Health Behaviours of Past
Australian Football Players:
Comparison with the General
Population.
School of Sport Science, Exercise and Health
Background
Australian Rules Football (ARF) is a
physically demanding game, with the
average pace of the game increasing
(1)
. Players are required to exhibit highly
developed fitness attributes, including
endurance, speed and upper and lower
body strength to cope with the extreme
physical demands that the game places
on the body (2). To achieve these high
levels of performance, athletes are
provided with expert health and fitness
guidance throughout their professional
career, especially regarding optimal
dietary strategies to enhance athletic
performance (3). Promoting a healthy
lifestyle has not always been a prominent
part of ARF and players from previous
eras were not always provided with
professional health support. There
is little known about how past player
health behaviours track following their
retirement from the elite level of the
game.
Some evidence from other sports
indicates slightly better sport nutrition
knowledge of athletes when compared
to non-athletes (4), and available data also
indicates a higher prevalence of arthritis
in retired American Football players (5)
and osteoarthritis in past Australian
Football League (AFL) players (6). In
one of the few studies measuring the
health status of former athletes, former
endurance and mixed sport athletes from
Finland had a higher total and active life
expectancy and lower risk for ischemic
heart disease and diabetes in later years
than in non-athletes (7). Among current
ARF players, alcohol consumption
seems related to the time of year, with
the highest levels being in the off season,
when compared to age matched nonelite athletes. However, this trend was
reversed during the playing season (8).
The way in which people in the general
population frame and practise a healthy
lifestyle has changed over time, although
a lifestyle including regular physical
activity has usually been considered
important for maintaining good health (9).
Current recommendations for receiving
health benefits from exercise include at
least 30 minutes of moderate intensity
physical activity on most (preferably
all) days of the week (10). In addition,
to achieve a healthy lifestyle it is
recommended that adults have a body
mass index (BMI) between 18.5 and 24.9
kg.m-2 (11), don’t smoke, consume no
more than two standard alcoholic drinks
per day (12) and eat two pieces of fruit and
five serves of vegetables every day (13).
There is very little information on the
general health and well-being of past
elite sports players and no research on
past ARF players. This report presents
the findings from a survey of past AFL
players on a range of current health
behaviours and compares them to the
levels found in the general community.
Methodology
A survey, completed by past AFL
players (n=592) with an average age of
55.1 y (±15.8) and playing career of 7.7
years (±4.1), sought recall on current
engagement in physical activity, alcohol
consumption, smoking, daily fruit and
vegetable consumption, consumption
of food from fast food outlets, as well
as self-reported height and weight
measures. Data on past players career
length, games played, and injuries
received were also collected as part of
the survey. Past players were also asked
to indicate their highest education level,
employment and relationship status, and
whether or not they had children.
Past players were able to complete the
survey online, by telephone, or by hard
copy, to maximise the response rate. All
past AFL players who were members
of the AFL Players Association (AFLPA)
were invited to participate in the survey.
Comparable data from national and
state-based health surveys were used
as a relative measure of the current
healthy lifestyles of past players
with the wider community. BMI,
alcohol, smoking, fruit and vegetable
consumption were indexed against
the most recent National Health
Survey (14). Physical activity was
compared against the Western
Australian Adult Survey of Physical
Activity (15) as the most recent
population measure of physical
activity. Fast food consumption was
compared with Healthway’s Survey
on Recreation and Health (16) as the
only measure of weekly fast food
consumption available nationally.
Key Findings
Health Behaviours by Age
ÌÌ The current health behaviour
profile of past players
and the wider community
are presented in Table 1,
which also shows health
behaviours of past players
between age groups.
ÌÌ Almost
three quarters of
past players (74%) were
non-smokers, more than
twice the proportion of the
general population (35%).
One in five past players were
past smokers (22%), almost
a third less than the general
population (55%).
ÌÌ Younger
past players were
the most likely to be a
non- smoker (90%), with
increasing age associated
with a lower proportion of
smokers and more past or
non-smokers.
