Fitness May Help Protect Retired NFL Players from Heart Disease Risks

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Ralph Giarnella MD

Southington Ct USA

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AHA: Fitness May Help Protect Retired NFL Players from Heart Disease Risks

By  Bankhead, Staff Writer, MedPage Today

Published: November 13, 2008

Reviewed by Zalman S. Agus, MD; Emeritus Professor

University of Pennsylvania School of Medicine.

NEW ORLEANS, Nov. 13 -- Retired National Football League players, though

considerably heftier than the norm, had significantly better heart disease risk

parameters than a matched set of community controls, according to researchers.

The former NFL players, who were significantly less likely to be sedentary than

controls, had a lower prevalence of diabetes, hypertension, and metabolic

syndrome, reported Alice Y. Chang, M.D., of the University of Texas Southwestern

Medical Center in Dallas, at the American Heart Association meeting here.

Of 151 former athletes and 150 controls who had coronary calcium assessments,

the ex-players were taller (187 versus 175 cm) and heavier (111.3 versus 96.3

kg), but the median body mass index was about 31.5 in both groups.

However, the retired athletes had a higher prevalence of hypercholesterolemia

and impaired fasting glucose.

The findings, Dr. Chang said, deliver something of a mixed message about heart

disease risk.

" First, being a professional athlete doesn't protect you from developing heart

disease later in life, " said Dr. Chang. " Secondly, remaining physically active

may help protect against many of the health risks of large body size in former

competitive football players. "

The investigators found that " age and hyperlipidemia, not body size, were the

most significant predictors of subclinical coronary atherosclerosis among

retired NFL players. "

The case-control study involved 201 former NFL players, who completed a health

questionnaire and visited screening sites in Dallas, Atlanta, Miami, and San

Francisco. The participants included recent retirees and older retirees.

The mean age of the group was 55, and 59% of the former players were African

Americans. Linemen (typically the largest players on a team) accounted for about

30% of the group. These results were not significantly different when

controlling for ethnicity or linemen status.

The retired players were compared with a control group drawn from two

prospective cohort studies.

Screening evaluations for the former players and the control group included

height, weight, waist and hip circumference, and blood pressure; fasting blood

glucose, lipids, and C-reactive protein; and coronary artery calcification

assessed by computed tomography.

The former players had a significantly smaller waist circumference (103.8 versus

107.4, P=0.007); larger waist-hip ratio (1.08 versus 0.98, P0.001); lower blood

pressure (127.6/77.3 versus 135.6/82.5 mm Hg, P0.001); higher total cholesterol,

LDL, and HDL (P0.001) and lower triglyceride level (P0.001); lower fasting

glucose level (101.4 versus 110.4 mg/dL, P=0.03); and lower high-sensitive CRP

(0.8 versus 2.4 mg/L).

Dr. Chang and colleagues found significant differences between the former

players and control group with respect to:

• Sedentary lifestyle - 35% of the players versus 49% of the control group

(P0.05)

• Diabetes -- 4.6% versus 17% (P0.01)

• Hypertension -- 38% versus 60% (P0.01)

• Metabolic syndrome -- 34% versus 46% (P0.05)

• Impaired fasting glucose -- 45.8% versus 23.8% (P0.01)

• Hyperlipidemia -- 42.2% versus 9.5% (P0.01)

• Smoking history (current or former) -- 30% versus 56% (P0.01)

Despite being much larger and heavier, the former NFL players had a prevalence

of significant coronary calcification (46%) similar to that of the control group

(48%). On the other hand, the players had a lower overall prevalence of heart

disease risk factors, which apparently afforded no protection against

atherosclerosis.

Larger body size might have made them more prone to hypercholesterolemia and

prediabetes. Staying physically fit might have offset the risks associated with

body size, said D. Levine, M.D., also of UT Southwestern.

" The prevalence of obesity, using normal criteria is really high when you look

at NFL players, " said Dr. Levine. " However, BMI is only a crude measure of

fatness. For the athletic community, it may be biased against very dense,

muscular people who have a high BMI but not much fat. The BMI might not tell the

whole story. "

Dr. Levine also noted that the study was based on retired players from a

different era. Current NFL players are about 50% larger than those of a quarter

century ago.

Whether current or former NFL players have an increased risk of cardiovascular

disease or death requires longer follow-up of more players.

Action Points  

• This study suggests that physical activity may help offset the heart risks

associated with large body size.


• Note that the findings came from a study of former professional athletes

and might not apply to other populations.


• Note that this study was published as an abstract and presented as a poster

at a conference. These data and conclusions should be considered to be

preliminary until published in a peer-reviewed journal.

The study received support from the AHA, the NFL Players Association, the NFL

Alliance, and from several additional nonprofit organizations.

Primary source: Circulation

Source reference:

Chang AY, et al " Cardiovascular risk factors and coronary atherosclerosis in

retired National Football League players: implications for coronary risk of

large body size in athletes " Circulation 2008; 118(Suppl 2): Abstract 5085.