To the Editor: Obesity is associated with increased morbidity and mortality.1 The 1999-2002 National Health and Nutrition Evaluation Survey (NHANES) determined that 31% of US adult men and women were obese, a doubling of obesity prevalence since NHANES II (1976-1980).2 Reports have indicated, although not fully documented, a trend toward larger players in the National Football League (NFL).3 We investigated whether, despite their status as professional athletes, a large proportion of NFL players would be classified as obese. We also compared the prevalence of obesity in the NFL with that of US males of a similar age sampled from the general population.
Weights, heights, and positions for active NFL football players in the 2003-2004 season were obtained from the official NFLWeb site.4 The Carolina Panthers confirmed that the weights and heights had been measured; we were unable to obtain similar information from the other teams. Two players were excluded from the study because their heights and weights were not available. Body mass index (BMI) was calculated for each of the players as weight in kilograms divided by height in meters squared, as was mean BMI for each team and position across all 32 teams and a frequency distribution of BMI for all players. Comparisons between teams with highest and lowest team BMIs were made using the t test. Body mass index was classified according to the National Institutes of Health guideline: normal weight (BMI 18.5-24.9), overweight (25-29.9), obese class 1 (30-34.9), obese class 2 (35-39.9), and obese class 3 (40).5 The American Football Conference and National Football Conference teams were ranked based on overall records and the NFL tiebreaker rules for the 2003-2004 season.6 All calculations were performed using Excel 2002 (Microsoft Corp, Redmond,Wash).
Data were available for 2168 NFL players (mean age, 26 years; range, 21-44 years). Ninety-seven percent, 56%, 26%, and 3% of NFL players had a BMI of 25 or greater, 30 or greater, 35 or greater, and 40 or greater, respectively (FIGURE 1). The percentage of NFL players with a BMI of 30 or greater was more than double the percentage among 20- to 39-year-old men in NHANES 1999-2002 (56% vs 23%). The percentage of players with a BMI of 40 or greater was similar to that among 20- to 39-year-old men inNHANES 1999-2002 (3.0% vs 3.7%). Cornerback-defensive backs had the lowest mean BMI (26.8 [SD, 1.2]) and guards had the highest mean BMI (38.2 [SD, 2.1]). The Arizona Cardinals had the highest team BMI (32.2 [SD, 4.9]) and the Tennessee Titans had the lowest BMI (30.5 [SD, 4.3]) (P=.04 for difference). There was no relationship between team BMI and ranking in either conference (FIGURE 2). There was also no relationship between player age and BMI.
More than a quarter of NFL players had a BMI that qualified as class 2 obesity. Although measurements of body composition are needed to determine the source of the increased weight, it is unlikely that the high BMI in this group, particularly in the class 2 obesity range, is due to a healthy increase in muscle mass alone. The high number of large players was not unexpected given the pressures of professional athletes to increase their mass.7 However, it may not be without health consequences. A recent study described increased sleep disordered breathing in professional football players, particularly those with a high BMI; linemen, who had the highest BMIs, also had higher blood pressures than did other players.3 The high prevalence of obesity in this group warrants further investigation to determine the short- and long-term health consequences of excessive weight in professional as well as amateur athletes.
Joyce B. Harp, MD
Lindsay Hecht, BSPH
Department of Nutrition
University of North Carolina at Chapel Hill
Chapel Hill, NC
Access to Data: Dr Harp had full access to all of the data in the study and takes
responsibility for the integrity of the data and the accuracy of the data analyses.
Financial Disclosures: None reported.
- Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death inthe United States, 2000 [published correction appears in JAMA. 2005;293:298]. JAMA. 2004;291:1238-1245.
- Hedley AA, Ogden CL, Johnson CL, Carroll MD, Curtin LR, Flegal KM. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999-2002. JAMA. 2004;291:2847-2850.
- George CF, Kab V, Levy AM. Increased prevalence of sleep-disordered breathing among professional football players. N Engl J Med. 2003;348:367-368.
- National Football League. NFL Players. Available at: http://www.nfl.com/players. Accessed December 7, 2003.
- National Institutes of Health. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults—the evidence report. Obes Res. 1998;6(suppl 2):51S-209S.
- National Football League. NFL Tiebreaking Procedures. 2004. Available at: http://www.nfl.com/standings/tiebreakers. Accessed September 20, 2004.
- Gutierrez P. NFL injuries: pain game. Los Angeles Times. January 25, 2000; Sports: 1-9.