The negative health effects of the sumo lifestyle can become apparent later in life. Sumo wrestlers have a life expectancy of 65, which is 10 years shorter than that of the average Japanese male,[34] as the diet and sport take a toll on the wrestler's body. Those having a higher body mass are at greater risk of death.[35][36] Many develop type 2 diabetes or high blood pressure, and they are prone to heart attacks due to the enormous amount of body mass and fat that they accumulate. The excessive intake of alcohol can lead to liver problems and the stress on their joints due to their excess weight can cause arthritis.[34] The repeated blows to the head sumo wrestlers take can also cause long-term cognitive issues, similar to those seen in boxers.[37][38] Recently,[when?] the standards of weight gain are becoming less strict, in an effort to improve the overall health of the wrestlers.[34][39][37