Dallas McCarver, 26! Luke Sandoe, 31! Shawn Rhoden, 46!

With each pro bodybuilder death comes the contention that the Mr. Olympia is the equivalent of the Hunger Games, with participants destined for early graves. But men do expire in their 40s or 30s and even their 20s. Is the average pro bodybuilder really dying younger than the average man? How does their mortality stack up to other pro athletes? What are the most common causes of the deaths? And what can be done to improve bodybuilder mortality?

PRO BODYBUILDERS VS. ALL AMERICAN MEN

In 2019, this was the first article at The Barbell. We originally focused on the men’s open competitors in the Mr. Olympia and Arnold Classic and had a database of 269 pro bodybuilders. In 2021, we added competitors from the Arnold precursor, the World Pro (mostly 1979-89), the Night of Champions (1978-2004), and its successor, the New York Pro, greatly expanding our database to 478 pro bodybuilders.

Now, we’ve added last year’s new competitors in the Mr. Olympia (1965-2022), Arnold Classic (1989-2022), and New York Pro (2005-2022) and updated with any added deaths, corrections, or confirmed living competitors from the five contests. Our database now has 508 pro bodybuilders who we confirmed were either alive (442) or dead (66) at the end of 2022.

We matched the birth year for each of those 508 (some birth years were estimated) with the mortality rate for all American men born that same year. (Though a large minority of competitors were not American, the U.S. Social Security actuarial life tables provide the best baseline.)

The numbers say:

PRO BODYBUILDER MORTALITY RATE: 13%

AMERICAN MALE MORTALITY RATE: 13.9%  

So, both percentages increased 0.4% over the 2021 update as the two populations age, but the difference of 0.9% has not changed.

If we break this down to those born in or before 1972 (now 50+) and those born before 1972 (under 50), the comparison looks like this:

And when we chart birth year mortality, it looks like this:

OBSERVATIONS

In the first chart, the mortality difference is slightly better but nearly the same for over-50 bodybuilders (-1.0%) as opposed to under-50 bodybuilders (-0.8%). In the second chart, there’s more variability in the over-60 bodybuilders because of smaller sample sizes, but the pro bodybuilder and American men lines follow each other closely.

• All adult American men includes a lot of unhealthy guys. 43% are obese. 14% smoke tobacco, and this was much greater in previous decades (28.5% smoked in 1990, for example). Also, those who have a serious health condition or develop one along the way are much less likely to pursue competitive bodybuilding. So, one could argue pro bodybuilders born in, say, the 1960s should be living substantially longer than average. Instead, the ’60s generation are dying at nearly the same rate as all American men. If that’s not alarming, it’s certainly not inspiring.

PRO BODYBUILDERS VS. OTHER PRO ATHLETES

Let’s broaden our comparison to include fit men who better compare to bodybuilders. We’ll also narrow our focus to look at only pro bodybuilders in our database born from 1954-79 (those turning 44-69 in 2023). This 26-year span corresponds to research done by FiveThirtyEight on the very high mortality of pro wrestlers in relation to pro athletes. In addition to precisely computing the pro bodybuilder and corresponding American male stats, we’ve updated 538’s findings with estimates for the last 8 years to see how bodybuilder mortality corresponds to not just all American men but also WrestleMania participants and NFL and MLB players.

Of the 320 pro bodybuilders born from 1954-79 on which we have reliable data, 32 are deceased. Again, for the American male mortality rate, we used the actuarial life tables that correspond to birth years for each of the 320.

And the numbers say…

PRO BODYBUILDER MORTALITY RATE: 10%

AMERICAN MALE MORTALITY RATE: 11.3%

PRO WRESTLER MORTALITY RATE: 18.6%

NFL PLAYER MORTALITY RATE: 5.6%

MLB PLAYER MORTALITY RATE: 4.1%

Here’s what it looks like when we graph those results next to the updated FiveThirtyEight stats:

OBSERVATIONS

Pro bodybuilders aged 44-69 (in 2023) are dying at a lower rate than the average American man and a much lower rate than pro wrestlers. However, they’re dying at 1.75 times the rate of former NFL players and nearly 2.5 times the rate of former MLB players. (For more on the difference in mortality between NFL and MLB players, here’s another more recent study.)

Many pro wrestlers use or have used performance-enhancing drugs. A stressful lifestyle, abuse of pain-killers and/or recreational drugs, insufficient health care, and obesity may also contribute to the high mortality rate of WrestleMania participants.

