Context

Understanding former professional football players’ engagement with health promoting behaviors (physical exercise, high quality diet, and good sleep hygiene) will be helpful for developing lifestyle interventions to improve their feelings of well-being, a relatively understudied facet of health among this population.

Objective

Examine associations among health-promoting behaviors and subjective outcomes related to well-being among former National Football League (NFL) players.

Design

Cross-sectional.

Setting

Online or hard-copy survey.

Patients or Other Participants

Former NFL players.

Main Outcome Measures

Self-reported health-promoting behaviors (exercise frequency, diet quality, sleep duration and disturbance) and factors related to well-being (PROMIS ® Meaning and Purpose [MP], Self-Efficacy [SE], Ability to Participate in Social Roles and Activities [SRA]). Multivariable linear regression models were fit for each well-being-related factor with health-promoting behaviors as explanatory variables alongside select demographic, behavioral, and functional covariates. Models were fit for the full sample and separately for individual age groups: <30 years; 30-39 years; 40-49 years; 50-59 years; 60-69 years; and 70+ years.

Results

A total of 1,784 former NFL players (aged 52.3±16.3 years) completed the survey. Lower sleep disturbance was associated with better MP (β[standard error]=-0.196[0.024]), SE (β[standard error]=-0.185[0.024]), and SRA (β[standard error]=-0.137[0.017]) in the full sample and almost all the individual age groups. More frequent moderate-to-vigorous exercise was associated with higher MP (β[standard error]=0.068[0.025]) and SRA (β[standard error]=0.151[0.065]) in the full sample, and with better MP, SE, and SRA among select middle-aged groups (between 40-69 years old). Diet quality, resistance training exercise frequency, other wellness activity frequency, and sleep duration were not associated with well-being-related factors in the full-group and sparse significant associations were observed in individual age group models.

Conclusions

Lower sleep disturbance and more frequent moderate-to-vigorous exercise frequency may be important targets for improving overall health and well-being among former NFL players.

Physical activity, diet quality, sleep hygiene, health-related quality of life
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Author notes

Samuel R. Walton, PhD, ATC;1, 2 [email protected] ; @SammoWalton

Kevin A. Carneiro, DO3, [email protected];

Abbie E. Smith-Ryan, PhD;1, [email protected]; @asmithryan

Lee Stoner, PhD1,4, [email protected]; @leestoner

Zachary Yukio Kerr, PhD, MPH1, [email protected] ;

Benjamin L. Brett, PhD5[email protected]; @BenjaminBrett1

Avinash Chandran, PhD1,6[email protected]; @avinashsc

J. D. DeFreese, PhD1, [email protected];

Rebekah Mannix, MD, MPH7,8[email protected]; @rebekahmannixmd

Landon B. Lempke, PhD, ATC9, [email protected]; @lblempke

Ruben J. Echemendia, PhD10,11, [email protected];

Michael A. McCrea, PhD5, [email protected];

Kevin M. Guskiewicz, PhD, ATC1, [email protected]; @KevinGuskiewicz

William P. Meehan III, MD12,13,14, [email protected];