Review of cardiometabolic risk factors among current professional football and professional baseball players

Protein Requirements for Maximal Muscle Mass and Athletic Performance Are Achieved with Completely Plant-Based Diets Scaled to Meet Energy Needs: A Modeling Study in Professional American Football Players

American football players consume large quantities of animal-sourced protein in adherence with traditional recommendations to maximize muscle development and athletic performance. This contrasts with dietary guidelines, which recommend reducing meat intake and increasing consumption of plant-based foods to promote health and reduce the risk of chronic disease. The capacity of completely plant-based diets to meet the nutritional needs of American football players has not been studied. This modeling study scaled dietary data from a large cohort following completely plant-based diets to meet the energy requirements of professional American football players to determine whether protein, leucine, and micronutrient needs for physical performance and health were met. The Cunningham equation was used to estimate calorie requirements. Nutrient intakes from the Adventist Health Study 2 were then scaled to this calorie level. Protein values ranged from 1.6-2.2 g/kg/day and leucine values ranged from 3.8-4.1 g/meal at each of four daily meals, therefore meeting and exceeding levels theorized to maximize muscle mass, muscle strength, and muscle protein synthesis, respectively. Plant-based diets scaled to meet the energy needs of professional American football players satisfied protein, leucine, and micronutrient requirements for muscle development and athletic performance. These findings suggest that completely plant-based diets could bridge the gap between dietary recommendations for chronic disease prevention and athletic performance in American football players.

Defining Exposures in Professional Football: Professional American-Style Football Players as an Occupational Cohort

Studies of professional American football players have shown that football-related activities lead to acute injuries and may have long-term adverse health outcomes including osteoarthritis, neurocognitive impairment, and cardiovascular disease. However, the full complement of what constitutes professional football exposure has yet to be effectively articulated. Most likely, professional football exposure encompasses a multifaceted array of experiences including head impacts and joint stresses, long-term pain medication use, dietary restrictions, and strenuous training regimens. To study the health of professional American football players, characterizing the group as an occupational cohort and taking advantage of methods established within the discipline of occupational epidemiology may be beneficial. We conducted a narrative review of existing football research, occupational epidemiological methods papers, and occupational medicine studies. Here we describe the traditional occupational epidemiological approach to assessing exposure in a novel cohort and show how this framework could be implemented in studies of professional football players. In addition, we identify the specific challenges associated with studying an elite athletic occupational group, including the healthy worker effect and other types of selection and information biases, and explore these in the context of existing studies of football-related health. The application of well-established occupational epidemiological methods to professional football players may yield new insights into the effects of playing exposure and may provide opportunities for interventions to reduce harm.

Effect of aerobic exercise training on cardiometabolic risk factors among professional athletes in the heaviest-weight class

BACKGROUND

High prevalence of metabolic diseases among young professional athletes with large body sizes has raised growing attention. However, few studies specifically examined whether additional aerobic exercise provides cardiometabolic beneficial effect among these young athletes under regularly intensive strength training.

OBJECTIVE

We conducted a pilot trial to evaluate the effects of aerobic exercise on overall metabolic syndrome (MetS), individual MetS components, and aerobic capacity among metabolically unhealthy athletes in the heaviest-weight class.

METHODS

Forty-nine professional athletes aged 15-30 years had large body weights (mean weight of 131 ± 15.5 kg and 108 ± 15.8 kg and mean BMI of 39.4 ± 4.7 kg/m(2) and 36.4 ± 5.1 kg/m(2) for 26 men and 23 women, respectively). They completed a supervised moderate intensity (maximal heart rate: 140-170 beats/min for 30-70 min/day) aerobic exercise training for 12 weeks. We collected and measured metabolic parameters and aerobic capacity for all participants before and after 12 weeks of aerobic exercise training.

RESULTS

At baseline, 42 (86 %) of all 49 metabolically abnormal athletes were diagnosed as MetS according to the NCEP ATP III criteria (≥3 MetS components). After aerobic exercise training, 30 % (13/42) of MetS individuals tended to become free of MetS (<3 MetS components), decreasing the prevalence of MetS by 30.4 % (from 17 to 10) in women and 23.1 % (from 25 to 19) in men (P = 0.001). All individual components of MetS, including fasting glucose levels, lipid profile, and blood pressure, were also significantly improved (all P-values <0.05). Overall and central obesity indexes, including BMI, waist circumference, Waist-hip ratio, and abdominal fat ratio, were significantly decreased in men whereas only overall adiposity indexes, such as BMI and body fat percentage, were significantly reduced in women. Also, participants' aerobic capacities were also significantly enhanced with longer running distances and decreased heart rates (all P-values <0.05).

CONCLUSIONS

Our pilot trial showed that moderate intensity aerobic exercise effectively improved cardiometabolic parameters in metabolically unhealthy professional athletes with routinely intensive strength training. Its long-term cardiovascular effects will be evaluated by future randomized controlled trials with well-designed exercise modalities.