Methodological Considerations for Investigating Iron Status and Regulation in Exercise and Sport Science Studies

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Alannah K.A. McKay Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia

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Marc Sim Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
Medical School, Royal Perth Hospital Unit, University Western Australia, Perth, WA, Australia

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Diego Moretti Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zürich, Zurich, Switzerland
Nutrition Group, Health Department, Swiss Distance University of Applied Sciences, Regensdorf, Switzerland

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Rebecca Hall Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
Olympic Winter Institute of Australia, Docklands, VIC, Australia

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Trent Stellingwerff Canadian Sport Institute-Pacific,Victoria, BC, Canada
Exercise Science, Physical & Health Education, University of Victoria, Victoria, BC, Canada

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Richard J. Burden English Institute of Sport, University of Manchester, Manchester, United Kingdom
Faculty of Sport, Allied Health and Performance Science, St Mary’s University, Twickenham, United Kingdom
School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, United Kingdom

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Peter Peeling School of Human Sciences (Exercise and Sport Science), University of Western Australia, Crawley, WA, Australia
Western Australian Institute of Sport, Mt Claremont, WA, Australia

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DOI:
https://doi.org/10.1123/ijsnem.2021-0343
Keywords:
methods; iron deficiency; iron isotopes; hepcidin; absorption; hemoglobin
First Published Online:
01 Apr 2022
In Print:
Volume 32: Issue 5
Page Range:
359–370
Restricted access

Iron deficiency is a common health issue in active and athlete populations. Accordingly, research into iron status, regulation, absorption, and iron deficiency treatment strategies is increasing at a rapid rate. However, despite the increase in the quantity of research, various methodological issues need to be addressed as we progress our knowledge in this area. The purpose of this review is to highlight specific considerations for conducting iron-related research in active and athlete populations. First, we discuss the methodological importance of assessment and interpretation of iron status, with reference to blood collection protocols, participant screening procedures, and biomarker selection. Next, we consider numerous variables that should be accounted for in the design of iron-related research studies, such as the iron regulatory hormone hepcidin and its interaction with exercise, in addition to an examination of female physiology and its impact on iron metabolism. Subsequently, we explore dietary iron and nutrient interactions that impact iron regulation and absorption, with recommendations made for optimal methodological control. Consideration is then given to key features of long-term study designs, such as the monitoring of training load, oral iron supplementation, dietary analysis, and general lifestyle factors. Finally, we conclude our recommendations with an exploration of stable iron isotope tracers as a methodology to measure iron absorption. Ultimately, it is our intention that this review can be used as a guide to improve study design, biomarker analysis, and reporting of findings, to maximize the quality of future research outputs in iron-related research focused on active and athlete populations.

McKay (alannah.mckay@acu.edu.au) is corresponding author.

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