Approaches to prevent iron deficiency in athletes

Abstract

For athletes, iron plays an important role in improving oxygen supply, energy production, muscle function, and cognitive performance.

However, iron deficiency is a common problem in athletes, especially endurance athletes, due to factors such as increased iron loss due to exercise-induced sweating, hematuria, and gastrointestinal bleeding. Exercise induces hematological adaptations due to increased demand of oxygen transport as well as inflammation, which reduces the ability to absorb iron post-exercise. Iron deficiency can lead to fatigue, reduced performance, poorer recovery and increased susceptibility to infections. Iron absorption is tightly regulated to prevent toxicity, with hepcidin playing a central role. Elevated hepcidin levels, which are influenced by exercise-induced inflammation and circadian rhythms, can significantly reduce iron absorption. In addition, the bioavailability of dietary iron varies, with heme iron from animal products being more readily absorbed than non-heme iron from plant sources. Athletes on a vegetarian or vegan diet may require increased iron intake to meet their needs.

Monitoring iron status through regular blood tests, including serum ferritin and hemoglobin levels, is critical for early detection and treatment of iron deficiency. Strategies to improve iron absorption include consuming iron-rich foods with promoters such as vitamin C, while inhibitors such as phytates and calcium should be avoided. In cases of significant deficiency, supplementation under medical supervision may be necessary. Understanding these factors and using appropriate nutritional and monitoring practices can help athletes maintain optimal iron levels and overall performance.