Re: Re: Optimum BMI for longevity (was CRON versus working out for longevity)

[Guest guest]

Some more info ( a few articles) on " heavier "

athletes. Bigger, even if fit, is not better.

Its " not " a good thing.

Tuesday, January 31, 2006

Heavy NFL players twice as likely to die before 50

By Hargrove

Scripps News Service

The amazing athletes of the National Football League

-- bigger and stronger than ever before -- are dying

young at a rate experts find alarming, and many of the

players are succumbing to ailments typically related

to weight.

The heaviest athletes are more than twice as likely to

die before their 50th birthday than their teammates,

according to a Scripps News Service study of

3,850 professional-football players who have died in

the last century.

“ Do you see any oversized animals anywhere in the

world living a long life? We're pretty much on our own

here. ”

— Tony Siragusa

Most of the 130 players born since 1955 who have died

were among the heaviest athletes in sports history,

according to the study. One-fifth died of heart

diseases, and 77 were so overweight that doctors would

have classified them as obese, the study found.

The bone-crushing competitiveness of professional

football is spawning hundreds of these behemoths --

many of whom top the scales at 300 pounds or more --

and the pressure to super-size now extends to younger

players in college and even high school.

As America anticipates Sunday's Super Bowl -- the

annual orgy of admiration for the NFL and its athletes

-- physicians are increasingly questioning whether, by

bulking up for their shot at fame and fortune, players

are sacrificing their health later in life.

" Clearly, these big, fat guys are having coronaries, "

said Yesalis, a Penn State professor of health

policy and sport science.

The trend lines are even more disturbing.

Twenty years ago, it was rare for a player to weigh

300 pounds. But more than 500 players were listed at

that weight or more on NFL training-camp rosters this

summer -- including San Francisco 49ers guard

Herrion, who collapsed and died after an exhibition

game in August.

The relatively recent explosion in the number of

300-pound linemen " presents a frightening picture in

terms of what we might expect 20 years from now, " said

Dr. Sherry Baron, who studied the issue in 1994 for

the National Institute for Occupational Safety and

Health.

The 49ers paid tribute to Herrion on during an

exhibition game six days after he died.

Baron's study, conducted at the request of the NFL

Players Association, found that while players

generally weren't dying sooner than average, offensive

and defensive linemen had a 52 percent greater risk of

dying from heart disease than the general population.

The Scripps study suggests that the risk for

those heaviest players is increasing, although exact

comparisons to the general population were impossible

to make because so many factors -- heredity, sedentary

lifestyles, eating habits, as well as size --

contribute to heart disease.

" We know that the body mass index levels have shifted

since our 1994 study, " Baron said. " More [football

players] now would be considered obese. "

Scripps was able to compare mortality rates for

professional-football players with the 2,403 Major

League Baseball players who have died in the last

century. The comparison found that football players

are more than twice as likely to die before age 50.

Asked to speculate on the cause for this difference,

experts noted that football players generally are

heavier than baseball players.

The threat isn't lost on retired players, who

acknowledge that they are spooked by the potential

problems they now face.

" Do you see any oversized animals anywhere in the

world living a long life? " asked Tony " Goose "

Siragusa, a 340-pound defensive tackle for 12 seasons

with the Indianapolis Colts and Baltimore Ravens.

" We're pretty much on our own here. "

The Scripps study tracked the deaths of 3,850

pro-football players born since 1905. Medical

examiners and coroners were contacted to determine the

causes of death for the 130 players who died before

age 50. The study found:

• Twenty-eight percent of all pro-football players

born in the last century who qualified as obese died

before their 50th birthday, compared with 13 percent

who were less overweight.

• One of every 69 players born since 1955 is now dead.

• Twenty-two percent of those players died of heart

diseases; 19 percent died from homicides or suicides.

• Seventy-seven percent of those who died of heart

diseases qualified as obese, even during their playing

days, and they were 2½ times more likely to die of

coronaries than their trimmer teammates.

• Only 10 percent of deceased players born from 1905

through 1914 were obese while active. Today, 56

percent of all players on NFL rosters are categorized

as obese.

• The average weight in the NFL has grown by 10

percent since 1985 to a current average of 248 pounds.

The heaviest position, offensive tackle, went from 281

pounds two decades ago to 318 pounds.

The NFL has expressed concern over whether players are

obese and risking health problems.

