Iron Deficiency in Vegetarian Athletes: A Narrative Review

Area of Science:

• Sports Nutrition
• Dietary Science
• Human Physiology

Background:

• Growing adoption of vegetarian diets (lacto-ovo, lacto-, ovo-vegetarian, vegan) in athletes.
• Iron status is a key nutritional concern due to lower non-heme iron bioavailability and increased exercise demands.
• Understanding iron deficiency in vegetarian athletes is crucial for health and performance.

Purpose of the Study:

• Synthesize and critically evaluate evidence on iron deficiency in vegetarian athletes.
• Examine prevalence, consequences, adaptive responses, and management strategies.
• Assess the risk of iron deficiency in vegetarian athletes compared to omnivores.

Main Methods:

• Literature review and critical evaluation of existing studies.
• Analysis of dietary iron intake, bioavailability, and absorption.
• Consideration of physiological adaptive mechanisms and iron losses.

Main Results:

• No consistent evidence of higher iron deficiency prevalence in vegetarian athletes versus omnivores.
• Vegetarian athletes often match or exceed omnivore iron intake, with adaptive mechanisms preserving iron balance.
• Methodological heterogeneity and limited data on elite/female athletes restrict definitive conclusions.

Conclusions:

• Vegetarian athletes are not inherently at greater risk of iron deficiency.
• Individualized, evidence-based dietary planning is essential for optimal iron status and performance in high-performance settings.
• Further research is needed on diet, physiology, sex, and training load interactions in iron metabolism.