pound every 10 weeks.

"The main point is that pedometer-based walking programs are effective at getting people to walk more, and they do result in a modest amount of weight loss," said study lead author Dr. Caroline R. Richardson, an assistant professor in the department of family medicine at the University of Michigan Medical School in Ann Arbor.

"It's not a huge response, but it's not no response -- it's a modest response," added Richardson, who also serves as a research scientist in the Health Services Research and Development Center at Ann Arbor Veterans' Affairs Medical Center.

The findings are published in the January/February issue of the Annals of Family Medicine.

Simple, inexpensive and pager-sized, pedometers are worn at the waist to automatically keep track of every step the wearer takes while walking, running, climbing, dancing, or engaging in a variety of sports.

According to experts, pedometer users may gain some flexibility as they set exercise goals -- for example, they can meet their target in a single daily outing or through several short outings spread across the day. In this way, pedometers may help encourage more people to exercise, fitness experts say.

But others question that theory.

To help settle the debate, Richardson's team analyzed data collected in nine pedometer-based walking studies conducted between 1995 and 2006.

In each study, 307 previously sedentary and overweight or obese patients were motivated to join a new walking program by using pedometers to monitor their total daily step counts.

Study size varied from 15 to 106 participants each, and almost three-quarters of the patients were women. Special diets were not included as part of the studies.

Nevertheless, the researchers found what they called "remarkably consistent" results. With the exception of those participating in one of the studies, all of the enrolled patients ended up losing a small amount of weight by each study's end.

On average, participants lost about a tenth of a pound per week -- an amount the authors described as "small but important." They noted that over the course of a year, this figure translates into an expected weight loss of five pounds.

Such weight loss resulted from an average step count increase of between 2,000 to 4,000 steps (one to two miles) per day per participant over the course of each study.

Assuming a walking pace of three miles per hour, such increases were calculated to be the equivalent of an additional 20 to 40 minutes of walking per day.

Richardson and her colleagues also noted that the longer the program lasted, the greater the ultimate weight loss.

Weight loss was modest for most participants, the researchers stressed. However, pedometer-based walking programs should confer significant health benefits beyond weight loss, including lowered blood pressure and a boost in cardiovascular health.

Those coping with type 2 diabetes or glucose intolerance may also reap related health rewards, Richardson's group noted.

"There are other things you can achieve as well," noted Richardson. "You can get stress relief, you may sleep better at night, have an improved mood. And focusing your motivation on some of these other changes may help you stick with the program. And if you stick with walking, you may eventually get the weight reduction goal you're looking for."

Alice H. Lichtenstein is director of the Cardiovascular Nutrition Lab in the U.S. Department of Agriculture's Human Nutrition Research Center at Tufts University in Boston. She was encouraged but not surprised by the findings.

"There's something about a pedometer that makes a difference," said Lichtenstein, who is also a former chair of the American Heart Association's nutrition committee.

"Perhaps the pedometer is reinforcing behavior change," she speculated. "With some people, it gives them a goal. For others, it serves as a reminder. And, of course, anyone who's made a commitment to wear a pedometer has likely made some sort of internal commitment to stick with the exercise program. And this is a way you can look and check and see how you're doing. And that's instant gratification."

More information

For more on pedometer use, visit the U.S. National Institutes of Health, Division of Nutrition Research Coordination.

MONDAY, Jan. 21 (HealthDay News) -- It's not whether you eat out, it's where you choose to dine that affects your waistline, new research suggests.

People who live in neighborhoods with more fast-food restaurants are more likely to be obese than are people who live near more "full-service" restaurants, the study found.

"A lot of people have tried to understand why the obesity epidemic has come up, and some people hypothesize that eating out more might have something to do with it," said Dr. Virginia Chang, senior author of the study and assistant professor of medicine and sociology at the University of Pennsylvania School of Medicine. "Our findings suggest that eating out per se is not necessarily bad."

An obesity epidemic has indeed overtaken the United States, with some two-thirds of adults now considered overweight and about one-third categorized as obese.

Previous studies have implicated eating out as one factor contributing to the spread, and Americans are patronizing restaurants more than ever.

In 1940, Americans spent about 15 percent of their food dollars at restaurants, compared to more than 40 percent in 2005. And, in 2005, fast-food restaurants captured about 30 percent of the eating-out budget, versus only about 12 percent in 1960, the study authors said.

Probably not coincidentally, only about 7 percent of U.S. adults were obese in 1940.

"Eating in restaurants is a dangerous game," said Mireille Guiliano, author of French Women Don't Get Fat. "You have no control. You don't know what the chef put in, whether it's a lot of salt and way above the daily requirements. That's one challenge, but also the portions. In many, many restaurants, the portions are huge."

While previous research had focused on state-level data, the new study, published in the February issue of the American Journal of Preventive Medicine, focuses more specifically on the county level.

The study authors looked at responses from more than 700,000 people participating in five years of an annual telephone survey of U.S. adults. Restaurant data came from the 2002 U.S. Economic Census.

Residents of areas with more fast-food restaurants and a higher ratio of fast-food to full-service restaurants were heavier than people from neighborhoods with more full-service restaurants.

"People who live in areas with more full-service restaurants do tend to be thinner," Chang said.

Restaurants were considered "fast food" if patrons paid before eating. In "full-service" establishments, patrons paid after eating.

The study pointed out that it's not clear if people actually consume fewer calories at full-service restaurants, or if individuals choose full-service restaurants because they offer healthier foods.

One study that compared "fast food" with food from full-service establishments found that meals from both contained similar amounts of total fat, but that full-service foods had lower amounts of saturated fats and higher levels of cholesterol and sodium.

For those fond of eating out, Guiliano recommends the "50 percent solution," meaning eat only half of what's on the plate. Or order two appetizers, share a dish and split dessert.

"You have to be a little bit savvy and know yourself and know how to plan," she said. "You shouldn't feel you should deprive yourself. You can have a little bit of everything. The French way is more about small portions and variety. Learn to not go overboard, because the price to pay is just too expensive."

More information

For more on healthy eating, visit the Harvard School of Public Health  .