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Call me at Half Time

by Dr. Deah on Jan.30, 2011, under Tasty Morsels: by Dr. Deah Schwartz

So in the New York Times Sports Section today is an article titled:  “Tipping the Scales Over” by Jere Longman and Rob Reischel.  The subtitle to the article in tiny font is, “As NFL linemen grow even larger, studies question the players’ health risks and find conflicting answers.”

OK, I admit it, I’m a sports fan….I read the sports section.  I have a sweatshirt that says, “A woman that loves sports is worth her weight in chips and beer.” I won’t go into how bizarre it is for a member of my family to give a whit about sports…they express amazement when they call during a game and I bark, “ I’ll call you back at half-time.”  Every year they ask me, “Where did YOU come from,” when I go to spring training to watch the Oakland A’s.  But enough about me….I really want to know what people think of this New York Times article, especially the typical person, not involved in the world of Size Acceptance and Eating Disorders Treatment.

After the title: the article goes on to make such quippy comments as calling this year’s super bowl the “Supersize Super Bowl,” and comparing the increased number of 300+ pound players to “supersize meals at fast food restaurants.”

“This year,” Longman explains, “the Green Bay Packers have 13 team members on their roster that weigh 300+ pounds,” quite an increase from past years.  The next banner heading of the article, ”Players Grow Bigger, And Studies Suggest Risks to Their Health. “Now I don’t know about you, but if I were a casual reader I would assume that the phrase, “studies suggest risks to their health” meant that despite the subtitle about “finding conflicting answers” re: a 300 + pound player’s health, that risks were more prevalent than not.  But because I have a doctorate , two masters degrees and am a glutton for punishment, I fought back my desire to start the crossword puzzle (and blocked out Bill Fabrey’s supportive voice in my head saying, “Deah don’t go there  you’ll just get upset!”) and continued to read the article.  A=Article D=Deah

A.  Between the years of 1970-2024 the number of 300+ pound football players in training camp went from 1-532.

D.  O.K. that’s a specific stat I can understand.

A.   “…the largest players are celebrated for their strength, spry, athleticism, and beer-belly physiques that give them an Everyman quality.”

D. To me this is just another way of saying, “awww isn’t it cute, the fat boy can actually do something that we wouldn’t think a fat boy could do.”  And how come women aren’t given the same latitude of beer-belly physiques being an Everywoman quality that is almost considered a positive fat statement in this context?

A.  Then the vague but Very Scary Death Card is played, “The enormousness of many players and the recent deaths of one active lineman, and several relatively young retired linemen have raised questions and brought conflicting answers about potential health risks associated with their size.”

D. OK, I’m ready, give me the Q & A, I have a fresh cup of “cawfee”. 

A.  “Various studies indicate that current NFL players are at greater risk than the general population for high blood pressure and that retired players are more prone to obesity, sleep apnea and metabolic syndrome: conditions like elevated blood pressure, insulin and cholesterol levels and excessive body fat around the waist that together heighten the risk for heart disease, stroke and diabetes. Retired linemen have been linked to higher mortality rates than the general public.

D. Ok, I’d love some citations of the studies. I know that if I was an online reader of the New York Times, there would be hyper links to all of the studies (at least I’m hoping). And I am NOT questioning the author’s research or ethics in his research.  But I love the feel of the paper in my hand and the smell of the newsprint….what can I say?  I’m even writing my responses to the article with a pen and paper as I am reading it. So all I have are the words in front of me.  And admittedly I’m no expert in sports medicine, but I would suggest that all NFL players would be at a higher risk than the general population in some of these areas for the simple reason that their life style probably changes exponentially once they are retired.  My hypothesis is they are working out less, under less pressure to perform, and in this particular statement I don’t see that the 300+ NFL players are being singled out from current NFL players in general, so maybe this isn’t a fat thing. I won’t even go in to the possibility of steroids and concussions as intervening variables because I haven’t researched it, but that is one place I would look for more data.

A. “I just can’t see how they can be healthy,” Dr. Charles Yesalis epidemiologist and professor emeritus of health policy at Penn State. “Yes some of it may be 280 pounds of muscle and then they carry 40 pounds of fat. It just overworks your heart. It puts a strain on your joints. You have the whole issue of concussive injuries.”

D.  Ahhh, I knew concussive injuries HAD to play a part, but I just don’t see the connection between fat and concussive injuries.  Football and concussive injuries, you betcha!  And there are scads of thin runners and skaters that have joint problems.

A. “It all adds up to things that are not good for your health, but it makes for a good carnival atmosphere when you see the behemoths out there.” 

D.  Wow, I had to read that sentence twice….2011 and we are still talking about fat people being side show freaks? I’m not sure why this surprises me. People are eating up shows like the Biggest Loser and Heavy as a voyeuristic chance to gawk at the fat freaks. But when I see these statements it just sickens me.  I watch football for football, not to see how the fat lineman can still run in for a post season touchdown!  I almost stopped reading the article at that point but “perseverance furthers” so I continued, the next chunk of the article quotes several studies:

A.  1994 study: Nat’l Inst. For Occupational Safety and Health “found retired players had a lower mortality rate over all than did the general population, but former offensive and defensive linemen had  a 52% higher death rate from cardiovascular disease. Since then the players have only grown larger; the average NFL weight is now 252 pounds.”

