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Pumping iron: prevent anemia by boosting iron consumption.

You're pretty fit, right? You exercise regularly, avoid red meat and eggs, eat natural foods--do all the right things. However, if you still feel worn down, you could be one of the estimated 80 percent of female athletes or 30 percent of male athletes who may be experiencing iron-deficiency anemia symptoms.

The word anemia is based on Greek words describing "without blood." Used as a catchall for a number of conditions, including iron-deficiency anemia and sports anemia, it occurs when the body's red blood cell count is abnormally low. This count is important because red blood cells carry oxygen throughout the body to replenish muscles and organs. Our bodies keep a careful tab on the number of red blood cells produced--too few cells means not enough nourishing oxygen flows through the body and too many can lead to the blood becoming thick.

Iron-Deficiency Anemia

According to sports medicine experts, the most common form of anemia among active adults results from iron deficiency. Stored only in a small amount by the body, iron is an important element in red blood cells. When iron stores are low, the body cannot produce the red blood cells needed and iron-deficiency anemia develops.

Even a slight iron reduction can affect an athlete's endurance. For no apparent reason, the athlete will feel tired or won't perform as usual. Fatigue to the point of not being able to complete a typical workout is an iron-deficiency-anemia hallmark, says Nancy Clark, M.S., R.D., a dietician and author of sports nutrition books. "People with anemia get tired with physical exertion--it's an unusual fatigue that is a change from how they usually feel," Clark states. Anemia is not abated by a good night's sleep or vacation, she adds.

Clark notes that the fatigue often coincides with other symptoms, such as an elevated heart rate at lower than normal exertion, chest discomfort, shortness of breath or dizziness. Sometimes people find themselves inexplicably chewing a lot of ice. "Obviously, anyone experiencing these symptoms should see their physician for an assessment," she recommends. This is especially true for athletes accustomed to "hitting the wall" and pushing themselves when their bodies want to stop. "If something is not right with your body, you should pay attention," Clark advises.

Ironically, stone elements of today's healthy lifestyle can contribute to iron deficiency. Research shows that people who participate in regular, vigorous exercise appear to have higher daily iron losses than sedentary people. This is because the iron requirements for people who exercise vigorously may be nearly 30 percent higher than for those who spend more time on the couch than at the gym.

In addition, "healthy" eating can be an anemia culprit. Watching fat grams often means cutting red meat or dark chicken, both iron sources, from one's diet. Also, "natural" foods, especially grains, have their benefits, but aren't iron fortified. Vegetarians have to be especially careful since their diets are often based on foods low in iron.

One misconception about anemia is that it only affects women. Although pre-menopausal women or women who have recently given birth have the highest incidence of iron-deficiency anemia because blood loss reduces the body's iron stores, men can also become anemic. One famous case is Olympic swimmer Tim Shaw, who still managed to win a silver medal in the 1976 Games despite being diagnosed with severe iron-deficiency anemia at the Olympic Trials. Shaw's anemia was brought on by an iron-poor diet. Long-distance runners also have an increased anemia risk. The repeated foot-to-ground contact can destroy red blood cells in the feet's capillaries if the runner is on poor surfaces or has inappropriate running shoes.

Moreover, people can also become anemic due to certain medications, such as those taken for heartburn, which can interfere with the body's ability to absorb iron. Also, chronic bleeding in the gastrointestinal tract can cause enough blood loss to produce anemia. This bleeding can stem from a variety of causes from ulcers to more serious disorders. This is another reason to have anemia symptoms checked.

Sports Anemia

Some endurance athletes experience sports anemia, a physiological change that results from the body adapting to heavy endurance training, says William O. Roberts, M.D., president-elect of the American College of Sports Medicine. With sports anemia, the plasma or liquid part of the blood increases, often with an increase in the total red cell count. The plasma increase dilutes the red blood cell count per volume, which can give the appearance of anemia. In effect, this allows blood to flow through small vessels with less restriction and provides added fluid for sweat-related cooling. The good news is sports anemia is actually a positive condition. According to Roberts, the dilution increases the body's oxygen-carrying capacity, which improves endurance.

Given the demands of rigorous exercise, sports medicine physicians recommend endurance athletes be screened regularly for iron-deficiency anemia. A simple, inexpensive blood test called serum ferritin provides a reliable count of your body's iron stores.


Fortunately, iron-deficiency anemia is usually simple to treat. A well-balanced diet including good iron sources is the best start. For example, add lean cuts of red meat or dark poultry to your meals on a regular basis. Iron is also found in liver, soybeans, oysters, egg yolks, some dried fruits and nuts. Drinking tea, cold or hot, decaf or not, at a meal interferes with the body's ability to absorb iron from food. Instead, enjoy a glass of orange juice. Consuming vitamin C in any form can increase iron absorption. A glass of OJ with an iron-fortified breakfast cereal may make your friend on the Atkins diet cringe, but your red blood cells will be strong enough to turn you into Popeye.

The recommended daily iron allowance is 10 milligrams for men, 15 milligrams for pre-menopausal women and 18 milligrams for teens. A balanced diet can provide most of the iron needs for men and post-menopausal women. Also, most medical experts recommend neither men nor women over 50 should take iron supplements without medical supervision. However, iron supplements are often recommended for pre-menopausal women or women who recently gave birth. Again, consult your doctor.

Our bodies are unique, what works for one person may not be right for another. Learning to do the right things for your health may mean some surprising dietary changes, such as eating moderate amounts of once-forbidden foods, to ensure you have the energy levels needed to achieve your fitness goals.

Karen Gervais, Ph.D., is a consulting psychologist and writer living in Whidbey Island, Washington. She specializes in mental and physical health issues.
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Author:Gervais, Karen
Publication:American Fitness
Geographic Code:1USA
Date:May 1, 2004
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