Abstract
Background
Professional American-style football players are among the largest athletes across
contemporary sporting disciplines. Weight gain during football participation is common,
but the health implications of this early-life weight gain remain incompletely understood.
We sought to define weight trajectories of former professional American-style football
athletes and to establish their relationship with 5 common health afflictions (cardiovascular
disease, cardiometabolic disease, neurocognitive impairment, sleep apnea, and chronic
pain).
Methods
A health survey was distributed to former National Football League (NFL) players.
Former players reported body weight at 4 time points (high school, college, professional,
and time of survey response) as well as maximal retirement weight. Logistic regression
was used to assess associations between weight gain during football participation
and health affliction.
Results
In this cohort of former NFL players (n = 3,506, age 53 ± 14 years), mean weight increase
from high school to time of survey response was 40 ± 36 pounds, with the majority
of weight gain occurring during periods of football participation (high-school-to-college
and college-to-professional). The prevalence of health afflictions ranged from 9%
(cardiovascular disease) to 28% (chronic pain). Weight gain during football participation
was independently associated with risk of multiple later-life health afflictions in
models adjusted for football exposure, lifestyle variables, and post-career weight
gain.
Conclusions
Early-life weight gain among American-style football athletes is common and is associated
with risk of adverse health profiles during later-life. These findings establish football-associated
weight gain as a key predictor of post-career health and raise important questions
about the central role of targeted weight gain in this population.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Clinicopathological evaluation of chronic traumatic encephalopathy in players of American football.JAMA. 2017; 318: 360-370
- Cincinnati, OH: Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health;.1994: 1-13
- Sleep-disordered breathing, hypertension, and obesity in retired National Football League players.J Am Coll Cardiol. 2010; 56: 1432-1433
- Depression and pain in retired professional football players.Med Sci Sports Exerc. 2007; 39: 599-605
- American-style football and cardiovascular health.J Am Heart Assoc. 2018; : 7
- Prevalence of metabolic syndrome in retired National Football League players.Am J Cardiol. 2008; 101: 1281-1284
- Body size changes among National Collegiate Athletic Association New England Division III football players, 1956-2014: comparison with age-matched population controls.J Athl Train. 2016; 51: 373-381
- Changes in height, body weight, and body composition in American football players from 1942 to 2011.J Strength Cond Res. 2013; 27: 277-284
- Obesity in the National Football League.JAMA. 2005; 293: 1061-1062
- Relation between playing position and coronary artery calcium scores in retired National Football League players.Am J Cardiol. 2014; 114: 1836-1840
- Sleep and breathing in professional football players.Sleep Med. 2003; 4: 317-325
- Comparison of National Football League linemen versus nonlinemen of left ventricular mass and left atrial size.Am J Cardiol. 2008; 102: 343-347
- Obesity and age of first non-ST-segment elevation myocardial infarction.J Am Coll Cardiol. 2008; 52: 979-985
- The impact of obesity on cardiovascular disease risk factors and subclinical vascular disease: the Multi-Ethnic Study of Atherosclerosis.Arch Intern Med. 2008; 168: 928-935
- AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society.J Am Coll Cardiol. 2014; 63: 2985-3023
- Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents.Lancet (Lond). 2016; 388: 776-786
- The preventable causes of death in the United States: comparative risk assessment of dietary, lifestyle, and metabolic risk factors.PLoS Med. 2009; 6e1000058
- Simplified calculation of body-surface area.N Engl J Med. 1987; 317: 1098
- Blood pressure and left ventricular hypertrophy during American-style football participation.Circulation. 2013; 128: 524-531
- Blood pressure and LV remodeling among American-style football players.JACC Cardiovasc Imaging. 2016; 9: 1367-1376
- Childhood adiposity as a predictor of cardiac mass in adulthood: the Bogalusa Heart Study.Circulation. 2004; 110: 3488-3492
- Association between duration of overall and abdominal obesity beginning in young adulthood and coronary artery calcification in middle age.JAMA. 2013; 310: 280-288
- Childhood adiposity, adult adiposity, and cardiovascular risk factors.N Engl J Med. 2011; 365: 1876-1885
