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Table 2 Comparison of effects of dietary iron treatment methods on iron status in female athletes

From: Iron and the female athlete: a review of dietary treatment methods for improving iron status and exercise performance

Study Subjects Protocol Findings
Tsalis et al. [42] 21 male and 21 female swimmers, iron-repleted (sFer >30 μg/L, Hb > 12 g/dl) aged 12–17 years BMI 20 Study design: - NS differences in iron status and exercise performance among 3 groups.
Supplementation and dietary randomised control trial 6-month intervention
A: Fe supplement (47 mg/d)
B: diet rich in Fe (26 mg/d)
C: placebo
Dietary assessment:
Records of daily food intake
Performance assessment:
Swimming tests
Ishizaki et al. [43] 8 collegiate rhythmic gymnasts, aged 18–19 years, BMI 19.7, sFer <20 μg/L Study design: - SIG increased sFer and δ-ALAD activity (enzyme responsible for RBC turnover) after diet intervention.
Dietary intervention 4-weeks intervention in 2 years cohorts:
−1st year self-selected diets - No effect on other parameters of iron status.
−2nd year fixed diet for 4 weeks (15 mg Fe/day)
Dietary assessment:
3-day FD 3 times in 1st / 2nd year at baseline, 4, 8 weeks
Performance assessment:
None
Lyle et al. [11] 60 exercising (2.3–2.5 days/week) females, previously sedentary, iron-repleted (sFer >20 μg/L, Hb > 12 g/dl) aged 18–19 years Study design: - Moderate aerobic exercise compromised iron status.
Supplementation and dietary randomised control trial 12-week intervention - Meat diet was more effective in protecting Hb and iron status than were iron supplements.
A: Fe 50 mg + low diet Fe
B: Fe 10 mg + low diet Fe
C: placebo
D: meat diet (18 mg Fe)
Dietary assessment:
7-day FD
Performance assessment:
Walking and treadmill tests
Anschuetz et al. [12] 12 male and 5 female collegiate middle distance runners and 6 male and 2 female non-running controls, aged 18–24 years, sFer <30 μg/L Study design: - sFer SIG greater in MHIA than LMIA group.
Dietary advice counselling intervention 4-week dietary advice counselling intervention in LMIA group only - SIG correlations between absorbable dietary Fe and sFer, sFe, TIBC and Hb.
LMIA: low/medium Fe availability diet - No significant difference in iron status indices between LMIA and MHIA groups post-intervention
MHIA: medium/high Fe availability diet
C: control
Dietary assessment:
3-day FD
Performance assessment:
None
Burke et al. [13] 14 male and 14 female collegiate cross country runners, aged 18–24 years, sFer >60 μg/L Study design: - NS improvements in haematocrit and TIBC in intervention group females.
Dietary randomised control trial 8-week intervention - No differences between the groups in other parameters of iron status.
IG: 9 oz lean beef/week - No difference in VO2max changes between the groups.
C: control group
Dietary assessment:
3-day FD
Performance assessment:
Treadmill tests
Alaunyte et al. [1] 11 female runners, recruited from running clubs, aged 20–44 years, BMI 23, sFer >30 μg/L Study design: - NS improvements in iron
Dietary intervention 6-week intervention (18.5 mg Fe/d) - SIG correlations between ↑ dietary iron and ↑ sFer (r = 0.8, P < 0.05).
Dietary assessment:
Multiple 24-h recalls
Performance assessment:
None
  1. Abbreviations: PA physical activity, SIG significant, NS non significant, IG intervention group, C control group, FD food diary, FFQ food frequency questionnaire, Hb haemoglobin, Fe iron, sFe serum iron, sFer serum ferritin, TIBC total iron binding capacity, RBC red blood cells, δ-ALAD Delta-aminolevulinic acid dehydratase