Influence of Artistic Gymnastics on Iron Nutritional Status and Exercise-Induced Hemolysis in Female Athletes

Abstract

This study evaluates the relationship between body iron losses and gains in artistic gymnastics female athletes. It shows that despite the low iron intake and exercise-induced hemolysis, iron deficiency or iron-deficiency anemia does not occur, but partial changes in the hematological profile do. The hypothesis that gymnasts' nutritional behavior contributes to anemia, which may be aggravated by exercise-induced hemolysis, led to this cross-sectional study, conducted with 43 female artistic gymnasts 6-16 yr old. The control group was formed by 40 nontraining girls, paired by age. Hemogram, serum iron, ferritin, soluble transferrin receptor, haptoglobin, total and fractional bilirubin, Type I urine, and parasitologic and occult fecal blood tests were evaluated. The athletes presented mean hematimetric and serum iron values (p = .020) higher than those of the control group. The bilirubin result discarded any hemolytic alteration in both groups. The haptoglobin results were lower in the athlete group (p = .002), confirming the incidence of exercise-induced hemolysis. Both groups presented low iron intake. The results suggest that artistic gymnastics practice leads to exercise-induced hemolysis and partially changes the hematological profile, although not causing iron deficiency or iron-deficiency anemia, even in the presence of low iron intake.

Micronutrient Intakes in 553 Dutch Elite and Sub-Elite Athletes: Prevalence of Low and High Intakes in Users and Non-Users of Nutritional Supplements

“…On the other hand, female athletes can suffer from amenorrhoea as a result of the high volume of exercise which could (temporarily) reduce the need for iron in the diet [ 40 ]. Athletes can also suffer from exercise-induced haemolysis, due to mechanically induced damage to red blood cells, which results in a higher iron loss by the body [ 41 ]. A low dietary iron intake in combination with exercise-induced haemolysis does not necessarily lead to iron deficiency (anaemia), as for example was seen in gymnasts [ 41 ].…”

Anemia ferropénica en el deporte e intervenciones dietético-nutricionales preventivas

“…Así, en un estudio realizado sobre atletas de fondo y medio fondo (91 hombres y 54 mujeres) se observó anemia ferropénica de un 2% de los deportistas y, además, un 7-10% 11 presentaron estadios de fase previa por déficit de Fe. Sin embargo, también se han observado incidencias en integrantes de deportes de equipo como el fútbol 12,13 , o baloncesto 1 , y en otros deportes individuales como el remo 14 , pelota a mano 15 y gimnasia artística 16 ; posiblemente por los saltos e impactos que se realizan durante su práctica.…”

“…Los constantes impactos contra el pavimento, durante una carrera, incrementan la hemólisis y es por ello que en deportes de larga duración, y de equipo, se da mayor prevalencia de anemia ferropénica 28,29 . También se ha observado hemólisis asociada al ejercicio en deportes como la natación 30 , remo 14 , triatlón 31 , gimnasia artística 16 , carrera no competitiva 32 , pelota a mano 33 o en entrenamiento militar riguroso 34 . Una de las causas de este tipo de hemólisis es que después de un ejercicio intenso los eritrocitos son más susceptibles al estrés, sea de tipo mecánico, oxidativo u osmótico.…”

Iron Supplementation and Physical Performance

“…Another explanation for compromised iron status in athletes is the shift of iron return to hepatocytes, rather than the RES, as a consequence of the increased intravascular hemolysis occurring mostly in weight-bearing activities, such as running. In these activities, hemolysis is due to the impact forces generated by the foot strike [73,74]. Increased intravascular hemolysis has been reported in runners [20] and female artistic gymnasts [73].…”

“…In these activities, hemolysis is due to the impact forces generated by the foot strike [73,74]. Increased intravascular hemolysis has been reported in runners [20] and female artistic gymnasts [73]. However, foot strike cannot totally explain the exercise-induced hemolysis since hypohaptoglobinemia, a situation that reveals the presence of hemolysis, has also been observed in swimmers [75].…”