Forgotten in the frenzy surrounding Super Bowl XL is

the tragic way the season started. The 6-foot-3,

315-pound Herrion collapsed in the 49ers' locker room

after the team's Aug. 20 exhibition in Denver. An

autopsy showed that his heart was scarred and

oversized and that heart disease had blocked his right

coronary artery. He was only 23.

At a memorial service for Herrion, NFL Commissioner

Tagliabue pointed out that he already had asked

medical experts to study the cardiovascular health of

players. That study is incomplete.

" We need to understand in a serious way what the risks

are, to the extent that there are risk factors, "

Tagliabue told reporters. " We've got to address them.

We are working on it. "

But in a statement, NFL spokesman Greg Aiello

dismissed the Scripps study, saying: " The issue

of obesity in our society transcends sports and must

be dealt with in a comprehensive, responsible way.

This media survey contributes nothing. "

Tagliabue wouldn't comment for this article.

The NFL also criticized a 2003 study by University of

North Carolina endocrinologist Joyce Harp. Published

in the Journal of the American Medical Association,

the study found that 56 percent of NFL players were

obese according to their body-mass indexes -- the

government standard based on height and weight.

The Scripps study also used the body-mass index

to determine whether a player was obese. The NFL says

it believes that standard is misleading because it

doesn't account for the player's muscles. But many

experts disagree and say that body-mass index is a

valid indication that a player may face greater health

risks.

" When you get that big -- regardless of whether your

body is muscle or fat -- your heart is stressed, " Penn

State's Yesalis said.

" Is it good for guys to be that big? Of course not, "

he said. " I fully support a weight limit of 275

pounds. It would reduce injuries and have a positive

effect on the short- and long-term health of these

men. "

The NFL Players Association declined to comment for

this article. But Guskiewicz, director of the

Sports Medicine Research Laboratory at the University

of North Carolina, is conducting research for the

association on the issue. He said he is alarmed at the

information he sees.

" We are finding a number of health issues among these

players, " Guskiewicz said. " They clearly have higher

prevalence of cardiovascular disease and hypertension,

especially in the offensive and defensive linemen. And

it clearly is higher than in the general population. "

Defensive lineman " The Refrigerator "

almost single-handedly brought 300-pounders into vogue

when he became a pop sensation for the Chicago Bears.

As a goal-line running back, he bulled his way to a

touchdown in Super Bowl XX in 1986. , who topped

out at 370 pounds during his career, said he has

actually gained some weight in retirement but tries

not to dwell on the risks.

" I've been big all my life, " said. " Mental

attitude is as important as your physical condition

after the NFL. I try to keep a happy balance. "

Weighty Issue

In November 2004, ESPN.com's Page 2 looked at the size

of NFL players. Take a look back at what we found:

• Caple: The NFL is living large

• '04 NFL weight rankings

• Large and small of it

• '79 Steelers vs. '04 Steelers

Several retired players said they believe that losing

weight is an issue of life or death.

" We've all got to remember to shed that armor when our

NFL career is over, " said Jim Lachey, who is 25 pounds

lighter since the days he weighed 294 while an

offensive tackle for the San Diego Chargers, Oakland

Raiders and Washington Redskins from 1985-95. " A lot

of guys are doing it. But, I know, there are others

with injuries that prevent them from running and doing

the things they must do to shed the weight. "

Tony Mandarich -- nicknamed " The Incredible Bulk "

while playing guard at 325 pounds for the Green Bay

Packers -- said he gained even more weight after

retiring and soon was put on high-blood-pressure

medicine.

" My doctor asked me, 'How many 320-pound men who are

80 years old do you see walking around?' That's when

the lightbulb came on over my head, " Mandarich said.

He changed his diet, began hiking and mountain-biking

regularly, and shed 60 pounds. " That doesn't mean I

won't die of a heart attack at 39, but I've given

myself the best chance,'' said Mandarich, who is 39

now.

The wakeup for many retired players came with the 2004

death of two-time NFL Defensive Player of the Year

Reggie White, known for his passionate religious faith

and pass-rushing skills. He died at age 43 of cardiac

arrhythmia compounded by breathing disorders.

" When I heard that Reggie had died, the first thing

that came into my head was that I hoped he'd let

himself go and was out of shape, " Mandarich said.

" Because if he was in shape, it's not a good thing for

any of us. "

Actually, White had dropped about 25 pounds from his

playing weight of 325, members of his family said. But

he also suffered from sarcoidosis, or inflammation in

his lungs, which led to thunderous snoring and a

profound sleep apnea.