The NFL began testing players for performance-enhancing drugs (PEDs) in 1987, while MLB only starting suspending doping violators in 2005, so this period overlaps with the “steroid eras” in football and baseball. Still, it’s likely the percentage of PED-users was much lower and most users used less than the average pro bodybuilder. This and a stronger emphasis on fitness amongst former pro athletes, likely contributes to their lower mortality. Ideally, the pro bodybuilder bar should be close in height to the NFL and MLB bars.

CAUSES OF PRO BODYBUILDER DEATHS         

Let’s break down the causes of death for the 66 pro bodybuilders who are deceased:

  • 27 Cardiovascular (18 heart attacks, 7 heart failures, 1 vasculitis, 1 aneurism)
  • 12 Unspecified Natural Cause (includes 6 unreleased cause)
  • 10 Cancer (3 undisclosed, 2 stomach, 2 leukemia, 2 liver, 1 skin)
  • 6 Kidney (3 kidney failures, 1 multiple organ failure, 1 failed kidney transplant, 1 sudden decline/chronic kidney disease)
  • 6 Unnatural (2 murders, 2 suicides, 1 overdose, 1 accidental)
  • 2 Brain (2 Alzheimer’s disease)
  • 2 Lung (1 Valley Fever, 1 pneumonia)
  • 1 Liver (1 liver failure) * also 2 liver cancers & 1 multiple organ failure

Now let’s chart those causes as well as the causes for all American men. The average year of death for our 66 pro bodybuilders was 2008, so we used statistics for male deaths for that year from the Center for Disease Control’s National Vital Statistics report.

OBSERVATIONS

 Pro bodybuilder kidney-related deaths at 9.1% is abnormally high and is likely associated with PEDs, especially insulin and diuretics.

Similarly, liver damage is associated with anabolic steroid usage, and if we add the two liver cancers and the multiple organ failure, including liver, of Andreas Münzer (who died with but not from liver cancer) that category is also abnormally high.

•  Cancer deaths are significantly lower than average in the pro bodybuilder group. This is likely, in part, because lung cancer is the No. 1 cause of cancer fatalities in men, and pro bodybuilders have a much lower propensity for smoking than the general population. This likely also explains the lower instances of pro bodybuilder respiratory deaths, both of which were from infections, as opposed to smoking-related diseases like emphysema.   

Heart disease is the leading cause of death in America and worldwide. Still, the 27 pro bodybuilder cardiovascular deaths stand out. If six or more of the 12 deaths listed as “unspecified natural cause” were heart-related (which seems likely), over half of the pro bodybuilder deaths have been cardiovascular. (Also, Chris Dickerson died of pneumonia while being treated for a heart condition.) This is alarming, but even more so when we consider the young age at which too many pro bodybuilders are dying from heart failure. Let’s explore this in more detail.

PRO BODYBUILDERS AND HEART HEALTH

Of the 66 pro bodybuilder deaths, 27 are known to be heart-related (and most likely more from the “unspecified natural” category). Shockingly, 11 of these occurred in bodybuilders under 45 (out of 18 deaths), 61%. Such deaths should be very rare. Conversely, only 3 of the 15 deaths of pro bodybuilders over 65 were cardiovascular (20%), far below the rate of all 65+ American men. When we chart by age groups—young adult (20-44), middle-aged (45-64), and senior (65+)—to show what percentage of deaths in each group were cardiovascular, it’s shocking to see pro bodybuilder deaths descend from sky-high to very-high to low while American male deaths ascend from very-low to high to very-high.

The first two blue bars are very alarming, especially when you consider that the greatest factors for heart disease (obesity, diabetes, smoking, lack of exercise) are largely disassociated from bodybuilding. Furthermore, a 2018 study demonstrated weight-training may greatly reduce the risks of heart attack and stroke.

Ideally, all the blue bars should be two-thirds as high as their red counterparts. Young or middle-aged men with low bodyfat who regularly exercise should not be dying of cardiovascular maladies at the same rate—let alone a much greater rate—as men of all ages. The most likely culprit is performance-enhancing drugs. Excessive growth hormone can enlarge the heart and induce failure. As for testosterone, there is contradictory data on its relationship to heart health, but there is much reason for concern when regularly injecting or ingesting great quantities of testosterone and/or anabolic steroids.

