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High Prevalence of Poor Iron Status Among 8- to 16-Year-Old Youth Athletes: Interactions Among Biomarkers of Iron, Dietary Intakes, and Biological Maturity
Open accessAbstract
Objective: The purpose of this study was to determine the prevalence of poor iron status in young athletes throughout the stages of iron deficiency and assess sex differences with iron deficiency in relation to growth and development and dietary intake.Methods: A cross-sectional analysis evaluated young male and female athletes (n = 91) between the ages 8 and 16 years. Anthropometric assessments, body composition, dietary intakes, and blood samples measuring ferritin, soluble transferrin receptor (sTfR), and hemoglobin (Hb) were examined. Prevalence was calculated as percentages, and independent samples t tests examined sex differences. Pearson product-moment correlation coefficient analyses quantified relationships among variables for the composite sample and each sex separately.Results: Iron depletion (low ferritin) was present in 65% and 86%, low iron levels (sTfR) in 51% and 68%, and anemia (low Hb) in 46% and 53% of the males and females, respectively. As iron deficiency progressed from low ferritin to high sTfR to anemia, prevalence decreased in both sexes, but always remained higher in females. Males were greater than females for weight, arm muscle size, and ferritin concentrations, while females were greater than males for biological maturity (p ≤ 0.05). Dietary iron intake was moderately to highly correlated (r = 0.543–0.723, p ≤ 0.05) with growth and development in females, but not males.Conclusions: Prevalence of poor iron status was higher than expected, particularly in adolescent females. Since rapid growth combined with sports participation may create high demands for iron bioavailability, emphasis may need to be placed on dietary iron intake for young athletes, particularly females.
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“Depleted iron stores (initial stage of iron deficiency) are observed frequently in studies on adolescent (particularly endurance) athletes [46].”
From Youth and Adolescent Athlete Musculoskeletal Health: Dietary and Nutritional Strategies to Optimise Injury Prevention and Support Recovery (2024) · cites this paper as [46]
In the citing paper
“Depleted iron stores, without clinical symptoms, are observed frequently in studies conducted on adolescent athletes (particularly endurance competitors) [55, 56].”
From Youth Athlete Development and Nutrition (2021) · cites this paper as [55]
In the citing paper
“Iron and folate deficiencies can impair red blood cell production and oxygen transport, potentially leading to anaemia, fatigue and reduced endurance capacity [119–121].”
From Dietary intake, nutrition knowledge, and behavior in youth team sport athletes: a scoping review and call to advance research and practice (2026) · cites this paper as [121]
In the citing paper
“In the present study, it is possible that the high intakes of eggs and meat, together with the beneficious interaction between iron and vitamin C intakes [17], induced a healthier iron status than that found in previous studies [46,48].”
From Nutritional Status and Implementation of a Nutritional Education Program in Young Female Artistic Gymnasts (2021) · cites this paper as [46]
In the citing paper
“However, others have reported that poor iron status is commonly found in female athletes in general [46] and in young female athletes in particular [46].”
From Nutritional Status and Implementation of a Nutritional Education Program in Young Female Artistic Gymnasts (2021) · cites this paper as [46]
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Metadata
- Authors
- Shoemaker, M. E., Gillen, Z. M., McKay, B. D., Koehler, K., & Cramer, J. T.
- Affiliations
- University of Nebraska–Lincoln (US)
- Corresponding author
- Cramer, Joel T.
- Venue
- Journal of the American College of Nutrition
- Publisher
- Informa UK Limited
- Published
- 2019-07-24
- Volume
- 39
- Issue
- 2
- Pages
- 155-162
- ISSN
- 0731-5724 (ISSN-L)
- 1541-1087
- OpenAlex
- W2962841694
- Cited by
- 29
- References
- 33
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 4 · 2023: 4 · 2022: 3 · 2021: 3 · 2020: 2 · 2019: 1
- FWCI
- 1.64
- Type
- journal article
- Language
- en
- Open access
- green
- mediatum.ub.tum.de
- Licence
- other-oa
- Locations
- Journal of the American College of Nutrition (publishedVersion)
- PubMed (publishedVersion)
- mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
- Health Sciences › Medicine › Physiology (medical) › Exercise and Physiological Responses
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
- Keywords
- iron deficiency, youth athletes, iron status, ferritin, soluble transferrin receptor, hemoglobin, anemia, sex differences, biological maturity, iron intake, growth and development, iron bioavailability
- MeSH terms
- Iron Deficiencies, Adolescent, Child, Cross-Sectional Studies, Diet, Female, Ferritins, Hemoglobins, Humans, Male, Nutritional Status, Receptors, Transferrin, Sex Factors, Biomarkers, Anemia, Iron-Deficiency, Iron, Dietary, Growth and Development, Athletes
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