ÌÌ Nearly
two thirds (62%) of
past players were at low risk
of long-term alcohol harm,
a lower proportion than the
general population (76%).
ÌÌ Compared
with the general
population (14%), half as
many past players were nondrinkers (7%).
ÌÌ Nearly
one in 5 (18%) past
players consumed alcohol
at “risky” levels for long-term
harm, three times greater
than the general population.
Similarly, 12% of past players
were at high risk of longterm alcohol harm, three
times as high as the general
population (4%). Alcohol
consumption at risky levels
was highest among 20-34
year old past players (62%).
ÌÌ One
in five (21%) past players
were drinking at “risky”
levels for short-term harm,
compared with 12% of the
general population. Almost
one third (28%) of past
players aged 20-34 were
drinking at “high risk” levels
for short-term alcohol harm.
ÌÌ A
greater proportion of shortterm “risky drinkers” were
observed as age increased
among past players, with
38% of past players aged
65+years at short-term
health risk from alcohol
consumption.
ÌÌ About
one quarter (23%) of
past players were classified
as acceptable weight,
with 60% classified as
overweight. With increasing
age, past players remained
above comparative
populations levels of being
overweight, with 29% of
50-64 year old past players
classified as “obese”.
two thirds (68%) of
past players were sufficiently
physically active, a greater
proportion than the general
population (62%). A similar
proportion of past players
(11%) and the general
population (11%) were
inactive.
ÌÌ Past
players aged 35-49
years reported the lowest
level of sufficient physical
activity (62%) and the highest
proportion of insufficient
physical activity (14%) of all
past player age groups.
ÌÌ Just
over one half (54%) of
past players consumed the
recommended two pieces
of fruit each day, slightly
higher than the proportion
in the general population
(46%). Recommended fruit
consumption was observed
to increase with age,
particularly in the 65+ year
old age group (66%).
ÌÌ Similar
to the general
population (7%), few past
players consumed the
recommended five serves of
vegetables each day (6%).
ÌÌ Over
half of past players
(59%) consumed fast food on
one or more days per week,
a slightly higher proportion
than the general population
(51%).
ÌÌ Among
past players aged 20
to 34 years, 84% consumed
fast food at least once a
week. The proportion of
past players consuming fast
food at least once a week
declined with age, with 30%
of 65+ year old past players
consuming fast food on one
or more days during the
week.
ÌÌ Over
Nearly one in 5 (18%)
past players consumed
alcohol at “risky” levels
for long-term harm,
three times greater than
the general population.
Table 1: Health behaviours and BMI by past player age group
Health Behaviours and BMI
Total
General
Population
Comparison
%(n)
%
Age Group (n=531)
20-34 years 35-49 years 50-64 years
%(n)
%(n)
%(n)
18.8(100)
Smoking status**
30.5(162)
24.7(131)
(n=531)
Smoker
Past smoker
Non-smoker
Alcohol consumption long-term risk**
26.0(138)
65+ years
%(n)
7.5(40)
22.2
10.0(10)
11.6(16)
6.8(11)
2.3(3)
18.5(98)
54.9
0.0(0)
10.9(15)
25.3(41)
32.1(42)
74.0(393)
34.9
90.0(90)
77.5(107)
67.9(110)
65.6(86)
(n=526)
Non-drinker
6.9(36)
14
2.0(2)
3.6(5)
8.1(13)
12.6(16)
61.8(325)
76
36.0(36)
61.6(85)
67.1(108)
75.6(96)
Risky
18.4(97)
6
26.0(26)
21.0(29)
17.3(28)
11.0(14)
High risk
12.9(68)
4
36.0(36)
13.8(19)
