This study evaluates the relationship between body iron losses and gains in artistic gymnastics female athletes. It shows that despite the low iron intake and exercise-induced hemolysis, iron deficiency or iron-deficiency anemia does not occur, but partial changes in the hematological profile do. The hypothesis that gymnasts’ nutritional behavior contributes to anemia, which may be aggravated by exercise-induced hemolysis, led to this cross-sectional study, conducted with 43 female artistic gymnasts 6–16 yr old. The control group was formed by 40 nontraining girls, paired by age. Hemogram, serum iron, ferritin, soluble transferrin receptor, haptoglobin, total and fractional bilirubin, Type I urine, and parasitologic and occult fecal blood tests were evaluated. The athletes presented mean hematimetric and serum iron values (p = .020) higher than those of the control group. The bilirubin result discarded any hemolytic alteration in both groups. The haptoglobin results were lower in the athlete group (p = .002), confirming the incidence of exercise-induced hemolysis. Both groups presented low iron intake. The results suggest that artistic gymnastics practice leads to exerciseinduced hemolysis and partially changes the hematological profile, although not causing iron deficiency or iron-deficiency anemia, even in the presence of low iron intake.
Thaiz Mattos Sureira, Olga Silverio Amancio and Josefina Aparecida Pellegrini Braga
Daniel Tan, Brian Dawson and Peter Peeling
This study aimed to quantify the hemolytic responses of elite female football (soccer) players during a typical weekly training session.
Ten elite female football players (7 field players [FPs] and 3 goalkeepers [GKs]) were recruited from the Australian National Women’s Premier League and asked to provide a venous blood sample 30 min before and at the immediate conclusion of a typical weekly training session. During this training session, the players’ movement patterns were monitored via a 5-Hz global positioning system. The blood samples collected during the training session were analyzed for iron status via serum ferritin (SF) analysis, and the hemolytic response to training, via serum free hemoglobin (Hb) and haptoglobin (Hp) measurement.
50% of the participants screened were found to have a compromised iron stores (SF <35 μg/L). Furthermore, the posttraining serum free Hb levels were significantly elevated (P = .011), and the serum Hp levels were significantly decreased (P = .005), with no significant differences recorded between the FPs and GKs. However, the overall distance covered and the movement speed were significantly greater in the FPs.
The increases in free Hb and decreases in Hp levels provide evidence that a typical team-sport training session may result in significant hemolysis. This hemolysis may primarily be a result of running-based movements in FPs and/or the plyometric movements in GKs, such as diving and tackling.
Sakuko Ishizaki, Takako Koshimizu, Kae Yanagisawa, Yoshiko Akiyama, Yuko Mekada, Nobuhiro Shiozawa, Noriko Takahaski, Jun Yamakawa and Yukari Kawano
This study was to assess the effect of a fixed dietary intake on biomarkers of red blood cell (RBC) biosynthesis and degradation. Over a two-year period, eight collegiate rhythmic gymnasts participated in this study. During the first year, they ate self-selected diets. During the second year, a fixed dietary intake involving consumption of common Japanese foods containing 15 mg iron and 1500 kcal energy was maintained for 4 wk at the beginning of the program. Fixed dietary intakes resulted in significantly increased intakes of protein, minerals and vitamins, and significantly decreased fat intake, but total energy and carbohydrate intakes were unchanged. Mean values of RBC, Hb, Ht, or TIBC were not affected by the intervention. A fixed dietary intervention appeared to enhance RBC turnover by increasing the capacity for erythrocyte biosynthesis and degradation, although the prevalence of iron-deficiency anemia remained unchanged.
Jadwiga Malczewska, Beata Szczepańska, Romuald Stupnicki and Witold Sendecki
The transferrin receptor-ferritin index (sTfR/logFerr) was determined in 131 male and 121 female athletes in order to assess the frequency of iron deficiency (threshold value of that index taken as 1.8). Blood was drawn for determining morphological indices as well as sTfR, ferritin, iron, total iron binding capacity (TIBC), and haptoglobin. A significantly (p < .01) higher incidence of iron deficiency was observed in women (26%) than in men (11%). The iron deficiency was latent, since no subject was found to be anemic. The plasma iron was significantly lower and TIBC higher (p < .001) in both iron-deficient subgroups than in the non-deficient ones. This confirmed the latent character of iron deficiency. Some hematological indices (Hb, MCH, MCHC, MCV) were significantly lower in iron-deficient female athletes than in male athletes, which suggested a more profound iron deficiency in the former. The sTfR/logFerr index might thus be useful in detecting iron deficiency in athletes, especially in those with erythropoiesis disorders, since physical loads may affect the widely used ferritin levels.
