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The Villages
Wednesday, January 19, 2022

John Madden’s big belly a symptom of his health issues

Dr. Gabe Mirkin

John Madden was 32 years old when the Oakland Raiders hired him to become the youngest head coach ever in the National Football League. He went on never to have a losing season, with an outstanding 103-32-7 record in his 10 seasons with the team. They made the playoffs eight times and won Super Bowl XI on January 9, 1977. His winning percentage of .759 remains the highest for an NFL coach with at least 100 victories. He was inducted into the Pro Football Hall of Fame at age 70 in 2006. After he retired from coaching in 1979, he arguably became even more famous as a career broadcaster and won 16 Emmy Awards on all four major networks.

No cause has been given for his sudden death at age 85, on December 28, 2021, but his pictures show significant abdominal obesity that suggests diabetes and heart problems. Abdominal obesity usually means that a person has too much fat in his liver that causes insulin resistance, diabetes and heart attacks.

Early Life and Career in Football
Madden was an offensive lineman in high school and won a football scholarship to the University of Oregon. While at the University of Oregon, he beat world-mile-record-holder John Landy in a 40 yard dash, but never played in a football game there because of a knee injury requiring surgery. He transferred to Cal Poly in San Luis Obispo, where he was all-conference offensive tackle and also was a catcher on their baseball team. He was the 244th overall draft pick by the NFL’s Philadelphia Eagles in 1958, but soon after he joined the team, he injured his other knee and never played professional football. However, quarterback Norm Van Brocklin took a liking to him and spent time teaching him the science of football as they watched football films together.
In 1960, at age 24, he was hired as an assistant coach at Allan Hancock College in Santa Maria, and became head coach there in 1962 In 1964 he became defensive assistant coach at San Diego State, and they became the top small college team in the country. At the incredibly young age of 31, he was hired as linebackers coach for the AFL’s Oakland Raiders and they reached the Super Bowl that year. The next year, Raiders head coach John Rauch resigned to take the same position with the Buffalo Bills, and John Madden at age 32 became the youngest AFL head football coach of all time. In the next seven years, the Oakland Raiders reached five AFC Championship games. On January 9, 1977, Madden’s Raiders won the Super Bowl, making them the top professional football team in the country. On January 4, 1979, he retired from coaching because of a stomach ulcer and the pressures of being a professional coach.

In 1979, at age 43, Madden started as a CBS color commentator and two years later he and Pat Summerall began an eight-year run of reporting on Super Bowls together. In 1994, Madden and Summerall joined Fox Sports for seven years. Madden’s contract was higher than any active NFL player. In 2002 at age 66 he joined ABC’s Monday Night Football with Al Michaels. Madden earned $5 million per year. In 2006 he joined NBC and became the first sportscaster to have worked for all of the Big Four U.S. broadcast television networks.

Why He Was Such a Popular Sportscaster
Madden knew more about football than just about every other broadcaster and used a “telestrator,” in which he drew the plays while he explained what had just happened. He also created a whole new language for each play. Examples include “Boom!”, “Whap!”, “Bang!”, “Doink!”‘ and “Bam!” He picked players to make up the “The All-Madden Team” that competed with the all-pro team picks. In addition to his work in radio, television, and movies, he endorsed and helped to develop the very popular Madden NFL video game series. He retired from broadcasting in 2009, at age 73.
Anxiety, Lifelong Medical Problems and Death
In 1960, when Madden was 24, the team manager and 16 team members of his California Polytechnic State University football team died in a plane crash. Nineteen years later, in 1979, Madden had a major panic attack on a flight from Tampa and he decided that he would never again travel in a plane. At first he travelled between cities on trains, but in 1987, he worked out a deal with Greyhound Lines to supply him with a custom bus and drivers in exchange for advertising and speaking events. His refusal to fly resulted in his never doing commentary for the Pro Bowl in Honolulu or any of the preseason games outside of North America.

In 1978, at age 42, he quit coaching the Oakland Raiders at a time when he was felt to be one of the best coaches in professional football. He had stomach ulcers, panic attacks, multiple joint problems and joint surgeries. In 2015, at age 79, he had bypass surgery for blocked arteries leading to his heart and had had several hospitalization for medical problems of his heart, hip, knee, and esophagus. He died at his home in Pleasanton, California, on December 28, 2021, at the age of 85.