D.  So is the assumption that the death rate is higher because the weights of the players are higher?  Could there be any other contributing variables to the cardiovascular disease that is associated with offensive and defensive linemen positions and consequences of retirement? Are there even data that support this statement?

A.  2005 study:  Conducted by University of North Carolina found, “more than a quarter of the N.F.L. players fit the category of Class II Obesity, which is between moderate and morbidly obese.”

D.  And….?  So…?  Were they playing football?  Were they fulfilling their job requirements?  Perhaps more than a quarter of the NFL players were also in the category of far sighted, or had bad senses of humor.  The topic of Obesity is so complex that to just make a diagnostic statement like this is not really informative.

I Love Football

A.  2006 study:  Scripps Howard newspapers study found, “that out of 3,850 pro football players over the last century the heaviest players were more than twice as likely as lighter players to have died before 50.  (The NFL disputed the methodologies used in this study”).

D.  Ok, even if the methodologies were disputed, if the point of THIS article is whether or not there are health risks for 300+ pound football players, what numbers were associated with heaviest versus lighter?

A.  2009 study:  Funded by the NFL and published in JAMA “504 active players were studied during their careers and findings indicated that during their careers, players, on the whole, did not appear to be at a greater risk of heart disease than other men their age.  The study said that NFL players had similar cholesterol levels and healthier blood-sugar levels and were less likely to smoke than the general population. Black players did not show higher cardiovascular risk than white players. The study did find, though, a higher likelihood over all of elevated blood pressure and borderline hypertension.”

D.  Now this seems to be leading to the other side of the coin.  I’m glad I kept reading, although I think separating out the variables of active players and retired players would make for a better analysis.  The life of an active player is really not the same as a retired player.  And what do Black and White players have to do with this article at all?

A.  “The question is, if you are an elite athlete, can you be healthy at 300 or 350 pounds?” said Dr. Robert A. Vogel, a cardiologist and professor at the University of Maryland School of Medicine and a co-chairman of the NFL’s subcommittee on cardiovascular health. “The simple answer is, being physically active is unquestionably a deterrent to the problems associated with weight. Having said that, are you at higher risk being a 350-pound lineman than a 210-pound quarterback? Yes.”

D.  Whoa, now we are talking quarterbacks???  Til now we’ver been talking about offensive and defensive linemen….Whole Different Animal!!!  Mixing Apples and Oranges.  How about keeping the comparison to a 350 pound lineman and a 210 pound lineman, that’s what the article has been about so far….Does anyone know a 350 pound quarterback?

A.  2009 study:  University of Texas Southwestern Medical Center at Dallas Published in the American Journal of Cardiology found that “retired N.F.L. players had significantly lower occurrences of diabetes, hypertension, sedentary lifestyles and metabolic syndrome than did non-athletes.”  Dr. Alice Chang’s (the head of the study) statement that accompanied the study was quoted, ‘Despite their larger body size, retired N.F.L. players do not have a greater prevalence of heart disease risk factors when compared to the general population.’

D.  Finally!!!  Another point of view but sadly the  last study cited in the article!  The rest of the article was more of a qualitative collection of data. Statements from players that bemoaned their inability to lose weight once they were done playing, others that said it gave them a fighting edge in the game, one player that underwent lap band surgery when his weight rose to a height that frightened him. They did mention the performance enhancing drugs as a contributor, (two points for me, but who’s counting?)  (Me)   It was the typical see saw debate that often accompanies articles that appear as if they are raising the question of Can Fat People Be Healthy? But the prevalent point of view, despite quotes from a study like the one by Dr. Chang, is ultimately, fat is bad and lighter is better.  The examples given of players collapsing from heart failure in these articles always cite the fat athletes and forget about those that were tall lanky basketball players that also freakishly and tragically collapsed on the court years before their time.

The fact that this article ends with a quote from Jerry Kramer all pro guard from the Packers in the 1960’s fuels my curiosity as to what people reading this article come away with.  Here is the quote,

“… give me an offensive guard who’s in great shape at 270 or 275 and understands leverage and positioning and I’ll bet he’ll whip the fat guy every time.”

As a person who despises size discrimination of any kind it was paradoxically refreshing to hear a 270-275 pound man not referred to as the “fat guy.” Conversely, I bet the 300 pound offensive guard would like to be called an offensive guard as well, and not just swept into the carnival freak show category of behemoth less effective fat guy (BLEFG).  It also leaves me with the lingering impression  that even when there is a tiny little corner of the world (well the size of a football field) where fat people can be successful and respected it is under attack and an open target for disrespectful language, analogies and negative judgment. In any event, I am looking forward to great game next Sunday, where everyone’s focus will NOT be on the size of the players but on how well the game is being played.  (And to my sisters and Dad…please don’tncall me until half time!).

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