Quantifying Iron Absorption, Loss and Balance in Endurance Trained Athletes Across a 12-Month Training Cycle

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Iron deficiency (ID) is the most common worldwide nutrient deficiency, is of particular concern to athletes due to the fundamental role of iron in optimal sports performance. Exercise-induced physiologic changes may be a possible explanation for the high rates of ID in athletic cohorts. These mechanisms include iron losses via sweat, gastrointestinal bleeding, hematuria, and repeated inflammatory mediated increases in the iron regulatory hormone hepcidin. Furthermore, in female athletes, the iron losses associated with menstruation add an extra burden that may contribute to the high rates of ID seen in female compared to male athletes (~35% vs ~10%, respectively). Although these mechanisms have been examined in isolation, whether the sustained and combined effects seen in high performance athletes have a meaningful impact on iron metabolism and long-term iron balance is unknown. Therefore, the primary aim of this study is to compare iron absorption, loss and overall balance using iron isotope tracers in endurance trained athletes with recreationally active individuals at regular intervals across a 12-month training cycle. 12 months after the iron isotope tracer is administered, participants will attend the laboratory at 3 monthly intervals for a 12 month period (5 visits). Participants will have a venous blood sample collected and measured for markers of iron status and isotopic the isotopic iron composition, as well as an assessment of hemoglobin mass. Information around habitual dietary intake (specifically iron), menstrual cycle history and training volume will also be collected at each visit. Outcomes of this study will increase our understanding of iron requirements for athletes against those of the general population.

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