Scientific Nutrition Update 42: Football and Heart Disease

Before I start what is likely going to be one of my controversial episodes, I need to make it very clear that I love football.  I played for a decade and coached for seven years.  However, there is emerging evidence of a link between football and heart disease.  On a more personal note, several of the men who have coached me at different points in my career have died from heart attacks.  Take every effort you can to control the risk factors you can.  Consult regularly with your physician, and make sure that you are working with him to control your blood pressure, your cholesterol, and everything else you can.

Script (remember I ad-lib):

For today’s episode I am going to talk about my favorite sport, the sport that made me who I am, the sport that taught me leadership, football.  Football is a particularly brutal sport, favoring size, strength, and speed in ever increasing quantities, with little advancements in equipment.  There has for a while now been an association between football and a brain disease called chronic traumatic encephalitis, and there is a link to Parkinson’s emerging also, but we are not discussing those today, today we are focusing on the link between football and heart disease.  Be aware there is a chance I get somewhat emotional or passionate while recording this episode. I played football for 10 years, and coached for 7 years, and so it can be difficult for me to talk about this side of the sport.

 

Okay let’s get started.  While researching this, I actually came across a study I hadn’t seen before from all the way back in 1958 that tried to look at whether people who had played football had a greater chance of developing heart disease.  They looked at the health records of 355 men who had played football in between 1901 and 1930. The issue is we can’t draw very many conclusions from it because they were not comparing football players to non-football players.  They were looking at in-group differences between football players. And from that it’s about what you expect, those who exercise more, or weigh less, are less likely to develop heart disease.

 

The big study that we are interested in is the study that was published much more recently at the beginning of April.  There is a couple factors they point to that may be contributing to some of the reasons people fear that football could lead to these kind of effects including STATIC HEMODYNAMIC STRESS, which is surges of blood pressure when the cardiac output is really constant, I think this comes from the short burst nature of football, but I am not sure I fully understood this, if you know please email me scinutrient@gmail.com, psychological stress (which I can strongly attest to, the mentality of Football is the reason I love it, but it takes a unique toll, NSAID usage (like Ibuprofen, I can also attest to this one, I popped advil like they were candy and way above the recommended dosages), deliberate body mass gain, and relatively low levels of aerobic conditioning which I am not convinced by.  However, let’s move past these factors and look at the important part, what the data says.

 

There was an initial alarm raised about the potential harm, with defensive linemen having a 2* greater risk of cardiovascular disease than the normal population, and remember we are comparing athletes to non athletes so we would expect the incidence to be lower.  Which is what we see with overall mortality being approximately 50% lower, so if we expected a similar reduction in cardiovascular disease then we are seeing a rate that is actually even more than 2* higher.

 

The worst part of all the data out there for me? It’s the worst for linemen.  Possibly 3-4 times worse for a lineman compared to a non-lineman. Though the effect seems to be singificantly worse for defensive lineman than offensive lineman, and I am not sure why.  However, after controlling for everything else anyone with a playing BMI over 30 seems to have approximately a 2* higher risk, which is still huge. Which makes sense because we are the ones who have to carry the most mass, and have the least incentive to participate in significant aerobic conditioning.  There is also an increase in fasting glucose levels for linemen even after controlling for weight, which I have no good explanation for, but is not a good sign. However, it is still disheartening for me to see this data bout a position that means so much to me, that I played for so long, and that I loved so much.  

 

Please realize when I am saying all of this it is coming not from a place of hate, not from someone who hates the sport of football, but from a place of love, from someone who loves football.  This is a hard thing for me to do, and I am not trying to say you should not play football. That is a very individual decision. I do think the people that choose to participate deserve to know the risks inherent in it.  If you enjoyed this episode, or learned something new please consider sharing it with a friend. If you have any thoughts you want to share send me an email at scinutrient@gmail.com or send me a voice message on Anchor.  Thank you for tuning in.

Bibliography (I may not directly address these studies in the episode but I looked at them and thought they might be valuable):

https://www.cdc.gov/niosh/hhe/reports/pdfs/1988-0085-letter.pdf?id=10.26616/NIOSHHETA88085

Baron SL, Hein MJ, Lehman E, Gersic CM. 2012. Body mass index, playing position, race, and the cardiovascular mortality of retired professional football players. Am J Cardiol 109(6):889-96.

Kim J, Zafonte R, Pascuale-Leon A, Nadler L, Weisskopf M, Speizer F, Taylor H, Baggish A. 2017. American‐Style football and cardiovascular health. Journal of the American Heart Association 7(8):1-10.

Pomeroy WC and White PD. 1958. Coronary heart disease in former football players. Jama 167(6):711-4.

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