Association of Body Mass Index and Waist Circumference with Subclinical Atherosclerosis in Retired NFL Players

Pokharel, Yashashwi; Basra, Sukhdeep S.; Lincoln, Andrew E.; Tucker, Andrew; Nambi, Vijay; Nasir, Khurram; Vogel, Robert A.; Wong, Nathan D.; Boone, Jeffrey L.; Roberts, Arthur J.; Ballantyne, Christie M.; Virani, Salim S.

doi:10.14423/smj.0000000000000173

Cited by 16 publications

(17 citation statements)

References 2 publications

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“…However, when they retire, many will increase their body fat levels substantially, while maintaining their high BMI. A study of 926 retired NFL players whose mean BMI was 30 and mean waist circumference was 40 showed that 61% were at risk for atherosclerosis; the most at risk being those with larger waist circumference (10). A number of other studies have reported various discrepancies between BMI and the accumulation of body fat in various other populations (10, 35–37).…”

Section: Problems With Bmi As a Measure Of Obesitymentioning

confidence: 99%

“…A study of 926 retired NFL players whose mean BMI was 30 and mean waist circumference was 40 showed that 61% were at risk for atherosclerosis; the most at risk being those with larger waist circumference (10). A number of other studies have reported various discrepancies between BMI and the accumulation of body fat in various other populations (10, 35–37). Clearly, BMI has limited relevance for assessing accurate markers of body composition and body fat distribution, which are important signs of metabolic health (1).…”

Section: Problems With Bmi As a Measure Of Obesitymentioning

confidence: 99%

“…While excess weight can directly and adversely affect the musculoskeletal system, there is little indication that excess weight, when not produced by a relative or absolute increase in FM, a relative or absolute decrease in lean mass, or a combination of both, is causally related to the metabolic underpinnings of obesity. Studies on the risk for cardiovascular disease in Football Players—a high-BMI population with large percentages of lean mass—caution that reliance on BMI as a sole determinant of disease risk may be inappropriate (10, 69). This and various other populations may be contributing to the percentage of false-positives observed through the use of BMI to ascertain metabolic disease risk (33).…”

Section: The Metabolic Phenomenonmentioning

confidence: 99%

“…Abdominal fat stores are more metabolically active and have a greater impact on health, regardless of the person’s weight (10, 48, 81, 82). Ruderman et al (48) suggest that many MONW individuals are included in this category.…”

Section: Who Is “Overfat”?mentioning

confidence: 99%

“…It is well documented that serious limitations exist when estimating body composition using BMI, due to the fact that it underestimates adiposity (body fat percentage) levels in the population at large (7–10). Different ethnic and gender cutoffs for BMI also exist (11).…”

Section: Introductionmentioning

confidence: 99%

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Overfat and Underfat: New Terms and Definitions Long Overdue

Maffetone¹,

Rivera-Dominguez²,

Laursen

2017

Front. Public Health

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For the first time in human history, the number of obese people worldwide now exceeds those who are underweight. However, it is possible that there is an even more serious problem—an overfat pandemic comprised of people who exhibit metabolic health impairments associated with excess fat mass relative to lean body mass. Many overfat individuals, however, are not necessarily classified clinically as overweight or obese, despite the common use of body mass index as the clinical classifier of obesity and overweight. The well-documented obesity epidemic may merely be the tip of the overfat iceberg. The counterpart to the overfat condition is the underfat state, also a common and dangerous health circumstance associated with chronic illness and starvation. Currently (and paradoxically), high rates of obesity and overweight development coexist with undernutrition in developing countries. Studies in cognitive linguistics suggest that accurate, useful, and unintimidating terminology regarding abnormal body fat conditions could help increase a person’s awareness of their situation, helping the process of implementing prevention and simple remedies. Our contention is that promoting the terms “overfat” and “underfat” to describe body composition states to the point where they enter into common usage may help in creating substantive improvements in world health.

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Section: Problems With Bmi As a Measure Of Obesitymentioning

confidence: 99%

Section: Problems With Bmi As a Measure Of Obesitymentioning

confidence: 99%

Section: The Metabolic Phenomenonmentioning

confidence: 99%

Section: Who Is “Overfat”?mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Overfat and Underfat: New Terms and Definitions Long Overdue

Maffetone¹,

Rivera-Dominguez²,

Laursen

2017

Front. Public Health

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Individual and cumulative health afflictions are associated with greater impairment in physical and mental function in former professional American style football players

Tenforde

Cortez

Coughlan-Gifford

et al. 2021

PM&R

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Background Former American style football players (ASF players) have recognized health concerns associated with prior sport participation. It remains unknown whether categorizations of current health conditions, referred to in this report as afflictions (conceptually framed as neurocognitive, cardiovascular, cardiometabolic, sleep apnea, and chronic pain) are associated with physical and mental function. Objective To evaluate the association of afflictions to physical and mental function. It was hypothesized that former National Football League players with any affliction would have worse function compared to unafflicted participants. It was anticipated that multiple afflictions would result in cumulative loss of function. Design Cross‐sectional retrospective design. Setting Academic medical multisite hospital system. Participants A total of 3913 of 15,611 former ASF players who played professionally from 1960 to 2019 (response rate 25%). Assessment of Risk FactorsSelf‐report survey. Main Outcome Measures Each participant completed the Patient Reported Outcomes Measurement Information System (PROMIS) Global Health Scale and Physical Function questionnaires. Responses were used to generate two physical function and one mental function subscale scores. Raw scores were converted to T‐scores categorized as impaired (T‐score < 40) or unimpaired (T‐score ≥ 40). Primary analyses measured the association of affliction to function (impaired or unimpaired). Results After adjusting for confounders (age, race, position, number of seasons, age of first exposure to football, alcohol use, smoking history, and current body mass index), each affliction was associated with reduced physical function on the Global physical function subscale (risk ratio [RR] = 1.23‐2.45, all P < .005), physical function scale (RR = 1.24‐2.75, all P < .01), and mental function scale (RR = 1.34‐2.87, all P < .001), except that cardiovascular affliction was not associated with mental function (RR = 1.15, P = .15). The lowest functional measures were observed in those afflicted by chronic pain. Cumulative afflictions were associated with worse function. Conclusions Afflictions are associated with cumulative reduction of function. Research evaluating how afflictions interact may help elucidate mechanisms for illness and develop interventions to optimize function.

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Neuroimaging Biomarkers of Chronic Traumatic Encephalopathy: Targets for the Academic Memory Disorders Clinic

2021

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Association of Body Mass Index and Waist Circumference with Subclinical Atherosclerosis in Retired NFL Players

Abstract: In retired NFL players both BMI and WC were associated with CAC. Higher BMI may be associated with an increasing trend for the presence of CAC independent of WC.

Cited by 16 publications

References 2 publications

Overfat and Underfat: New Terms and Definitions Long Overdue

Overfat and Underfat: New Terms and Definitions Long Overdue

Individual and cumulative health afflictions are associated with greater impairment in physical and mental function in former professional American style football players

Neuroimaging Biomarkers of Chronic Traumatic Encephalopathy: Targets for the Academic Memory Disorders Clinic

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