CONTEXT: Understanding former professional football players' engagement with health-promoting behaviors (physical exercise, high-quality diet, and good sleep hygiene) will be helpful for developing lifestyle interventions to improve their feelings of well-being, a relatively understudied facet of health among this population. OBJECTIVE: Examine associations among health-promoting behaviors and subjective outcomes related to well-being among former National Football League (NFL) players. DESIGN: Cross-sectional. SETTING: Online or hard-copy survey. PATIENTS OR OTHER PARTICIPANTS: Former NFL players. MAIN OUTCOME MEASURE(S): Self-reported health-promoting behaviors (exercise frequency, diet quality, and sleep duration and disturbance) and factors related to well-being (Patient-Reported Outcomes Measurement Information System - Meaning and Purpose [MP], Self-Efficacy, and Ability to Participate in Social Roles and Activities [SRA]). Multivariable linear regression models were fit for each well-being-related factor with health-promoting behaviors as explanatory variables alongside select demographic, behavioral, and functional covariates. Models were fit for the full sample and separately for individual age groups: <
30 years, 30 to 39 years, 40 to 49 years, 50 to 59 years, 60 to 69 years, and 70+ years. RESULTS: A total of 1784 former NFL players (aged 52.3 ± 16.3 years) completed the survey. Lower sleep disturbance was associated with better MP (β [standard error] = -0.196 [0.024]), Self-Efficacy (β [standard error] = -0.185 [0.024]), and SRA (β [standard error]= -0.137 [0.017]) in the full sample and almost all the individual age groups. More frequent moderate-to-vigorous exercise was associated with higher MP (β [standard error] = 0.068 [0.025]) and SRA (β [standard error] = 0.151 [0.065]) in the full sample and with better MP, Self-Efficacy, and SRA among select middle-aged groups (between 40 and 69 years old). Diet quality, resistance training exercise frequency, other wellness activity frequency, and sleep duration were not associated with well-being-related factors in the full group, and sparse significant associations were observed in individual age group models. CONCLUSION: Lower sleep disturbance and more frequent moderate-to-vigorous exercise frequency may be important targets for improving overall health and well-being among former NFL players.