Combined Heme Iron Supplementation and Nutritional Counseling Improves Sports Anemia in Female Athletes

Athletes frequently suffer from anemia due to rigorous training, reduced food intake (for weight control), and destruction of erythrocytes. Menses can also render anemia improvements problematic. We investigated the effects of a combined supplementation and nutritional counseling intervention in female athletes exhibiting anemic symptoms. Capsules containing heme iron were used for supplementation (Fe at 14 mg/day). Nutritional counseling was based on indices of iron status (blood hemoglobin [Hb], serum ferritin [Fer], and soluble transferrin), nutrient status, and energy expenditure based on food intake and activity logs and training loads. Thirty female participants (mean age = 20.2 ± 1.3 years; Hb, 12.4 ± 0.7 mg/dL; Fer, 17.8 ± 13.7 ng/mL) who engaged in fencing, long jump, handball, or volleyball, were supplemented with capsules every day for 2 months but received no nutritional counseling. Participants in whom initial Hb and Fer values were >11.5 mg/dL and 10 ng/mL, respectively (n = 20), exhibited improved iron status. This was not observed in the remaining 10 participants, all of whom trained excessively and exhibited low Hb and Fer levels; these individuals received daily capsules for a further 2 months in addition to nutritional counseling. Heme iron supplementation and increased levels of food-derived minerals and proteins following nutritional counseling significantly increased blood iron levels, with a concomitant decrease in negative mood and an increase in “vigor” without constipation. In conclusion, long-term heme iron supplementation, in combination with nutritional counseling, could improve sports anemia in highly trained female athletes.