Iron considerations for the athlete: a narrative review

Area of Science:

• Sports Medicine
• Human Physiology
• Nutritional Science

Background:

• Iron is crucial for oxygen transport and energy metabolism, vital for athletic performance.
• Iron deficiency is prevalent in athletes, especially females and endurance athletes, affecting 15-35% of females and 5-11% of males.
• Growing research links exercise to altered iron regulation and absorption in athletes.

Purpose of the Study:

• To review current research on factors affecting iron status in athletes.
• To explore the role of exercise-induced hepcidin in athlete iron metabolism.
• To summarize the impact of sex hormones, diet, training, and environmental stress on athlete iron status.

Main Methods:

• Literature review of existing research on iron metabolism in athletes.
• Analysis of studies investigating exercise-induced hepcidin.
• Examination of factors including sex hormones, diet, training load, and altitude exposure.

Main Results:

• Iron deficiency is common in athletic populations, with higher prevalence in females.
• Exercise increases hepcidin, a key hormone influencing iron absorption and potentially leading to deficiency.
• Sex hormones, macronutrient intake, training intensity, and environmental stressors like hypoxia modulate iron status.

Conclusions:

• Athlete iron status is complex, influenced by physiological and external factors.
• Understanding exercise-induced hepcidin changes is key to managing iron deficiency in athletes.
• Further research is needed to refine recommendations for optimizing iron status in athletes.