7.5(12)
0.8(1)
Low risk
Alcohol consumption short-term risk**
(n=526)
Non-drinker
6.8(36)
14
2.0(2)
3.6(5)
8.1(13)
12.6(16)
Low risk
63.5(334)
62
60.0(60)
78.3(108)
64.0(103)
49.6(63)
Risky
21.1(111)
12
10.0(10)
12.3(17)
22.3(36)
37.8(48)
High risk
8.6(45)
12
28.0(28)
5.8(8)
5.6(9)
0(0)
Body Mass Index**
(n=453)
Underweight
0(0)
1.2
0(0)
0(0)
0(0)
0(0)
Acceptable
23.0(104)
31.1
37.5(36)
22.0(28)
10.0(14)
28.9(26)
Overweight
59.6(270)
42.2
57.3(55)
63.8(81)
61.4(86)
53.3(48)
17.4(79)
25.5
5.2(5)
14.2(18)
28.6(40)
17.8(16)
Obese
Physical activity level**
(n=527)
Inactive
10.6(56)
11.1
3.0(3)
8.0(11)
14.4(23)
14.6(19)
Insufficient
21.6(114)
26.6
23.3(23)
30.4(42)
16.9(27)
16.9(22)
67.8(357)
62.3
73.7(73)
61.6(85)
68.7(110)
68.5(89)
One piece or less
46.2(244)
53.9
52.0(52)
52.2(72)
47.5(77)
33.6(43)
Two or more pieces
53.8(284)
46.1
48.0(48)
47.8(66)
52.5(85)
66.4(85)
Less than five serves
93.8(496)
92.7
97.0(97)
96.4(133)
93.2(151)
89.1(115)
Five or more serves
6.2(33)
7.3
3.0(3)
3.6(5)
6.8(11)
10.9(14)
Sufficient
Daily fruit consumption**
Daily vegetable consumption*
Weekly fast food consumption**
(n=528)
(n=529)
(n=530)
On one or more days per week
58.7(311)
51.4
84.0(84)
70.3(97)
56.2(91)
30.0(39)
Less than once per week
41.3(219)
48.6
16.0(16)
29.7(41)
43.8(71)
70.0(91)
missing values excluded; * p <0.05, ** p <0.01; General population figures are for males only
Health Behaviours by Career
Characteristics
ÌÌ Table 2 presents the significant
associations between past-player
health behaviours and their career
characteristics.
health behaviours of past
players were largely unrelated to
their playing career. The years
since retiring was a significant
factor for all health behaviours and
followed a pattern similar to that
observed between different age
groups.
ÌÌ Career
injuries affecting current
daily activities was associated with
having a higher BMI.
ÌÌ Past
players who incurred
between six and ten serious
injuries were significantly more
likely to smoke.
ÌÌ Current
ÌÌ Arthritis
was associated with a
higher BMI, being a smoker and
being inactive.
The University of Western Australia
Table 2: Associations between health behaviours and BMI and career characteristics
Health Behaviours and BMI
Number
of games
Career
length
Years
retired
Aged
retired
Number
of serious
injuries
Number of
Arthritis Injuries
concussions
affect
daily living
Smoking status
-
-
**
-
**
-
*
-
Alcohol consumption long-term risk
-
-
**
-
-
-
-
-
Alcohol consumption short-term risk
-
-
**
-
-
-
-
-
Body Mass Index
-
-
**
-
-
-
**
**
Physical activity level
-
-
**
-
-
-
**
-
Daily fruit consumption
-
-
**
-
-
-
-
-
Daily vegetable consumption
-
-
*
-
-
-
-
-
Weekly fast food consumption
-
-
**
*
-
-
-
-
* p <0.05, ** p <0.01
‘high risk’ of alcohol-related
harm in both the short and
long-term than their married
or divorced/separated
counterparts.
Health Behaviours by
Demographics
ÌÌ Table 3 presents the
significant associations
between past-player health
behaviours and various
demographic variables.
ÌÌ Past
players with children were
less likely to 1) consume junk food
and 2) be risky drinkers in the
short and long-term.
Discussion
ÌÌ Past
players who were
retired were more likely to
be past smokers and to
consume the recommended
amount of fruit and
vegetables.
ÌÌ Lower
levels of education in
past players were associated
with overweight and obesity
and being a smoker.
