The Super Bowl is all fun and games — until someone double dips and spreads their stomach bug.
Turns out, Super Bowl Sunday brings a surprising number of public health woes, from the serious (more drunk driving and flu-related deaths) to the mild (stomach problems from eating too many slices of pizza).
Here’s how your health might take a hit this weekend:
Close calls on the field can stress the heart
Close calls on the field can actually create chest pains or other cardiac symptoms in football fans with their eyes glued to the game, according to a 2008 study published in the New England Journal of Medicine.
The study analyzed 4,279 heart patients in Germany and found the rate of heart attacks in men tripled on days when their favorite soccer team was playing.
During the World Cup playoff season, the doctors saw an average of 43 heart problems crop up each day in the study group. At other times of the year, they saw about 15 cardiac problems a day. The symptoms ranged from chest pain and irregular heartbeats to full-blown heart attacks.
Though that study was tied to the World Cup, those effects are thought to carry over to most high-stress sports viewing.
All those parties can spread the flu
When a hometown team gets into the Super Bowl, that’s associated with a spike in flu deaths, at least among the elderly, according to a study published last year in the American Journal of Health Economics.
Researchers looked at county-level statistics from 1979 to 2009 and saw an 18 percent increase in the number of flu deaths in people over 65 in cities that sent a team to the Super Bowl in a given year.
It’s super hard to stop eating
If the spread in front of the TV weren’t temptation enough, there are all the ads: Snickers. Butterfingers. Doritos. Taco Bell.
It’s hard to resist.
A 2014 study in PLOS One noted a significant spike in average calorie counts per serving of food purchased in the United States during Super Bowl week.
And all that extra chowing down isn’t doing your body any favors. High-fat foods, in particular, can cause some digestive problems. That said, a one-day junk food spree probably won’t hurt you too much in the long run.
Stale snacks can be breeding grounds
No matter how many calories you eat, your snacks are probably going to suffer a predictable fate on Sunday — being left out on the table to grow tepid as the game progresses. And that’s not good for you.
Cooked food hits the danger zone when it reaches room temperature, according to the US Department of Agriculture. Bacteria will grow rapidly on your plate of half-eaten nachos. And if your seven-layer dip has been sitting out for more than two hours, you ought to toss it or run the risk of facing its wrath later on.
Driving home can be dangerous
Super Bowl Sunday also poses a big public health problem — more drunk drivers out on the roads.
An analysis by California safety officials found that the number of alcohol-related crashes on Super Bowl Sunday is 57 percent higher in Los Angeles and a whopping 117 percent higher in San Diego than on a normal Sunday this time of year. The study looked at crashes that happened between 5 p.m. Sunday and 4 a.m Monday during each Super Bowl game between 2009 and 2013.
The National Highway Traffic Safety Administration has reported seeing similar spikes across the country.
Sitting (even on the edge of your seat) makes you less healthy
Too much time on the couch can cost you. Sitting too much is tied to a whole host of health problems, including increased risk of heart disease and diabetes.
Researchers don’t quite understand why that is, but they think it has to do with how your muscles change when you’re sedentary. Muscle cells release less lipase — which eliminates fat from the bloodstream — when they’re not doing work.
Even regular exercise can’t completely negate the damage sitting does, according to a review of 41 studies published in 2015 in the Annals of Internal Medicine.
Sure, one afternoon on the couch won’t hurt you. Just don’t make a habit of it.
A version of this story initially appeared in February 2016.