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Cited by 158Iron Metabolism and DisordersCardiovascular and exercise physiologyExercise and Physiological Responses

Iron supplementation benefits physical performance in women of reproductive age: A systematic review and meta-analysis

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Pasricha, Sant-Rayn, Low, Michael, Thompson, Jane, Farrell, Ann, De-Regil, Luz-Maria·2014·The Journal of Nutrition
DOI 10.3945/jn.113.189589
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Abstract

Animal and human observational studies suggest that iron deficiency impairs physical exercise performance, but findings from randomized trials on the effects of iron are equivocal. Iron deficiency and anemia are especially common in women of reproductive age (WRA). Clear evidence of benefit from iron supplementation would inform clinical and public health guidelines. Therefore, we performed a systematic review and meta-analysis to determine the effect of iron supplementation compared with control on exercise performance in WRA. We searched the Cochrane Central Register of Clinical Trials, MEDLINE, Scopus (comprising Embase and MEDLINE), WHO regional databases, and other sources in July 2013. Randomized controlled trials that measured exercise outcomes in WRA randomized to daily oral iron supplementation vs. control were eligible. Random-effects meta-analysis was used to calculate mean differences (MDs) and standardized MDs (SMDs). Risk of bias was assessed using the Cochrane risk-of-bias tool. Of 6757 titles screened, 24 eligible studies were identified, 22 of which contained extractable data. Only 3 studies were at overall low risk of bias. Iron supplementation improved both maximal exercise performance, demonstrated by an increase in maximal oxygen consumption (VO2 max) [for relative VO2 max, MD: 2.35 mL/(kg ⋅ min); 95% CI: 0.82, 3.88; P = 0.003, 18 studies; for absolute VO2 max, MD: 0.11 L/min; 95% CI: 0.03, 0.20; P = 0.01, 9 studies; for overall VO2 max, SMD: 0.37; 95% CI: 0.11, 0.62; P = 0.005, 20 studies], and submaximal exercise performance, demonstrated by a lower heart rate (MD: -4.05 beats per minute; 95% CI: -7.25, -0.85; P = 0.01, 6 studies) and proportion of VO2 max (MD: -2.68%; 95% CI: -4.94, -0.41; P = 0.02, 6 studies) required to achieve defined workloads. Daily iron supplementation significantly improves maximal and submaximal exercise performance in WRA, providing a rationale to prevent and treat iron deficiency in this group. This trial was registered with PROSPERO (http://www.crd.york.ac.uk/PROSPERO/prospero.asp) as CRD42013005166.

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  • Iron supplementation improves maximal and submaximal exercise performance and VO2max in nonanemic iron-deficient individuals and athletes.

    “However, a meta-analysis gathering data from 15 studies carried out in endurance athletes found a moderate but significant favorable effect on VO2max of iron intervention (oral iron in most studies, with dosages varying from 10 to 300 mg/day and for durations ranging from 14 to 84 days).”

    From Vitamins and Minerals for Energy, Fatigue and Cognition: A Narrative Review of the Biochemical and Clinical Evidence (2020) · cites this paper as [132]

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  1. Day JR, Rossiter HB, Coats EM, Skasick A, Whipp BJ. The maximally attainable VO2 during exercise in humans: the peak vs. maximum issue. J Appl Physiol. 2003;95:1901-7.
  2. Donoso H, Walter T, Nunez S. Effect of therapy in physical work capacity of iron deficient female athletes: a double blind, randomized, controlled study. Fed Proc. 1984;43.
  3. LaManca JJ, Haymes EM. Effects of iron repletion on VO2max, endurance, and blood lactate in women. Med Sci Sports Exerc. 1993;25:1386-92.
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  7. Walsh R, McNaughton L. Serum iron levels in young female swimmers during pre-season phase of competition and the effects of iron supplementation upon them. J Hum Mov Stud. 1989;17:229-38.

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Authors
Pasricha, S.-R., Low, M., Thompson, J., Farrell, A., & De-Regil, L.-M.
Affiliations
  • The University of Melbourne (AU)
  • The Alfred Hospital (AU)
  • The University of Adelaide (AU)
  • Monash Health (AU)
Corresponding author
Pasricha, Sant-Rayn
ORCID
Venue
The Journal of Nutrition
Publisher
Elsevier BV
Published
2014-06
Volume
144
Issue
6
Pages
906-914
ISSN
0022-3166 (ISSN-L)
DOI
10.3945/jn.113.189589
OpenAlex
W2127091926
Cited by
158
References
60
Citations by year
2026: 9 · 2025: 9 · 2024: 14 · 2023: 21 · 2022: 10 · 2021: 17 · 2020: 10 · 2019: 11 · 2018: 19 · 2017: 8 · 2016: 10 · 2015: 13 · 2014: 5 · 2012: 1
FWCI
1.83
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Nutrition (publishedVersion)
  • PubMed (publishedVersion)
  • Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
Funders
  • Vifor Pharma
  • Medical Research Council
  • National Health and Medical Research Council
Topics
  • Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
  • Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
  • Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
Keywords
iron supplementation, iron deficiency, women of reproductive age, exercise performance, VO2max, submaximal exercise, heart rate, anemia, iron deficiency prevention, oral iron, physical fitness, pregnancy and lactation, iron deficiency screening
MeSH terms
Female, Humans, Oxygen Consumption, Reproduction, Exercise, Randomized Controlled Trials as Topic, Anemia, Iron-Deficiency, Iron, Dietary, Dietary Supplements, Observational Studies as Topic

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