Effects of current exercise and diet on late-life cognitive health of former college football players

Journal Title (Medline/Pubmed accepted abbreviation): Phys. Sportsmed.
Year: 2011
Volume: 39
Issue: 3
Page number: 11-22
doi: 10.3810/psm.2011.09.1916

Summary of background and research design:

Background: Football is a sport that includes purposeful and accidental high impact contact to the head, therefore greatly increasing the risk and frequency of head trauma.  Repetitive hits to the head are correlated with swelling of the tissue in and around the brain, which can cause changes in behavior, formation and control of emotion, and the ability to think and remember.  However, many symptoms do not present themselves until years later.  A higher quality diet (increased consumption of vegetables, vitamins and minerals, omega-3 fatty acids, polyphenols, etc.) has been associated with increased cognitive health of current and former football players.

Research goals:To compare the dietary habits and cognitive health of people who played Division I football to those who played non-collision sports and those who did not play sports in college.

Subjects:There were 400 participants- 214 played collision sports, 136 played non-collision sports, and 50 did not play college sports.  The age range was 22-98 y, mean ± standard deviation = 64.1 ± 13.3 y.

Experimental design: cross-sectional study (no intervention)

Protocol :Alumni from a midwestern university were asked to complete a questionnaire regarding social demographics, current exercise frequency, current dietary patterns, and cognitive health.

Summary of research findings:
  • Football players had a higher current body mass index (BMI) than those in the other groups.
  • Past athletes exercised at a higher frequency and intensity than former non-athletes.
  • The quality of their current diets was similar, though football players reported consuming less dairy products than those in the other groups.
  • Former football players reported a higher frequency of physical and mental health problems.  For example, former football players experienced more praxis (difficulty manipulating tools such as scissors), delayed recall (forgetting appointments, etc.), and difficulties with orientation to person (forgetting people’s names).
  • Income was negatively associated with cognitive difficulties.  Greater intake of total dietary fat was associated with increased level of cognitive difficulties in football players only.
  • In general, higher income, lower BMI, more exercise frequency and intensity, and higher quality of diet were correlated with higher mental health.

Key practice applications:

Playing collision sports at a high level is correlated with declines in cognitive health.  However, current lifestyle habits (quality of diet, BMI, exercise) are also associated with cognitive health, and lifestyle choices can be made to minimize the consequences of any damage that was done.  One of the most important thing former football players can do is eat a diet low in saturated fat to protect their mental capacities.


The groups were significantly different in terms of age (nonathletes were younger), gender (there were no female football players and a smaller proportion of women in the non-collision sport group compared to non-athletes), race (there were more African-American football players), marital status (non-athletes were more likely to be single), and income (non-athletes tended to have a lower income).  Age, gender, and race have all been associated with differences in the cognitive effects of repetitive collisions, so it is difficult to make any definitive conclusions about the differences between these groups.  Also, the size of the groups was different so, statistically, some correlations may have been more pronounced in the larger group (the football group) compared to the others.  Also, because this was a cross-sectional study, one cannot make any conclusions about causation.

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