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Sports participation has long been hailed as part of a healthy lifestyle promising, among other benefits, a reduced risk of disease, stronger bones and muscles, and better brain health. Athletes themselves are considered prime examples of the benefits of playing sports, with their athleticism, fit physiques and superior physical conditioning reinforcing the idea that sports and good health go hand in hand. But a recent article in the British Journal of Sports Medicine (BJSM) suggests that when it comes to football, the health and longevity of the athletes seen on TV every Sunday is potentially worse than the fans who cheer from the couch.
It’s not the first study to raise a flag about the health of professional football players. Over the past couple of decades, researchers have identified several long-term consequences of playing football, including concerns about cognitive and cardiac health. And recently, signs of advanced aging have been noticed in the years following retirement from the game. Given the emerging picture that football affects health, and perhaps longevity, the BJSM study looked at whether a career in football enhanced or hindered healthy aging.
“We hypothesized that American-style football participation represents a risk factor for early aging as reflected by the presence of premature chronic disease and reduced health span,” said the researchers from Harvard’s T.H. Chan School of Public Health.
Fitness and regular exercise are considered important pillars of healthy aging, so the idea that football may negate the age-positive effects of exercise is provocative. But understanding more about the effect of football on health provides an opportunity to establish policies designed to improve player health starting as soon as they suit up for their first game.
To test their hypothesis, the Harvard researchers compared the prevalence of arthritis, dementia/Alzheimer’s disease and hypertension among 4,000 former football players age 25 to 59 against a similarly aged cohort of men of the same race and body weight, but with no experience playing football. What they found was all football players, with the exception of those in their 20s, aged about a decade earlier than their matched counterparts in the general population. This trend was particularly significant among linemen.
Arthritis and dementia/Alzheimer’s were more prevalent among retired football players than in the general population. Hypertension was twice as likely to be present in the youngest football players (25-29) than in their non-football-playing matched peers. Diabetes was also significantly higher among football players in their 20s than among the general population.
To be clear, chronic diseases are more common with age regardless of whether or not you play football. But in football players, age-related health conditions were found about 10 years earlier, which affects not just mortality but also quality of life. Cardiometabolic disorders (heart attack, stroke, diabetes, insulin resistance and fatty liver disease) are the No. 1 cause of death in football players, which is consistent with the early onset of diabetes and hypertension in football players in their 20s. The earlier chronic diseases set in, the more impact they have on mortality.
The realization that dementia/Alzheimer’s and arthritis occur earlier in football players is also significant even if they doesn’t always adversely affect mortality. Football players end up spending more years suffering from arthritis and dementia than the rest of the population, a phenomenon many football players and their families have already identified.
With a caveat that the study wasn’t designed to explain why football players age so fast, the researchers point out that repeated blows to the head and injuries to knees, hips, ankles and shoulders, which are so common in football, are linked to poor brain and joint health. Over half of former players reported at least one concussion during their playing career. About one-quarter reported three or more concussions. When it comes to arthritis, 40 per cent of retired players under 60 reported having arthritis compared with about 12 per cent of men the same age who didn’t play football.
Football players also carry a lot of weight, which they don’t always lose upon retirement, are known to rely on pain medication throughout their career and are prone to using steroids to increase strength and body mass, all lifestyle choices that can have an adverse effect on health. This is especially true of linemen who are bigger and take more hits than other players on the field, hence their tendency to age even quicker than their teammates.
“Professional American-style football participation should be considered a risk factor for reduced health span with contributions from the premature emergence of diseases that may impact both the quality and duration of life,” the Harvard researchers said.
It’s no coincidence that this study was published in January as the NFL season was gearing up for the 57th edition of the Super Bowl on Feb. 12. But the results should be reviewed by other hard-hitting sports like hockey and rugby with the goal being to treat and/or prevent the health risks associated with chronic conditions like dementia, arthritis and cardiovascular disease earlier rather than later.
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