- Relationship of body mass index in young adulthood and health-related quality of life two decades later: the Coronary Artery Risk Development in Young Adults study.Int J Obes (Lond). 2011; 35: 134-141
- Childhood obesity, other cardiovascular risk factors, and premature death.N Engl J Med. 2010; 362: 485-493
- Association of insulin resistance and glycemic metabolic abnormalities with LV structure and function in middle age: the CARDIA study.JACC Cardiovascular Imaging. 2017; 10: 105-114
- Childhood obesity and adult morbidities.Am J Clin Nutr. 2010; 91: 1499S-1505S
- Duration of abdominal obesity beginning in young adulthood and incident diabetes through middle age: the CARDIA study.Diabetes Care. 2013; 36: 1241-1247
- Duration of adulthood overweight, obesity, and cancer risk in the Women's Health Initiative: a longitudinal study from the United States.PLoS Med. 2016; 13e1002081
- Prevalence of overweight among high school football linemen.JAMA. 2007; 297: 363-364
- Body fatness and increased injury rates in high school football linemen.Clin J Sport Med. 1998; 8: 115-120
- Temporal changes in cardiovascular remodeling associated with football participation.Med Sci Sports Exerc. 2018;
- Prevalence of overweight and obesity in collegiate American football players, by position.J Am Coll Health. 2008; 57: 33-38
- Prevalence of cardiovascular disease risk factors among National Football League players.JAMA. 2009; 301: 2111-2119
- Ascending aortic dimensions in former National Football League athletes.Circ Cardiovasc Imaging. 2017; 10: e006852
- Impact of American-style football participation on vascular function.Am J Cardiol. 2015; 115: 262-267
- Sleep-disordered breathing and cardiovascular correlates in college football players.Am J Cardiol. 2017; 120: 1410-1415
- Associations between BMI change and cardiometabolic risk in retired football players.Med Sci Sports Exerc. 2017;
- 25-year weight gain in a racially balanced sample of U.S. adults: The CARDIA study.Obesity (Silver Spring). 2016; 24: 1962-1968
- Trends in the prevalence of coronary heart disease in the U.S.: National Health and Nutrition Examination Survey, 2001-2012.Am J Prev Med. 2016; 51: 437-445
- Increasing trend of diabetes combined with hypertension or hypercholesterolemia: NHANES data analysis 1999-2012.Sci Rep. 2016; 6: 36093
- Prevalence of self-reported clinically diagnosed sleep apnea according to obesity status in men and women: National Health and Nutrition Examination Survey, 2005-2006.Prev Med. 2010; 51: 18-23
- Estimates of pain prevalence and severity in adults: United States, 2012.J Pain. 2015; 16: 769-780
- Trends in long-term opioid therapy for chronic non-cancer pain.Pharmacoepidemiol Drug Saf. 2009; 18: 1166-1175
- The global prevalence of dementia: a systematic review and metaanalysis.Alzheimers Dement. 2013; 9: 63-75e62
- Dietary practices, attitudes, and physiological status of collegiate freshman football players.J Strength Cond Res. 2001; 15: 507-513
Demirel E. Daily Beast. College football fattens players up and then abandons them. Available at: https://www.thedailybeast.com/college-football-fattens-players-up-and-then-abandons-them. Accessed September 9, 2018.
- Agreement between self-report questionnaires and medical record data was substantial for diabetes, hypertension, myocardial infarction and stroke but not for heart failure.J Clin Epidemiol. 2004; 57: 1096-1103
- Body mass index versus body fat percentage in prospective National Football League athletes: overestimation of obesity rate in athletes at the National Football League Scouting Combine.J Strength Cond Res. 2018; 32: 1013-1019
Article Info
Publication History
Published online: August 10, 2018
Footnotes
Funding: ALB has received funding from the National Institutes of Health/National Heart, Lung, and Blood Institute (R01 HL125869) to study cardiac structure and function in American-style football athletes. JHK has received funding from the National Institutes of Health/National Heart, Lung, and Blood Institute (K23 HL128795) to study vascular function in American-style football athletes. RZ, FES, MW, A P-L, LEN, and ALB have received research funding from the Football Players Health Study at Harvard University, which was funded by a grant from the National Football League Players Association. Funding agencies had no role in study design, data collection, or analysis. Funding agencies also had no role in the preparation of the manuscript.
Conflict of Interest: None.
Authorship: TWC and SK are co–first authors of the article. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, the National Football League Players Association, Harvard Medical School, Harvard University or its affiliated academic health care centers, or the Massachusetts General Hospital. All authors had access to the data and a role in writing this manuscript.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
