Tim McCarver: Heart Failure in a Great Athlete

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Tim McCarver was twice a major League all-star catcher and was a member of two World Series-winning teams during his 21 years of playing for the St. Louis Cardinals, Philadelphia Phillies, Montreal Expos and Boston Red Sox. After his playing career, he became a TV broadcaster who won three Emmy Awards, called a then-record 23 World Series and 20 All-Star Games, and in 2016 was inducted into the Sports Broadcasting Hall of Fame. On February 16, 2023, at age 81, he died of heart failure.

Early Years and Baseball Career
McCarver was born on Oct. 16, 1941, in Memphis, where his father was a policeman. He was outstanding in high school football and baseball, and was offered football scholarships to Notre Dame and Alabama. Instead, he signed a $75,000 contract to play for the St Louis Cardinals. Thus he became a major leaguer at age 17, but he appeared in only eight games in his first season and was sent to the minor leagues. From 1963 on he played catcher for some of the most famous major league pitchers. He caught 214 games pitched by Bob Gibson and 236 games pitched by Steve Carlton. In 1964, he hit the home run that won the 1964 World Series. In 1966, he scored the winning run in the 10th inning of the All-Star Game, and that same year he was the first catcher to lead the National League in triples with 13. In 1967, he finished second for the National League Most Valuable Player award.

Broadcasting Career
After his playing career was over, his vast baseball knowledge made him one of the best baseball broadcasters, and he won three Emmy Awards for Sports Events. From 1980 to 1982 he called games for the Philadelphia Phillies, 1983 to 1998 for the New York Mets, 1999 to 2001 for the New York Yankees and in 2002 for the San Francisco Giants. During this time, he also broadcast games nationally for NBC and ABC. He broadcast freestyle skiing at the 1988 Winter Olympics and parts of the 1992 Winter Olympics. He continued to broadcast major league baseball until July 2020, when he announced that he had a condition that put him at high risk for serious complications if he developed COVID-19. In April 2022, he announced his final retirement from broadcasting and on February 16, 2023, he died of heart failure at age 81.

Having Fat in the Belly Can Cause Heart Failure
I have never seen McCarver’s medical records, and his obituaries have only listed heart failure as the cause of his death with no further explanation, so I can only guess what could cause a great athlete to die of heart failure. Athletes usually have big strong muscles that give them big, strong hearts (J Epidem & Comm Health, Nov 11, 2019), However, if you look at pictures of McCarver in later life, you will see that even though he was not overweight, he had a big belly and small buttocks. That means that genetically he stored fat primarily in his belly and that puts him at high risk for diabetes and heart failure (JAMA, 2017;317(6):626-634) as well as dementia, strokes, and heart attacks (JAMA Netw Open, Feb 1, 2022;5(2):e2146324). Many other studies have established that having a fatty liver is associated with:
• increased heart attack risk factors such as high blood sugar, high blood pressure or high  cholesterol levels (Lancet: Gastroenterology & Hepatology, Sept 20, 2021; J Am Coll Cardiol, 2021;78(5):513-531; J Am Coll Cardiol, 2016;68(14):1509-1521)
• increased risk for heart attacks (Lancet, 2005;366(9497):1640-1649)
• reduced cognitive scores for mental function (J Gerontol A Biol Sci Med Sci, 2009;64(1):103-109).
Storing fat in your belly is a stronger risk factor for diabetes than just being overweight, and is arguably the most common cause of Type II diabetes in North America today (BMC Public Health, November 18, 2019). You can have excess liver fat, even if you are not overweight (JAMA Netw Open, 2022;5(12):e2247186).  Signs of a Fatty Liver

Lessons From Tim McCarver’s Death
Fat can be removed from the liver with diet (Diabetologia, 2011 Oct; 54(10): 2506-2514) and with exercise (Scandinavian Journal of Medicine & Science in Sports, March 13, 2017;27(5)).
• If you have a big belly or your blood sugar is greater than 140 one hour after a meal, I recommend that you lose weight if overweight. Check with your doctor. The DIRECT trial found that 46 percent of 149 diabetics who were not on insulin became non-diabetic through a one-year, plant-based weight-loss program (Lancet, Feb 10, 2018;391(10120):541-551).
• Since most liver fat comes from dietary sugar, avoid or severely restrict all sugared drinks and sugar-added foods.  People who eat a lot of sugar can develop a liver full of fat that can lead to diabetes (Clin Sci (Lond), Sep 18, 2017).
• If you have a big belly, restrict all refined carbohydrates such as foods made from flour (bakery products, pasta, many breakfast cereals and so forth).
• Restrict red meat, processed meat and fried foods (Nutrients, Oct 6, 2022;14(19):4152).
• Eat plenty of vegetables, fruits, seeds and nuts which are rich sources of soluble fiber (Diabetologia, April 8, 2022;65:1119–1132).
• Don’t eat at night. Eating before going to bed can cause excess fat to be stored in the liver (J Clin Endocrinol Metab, Aug 1, 2020;105(8):dgaa354).
• Try to exercise every day (World J Gastroenterol, Jul 21, 2016;22(27):6318-27).

Caution: Intense exercise can cause heart attacks in people who already have blocked arteries. Check with your doctor before starting an exercise program or increasing the intensity of your existing program.

James Timothy McCarver
October 16, 1941 – Feb 16, 2023