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Miami Herald, FL 01-30-07 What happens in the fifth quarter? Diabetes. Sleep Apnea. Heart attacks BY HOWARD COHEN hcohen@MiamiHerald.com Joe Martin-Culet is 17, 6-8, 330 pounds. The Coconut Creek high school senior is one of 40 Broward and Miami-Dade high school football players who will play Wednesday on Team USA as part of Super Bowl XLI festivities. His teammates Ryan Goldman, Ernest Goodley and Joshua Stanley, from several Broward County schools, range from 260 to 330 pounds. Put them together and that's more than a half-ton on the field. Just four school kids. In football today, bigger is definitely better. Consider: More than 300 NFL players topped 300 pounds in 2005; in 1975, there were none. ''I played at 240,'' says retired Miami Dolphin Marv Fleming from his Los Angeles home. Today, at 255, he swims and watches his diet. ''No sugar.'' Now a motivational speaker, Fleming, 55, played tight end for the Dolphins from 1970 to 1974, including playing on the 1972 perfect season team. A while back, on an airplane, Fleming spotted former Chicago Bears defensive tackle William Perry -- nicknamed ''The Refrigerator'' due to his girth during his '80s heyday. Fleming says he was taken aback. ''I kept looking, God, the guy is so big! He had to have the whole row, three seats. Looked like he was inching toward 500 pounds. It looks good at the time playing football,'' Fleming says. ``Refrigerator Perry is good for football. But is it good for life? I don't think so.'' It's an issue many are now deliberating. What happens in the fifth quarter, when the game is over and players are no longer training but have gargantuan appetites? So far there aren't any longevity studies on post-career NFL stars but we know this: San Francisco 49er Thomas Herrion, 23; Minnesota Vikings Korey Stringer, 27; New Orleans Saint Frank Warren, 43; Green Bay Packer Reggie White, 43; and Chris Stewart, a 17-year-old Oklahoma City high school player, have all died since 2001. Causes of their deaths included heat stroke, heart attack and a respiratory ailment associated with sleep apnea -- a cessation of breathing typified by snoring. Dr. Arthur ''Archie'' Roberts, a 1967 Miami Dolphin turned cardiothoracic surgeon, screens retired NFL players through his New Jersey-based Living Heart Foundation. He recently screened 550 retired NFL players with an average age of 52 for a study and released the results Saturday. No one is cheering: • 52.5 percent of linemen had metabolic syndrome -- a cluster of health problems derived from obesity that leads to diabetes, high blood pressure, heart disease and early heart attacks. Non-linemen, who carried less weight, fared better: 22.2 percent. • 36.9 percent of linemen had enlarged hearts versus 24.5 percent of non- linemen. • Three-quarters of the linemen suffered from obstructive sleep apnea -- a malady doctors are increasingly realizing can signal cardiovascular disease. Half of the non-linemen suffered sleep apnea. Sleep apnea, which garnered more public attention since it was a chief factor in White's death in 2004, affects 12 to 18 million Americans, according to the National Institutes of Health and SleepApneaInfo.com. The ailment affects 4 percent of the general population -- 14 percent of professional football players. Says Roberts, ``What we have learned is that there are amazing changes from the active playing days when players are young and conditioned and strong to when they go through . . retirement and further into their life after football -- the fifth quarter. ``They go through changes just as the general public does through aging, but . . . football players, specifically linemen, have that large body size to carry around with over retirement.'' Muscles, through disuse, atrophy. Fat builds. Their size or injuries from the game limits their ability to exercise. ''Those are additional risk factors for cardiovascular disease,'' says Roberts, 64. Another new study published in the latest Journal of the American Medical Association, this one focusing on high school athletes, similarly threw warning flags. Researchers at Iowa State University found that nearly half of the offensive and defensive linemen playing on Iowa high school teams are overweight and one in 10 are considered medically severely obese. Hialeah high school football coach Steve Smith, who is coaching Team USA players for Wednesday's competition at Lockhart Stadium in Fort Lauderdale, has observed the same trend locally. ''The kids are getting bigger every year. It's unbelievable,'' Smith says. ``It's not just offensive linemen, it's every position. They lift a lot more in the weight room, especially in South Florida, where there is such great talent. They know they need to be in a weight-lifting program and get bigger, faster and stronger so they can compete against other schools and go in for scholarships.'' The South Florida climate also poses specific health risks for these supersized younger athletes, says Arlette Perry, director of the University of Miami's Laboratory of Clinical and Applied Physiology. ``At 300 pounds if you are carrying 20 percent fat you are talking about 60 pounds of fat. They may have trouble thermal regulating because of that size . . . when it's 90 degrees outside and 90 percent humidity every summer. There are cases of football players going down with heat stroke or exhaustion and it's usually linemen. Or, they get dehydrated because they can't control the rise in their core temperature.'' Perry urges the NFL to commission follow-up longevity studies on its players. Linemen ''have to eat extra high calorie foods to keep up their weight . . . because the rest of the players are getting so much bigger and stronger,'' Perry adds. ``To play professionally at that size is an advantage. The people on the line opposite you are every bit as strong. If most of the guys are 300 pounds and you are only 240, you'll be whipped around like nothing. People are getting more encouragement. Massive guys are getting starting positions in high school, college and the pros.'' Football fans, too, have come to expect XXL players. ''As someone who follows the NFL draft, people really stress weight and height,'' says Mike Kaplan of Coral Springs. 'Someone says the lineman is 6-5 and weighs 330 pounds and you think, `Yeah, this guy can block.' '' This is why Martin-Culet, the Coconut Creek Team USA line guard and tackle, makes sure he fits the part. ''It's advantageous,'' he says after practice on the Florida International University football field. The teen, who plans on attending college in the fall and eventually wants to turn pro, says he works out three times a week lifting weights, runs 600-yard dashes, skips breakfast and eats a ''big'' dinner. ''I'm really living for the moment,'' he says. ``When it gets to that point [after the football career], I'll take care of it. I'm not working for my future.'' When the fifth quarter arrives Martin-Culet figures his size will come in handy. ``I was considering body guard security.''
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