Compared with the general
population, more past AFL players
were non-smokers, of acceptable
weight, sufficiently physically active
and regularly consumed two serves
of fruit every day. However, past
players were over represented as
risky short and long term alcohol
drinkers and consumers of fast
food compared with the general
population.
ÌÌ Past
players who were
unemployed were more likely
to consume junk food and
be at ‘high risk’ of alcoholrelated harm in the short and
long-term.
ÌÌ Being
single was associated
with a lower BMI and being
sufficiently active.
ÌÌ Being
employed full time
was associated with being
overweight.
The results also show that current
health behaviours are influenced
largely by past players current
age, education level, marital and
employment status and having
children, rather than their career
ÌÌ Having
children was
associated with higher levels
of BMI, being inactive and
being a past smoker.
ÌÌ Single
past players were
more likely to smoke,
consume junk food and be at
Table 3: Associations between health behaviours and BMI and past player characteristics
Health Behaviours and BMI
Education
Marital status
Employment
Children
Smoking status
**
**
**
**
Alcohol consumption long-term risk
-
**
**
**
Alcohol consumption short-term risk
-
**
**
**
Body Mass Index
**
*
*
**
Physical activity level
-
*
-
**
Daily fruit consumption
-
-
**
-
Daily vegetable consumption
-
-
*
-
Weekly fast food consumption
-
*
**
**
* p <0.05, ** p <0.01
02 | www.uwa.edu.au
length, number of games played, age
retired or injuries received during their
career.
The current age of past players was
the most common characteristic
differentiating health behaviours, a
finding typical of community surveys
and changes in lifestyle with age (17-18).
Although with increasing age, past
players appear to more closely match
the health behaviours of the general
community, this finding could reflect
changes in the professional status
of ARF during a player’s career and
younger past players may ultimately
show better longer term tracking
of health behaviours. This may
also link with greater at-risk alcohol
consumption among younger past
players tracking over time. This is of
some potential concern given most
past AFL players (at all ages) are
consuming alcohol at some level,
with only 2% of 20-34 year olds being
non-drinkers.
Relationships between different
AFL playing characteristics such
as, longevity, games played and
injures and current health behaviours
did not materialise in this study,
although, with the exception of
alcohol consumption, past players
generally perform better in engaging
in healthy behaviours than the general
community. This finding may reflect
the type of person who reaches the
elite level as an AFL player, rather
than distinguishing them by length of
career or number of games played.
To achieve at least one AFL game, a
past player would have at least led a
more physically active lifestyle than
most people in the wider community.
The aspects of a player’s career that
seemed to impact in some way on
their health behaviours related to
serious injuries, particularly those that
affected current daily activities, and
also arthritis. These factors would
have a similar impact on anyone in
the community, although it is likely the
risk of receiving these types of injuries
and outcomes would be higher
among past players.
Comparing past player’s health
behaviours with the general
community showed very similar
patterns, with education level
associated with healthier choices,
being single associated with lower
BMI, but riskier health behaviours,
employment was associated
with being overweight, although
unemployment was associated with
risky alcohol consumption (19-20). Past
players with children were found
in this study to reflect the wider
population of parents (18).
This is the first study to compare
current health behaviours of past ARF
players with the general population.
It is possible that the past players
in this survey do not reflect all past
players and caution should be taken
in generalising the results. The health
behaviour questions in this survey
were selected to allow comparisons
with national data. These questions
may not have been sensitive enough
to differentiate past players by their
career attributes and the manner in
which past players engage in health
behaviours may yet emerge with
more specific questions about their
health behaviours, or aspects of their
playing career. This self-report survey
is limited by the respondent’s ability
to recall their health behaviours,
as well as specific aspects of their
playing career.
While considering the limitations of
this survey, the results show a pattern
of more past players engaging in
healthy behaviours with the exception
of alcohol consumption. The
demographic profile of past players
was most commonly associated
with their health behaviours.
While the age associations may
change naturally with greater
past players having a professional
AFL career, there seems merit in
further exploring the education and
employment opportunities afforded
to past players, given their positive
associations with longer term health
behaviour patterns.
