Eat steak a few times a year without guilt

Dear Dr. Roach: I was diagnosed with atrial fibrillation in 2017. A week later, I had an MRI that showed I’d had a ministroke and probably several others in the past. I love ribeye steak, and eat it maybe two or three times a year. Is this safe? — R.A.

Atrial fibrillation is a rhythm problem of the heart. The natural rhythm is lost, so the heartbeat becomes irregular. Because of the lack of normal movement in the heart, the blood can pool and form clots in the left atrium; these clots can travel downstream to lodge in a blood vessel. Clots can cut off the blood supply to the area where they lodge. It’s most critical when it happens in the brain, since if brain cells die, function is lost.

A stroke is just a focal area of cell death in the brain. The size and location of the area in the brain where cell death occurs determines how significant the stroke is. Strokes can range from unnoticeable to devastating to fatal. Most people with atrial fibrillation take medication to reduce the risk of stroke.

Eating poorly can increase the risk of heart disease and stroke as well, but most commonly this happens via a different mechanism. High amounts of saturated fat — such as in ribeye steak, which is fattier than many cuts of beef — increase the risk of damage to blood vessels through buildup of cholesterol plaques. These plaques cut off blood supply, and this causes a heart attack or stroke.

Even if you don’t have any evidence of plaques, a healthy diet of mostly plants, with whole grains, nuts and seeds, some fatty fish if you enjoy that and sparse amounts of meats reduces many health risks.

However, eating two or three steaks a year is not going to cause harm.

And if having a steak a few times a year is truly enjoyable, the risk is small, and you should enjoy those meals without guilt.