Beneath sport's image of fitness and heartiness lies a less healthy reality, say medical investigators, who have found that for fragile spectators, a sports match can quite literally be a sudden-death playoff.
Doctors eyeing the Euro 2008 are bracing for a rise in emergency calls, cardiac arrests, wife beatings, punch-ups, drunken driving, depression, self-harm and even suicide.
"The more important the game, the greater the risk" says Ute Wilbert-Lampen, an investigator at the Munich University Clinic in southern Germany.
During the 2006 World Cup, her team found, cardiac arrests and palpitations among men in the greater Munich area more than tripled compared to the same period over three preceding areas. Among women, the rate was double.
Behaviour therapy, pills to calm some fans
The number of cases surged when Germany played and peaked massively in the quarter-finals against Argentina, which the national team won, and in the semis against Italy, which it lost. Both games were decided after extra time and the penalty shootout, which previous research has already fingered as a risk.
The figures are so alarming that some experts urge people with a potential risk to take stress-receptor blockers, aspirin and statins, or even consider behaviour therapy to calm down before hitting the sofa.
"We advise our patients not to watch important matches after a heart attack or if they are considered to be a high cardiac risk," said Herve Douard, a cardiologist at the University Hospital Clinic in Bordeaux.
Researchers at the University of Birmingham, in central England, suggested in all seriousness that penalty shootouts be scrapped "on public health grounds" after discovering that the number of heart attacks in Britain rose by 25 percent on the day England lost to Argentina on kicks in the 1998 World Cup.
Violence increases if team wins or loses
Another threat to life and limb is from domestic violence.
According to figures by Britain's Home Office, cases of wife
beatings in England and Wales surged on the day of each of England's five games in the 2006 tournament, with a high of 31 percent over the normal rate.
Counter-intuitively, football-related violence seems to rise when a team wins, rather than when it loses, says Vas Sivarajasingam of Cardiff University Wales, who looked at the city's emergency room admissions when the national side played.
Every big sporting fiesta brings with it a rise in beer-fuelled car smash-ups, of accidents or acts of self-harm involving high-spirited or depressed fans. In February 2005, a celebrating Welsh fan cut off his own testicles to fulfil a pledge after his side beat England in the Six Nations rugby tournament.
Then there are the longer-term health problems of the footy fan's couch-potato lifestyle: non-stop boozing and snacking on starchy, fatty, salty or sweet foods.
Unhealthy advertising during games 'inappropriate'
Alcoholism, obesity, diabetes and heart disease are entrenched problems in Europe, and Jeff Collin, a University of Edinburgh lecturer, blasts UEFA for accepting sponsorship from Carlsberg, Coca-Cola and McDonald's, who sell beer, soda and hamburgers.
"It's fundamentally inappropriate for such events to be used
primarily as a means of advertising unhealthy products, particularly when you take into account the scale of public subsidy that's typically associated with them," he said.
"Using public money to advertise McDonald's doesn't seem a particularly appropriate strategy for promoting public health." – (Sapa, June 2008)
Soccer fans risk heart attacks
Soccer fans warned of fatal illness