There are several explanations as to why December 25 and 26 are the top two days for cardiac deaths. Find out why — and how you can stay healthy.

While the holidays can be a time of great joy and family togetherness, you don’t need us to tell you that they also can be a time of great stress.

In fact, it’s been proven time and time again that heart attacks tend to spike around Christmas and New Year’s; one recent study out of New Zealand pegged that number at 4 percent and another found that the top three days for cardiac deaths are December 25 and 26 and New Year’s Day, respectively.

Here are five reasons that stress and other factors affect your heart health particularly during this time of year — and what you can do about it.

1. Family stress.

Maybe your mom wants to bring her new boyfriend to the holiday meal and your brother is having none of it, or you have to spend four-plus hours ferrying the kids across the 405 and back again to see all the different sets of grandparents. Family drama and the holidays can be a toxic mix. Do your best to set boundaries and find healthy ways to relieve your stress, including meditation or taking a brisk walk outdoors.

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2. Rich and indulgent foods.

Congrats! You passed on the double chocolate brownies at the office cookie exchange. But now your Aunt Mary is practically assaulting you while getting you to try her famous fruitcake crisps with cream cheese icing. Extra sugar, fat, salt, calories and the weight gain that go hand-in-hand with it can definitely do a number on your ticker, especially if you’re already at risk for heart disease. Learn to enjoy in moderation: take small bites of the treats you truly enjoy and pass (politely) on the ones that are only so-so. Then make up for your indulgence at other meals: try a heart-healthy meal such as an omelet loaded with veggies for breakfast or a 10-vegetable bean soup for lunch.

Eggs are a good source of protein (both whites/yolk), contain heart-healthy unsaturated fats and also great source of important nutrients, such as vitamin B6, B12 and vitamin D,” said Kurt Hong, MD, associate professor of clinical medicine at the Keck School of Medicine of USC and a primary care physician at Keck Medicine of USC. “As with any food, the key here is consumption in moderation.”

3. Too much booze.

It can be tempting to enjoy a bottomless glass of wine when it’s offered to you, particularly if you’re feeling stressed about family. But once again, everything is better in moderation.

“There are still people drinking alcohol, and as long as alcohol is around, we’ll have patients with the alcoholic liver cirrhosis,” said Yuri Genyk, MD, professor of clinical surgery at the Keck School of Medicine of USC and surgical director of the liver transplant program at Keck Medicine of USC. “It’s just a reality that we deal with.”

Drinking too much alcohol can lead to atrial fibrillation, an abnormal heart rhythm. In turn, this ups your chances for a heart attack stroke and heart failure. Here are more ways you can avoid a visit to the hospital during the holidays, according to Michael Levine, MD, an assistant professor of emergency medicine at the Keck School of Medicine of USC and an emergency medicine physician at Keck Medicine of USC.

4. Travel.

Traveling can be harmful to your heart in a few different ways. The very act of getting from place to place can be stressful, whether you’re traveling by plane or car. Getting to the airport and making it through security is anxiety-inducing enough, then you’re stuck in a tiny little seat for hours on end, with added worries of delays and potentially missing connecting flights. Flying is particularly dangerous for those with peripheral artery disease (PAD) because it can increase risk of blood clots, according to the American Heart Association. It’s always a good idea for everyone to stay hydrated and stand up and walk around at least once every hour while en route.

Car travel, likewise, can be stressful, especially if you’re prone to road rage. Always try to give yourself as much time as possible to get to your destination and try to find your zen when you’re behind the wheel.

Another way travel can be harmful to your health is that it can throw you off your routine. It’s not unusual to exercise less, sleep less and eat more when you’re on the road. Of course some of that may be beyond your control, but you should always do your best to mindful about taking care of yourself and your health.

It’s not just your heart you have to worry about when you travel; use these strategies to prevent colds and flu when on the road.

5. Putting off seeking medical help.

It could be that you’re in a strange city and don’t want to head to the ER to see an unknown doctor and risk a high medical bill. Or maybe you’re having such a great time with the grandkids at home, you don’t want to make a big deal in the moment and interrupt the fun for a questionable chest pain. Whatever the reason, it’s imperative to seek medical help as soon as possible if you suspect you’re experiencing a heart attack or stroke. Quite literally, it could mean the difference between life and death.

“As a general rule, if someone makes it to the hospital alive, their odds of survival are very high,” Dr. Levine said. “The key is very good, supportive care.”

By Anne Fritz

If you are in the Los Angeles area and are looking for exceptional care from some of the top physicians in the world, be sure to schedule an appointment by calling (800) USC-CARE (800-872-2273) or by visiting keckmedicine.org/request-an-appointment.