Early-life Weight Gain and the NFL

Any long term (American-style) football fan has noticed the markedly increasing size of players at all levels of competition from high school to the National Football League (NFL). The sport may select for inherently large individuals but early-life weight gain is still common and the health implications remain incompletely understood. A recently published clinical research study looks at quantifying the weight trajectories among former NFL athletes and the relationship with five common heath afflictions:

• cardiovascular disease
• cardiometabolic disease
• neurocognitive impairment
• sleep apnea
• chronic pain

The study cohort consisted of 3506 former NFL players with a mean weight increase from high school to survey response of approximately 40 pounds. The majority of the weight gain occurred during their periods of football participation (high school to college to professional).

The results demonstrate that weight gain from high school to college had significant associations with later-life cardiometabolic disease, chronic pain, and sleep apnea. In contrast, weight gain from college to professional football had significant associations with later-life cardiovascular disease, neurocognitive impairment and sleep apnea. These associations retain clinical significance after controlling for post football weight gain, position played and key lifestyle variables including habitual exercise, smoking and alcohol use. These findings support the central hypothesis of this study: early-life weight gain among football athletes is a novel risk factor for later-life disease.

The weight gain reported during early adulthood among these elite athletes is of a similar magnitude to that observed in studies of ethnically similar nonathletic populations. Although imperfect, a comparison of the affliction rates of cardiovascular disease and cardiometabolic disease in the study cohort are similar to the general US population. This observation suggests that the cardiovascular health protective effects of routine exercise during youth may be offset by the concomitant weight gain among football athletes. In contrast, sleep apnea, chronic pain and neurocognitive impairment are more common among former NFL athletes than among the general public.

The authors conclude that further research, ideally involving prospective data coupled with clinical phenotype is required to further explore mechanisms underlying the link between football associated early-life weight gain and later-life health afflictions.

Churchill TW, Krishnan S, et al. Weight gain and health affliction among former National Football League players. The American Journal of Medicine, Vol 131, No 12, December 2018: 1491-1498.