<h4>Background</h4>Iron facilitates key biological functions underpinning sports performance, and up to 60% of female athletes experience iron deficiency. However, the effects of iron deficiency on sports performance in female athletes is unclear, as are the degree of benefits of iron supplementation (FeSup). This study characterizes the effects of iron deficiency and FeSup on sports performance in high-level female athletes.<h4>Methods</h4>Searches of the electronic databases MEDLINE, SPORTDiscus, Web of Science, Scopus, and CINAHL were performed in July 2023. Studies were included that evaluated the effects of iron deficiency or FeSup on sports performance in high-level (maximal oxygen uptake (VO<sub>2max</sub>) > 45 mL/kg/min, or trained > 5 h/week) iron deficient (ID) (serum ferritin (sFer) < 40 µg/L) female athletes. Studies were assessed using a modified Downs and Black Quality Assessment Checklist.<h4>Results</h4>A total of 23 studies comprising 669 athletes (age range: 13-47 years) across 16 sports were included in the review. Iron deficiency negatively affects endurance performance by 3%-4%. However, endurance performance improved by 2%-20% when ID athletes were treated with 100 mg/day of elemental iron for up to 56 days via oral supplementation, or bi-daily via parenteral administration over 8-10 days. ID non-anemic athletes with low sFer stores may be predisposed to reduced maximal aerobic capacity. However, maximal aerobic capacity improved by 6%-15% following 16 mg/day-100 mg/day of elemental iron for 36-126 days. Isokinetic strength and anaerobic power performance may be impeded (-23% to +4%) among ID athletes, but the effect of FeSup on anaerobic power varied markedly (-5% to +9%) following 100 mg/day of elemental iron over 42-56 days, or 100 mg of elemental iron bi-daily over 8-10 days. The quality of studies was moderate (77%), ranging from low (57%) to high (100%). Moststudies (n = 18) contained group sizes ≤ 20 athletes, thus limiting the likelihood of detecting significant effects (statistical power > 0.80).<h4>Conclusion</h4>High-level ID female athletes experience a negative impact on endurance performance, which can be improved by supplementing with ∼100 mg of elemental iron per day or bi-daily. The decrements in other performance parameters characterizing a range of sports coincide with the severity of iron deficiency.
when there is a reduced amount of oxygen in the tissues of the body. Hypoxemia refers to a reduction in arterial oxygenation below the normal range, regardless
Hypoxia is a condition in which the body or a region of the body is deprived of an adequate oxygen supply at the tissue level. Hypoxia may be classified as either generalized, affecting the whole body, or local, affecting a region of the body. Although hypoxia is often a pathological condition, variations in arterial oxygen concentrations can be part of the normal physiology, for example, during s
Hemoglobin plays a substantial role in carrying oxygen throughout the body, and when it is deficient, anemia can result, causing 'anaemic hypoxia' if tissue oxygenation is decreased. Iron deficiency is the most common cause of anemia. As iron is used in the synthesis of hemoglobin, less hemoglobin will be synthesised when there is less iron, due to insufficient intake, or poor absorption.
Anemia is typically a chronic process that is compensated over time by increased levels of red blood cells via upregulated erythropoetin. A chronic hypoxic state can result from a poorly compensated anaemia.
Iron deficiency anemia is one of the most prevalent hematological disorders among women and represents a major global public health concern. Women of reproductive age, pregnant and lactating women, and adolescent girls constitute the most vulnerable groups. Iron plays a critical role in hemoglobin synthesis, oxygen transport, cellular energy metabolism, and immune system function. Consequently, iron deficiency affects not only the hematological system but also the overall physiological performance of the body.
Iron is an essential trace element that participates in multiple physiological processes, including oxygen transport, electron transfer, DNA synthesis, and red blood cell production. Iron loss is particularly severe among athletes, so maintaining iron homeostasis is crucial for sports nutrition and health. Excess iron, iron deficiency, and ferroptosis can lead to muscle disorders and health issues, including sarcopenia, muscular atrophy, myocardial fibrosis, skeletal muscle injury, cardiovascular disease, and metabolic disorders. Maintaining iron homeostasis within physiological limits is essential for athletes to sustain high-intensity performance and accelerate recovery. Therefore, a comprehensive review of the effects of iron homeostasis and ferroptosis on muscle health is significant for identifying potential therapeutic targets and developing new disease treatment and prevention strategies. This paper systematically reviews research progress on targeted therapies for iron overload and ferroptosis in muscle diseases, clarifies the impact of iron on athletes' physiological functions and competitive performance, and explores the potential application of iron in precision nutritional regulation. It aims to provide new insights for preventing exercise-induced muscle injury, myocardial damage, and overtraining syndrome in athletes.
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