Page 131 - Athletic Health Handbook
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Medicine has known for decades Obesity in the National Physically, linemen were noted to
that obesity can lead to multiple Football League have the largest neck circumference
medical problems. Individuals that are (19.1 +/- 0.9 inches) as well as the
overweight have an increased predis- A study published in the Journal of highest BMI (36.6 +/- 2.6). This
position for multiple medical maladies the American Medical Association in study identified the prevalence of
including diabetes, cancer, hyperten- 2005 calculated the BMI for approx- sleep-disordered-breathing among
sion, and sleep apnea. A strong posi- imately 2,100 NFL players.1 Using all professional football players to be
tive correlation with obesity and body mass index the majority of approximately 40 percent, with the
poor health is well established.3 players would qualify as being over- most severe cases occurring in linemen
weight. The study found 56 percent and players with large neck circum-
Body Mass Index of the players had BMIs greater than ference (34 percent). This prevalence
30, indicating Class 1 obesity. Twenty- of sleep-disordered breathing in foot-
Body mass index is calculated as the six percent had a BMI greater than 35, ball players is clearly higher than that
weight of the player in kilograms or Class 2 obesity. Three percent of found in a cross-sectional study of
divided by the height of the player in NFL players had a BMI greater than men of similar age.4
meters squared. Muscle mass is defi- 40, or Class 3 obesity (see Figure 2).
nitely included in the body mass index When compared to the National The NEJM study emphasizes the
and increased muscle mass will thereby Health and Nutrition Evaluation alterations of physiognomy associated
result in a higher BMI. Controversy Survey (NHANES), the NFL has two with large body mass and how it
exists between NFL administration times the incidence of obesity when affects the overall physical outcomes
and medical researchers over the compared to the general population. of these large individuals. Despite
amount of adipose tissue associated being in tremendous aerobic condi-
with a player’s increase in BMI over Sleep-Disordered Breathing tion, the alterations in physiognomy
the past two decades. lead to aberrant breathing patterns
Sleep apnea is noted to have increased while asleep. Associated with this
Performance and Player Body prevalence among professional foot- altered sleep pattern are significant
Mass: Is There a Correlation? ball players and has been implicated effects on blood pressure. Systolic and
as one of the causes of death of All-Pro diastolic blood pressure elevations
Most NFL teams (and likely collegiate defensive lineman Reggie White in are prevalent in linemen versus their
and high school teams as well) believe 2004. Regardless of whether BMI smaller teammates. The accompanying
that bigger is better, especially for includes muscle or fat, a consistent hypertension will lead to significant
offensive or defensive linemen. Inter- correlation has been found between cardiovascular disease and must be
estingly enough, outcomes for the large body mass and sleep apnea, treated. It must be recognized that
2003–2004 seasons identified no especially among football players. In the presence of untreated sleep-disor-
relationship between a team’s average a study published in the New England dered breathing will not only affect
player BMI and its success (see Journal of Medicine by George et al, a young player’s performance on the
Figure 1). The Arizona Cardinals, the an 85 percent incidence of sleep- field, but will also have significant
team with the highest average BMI, disordered breathing in offensive and implications on their health in the
had the worst record in its division.1 defensive linemen was identified.4 future. Hypertension, cardiovascular
disease, cerebral vascular disease, and
diabetes are becoming valid concerns
for the oversized athlete as they age.

Premature Mortality

Scripps Howard News Service inves-
tigated over 3,800 deaths of profes-
sional football players over the last 100
years. This study concluded that the
incidence of death before an athlete’s
50th birthday was twice as common
in those athletes with a BMI greater
than 35. The study identified that

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