OH. Mr Johnston is now at the University of Cincinnati, Cincinnati, OH.Context: Metabolic syndrome is a clustering of symptoms associated with abdominal obesity that demonstrates a high risk for cardiovascular disease and type II diabetes mellitus.Objective: To evaluate football linemen in National Collegiate Athletic Association Divisions I, II, and III schools for the presence of metabolic syndrome according to the American Heart Association/National Heart, Lung, and Blood Institute criteria as well as to document other related biomarkers.Design: Cross-sectional descriptive study. Setting: Three university locations on the first full day of football camp in early morning.Patients or Other Participants: Of 76 football linemen, 70 were able to provide blood samples.Main Outcome Measure(s): Height, mass, blood pressure, upper-body skinfolds, and waist circumference were measured at various stations. Two small venous samples of blood were collected and analyzed in a hospital laboratory for fasting insulin, glucose, high-density lipoprotein, total cholesterol, triglycerides, C-reactive protein, and glycosylated hemoglobin. The last station was a verbal family history for cardiovascular disease and diabetes; also, athletes filled out a nutrition attitudes questionnaire.Results: Of the 70 athletes, 34 were identified as having metabolic syndrome according to measures of blood pressure, waist circumference, fasting glucose, high-density lipoprotein, and triglycerides. The mean total cholesterol-to-high-density lipoprotein cholesterol ratio for the group was 4.95, with 32 participants displaying values higher than 5.0. Twelve volunteers had total cholesterol levels greater than 200 mmol/L, 15 had high levels of C-reactive protein, and 9 had slightly elevated levels of glycosylated hemoglobin.Conclusions: Although athletes might be assumed to be protected from risks of cardiovascular disease, we found a high incidence of metabolic syndrome and other associated adverse biomarkers for heart disease in collegiate football linemen. Early screening, awareness, and intervention may have favorable effects on the overall health outcomes of football linemen.Key Words: obesity, football players, dyslipidemia, hypertension, insulin, C-reactive protein Key Points N Football linemen with abdominal adiposity exhibited the clustering of symptoms associated with higher risks of diabetes and cardiovascular disease (metabolic syndrome).N Athletes with a waist circumference equal to or greater than 40 in (101.60 cm) should be evaluated for other risk factors (fasting blood glucose, blood cholesterol, and triglyceride levels and prehypertensive blood pressure levels) to determine metabolic syndrome status and risks.

Purpose-To estimate the prevalence of metabolic syndrome and insulin resistance in a cohort of Division 1 collegiate football players.Methods-Ninety football players were evaluated in a cross-sectional study to estimate the prevalence of metabolic syndrome, insulin resistance, and associated risk factors. Obesity was defined as a body fat ≥25% determined by BOD POD measurements. The National Cholesterol Education Program Adult Treatment Panel III criteria were used to estimate prevalence of metabolic syndrome. Quantitative insulin sensitivity check index calculations were performed to estimate prevalence of insulin resistance. Linear regression techniques were used to determine association between body fat percentage and other measured continuous parameters. Fisher exact test was used to determine association between nominal variables, and one-way ANOVA compared the three groups defined by position.Results-Summary measures showed a small prevalence of abnormal individual measurements. There was an association between body fat percentage and most evaluated parameters (P < 0.05). The prevalence of obesity, insulin resistance, and metabolic syndrome was 21%, 21%, and 9%, respectively. Obesity is closely associated with metabolic syndrome (P < 0.0001) and insulin resistance (P < 0.0001) in this population. All subjects with metabolic syndrome were obese, and the odds for insulin resistance in the obese group are 10.6 times the odds for the nonobese group. Linemen (n = 29) had 19 of the 19 obese subjects, 13 of the 19 subjects with insulin resistance, and all subjects with metabolic syndrome.Conclusions-There is a strong association between obesity and both metabolic syndrome and insulin resistance in Division 1 collegiate football players. Linemen are at significant risk for metabolic syndrome and insulin resistance compared with other positions. This may be predictive of future health problems in Division 1 collegiate football players, especially linemen. None of the authors of this article have any conflicts of interest or financial conflicts to disclose. James R. Borchers, M.D., M.P.H., 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 analysis.The results of this present study do not constitute endorsement by American College of Sports Medicine. American football is a game that emphasizes the importance of size of athletes to be successful. This is especially true for football linemen. There are concerns about morbidity and mortality that may be associated with the increased size of linemen compared with the size of other players in football. Former National Football League (NFL) linemen have an increased risk of cardiovascular disease compared with other players and three times the risk of cardiovascular death compared with other position players (2). This may be directly related to size of football linemen and associated morbidity that accompanies increased size and obesity. NIH Public AccessFootball linemen of all ages are more ...

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