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.