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Iron Supplementation Benefits Physical Performance in Women of Reproductive Age: A Systematic Review and Meta-Analysis
Open accessAbstract
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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“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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Metadata
- 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
- Venue
- The Journal of Nutrition
- Publisher
- Elsevier BV
- Published
- 2014-06
- Volume
- 144
- Issue
- 6
- Pages
- 906-914
- ISSN
- 0022-3166 (ISSN-L)
- 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
- FWCI
- 1.83
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- 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 › Physiology (medical) › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Physiology (medical) › 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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