Incidence of Iron Deficiency and Iron Deficient Anemia in Elite Runners and Triathletes.
OBJECTIVE
To assess the incidence of iron deficiency (ID), and iron deficient anemia (IDA) within a cohort of highly trained runners and triathletes, and to examine the association of oral iron supplementation history with serum ferritin (sFe) and hemoglobin (Hb) concentrations.


METHODS
A retrospective analysis of routine blood test data taken from 2009 to 2015 from (n = 38) elite level runners and triathletes between the ages of 21 to 36 years. Oral iron supplement intake was assessed through a questionnaire.


RESULTS
Triathletes (female, FT; male, MT) and runners (female, FR; male, MR) had higher incidence of at least 1 episode of ID (FT 60.0%, MT 37.5%, FR 55.6%, MR 31.3%) compared with values reported in the literature for endurance athletes (20%-50% females, 0%-17% males). Male triathletes and runners had a higher incidence of IDA than their female teammates (25% MT, 20% FT, 6.3% for MR, 0% FR), a finding which has previously not been reported. Hemoglobin concentrations were low, with incidence of Hb <140 g/L in men occurring at least once in 87.5% of triathletes, and 31.3% of runners, and Hb <120 g/L in women occurring at least once in 20% of triathletes, but 0% of runners. Although the athletes were appropriately treated with oral iron (mean 94 ± 115 mg/d), there was no observed correlation between iron intake and sFe or Hb.


CONCLUSIONS
Even with monitoring and treatment in place, ID and IDA are significant concerns for the health and performance of elite runners and triathletes, and this issue affects males and females.
*Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada; †Health and Performance Centre, University of Guelph, Guelph, ON, Canada; ‡Department of Family Medicine, McMaster University, Hamilton, ON, Canada; and §The International Olympic Committee's Medical Commission.
Alexandra
A
Coates
Margo
M
Mountjoy
Jamie
J
Burr
D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000453:epidemiology*; D056352:Athletes; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D015994:Incidence; D007501:Iron / Q000097:blood; D000090463:Iron Deficiencies; D008297:Male; D012189:Retrospective Studies; D012420:Running; D055815:Young Adult
D007501:Iron