Get an annual physical with bloodwork (more frequently if you’re cycling PEDs) and monitor your own blood pressure regularly (you can buy a monitor for under $30) to make certain it stays in the normal range. Furthermore, do not ignore warning signs like elevated cholesterol or high blood pressure, but take appropriate steps to reduce these to safe ranges, even if this means halting a drug cycle or ending a contest prep. Too many bodybuilders—from Mr. Olympia competitors to gym rats who never intend to step on a stage—are dying way too young from preventable heart-related maladies.  

 PRO BODYBUILDER DEATHS: CONCLUSIONS

• Are pro bodybuilders dying younger than average? It depends. Both overall and in the modern era, they’re dying at a slightly lower rate than the­ average American man. But this should not be the standard. They’re dying at a much faster rate than pro athletes in major sports. Heart and kidney maladies are the disproportionate causes, and performance enhancing drugs are the principal culprits.

 Pro bodybuilders are dying under 50 of cardiovascular causes at a shockingly high rate. Look again at the “Birth Years 1954-79” mortality chart. At least 16 of the 32 pro bodybuilder deaths were cardiovascular, HALF, 15 of which occurred in men aged 32-52. Eliminate those 15 and the 3 kidney-related deaths, aged 31-47, and that chart’s pro bodybuilder mortality plummets to 3.75%, lower than even major league baseball players. Only eliminate half of those 18 deaths (9 lives lost, 9 lives saved) and that mortality rate would still drop all the way to 7.2%. In 2021, Arnold Schwarzenegger and Olympia owner Jake Wood said they want to be proactive in the wake of recent high-profile deaths in competitive bodybuilders. As the statistics above show, moving forward, heart and kidney health needs to be a principal focus for competitive bodybuilding.

ADDENDUM: THE PRO BODYBUILDER DEATHS (AGES & CAUSES)

Baitollah Abbaspour (36, complications from vasculitis), Agathoklis Agathokleous (33, cancer), Art Atwood (37, heart attack), Mohammed Benaziza (33, heart failure), Leon Brown (74, liver cancer), Mario Carrier (54, unreleased), Gianluca Catapano (47, natural causes), Franco Columbu (78, heart attack), Ed Corney (85, brain aneurism), Vince Cummerford (52, heart attack), Nelson Da Silva (51, unreleased), Miroslaw Daszkiewicz (60, natural causes: chronic disease), David Dearth (55, heart attack), Chris Dickerson (82, pneumonia after a heart ailment), Greg DeFerro (53, heart failure), Paul DeMayo (37, heroin overdose), Dave Draper (79, heart failure), Nasser El Sonbaty (47, kidney failure), Johnny Fuller (62, leukemia), Josef Grolmus (59, unreleased), Pavel Grolmus (37, murder), Jose Guzman (61, natural causes), Phil Hernon (55, sudden decline/chronic kidney disease), Frank Hillebrand (45, heart attack), Dave Johns (40, Valley Fever), Eduardo Kawak (47, heart attack), Rod Koontz (64, liver cancer), Greg Kovacs (44, heart attack), Kent Kuehn (85, natural causes), Reg Lewis (85, unreleased), Mike Matarazzo (48, heart failure), Dallas McCarver (26, heart attack), Cedric McMillan (44, heart attack), Ray McNeil (29, murder), Mike Mentzer (49, heart failure), Ray Mentzer (47, kidney failure), Steve Michalik (63, suicide), Andreas Münzer (31, multiple organ failure), Serge Nubret (72, natural causes), Sergio Oliva (71, kidney failure), Bill Pettis (69, accidental: drowning), Harold Poole (70, natural causes), Tom Prince (52, cancer), Jorma Raty (60, heart attack), Shawn Rhoden (46, heart attack), Carlos Rodriguez (46, stomach cancer), Don Ross (48, heart attack), Salvador Ruiz (68, leukemia), Heinz Sallmayer (32, heart failure, linked to diuretic use), Luke Sandoe (31, heart failure), Sonny Schmidt (50, cancer), Larry Scott (75, Alzheimer’s), Daniele Seccarecci (32, heart attack), Mike Sheridan (51, undisclosed), Chuck Sipes (60, suicide), Daryl Stafford (59, heart attack), Wilfred Sylvester (64, Alzheimer’s), Ron Teufel (45, liver disease), Dennis Tinerino (64, stomach cancer), Ed Van Amsterdam (40, heart attack), Casey Viator (62, heart attack), Derrick Whitsett (37, heart attack), Jusup Wilkosz (71, unreleased), Scott Wilson (67, skin cancer), Luke Wood (35, failed kidney transplant), Don Youngblood (51, heart attack)

(Research assistance: Peter McGough, Joe Roark, musclememory.com)