Yuki Kokubo, Yuri Yokoyama, Kumiko Kisara, Yoshiko Ohira, Ayaka Sunami, Takahiro Yoshizaki, Yuki Tada, Sakuko Ishizaki, Azumi Hida and Yukari Kawano
This cross-sectional study explored the prevalence of iron deficiency (ID) and associations between dietary factors and incidence of ID in female rhythmic gymnasts during preseason periods. Participants were 60 elite collegiate rhythmic gymnasts (18.1 ± 0.3 years [M ± SD]) who were recruited every August over the course of 8 years. Participants were divided into 2 groups according to the presence or absence of ID. Presence of ID was defined either by ferritin less than 12 µg/L or percentage of transferrin saturation less than 16%. Anthropometric and hematologic data, as well as dietary intake, which was estimated via a semiquantitative food frequency questionnaire, were compared. ID was noted in 48.3% of participants. No significant group-dependent differences were observed in physical characteristics, red blood cell counts, hemoglobin, hematocrit, haptoglobin, or erythropoietin concentrations. The ID group had a significantly lower total iron-binding capacity; serum-free iron; percentage of transferrin saturation; ferritin; and intake of protein, fat, zinc, vitamin B2, vitamin B6, beans, and eggs but not iron or vitamin C. The recommended dietary allowance for intake of protein, iron, zinc, and various vitamins was not met by 30%, 90%, 70%, and 22%–87% of all participants, respectively. Multiple logistic analysis showed that protein intake was significantly associated with the incidence of ID (odds ratio = 0.814, 95% confidence interval [0.669, 0.990], p = .039). Participants in the preseason’s weight-loss periods showed a tendency toward insufficient nutrient intake and were at a high risk for ID, particularly because of lower protein intake.
Torben Pottgiesser, Laura A. Garvican, David T. Martin, Jesse M. Featonby, Christopher J. Gore and Yorck O. Schumacher
Hemoglobin mass (tHb) is considered to be a main factor for sea-level performance after “live high–train low” (LHTL) altitude training, but little research has focused on the persistence of tHb following cessation of altitude exposure. The aim of the case study was to investigate short-term effects of various hematological measures including tHb upon completion of a simulated altitude camp. Five female cyclists spent 26 nights at simulated altitude (LHTL, 16.6 ± 0.4 h/d, 3000 m in an altitude house) where tHb was measured at baseline, at cessation of the camp, and 9 d thereafter. Venous blood measures (hemoglobin concentration, hematocrit, %reticulocytes, serum erythropoietin, ferritin, lactate dehydrogenase, and haptoglobin) were determined at baseline; on day 21 during LHTL; and at days 2, 5, and 9 after LHTL. Hemoglobin mass increased by 5.5% (90% confidence limits [CL] 2.5 to 8.5%, very likely) after the LHTL training camp. At day 9 after simulated LHTL, tHb decreased by 3.0% (90%CL −5.1 to −1.0%, likely). There was a substantial decrease in serum EPO (−34%, 90%CL −50 to −12%) at 2 d after return to sea level and a rise in ferritin (23%, 90%CL 3 to 46%) coupled with a decrease in %reticulocytes (−23%, 90%CL −34 to −9%) between day 5 and 9 after LHTL. Our findings show that following a hypoxic intervention with a beneficial tHb outcome, there may be a high probability of a rapid tHb decrease upon return to normoxic conditions. This highlights a rapid component in red-cell control and may have implications for the appropriate timing of altitude training in relation to competition.
Ben Desbrow, Nicholas A. Burd, Mark Tarnopolsky, Daniel R. Moore and Kirsty J. Elliott-Sale
). Combined oral contraceptives increase high-sensitivity C-reactive protein but not Haptoglobin in female athletes . Sports Medicine, 47 ( 1 ), 175 – 185 . PubMed ID: 27084393 doi:10.1007/s40279-016-0534-9 10.1007/s40279-016-0534-9 Centers for Disease Control and Prevention . ( 2011 ). Centers for