Health-Promoting Behaviors and Their Associations With Factors Related to Well-Being Among Former National Football League Players: An NFL-LONG Study

J Athl Train. 2025 Feb 1;60(2):185-197. doi: 10.4085/1062-6050-0537.23.

Abstract

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 measure(s): Self-reported health-promoting behaviors (exercise frequency, diet quality, and sleep duration and disturbance) and factors related to well-being (Patient-Reported Outcomes Measurement Information System - Meaning and Purpose [MP], Self-Efficacy, and 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 to 39 years, 40 to 49 years, 50 to 59 years, 60 to 69 years, and 70+ years.

Results: A total of 1784 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]), Self-Efficacy (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, Self-Efficacy, and SRA among select middle-aged groups (between 40 and 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.

Conclusion: 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.

Keywords: diet quality; health-related quality of life; physical activity; sleep hygiene.

MeSH terms

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Diet
  • Diet, Healthy
  • Exercise
  • Football* / psychology
  • Health Behavior*
  • Health Promotion*
  • Humans
  • Male
  • Middle Aged
  • Self Efficacy
  • Self Report
  • Sleep
  • Sleep Hygiene
  • Surveys and Questionnaires