Not every former athlete ages the same way

Why 'former athlete' isn't one health profile

A retired marathoner, a former offensive lineman and an ex-powerlifter trained for years in completely different ways. They carried different body sizes, absorbed different injuries and built different habits around food, pain and recovery. It would be surprising if they aged the same way.

A 2023 scoping review in BMJ Open Sport & Exercise Medicine pulled together 20 studies of former athletes with average ages between 40 and 65. Its headline conclusion was that former elite athletes don't consistently keep a health advantage, and that ongoing physical activity seems to be a key factor.

None of this is a verdict on your future. It's a starting point for asking better questions about your own body, with your history as context rather than as destiny.

Endurance backgrounds

Across the studies in that review, former endurance athletes who remained physically active generally had lower BMI, body fat and waist-to-hip ratio than non-athlete controls, along with better cholesterol and triglyceride levels, lower blood pressure and higher aerobic capacity.

That's encouraging, but it isn't a free pass. Advantages were clearest in those who kept moving. Endurance athletes can also carry legacies such as low body weight with low energy intake, which can affect hormones and bone, especially if periods stopped during training years. Heart rhythm and heart structure questions sometimes come up in very long-term endurance athletes and are best discussed with a cardiologist.

Collision and team-sport backgrounds

Results for team sports were more mixed. In the review, former NFL players had higher body weight and a higher prevalence of high blood pressure in some studies, sedentary former soccer players had worse cholesterol and triglycerides than sedentary controls, and former college team-sport athletes performed worse than recreationally active controls on some fitness tests. Former soccer players reported more knee problems.

The Harvard Football Players Health Study adds a striking detail: every 10 pounds gained between college and professional play was associated with a 25% higher risk of sleep apnea, a 14% higher risk of heart disease and an 11% higher risk of cardiometabolic conditions later in life. Those are associations in a group with extreme exposures, but they suggest career weight history matters, not just current weight.

Strength and power backgrounds

Strength and power athletes are the least studied group. In the review, former weightlifters still jumped highest among groups studied, a reminder that muscle and power can be preserved. But a large starting muscle mass can mask how much has been lost, and body weight may stay high after training volume drops.

For some people in this group, a frank, judgment-free conversation about any past anabolic steroid or supplement use also matters, because it can affect how hormone results are interpreted.

What the different histories have in common

• Ongoing activity is the strongest thread: those who kept moving tended to look healthier.
• Old injuries can limit activity for decades, which can quietly drive weight gain and metabolic change.
• Athletes are trained to play through discomfort, which can delay reporting symptoms such as chest pain, poor sleep or low mood.
• Habits around eating were built for a training load that may no longer exist.

What that means for what to measure

• Endurance history: a cardiovascular risk discussion, and a look at energy intake, bone and hormones if training involved very low body weight or lost periods.
• Collision or team-sport history: blood pressure, weight and waist, blood sugar and lipids, and a sleep apnea screen.
• Strength or power history: body composition and function rather than body weight alone, plus an honest substance-use history.
• Everyone: a baseline panel covering metabolic, lipid, liver, kidney, thyroid and hormone markers.

An honest word on the evidence

Most studies of former athletes are cross-sectional snapshots, so they show associations, not cause and effect. Prior injuries, diet and current activity are rarely controlled for. Samples skew toward elite male athletes; the scoping review notes that findings may not apply to women or to people who played at lower levels. Treat these patterns as reasons to check, not as predictions.

How HealifyMD fits in

HealifyMD is fully online. A licensed clinician can review your sports history, order labs, screen for issues such as sleep apnea, and discuss options. We don't perform imaging such as coronary calcium scans or bone density scans, so your clinician will refer you when those are needed. At HealifyMD, the comprehensive lab panel is listed at $199 and a continuous glucose monitor with one 14-day sensor is $189 (both one-time). Prices are confirmed at your eligibility review, there's no membership fee, and the eligibility check is free.