Abstract

Background: Metabolic syndrome in football players is a common, yet poorly understood phenomenon. With 88,000 college football players and one million high school football players, there is a large, at-risk population. Hypothesis: We hypothesized that metabolic syndrome in football players is driven by oxidative stress and positive energy balance. Methods: A single site, cross-sectional study was performed at Vanderbilt University Medical Center of high BMI college football players (n=33). Prevalence of metabolic syndrome was determined. Data related to diet composition, oxidative stress, inflammation, body composition, glucose disposition, lipoprotein metabolism, and endothelial function were assessed to identify drivers of the metabolic syndrome in this cohort. Results: Prevalence of clinical metabolic syndrome was 33% (11/33) despite high cardiorespiratory fitness in all players (Table 1). Elevated waist circumference, HDL, and elevated blood pressure were present together in 73% of cases. Cases had increased oxidative stress (F2-isoprostanes) and inflammation (CRP). Insulin resistance was not worse by HOMA. Visceral fat predicted HDL and CRP. Respiratory quotient was identical between groups but metabolomics revealed decreased TCA cycle intermediates in cases. There were no differences in caloric intake but cases had gained more weight (4.2 vs 2.0 kg, p=.06). Conclusion: High BMI collegiate football players have metabolic syndrome at unexpectedly high rates with a unique set of risk factors and unusual pathophysiology. They have low HDL despite normal triglyceride levels and no defects in glucose metabolism. These data suggest deleterious effects of positive energy balance and oxidative stress irrespective of exercise quantity. These results provide strong rationale to conduct larger, longitudinal studies.

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