" These guys live such an extreme lifestyle with their

weight that they are going to be prone to

hypertension, diabetes and coronary artery disease.

There is no question about it, " said Dr. Barry Maron,

director of the Hypertrophic Cardiomyopathy Center at

the Minneapolis Heart Institute Foundation.

Several medical examiners contacted by Scripps

remarked on the size of retired players who died of

heart-related causes.

" He was a rather big boy at 6-foot-2 and 498 pounds, "

said Steve Gelman of the San Francisco Medical

Examiner's office when asked why Joe Drake, a retired

guard for the San Francisco 49ers and the Philadelphia

Eagles, died in 1994 at 31.

" Essentially, he had clogged arteries and a heart

attack. Mr. Drake was going out to lunch with some

friends when he complained of sweating and nausea just

before he collapsed on the street next to his car, "

Gelman said.

Willis Leggett of Muskogee, Okla., said he does not

blame football for the death of former Eagles

offensive guard and tackle Leggett. Doctors told

Leggett that his son died of congestive heart failure

at age 35.

" God put on this earth and God took him off, "

Leggett said. " If he hadn't played football, he

probably would have died sooner. Football was his goal

and that's what he wanted to do. No one could change

his mind. "

(The Scripps study created a computer database

of the deaths of 3,850 former professional-football

players using records assembled by

professional-football statistician Neft, who was

assisted by Bob Carroll and Rich Bozzone.)

--------------------------------------------------------------------------------

Tuesday, January 31, 2006

Bigger isn't better, especially post-career

--------------------------------------------------------------------------------

By Lee Bowman

Scripps News Service

It's part of the American persona to be big, larger

than life -- robust in that Bunyan, Davy

Crockett, Henry sort of way. Heroic dimensions

fit a heroic country.

But over the past few decades, Americans have been

living ever larger in ways that may not be so good for

us. Measured by the scale of body-mass index, the

weight-to-height ratio that's the foundation of most

obesity studies, 65 percent of Americans are

considered overweight or obese.

Estimates of how significant those extra pounds are to

health vary, however. A 2004 study by the federal

Centers for Disease Control and Prevention calculated

that obesity contributes to as many as 400,000

premature deaths each year in the United States. A

statistical re-check of that study a year later rolled

that toll all the way down to 26,000 a year.

The updated study confirmed the long-held view among

obesity experts that being at least 50 pounds

overweight is hazardous, but also found that being as

much as 40 pounds overweight actually seems to protect

people from early death.

Many experts say ranking high on the BMI scale may not

reflect how " fat'' someone really is or to what extent

his or her weight represents an increased risk for

various medical problems or premature death today or

years later.

" No one has ever suggested that BMI is the only

criterion to use, because it clearly is not,'' said

Dr. Bray of the Pennington Biomedical Research

Center in Baton Rouge, La.

Factors like a person's age, level of physical

activity, rate of weight gain, blood pressure and

cholesterol levels also have to be taken into account

in measuring an individual's health, he added.

Some researchers prefer to consider how much fat is

under the skin in select spots; other recent studies

suggest that waist size is the telltale statistic. By

that standard, people should watch out if it's greater

than 40 inches for men or 35 inches for women, studies

show.

The different standards bring mixed results,

particularly when athletes are measured. For instance,

one 2003 study involving 53 players on the

Indianapolis Colts found that while the BMI showed

many of the players to be overweight, their percentage

of body fat was well below the 25 percent range that

marks obesity. But another study, done with Division I

college football players the same year, found that

offensive and defensive linemen were, on average,

carrying greater than 25 percent body fat.

Still another 2003 study found increasing rates of

sleep apnea and high blood pressure among pro-football

players and especially among the biggest linemen.

There's lots of evidence that being fit can trump bulk

when the relative risk of developing diseases ranging

from heart disease to cancer is analyzed.

" We've studied this from many perspectives in women

and in men, and we get the same answer: It's not the

obesity, it's the fitness,'' said Blair,

president and chief executive of the Institute

for Aerobic Fitness in Dallas.

At the same time, being big may take a toll on systems

from bones and joints to the liver and hormonal system

that regulates glucose levels in the bloodstream,

which influences not only the heart and blood vessels,

but also body systems that regulate cell division and

increase the odds for cancer.

Obesity produces hormonal and metabolic changes that

make it easier for cancer to gain a foothold.

