The excitement of football, and even the activities and feelings of anticipation leading up to games, can be unhealthy in ways many do not realize, according to Jody Gilchrist, a nurse practitioner at the University of Alabama at Birmingham's Heart and Vascular Clinic at The Kirklin Clinic at Acton Road.

Critical matchups, tight games and crushing defeats provide heightened sensory inputs that trigger sympathetic responses and the release of adrenaline, which can reduce blood flow to the heart and other muscles and increase heart rate and blood pressure.

Chronic high levels of stress hormones lead to higher heart rates and higher blood pressures that over time tend to cause the heart to thicken, just as any other muscle would in response to heavy workloads.

"The body doesn't distinguish between 'bad' stress from life or work and 'good' stress caused by game-day excitement," Gilchrist said. "It impacts your health either way."

In addition to the effects of stress on the body, some add insult to injury by eating and drinking more than they should while cheering on their favorite teams. Moderation is the key, but people tend to eat more under stress.

"Some people are stress eaters, and others tend to eat more when watching TV," Gilchrist said. "They are distracted by the entertainment and don't realize how much they're eating, and they don't listen to their brains telling them they are full."

Alcohol can further complicate matters, particularly for heart patients.

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"Since alcohol is metabolized by the liver, it can alter the way heart medications and other drugs work in the body," Gilchrist said.

Drug interactions aside, physicians generally recommend limiting alcohol intake to two drinks per day, for both dietary and behavioral reasons.

"Binge drinking is bad because alcohol contains empty calories," Gilchrist said. "Since alcohol decreases your inhibitions, you are more likely to overeat or eat things that you might normally avoid. You can try substituting light beers for regular beers, or mix a half glass of wine with seltzer to make it go further."

Gilchrist recommends several tips to keep these issues under control while watching the big game:

• Help minimize stress by watching the game with people you enjoy. • Knock out a few pushups and situps during commercial breaks. • Chew gum or squeeze a stress ball to reduce anxiety and smooth out your emotions. • Take a brief walk at halftime, or if you are attending the game, take a walk around the stadium or to another section to meet a friend. • Manage your net dietary intake by planning ahead and making healthier choices at other times of day in anticipation of splurging a bit during the game. • If tailgating at the stadium, try to conserve calories earlier in the day. • If tailgating at home, consider using vegetables in place of chips for dips, and substitute Greek yogurt for sour cream or cream cheese dips. • Because sodium causes fluid retention -- something especially bad for heart patients -- a good rule of thumb is to avoid foods that have more than 1 mg of sodium per calorie. At about 0.5 mg of sodium per calorie, natural foods such as fresh fruits and vegetables generally contain much less, so opt for them whenever possible. • Do your best to avoid sodas, which are extremely high in sodium.

For a collection of winning snacks, main courses, side dishes and desserts, download UAB's Heart Healthy Tailgate Recipes.

"Even the smallest choices can have a positive impact on your health, so make a point to incorporate many small changes rather than setting unrealistic goals, such as staying away from fun foods altogether," Gilchrist said.

In the end, your health will win -- even if your team does not.