References
1. Norton K, Craig N, Olds T. The evolution of Australian
football. Journal of Science and Medicine in Sport.
1999;2(4):389-404.
2. Gray AJ, Jenkins DG. Match analysis and hte
physiological demands of Australian football. Sports
Medicine. 2010;40(4):347-60.
3. American College of Sports Medicine, American Dietetic
Association, Dietitions of Canada. Nutrition and athletic
performance. Medicine and Science in Sport and Exercise.
2000;32(12):2130-45.
4. Heaney S, O’Connor H, Michael S, Gifford J, Naughton
G. Nutrition Knowledge in Athletes: A systematic Review.
International Journal of Sport Nutrition and Exercise
Medicine. 2011;21:248-61.
5. Nicholas SJ, Nicholas JA, Nicholas C, Diecchio JR,
McHugh MP. The health status of retired American football
players. Super Bowl III Revisited. The American Journal of
Sports Medicine. 2007;35(10):1674-9.
6. Deacon A, Bennell K, Kiss Z, Crossley K, Brukner P.
Osteoarthritis of the knee in retired, elite Australian Rules
footballers. Medical Journal of Australia. 1997;166:187-90.
7. Sarna S, Kaprio J, Kujala UM, Koskenvuo M. Health
status of former elite athletes. The Finnish experience.
Aging. 1997;9(1-2):35-41.
8. Dietze PM, Fitzgerald JL, Jenkinson RA. Drinking by
professional Australian Football League (AFL) players:
prevalence and correlates of risk. Medical Journal of
Australia. 2008;189:479-83.
9. van Mechelen W. A physically active lifestyle - public
health’s best buy? British Journal of Sports Medicine.
1997;31:264-5.
10. Australian Government Department of Health and
Aged Care. National Physical Activity Guidelines for Adults.
Canberra, Australia: 2005.
11. World Health Organisation. Obesity, preventing and
managing the global epidemic. WHO Technical Report
Series no. 894. Geneva: WHO, 2004.
12. National Health and Medical Research Council.
Australian Guidelines to Reducing Health Risks from
Drinking Alcohol. Canberra: Commonwealth of Australia,
2009.
13. National Health and Medical Research Council.
Australian Dietary Guidelines. Canberra: Commonwealth of
Australia, 2011.
14. Australian Bureau of Statistics. 2007-2008 National
Health Survey: Summary of results. Canberra: ABS, 2010.
15. Rosenberg M, Mills C, McCormack G, Martin K,
Grove B, Pratt S, et al. Physical activity levels of Western
Australian adults 2009. Perth: Health Promotion Evaluation
Unit, University of Western Australia, 2010.
16. Pettigrew S, Pescud M and Ferguson R. Western
Australians’ engagement in various health-related
behaviours. Perth: Health Promotion Evaluation Unit, The
University of Western Australia, 2012.
17. Boslaugh SE, Kreuter MW, Nicholson RA, Naleid K.
Comparing demographic, health status and psychosocial
strategies of audience segmentation to promote physical
activity. Health education research. 2005;20(4):430-8.
18. Begg S, Vos T, Barker B, Stevenson C, Stanley L,
Lopez A. Burden of disease and injury in Australia, 2003.
Australian Institute of Health and Welfare AIHW, 2007.
19. Mathers CD, Schofield DJ. The health consequences of
unemployment: the evidence. Medical journal of Australia.
1998;168:178-85.
20. Petrie D, Doran C, Shakeshaft A, Sanson-Fisher R.
The relationship between alcohol consumption and selfreported health status using the EQ5D: Evidence from rural
Australia. Social Science & Medicine. 2008;67(11):1717-26.
The University of Western Australia | 03
School of Sport Science, Exercise and
Health
The University of Western Australia
M408, 35 Stirling Highway
Crawley WA 6009
Tel: +61 8 6488 4654
Fax: +61 8 6488 1039
Email: [email protected]
www.uwa.edu.au
CRICOS Provider Code: 00126G
UniPrint 00000