Everyone with a Big Belly Should be Checked for Diabetes
I have never seen John Madden’s medical records, but he had a very large belly, which is often a sign of a fatty liver that causes diabetes that leads to heart diseases. Because his grandson has type I diabetes (juvenile diabetes), Madden had been an active spokesperson and fundraiser for the Juvenile Diabetes Research Foundation for many years. Madden is likely to have been affected by the far more common Type II diabetes, although I could find no record of this. More than seventy percent of North Americans adults will become diabetic or pre-diabetic, diseases that may be reversed with lifestyle changes. Insulin resistance (failure to respond to insulin) causes the majority of all cases of type II diabetes and prediabetes, and insulin resistance is caused by excess fat in the liver (J Clin Invest, May 19, 2020).

Definition of Insulin Resistance
Insulin drives sugar, fat and protein into cells. Insulin resistance means that the cells do not respond to insulin, so sugar builds up in the bloodstream. Everyone’s blood sugar rises after they eat, but if blood sugar rises too high, sugar irreversibly sticks to cells and can destroy every kind of cell in your body. To prevent blood sugar from rising too high, your pancreas releases insulin into your bloodstream, which lowers blood sugar by driving sugar from the bloodstream into the liver. However, if the liver is full of fat, it does not accept the sugar and blood sugar levels rise even higher. Insulin resistance can be reversed by emptying fat from the liver and muscles.

Sequence From Fatty Liver to Diabetes
• After you eat, your blood sugar level rises
• Your pancreas responds to the rise in blood sugar by releasing insulin
• Insulin lowers blood sugar by driving sugar from your bloodstream into your liver and muscles
• Your liver and muscles can store only a limited amount of sugar
• All extra sugar that cannot be stored is converted to fatty triglycerides
• Extra triglycerides damage your blood vessels, so insulin drives triglycerides from your bloodstream into your liver, fat cells and muscles
• Your fat cells fill up with fat and you become fatter
• Your liver cells fill up with fat and you develop a fatty liver
• Fat in your liver prevents your liver from accepting sugar from your bloodstream, so you stop responding to insulin and become insulin insensitive (Gastroenterology, 2008;134(5):1369–1375)
• The more fat you have in your liver, the greater your insulin resistance (Gastroenterology, 2008;135(1):122–130)
• The higher your insulin levels, the more fat you deposit in your liver (Hepatology, 2014;59(6):2178–2187) because insulin resistance causes even more fat to be deposited in your liver (J Clin Invest, 2020;130(3):1453–1460)
• Insulin resistance causes you to deposit fat in your belly so that you end up shaped like an apple with a large belly and small buttocks (J Clin Invest, 1986;78(6):1648–1657)
• Since sugar can’t get into a fatty liver, your blood sugar continues to rise higher and higher until you are diabetic. It is the liver fat, and not muscle fat, that leads to diabetes (Proc Natl Acad Sci USA, 2009;106(36):15430–15435)
• Being fat without having excess fat in your liver does not cause diabetes (Obesity, 2010;18(8):1510–1515)
• A high rise in blood sugar causes sugar to stick to the outside membranes of cells, which damages and destroys them
• Insulin resistance and the resultant high blood sugar levels can damage every cell in the body to cause inflammation that causes heart attacks and cancers (Diabetes, 1992;41(3):368–377)
• As a person loses weight, liver fat is reduced and the person becomes better able to respond to insulin (Cell Metab, 2016;23(4):591–601)

My Recommendations
Just about everyone who has a big belly and small buttocks stores fat in their liver and is already diabetic or pre-diabetic. To prevent fat from getting into your liver, you have to prevent blood sugar levels from rising too high after meals. You can do this by:
• Exercising before or after you eat. Contracting muscles remove sugar from your bloodstream without needing insulin.
• Basing your diet on vegetables, fruits, whole grains, beans, nuts and other seeds.
• Severely restricting foods with added sugar and all sugared drinks including fruit juices, mammal meat, processed meats, and fried foods. If you are overweight, also restrict sources of refined carbohydrates such as bakery products, white rice, milled corn, pasta and most dry breakfast cereals. See Diabetes is Often Missed

Dr. Gabe Mirkin is a Villager. Learn more at www.drmirkin.com

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