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Abstract
Anemia has been identified as the most common medical condition among athletes. It is more common in females. We conducted a literature search for articles describing anemia in adolescent athletes and analyzed the data with respect to prevalence, diagnostic criteria, effect of iron supplementation, and prevention. Among the studies, the prevalence of anemia ranged from 22-65% using hemoglobin as the most common screening test. Although all studies showed greater incidence of iron deficiency and iron deficiency anemia in athletes compared to the control population, there was no consensus about the role of iron supplementation.
Keywords: Adolescence, anemia, athletes, public health
Introduction
Most athletes are in excellent health with lifestyles combining regular exercise with a nutritious diet (1,2). However even the healthiest athletes are at risk for iron deficiency and iron deficiency anemia. Athletes subjecting themselves to prolonged strenuous exercise, and daily endurance training risk developing anemia. Iron deficiency can occur with or without the development of anemia and may be symptomatic or asymptomatic (3). The laboratory parameters of the same are seen in table 1.
Anemia is present when red cell mass is reduced below normal limits. Measuring red cell mass directly is uncommon. Instead, the hemoglobin level and hematocrit are commonly used (see table 1). The clinical presentation and management of anemia varies according to the mechanism of red cell mass loss. The mechanism of anemia can be classified using three broad categories: hypoproliferation, ineffective erythropoiesis, and blood loss or hemolysis.
Iron deficiency can result in a hypoproliferative anemia. Iron is a key component of hemoglobin and key to the molecule's ability to carry oxygen. A lack of iron impairs hemoglobin synthesis and ultimately results in hypoproliferation of red cells in the marrow. While iron stores are depleted by erythropoiesis transferrin saturation decreases, total iron binding capacity (TIBC) increases, and ferritin levels decrease. Transferrin is a protein that transports iron in plasma while ferritin is the predominant storage form of iron. The increase in TIBC reflects decreased saturation of transferrin as iron stores are depleted. A microcytic, hypochromic anemia emerges once iron stores are completely depleted and hemoglobin synthesis is consequently impaired.
Exercise performance is dependent on the capacity of the body to transport oxygen. Thus a shortage of hemoglobin in the...