Forty-four years ago, when the Packers won Super Bowl I, their largest players weighed 260 pounds. As Green Bay prepares to face Pittsburgh in Super Bowl XLV, 13 players on the Packers' active roster weigh 300 or more pounds, reflecting a trend over the past several decades in which players have become as supersized as fast-food meals.
In 1970, only one NFL player weighed as much as 300 pounds, according to a survey conducted by The Associated Press. That number has expanded like players' waistlines from three 300-pounders in 1980 to 94 in 1990, 301 in 2000, 394 in 2009 and 532 as training camps began in 2010.
On one hand, the largest players are celebrated for their strength, spry athleticism and beer-belly physiques that give them an Everyman quality.
On the other hand, the enormousness of many players, and the recent deaths of one active lineman and several relatively young retired linemen, have raised questions — and brought conflicting answers — about potential health risks associated with their size.
Various studies indicate that current NFL players are at a greater risk than the general population for high blood pressure and that retired players are more prone to obesity, sleep apnea and metabolic syndrome: conditions like elevated blood pressure, insulin and cholesterol levels and excessive body fat around the waist that together heighten the risk for heart disease, stroke and diabetes. Retired linemen have been linked to higher mortality rates than the general public.
"I just can't see how they can be healthy," said Dr. Charles Yesalis, an epidemiologist and professor emeritus of health policy at Penn State. "Yes, some may be 280 pounds of muscle, but then they carry 40 pounds of fat. It just overworks your heart. It puts a strain on your joints. You have the whole issue of concussive injuries.
''It all adds up to things that are not good for your health, but it makes for a good carnival atmosphere when you see the behemoths out there."
A 1994 study conducted by the National Institute for Occupational Safety and Health found that retired players had a lower mortality rate over all than did the general population, but that former offensive and defensive linemen had a 52 percent higher rate of death from cardiovascular disease. Since then, the players have only grown larger; the average NFL weight is now 252 pounds.
A 2005 study by the University of North Carolina found that more than a quarter of the NFL's players fit the category of Class II obesity, which is between moderate and morbidly obese. A 2006 survey by Scripps Howard newspapers of the deaths of 3,850 professional pro football players over the past century found that the heaviest players were more than twice as likely as lighter players to have died before their 50th birthdays.
The NFL disputed the methodologies of the North Carolina study and the Scripps Howard study. A 2009 study of 504 active players, funded by the league and published in the Journal of the American Medical Association, indicated that during their careers, players, on the whole, did not appear to be at a greater risk of heart disease than other men their age.
The study said that NFL players had similar cholesterol levels and healthier blood-sugar levels and were less likely to smoke than the general population. Black players did not show higher cardiovascular risk than white players. The study did find, though, a higher likelihood over all of elevated blood pressure and borderline hypertension.
"The question is, if you are an elite athlete, can you be healthy at 300 or 350 pounds?" said Dr. Robert A. Vogel, a cardiologist and professor at the University of Maryland School of Medicine and a co-chairman of the NFL's subcommittee on cardiovascular health. "The simple answer is, being physically active is unquestionably a deterrent to the problems associated with weight. Having said that, are you at higher risk being a 350-pound lineman than a 210-pound quarterback? Yes."
Another 2009 study, published in The American Journal of Cardiology, found that retired NFL players had significantly lower occurrences of diabetes, hypertension, sedentary lifestyles and metabolic syndrome than did non-athletes.
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''Despite their larger body size, retired NFL players do not have a greater prevalence of heart disease risk factors when compared to the general population," the study's lead author, Dr. Alice Chang, an assistant professor of internal medicine at the University of Texas Southwestern Medical Center at Dallas, said in a statement that accompanied the study.
The NFL began to put a premium on weight in early 1980s, with the success of the Washington Redskins and their offensive line, known as the Hogs. Rule changes also allowed offensive linemen to use their hands more in blocking.
"You need to be physically strong enough to do this job," said Howard Green, a 365-pound defensive end for the Packers, whose defensive front is the largest in the league. "That's why so many of us are the weight we are."
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Performance-enhancing drugs have also clearly played some role in the larger size of players, though it is impossible to say precisely how much.
Almost no players admit to using banned substances, and the NFL does not test for human growth hormone, though Commissioner Roger Goodell has said such testing was needed "to protect the integrity of our game."
The issue of health and player size came to the forefront after the death in 2005 of Thomas Herrion, a 6-foot-3, 310-pound offensive lineman with San Francisco who collapsed and died after an exhibition game. A coroner's report said that Herrion's death was caused by heart disease that left a significant blockage in his right coronary artery.
Reggie White, a 300-pound Hall of Fame defensive end for Philadelphia and Green Bay, died in 2004 at age 43 of cardiac arrhythmia, with sleep apnea a possible contributing factor. Frank Warren, a retired defensive lineman with New Orleans, died in 2002 of a heart attack at age 43, five days after an interview with the HBO program "Real Sports" about the cardiovascular risks of obesity associated with NFL players. Another retired 300-plus pound defensive lineman, Norman Hand, who last played with the Giants, died last May of hypertensive cardiovascular disease at age 37.
Warren, who also had drug problems, told "Real Sports," ''Looking back, I don't know if I would change or not — money, the glory, knowing that I'm better than the next guy, that I can beat him at will."
The NFL offers sophisticated and free cardiovascular screenings for retired players and urges them to exercise and eat sensibly. Mark Murphy, the Packers' team president, who played safety for Washington during the Hogs era, said: "I think the smartest players are the ones that lose weight right away. It's not easy going through life that way."
Ryan Pickett, a defensive end for the Packers, said he found it difficult to get below his current 338 pounds.
''My problem is, I can go up too easily," he said, adding that upon retirement, "I want to go lower than this — I don't know how much, exactly, but a lot."
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Some players are not waiting for retirement to shed weight. In April, Max Jean-Gilles, a guard with the Philadelphia Eagles, underwent gastric lap-band surgery after his weight swelled to nearly 400 pounds following an operation to correct an ankle injury. He played this past season at a listed weight of 358 pounds.
"I didn't want to be 400 pounds after football, then have heart problems," Jean-Gilles told reporters after the gastric surgery. "I said, 'Oh, man, I can't live like this.' I was breathing heavy."
The issue of weight and heart risks has spread even to high schools, where studies indicate that more than half of linemen are overweight. Some medical experts have called for weight limits on players, although that seems unlikely in the immediate future. Even so, some former NFL linemen wonder whether it is really necessary to weigh 300 pounds to play effectively today.
"You can see by looking at the defensive linemen that they carry 30, 40, 50 pounds of fat," said Jerry Kramer, the All-Pro guard who led the Packers' famed sweep in the 1960s while playing at about 250 pounds. "Fat doesn't make you strong and quick. It makes you heavy. Muscle makes you strong. We've gotten enamored with the 300-pounder, but give me an offensive guard who's in great shape at 270 or 275 and understands leverage and positioning, and I'll bet he'll whip the fat guy every time."