Iron deficiency in athletes is a real thing

 

Iron is really important for energy production which is a fundamental part of endurance sport (1). Low iron levels can have a large detrimental effect on performance due to reduced oxygen transport, reduced immune and neural function, and poor carbohydrate metabolism, and in turn energy production (2).

Symptoms if Iron Deficiency include (2):

• Fatigue and a reduced training capacity
• Pale skin and inner eyelids, mouth
• Decreased cognitive (brain) function and motor performance
• Reduced temperature regulation/always feels cold
• Decreased immune function/unresolved infections
• Poor appetite
• Symptoms can be confused with overtraining

Athletes most at risk of iron deficiency include (1):

• Individuals with high iron requirements; such as high growth periods (ie adolescents)
• Individuals with increased losses of urine (sweating), menstrual
• Engaged in prolonged strenuous exercise
• Individuals with a Low energy intake or an imbalanced diet (<1200kcal/day)
• A low intake of iron rich foods (e.g. meat) especially for Vegan/vegetarian athletes
• A Copper deficiency
• Individuals who take calcium supplements (as it inhibits iron absorption)

Treatment

Treatment includes dietary changes and iron therapy (supplements or Iron injection) (2).

Dietary changes

Dietary changes include increased dietary iron and total energy intake (2). Increased intake of well absorbed iron (haem iron such as lean red meats, shellfish, liver, dark cuts of poultry, fish, eggs, oysters. Increase non‐haem sources as well, e.g. iron‐fortified foods breakfast cereals, wholegrains, nuts, seeds, legumes, green leafy vegetables

Increase foods with Vitamin C which increases Iron Absorption in the body (2).

Decrease the following foods which decrease absorption of Iron in the body (2): Phytates (cereals, legumes, nuts); Oxalate (leafy vegetable); Excess Zinc, Calcium or Manganese; Polyphenols (tea, red wine, coffee)

References

1. Sinclair, Lisa M., and Pamela Sue Hinton. “Prevalence of iron deficiency with and without anemia in recreationally active men and women.” Journal of the American Dietetic Association6 (2005): 975-978.
2. World Health Organization. “Iron deficiency anaemia: assessment, prevention and control: a guide for programme managers.” (2001).