" Overweight and obesity has a very broad impact on

cancer across most cancer sites,'' said Eugenia Calle,

a researcher with the American Cancer Society.

And to the extent that many athletes use anabolic

steroids to bulk up, they also increase their risk for

a variety of health problems, ranging from blood clots

and muscle injuries to premature heart attacks and

strokes.

Ruth Wood, a professor of neurobiology at the

University of Southern California, has found

increasing evidence in animal studies that steroids

may be physically as well as psychologically addictive

for athletes. But she also noted that her research and

that of several other scientists confirms that taking

large amounts of steroids can produce more aggressive

behavior.

While there have been many individual reports of

steroid abusers having episodes of " 'roid rage'' in

recent years, Wood said the fact that athletes " feel

better when they're taking them than when they're

not'' suggests that people taking the drugs may feel

invulnerable and thus more prone to take risks in

general.

And studies with hamsters by Melloni, a

behavioral neuroscientist at Northeastern University

in Boston, have found that steroid use may influence

players long after they stop taking the drugs: " What

we know at this point is that aggressiveness doesn't

simply cease after the ingestion of steroids does.''

Just old-fashioned physical training causes endurance

athletes' hearts to actually enlarge to handle the

added aerobic burden they put on their circulatory

systems. But those thicker heart muscles can sometimes

also mask and make worse a genetic heart defect that

puts people at increased risk of sudden cardiac death,

which has been identified as the cause of death for

several pro players in recent years.

Still, many medical experts say the greatest risk for

big men like football linemen and basketball centers

probably doesn't confront them while they're still

playing, but later on, after they stop.

" Guys in their 20s and 30s can handle it, but by the

time they're in their late 30s and early 40s, they get

a large amount of joint pain, arthritis,'' said Dr.

Bonsell, an orthopedic surgeon at Baylor

University's Medical Center in Dallas. " On the medical

side of things, it's even more serious -- diabetes and

an elevated risk of heart disease and heart attack.''

Contact Lee Bowman at BowmanL@...

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ESPN.com: NFL

Tuesday, January 31, 2006

Compared to baseball, football players die younger

By Hargrove

Scripps News Service

Professional football players are now more than twice

as likely as Major League Baseball players to die

before their 50th birthday, and medical experts say

the culprit is probably differing body bulk.

As part of a study of early mortality within the

National Football League, Scripps News Service

compared the lifespan of 3,850 deceased football

players against that of 2,403 dead baseball players.

The study found that baseball players and football

players born before 1955 were about equally likely to

suffer an early death. But the mortality rates sharply

differ among athletes born more recently.

Among the 8,961 pro-football players born in the last

50 years, at least 130 are already dead. Among 4,382

professional baseball players, 31 are known to have

died. That means 1 in every 69 football players is

dead compared to 1 in every 154 baseball players.

Medical experts were quick to suspect body weight.

Offensive and defensive linemen average at least 100

pounds more than most baseball players.

" There certainly seems to be a big difference between

baseball players and football players, speaking just

from what I see on TV,'' said Dr. Sherry Baron of the

National Institute for Occupational Safety and Health.

" This comparison is very interesting.''

Baron said she plans to soon repeat her 1994 study of

mortality rates within the NFL. She concluded 11 years

ago that most NFL players were not dying prematurely,

although she said linemen had a 52 percent greater

risk of death from heart disease.

The most common causes of death among baseball players

are accidents, especially auto accidents, the Scripps

study found. Only a third of the baseball

players died of medical causes.

But a majority (52 percent) of the deceased football

players succumbed to conditions such as coronary

disease, stroke and cancer -- diseases known to be

more common among obese people.

The deceased baseball players averaged 192 pounds

during their athletic careers while the dead football

players averaged 238 pounds. Football players who died

of medical causes averaged 248 pounds.

" There seems to be a linear relationship between

weight and the likelihood of cardiovascular disease,''

said Guskiewicz, director of the Sports Medicine

Research Laboratory at the University of North

Carolina.

Guskiewicz has found increased occurrences of

hypertension and heart disease among 2,700 retired NFL

players. " It's clearly higher than in the general

population,'' he said.

[Guest guest]

Along with the one Tony posted, the one below says a

BMI Of 18.5 to 21.9 is best.

