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The United States of Football & my family’s Apolipoprotein E4 genotypes

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Head injury is a topic of much concern among football players from ages 8-80. My 7 and 9-year old sons have started playing football (tackling in our town starts at age 8) and so I was eager to see the new documentary film The United States of Football that tracks an ongoing discussion of chronic traumatic encephalopathy (CTE) among current & former NFL players as well as NFL league officials and youth football coaches. It is a frightening topic, but I am grateful to the filmmakers for informing me about this very serious issue.

In the days since viewing the film, my sons and I have been talking about what it feels like to get a “ding” and, if they experience white flashes of light, why it is important for them to notify the coach and me so that they can sit out for the rest of the game. We also have been practicing proper heads up tackling technique and the importance of NOT hitting another child in the head. Given that they are typical rambunctious young fellows, who, if not padded up on the football field, are climbing (and falling from) trees, riding (and crashing) bikes or playing chase (and colliding with other kids) in our neighborhood, we feel that their relative risk of serious head injury on the youth football field is acceptable.

I also checked my 23andMe results for my Apolipoprotein E4 genotype status. Luckily it is negative. I checked my genotype because there is some evidence that this one particular genotype is associated with the development of CTE.

The development of chronic traumatic encephalopathy has also been linked to the ε4 genotype. Having the same Apolipoprotein E ε4 genotype also predisposes the individual to incurring significantly more severe chronic traumatic encephalopathy compared to those without the ε4 genotype, given the same degree of chronic TBI.

My wife still needs to upgrade to the new 23andMe genotyping platform to get her E4 status. If she is positive, our plan is to have both of our children tested and, if they are carriers, we will discourage them from playing any sports where head injury is common. Conversely, we also understand that a negative Apolipoprtein E4 status is not a green light for head bashing.

Regardless of genotype, the plan is to carefully monitor how much “contact” they are experiencing (estimated about 700 hits per season in high school), and be quick to protectively withdraw them if it becomes too intense (about 1 “ding” per 250 hits for adults). Helmet sensors (linear accelerometers)? Perhaps not (an ideal system should measure both linear and rotational acceleration).

Football fans? Yes. But reading books, creative writing, drawing, playing music … and playing sports for fun … shall remain the low-impact mainstay of their childhood.



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