Every year on 22 December, Spain’s Christmas Lottery draws intense public attention and emotion. Despite the persistent belief that winning a major prize can endanger health, acute joy rarely triggers cardiac events. Instead, evidence points to long-term stress and anxiety after a win as more meaningful health risks.

Speaking with El Médico Interactivo, part of the Medscape Professional Network, in the context of Spain’s Christmas lottery El Gordo, Rosa Pérez Losa, PhD, emphasised that intense joy itself rarely triggers cardiac events.

Pérez Losa is outreach secretary at the Spanish Society of Emergency Medicine and emergency coordinator at the public emergency medical service in Catalonia, Spain. She stated that the belief that winning a large prize could directly cause a heart attack is medically unfounded. “The emotion of receiving a prize, no matter how large, does not usually cause cardiac problems,” Pérez Losa said. “Joy is good for the heart because it not only promotes the release of dopamine but also reduces levels of stress and cortisol.”

“What can truly affect the heart or provoke a heart attack is not intense emotion but prolonged stress and anxiety, worry, insomnia, and increased cortisol,” Pérez Losa said. “A poorly managed lottery prize, which could even lead to financial ruin, could trigger all of these problems. The real risk for a heart attack depends on factors such as obesity, a sedentary lifestyle, smoking, high cholesterol, and hypertension.”

Emergency department data support this assessment, showing no notable increase in cardiac admissions on lottery draw days in Spain. “From the emergency services, no significant rise in admissions is recorded on the day of the draw. Celebrations linked to winning the lottery do not usually cause accidents or emergencies,” Pérez Losa said. However, she added that scientific evidence suggests that in some cases, an individual’s health may worsen after receiving a substantial financial prize, particularly if the person is unprepared to manage large amounts of money.

The Real Danger Is Stress After the Win

Paradoxically, the prize itself can become a source of harm. Pérez Losa noted that receiving a large sum of money all at once can destabilise an individual who lacks financial knowledge or experience. This situation can generate anxiety and stress, which in turn may affect both physical and mental health, contributing to digestive problems, increased blood pressure, sleep disturbances, irritability, and depression.

“Learning to manage money and having expert support is key to turning a prize into an opportunity rather than a health risk,” she said. Her advice to winners is clear: “Enjoy the initial dopamine surge but then return to normality. Do not go on television, do not tell too many people, and continue with everyday life. Manage the money wisely, either independently or with a financial adviser.”

The lottery, alongside bingo, is among the most popular in-person games of chance for young individuals and adolescents in Spain. According to the Survey on Drug Use in Secondary Schools in Spain 2023, a national school-based survey comes amid growing concerns about gambling-related harm among young individuals worldwide. “The constant pursuit of prizes can lead to gambling addiction, which is a recognised addiction,” Pérez Losa said.

Although evidence suggests that greater wealth is associated with better health, it does not guarantee overall well-being. “Studies show that better health outcomes are linked not only to lower poverty levels but [also] to access to resources such as healthcare services, medicines, and quality food. Individuals with fewer resources tend to have poorer health indicators,” she noted.

“Having money helps, but receiving it suddenly without knowing how to manage it may not bring happiness and could even lead to health problems,” Pérez Losa said. “The key is to manage it in a conscious and responsible way.”

Towards a Healthier Christmas

Pérez Losa noted that December is a particularly busy period for emergency departments, not only because of COVID and other respiratory viruses such as influenza but also due to indigestion, alcohol and food poisoning, and exacerbations of chronic conditions.

For healthier holiday meals, she recommended incorporating fruits and vegetables into menus and choosing vegetable-based side dishes instead of fried foods, thus reducing the amount of fat and sauce. “Swapping appetisers for lighter options — such as small salads, white asparagus, courgette with lemon, or roasted aubergines — and serving smaller portions help control overall consumption,” she said.

She also advised baking or grilling instead of frying and paying close attention to leftovers, particularly seafood and other perishable foods, to reduce the risk for food poisoning. “Regarding alcohol, it is advisable to drink water during meals and reserve alcoholic drinks for toasts, avoiding alcohol alongside food to prevent overloading the body and impairing digestion,” Pérez Losa said.

Pérez Losa described the festive season as an opportunity for positive change and health education within families. “The messages conveyed at home have a profound impact,” she said. “Christmas is often associated with gambling and the lottery, alcohol with joy, and cigarettes with celebration, and these associations are frequently modelled in front of children and adolescents.”

She urged families to use Christmas as a time for honest conversations: Alcohol should be presented as an occasional choice; tobacco is a source of nicotine, one of the most addictive substances comparable to heroin in terms of dependence; and excessive gambling in adolescence can normalise unhealthy relationships with money, luck, and control later in life.

With minor changes and conscious conversations with children, particularly adolescents, families can enjoy the festive period while reinforcing messages that may positively shape their long-term health and well-being.

This story was translated from El Medico Interactivo.