Also, data from the Nurses Health Study showed the

relative risk of a middle-aged woman developing

type 2 DM over a 14y follow up with a BMI of 23-24.9

was 300-400% (or 3-4X) greater than women with a BMI

of 22 or less! Of course, the relative risk for women

with a BMI over 30 was 40X to more than 90X as

great as a women with a BMI <22

So, while we can continue to debate the merits of a

BMI or 18.5 -21.9 vs 23, and the influence of the

degree of fitness within those ranges, I dont see the

evidence supporting a BMI over 23, regardless of

fitness level, for longevity.

Regards

Jeff

" Impact of Overweight on the Risk of Developing Common

Chronic Diseases

During a 10-Year Period

Alison E. Field, ScD; Eugenie H. Coakley; Aviva Must,

PhD; L.

Spadano, MA; Nan Laird, PhD; H. Dietz, MD,

PhD; Rimm, ScD;

Graham A. Colditz, MD, DrPH

Background: Overweight adults are at an increased risk

of developing

numerous chronic diseases.

Methods: Ten-year follow-up (1986-1996) of middle-aged

women in the

Nurses' Health Study and men in the Health

Professionals Follow-up Study

to assess the health risks associated with overweight.

Results The risk of developing diabetes, gallstones,

hypertension, heart

disease, and stroke increased with severity of

overweight among both

women and men. Compared with their same-sex peers with

a body mass index

(BMI) (calculated as weight in kilograms divided by

the square of height

in meters) between 18.5 and 24.9, those with BMI of

35.0 or more were

approximately 20 times more likely to develop diabetes

(relative risk

[RR], 17.0; 95% confidence interval [CI],

14.2-20.5 for women; RR, 23.4; 95% CI, 19.4-33.2 for

men). Women who

were overweight but not obese (ie, BMI between 25.0

and 29.9) were also

significantly more likely than their leaner peers to

develop gallstones

(RR, 1.9), hypertension (RR, 1.7), high cholesterol

level (RR, 1.1), and

heart disease (RR, 1.4). The results were similar in

men.

Conclusions: During 10 years of follow-up, the

incidence of diabetes,

gallstones, hypertension, heart disease, colon cancer,

and stroke (men

only) increased with degree of overweight in both men

and women. Adults

who were overweight but not obese (ie, 25.0BMI29.9)

were at

significantly increased risk of developing numerous

health conditions.

Moreover, the dose-response relationship between BMI

and the risk of

developing chronic diseases was evident even among

adults in the upper

half of the healthy weight range (ie, BMI of

22.0-24.9), suggesting that

adults should try to maintain a BMI between 18.5 and

21.9 to minimize

their risk of disease.

Arch Intern Med. 2001;161:1581-1586

[Guest guest]

At 11:14 AM 9/29/2006, you wrote:

>Hi folks:

>

>My take on this is that maybe we should not be looking for an optimal

>BMI. But instead look at what may be an optimal biomarker

>performance, which might include BMI as one of a total of perhaps a

>dozen biomarkers. And it would include HDL etc., carotid IMT, T3,

>CRP, IL-6 perhaps, .......... .

>

>But we don't really know what the ideal set of biomarkers is, nor the

>ideal overall value for them that is associated with the lowest

>mortality. We don't even know whether, as body weight declines, the

>biomarkers also decline all the way to literal starvation. If they

>do then, of course, that would be less helpful.

>

>The ultimate test would be to know the mortality/longevity data for a

>number of points on the range of values for the biomarker set. But

>we will not have something like this until someone does the work, and

>that may not be for fifty years. But, imo, that is probably what we

>need.

>

>In any event, it seems highly probable that 30% restriction is way

>better than zero restriction. So perhaps I should not complain.

>Twenty years ago next to nothing was known compared with what we know

>today.

>

>Rodney.

>

>PS: At the very least I think we know that 'waist-to-hip' is a much

>better measure than BMI.

Even waist-to-height would be better than BMI, methinks, which we know is

inherently mathematically flawed.

For that reason, too, I question whether a previous poster's suggestion

that women should have an average ideal BMI that's lower than men's could

be correct because women, being on average shorter, are already going to

have deceptively low BMIs for any given degree of body fat.

Maco

[Guest guest]

All in our files, I might add.

on 9/29/2006 10:16 AM, citpeks at citpeks@... wrote:

Dennis,

A study of BMI vs. mortality for over 1 million people found that the

lowest mortality was around BMI of 23. This is just above the middle

of the " normal " BMI range which is between 18.5 and 25.