The NFL is worse than trans fat

This began as a Facebook comment about the NIH-NFL “unrestricted gift” debacle. Since no one wants to read really long Facebook comments and I haven’t posted anything in a while (c’mon, I’m trying to finish a PhD here!), I thought I’d edit it up and post it here even though it’s not within the purview of this blog. Many of my ideas come from a sudden burst of passion on a topic, so in that respect this has a similar genesis to other posts that have appeared and will appear here. For the nine or ten people that read everything I write here, enjoy! 

I’m deeply disturbed by the NFL’s efforts to subvert research into chronic traumatic encephalopathy (CTE) linked to football activity. As was extensively detailed in the compelling Frontline documentary League of Denial, NFL team doctors without backgrounds in neurology went to great lengths to cast doubt on findings that could have improved player safety earlier. Dr. Bennet Omalu first reported the discovery of cortical amyloid and tau protein (ptau) aggregates in a deceased football player in a 2005 research article that the NFL’s so-called Mild Traumatic Brain Injury (MTBI) committee later attempted to have retracted. Meanwhile, team physicians that served as members of the MTBI continued to put players in dangerous situations on the field. Omalu suffered professionally for opposing the financial and political might of the NFL, but his and others’ efforts gradually built up evidence for what has come to be known as the NFL’s concussion crisis.

Research associating football with neurodegeneration complemented a rash of high-profile former and current player suicides, bringing even greater public awareness. In 2013, a $765 million class-action settlement was reached between the NFL and encephalopathy-afflicted players to cover future healthcare needs. That settlement was summarily dismissed by a federal judge in 2014 as being inadequate, but is now going forward without a cap on maximum benefits after the Supreme Court declined a hearing to potentially expand the class late last year. The first payments, to two former players diagnosed with encephalopathy before their 45th birthdays, only went out last month. The NFL estimates nearly 30% of former players could develop Alzheimer’s or moderate dementia in the required timeframe, and many expect the payments from the suit to exceed $1 billion. Encephalopathy is a broad term for degenerative brain conditions, but CTE can only be definitively diagnosed postmortem as it requires cortical tissue analysis. As stated in a recent report: “neuropathological criteria for CTE require at least 1 perivascular ptau lesion consisting of ptau aggregates in neurons, astrocytes, and cell processes around a small blood vessel.” That report, which came out on July 25th, made its way through sports media for its revelatory diagnosis of CTE in 110 of 111 former NFL players’ brains based on the aforementioned criteria. The sample was biased, coming from families who chose to donate the brains to research, but compellingly shows that definitive CTE diagnoses aligned with the families’ perception of cognitive dysfunction.

Even that four-day-old paper isn’t the latest CTE-related quagmire for Roger Goodell’s organization. Yesterday news came out that the NFL is going to back out of its incredibly token funding of NIH brain research after the gift was tainted by NFL efforts to steer funding to their chosen projects. Public-private partnerships must always be wary of this kind of undue influence, and indeed congress found last year that the NFL was attempting to restrict their “unrestricted” gift. Interestingly, it was a $6 million grant from that $30 million that funded the aforementioned July 25th JAMA report, about which corresponding author Dr. Ann McKee said publicly, “It is no longer debatable whether or not there is a problem in football—there is a problem.” It appears that the undeniable correlation of CTE with former football activity has compelled the league to back into its old tricks of obstruction and evasion. Meanwhile, the studies the NFL wanted to shut down will proceed with taxpayer funding.

I try not to be too preachy when people bring up the NFL with me, but those who have know that I stopped watching football after seeing League of Denial and following the events thereafter. It’s a small, maybe meaningless gesture, but there are some signs that disgust with the NFL may finally be hurting their bottom line. In this post I’ve tried to summarize the events of the four years following League of Denial’s 2013 release. While the momentum has shifted, the NFL continues to act in bad faith with respect to the science and the players. Fortunately, at least to me, it’s become common to hear about players retiring early to preserve their future cognitive health.

I’m still most concerned for children and families that don’t have the time or resources to worry about these occurances, that might consider football a way to rise out of poverty or obscurity. Many children between the Pop Warner and high school levels have suffered catastrophic injuries or died as a result of football-related trauma. I can’t help but worry that football is as appealing to them as it was to me as a kid – the mythos of the NFL season, of following your team hopefully to the playoffs and the Super Bowl…I can’t deny that it’s compelling to watch. If only we knew that those athletic feats, crushing blows, and the wherewithal to get back on the field after a concussion would lead to so much turmoil off the field so soon after.