Prevalence of iron deficiency and anemia among strenuously trained adolescents

Purpose: There is a lack of awareness among physicians, dieticians, and public health planners as to the prevalence of iron deficiency and anemia among adolescents undergoing strenuous physical training. The aim of this study was to estimate the prevalence of iron deficiency and anemia among male adolescents undergoing such activity. Methods: We studied 292 male adolescents on the day of entry into a volunteer military unit. Hemoglobin (Hb), mean corpuscular volume, ferritin, iron, iron-transferrin saturation, and soluble transferrin receptor (TfR) were measured, and TfR-F index was calculated. Results: The mean Hb level (±SD) in the study population was 14.7 ± .9 g/dL (range, 10.8-16.8 g/dL), mean ferritin level was 50.6 ± 32.6 ng/mL (range, 5.4-162.5 ng/mL), and mean iron level was 97.1 ± 39.9 μg/dL (range, 24-267 μg/dL). The prevalence of anemia (Hb <14 g/dL) was 18.5%, and 3.4% had Hb concentrations less than 13 g/dL. Iron deficiency (ferritin <22 ng/mL) was present in 18% of the subjects, and 11.3% had ferritin levels less than 17 ng/mL. The mean soluble transferrin receptor concentration was 1.9 ± .8 mg/L, and the mean TfR-F index was 1.21 ± .57. Conclusions: Nearly 19% of the study subjects had mild anemia at recruitment, and depletion of iron stores was observed among 18%. Overall, these changes were not accompanied by a significant increase in soluble TfR. This high prevalence is most likely the result of "sports anemia" due to the intense physical training regimen adopted prior to their recruitment.