Monday, November 5, 2012

Anemia and the Endurance Athlete: Tips to help you prevent Iron-Deficiency

                     The USS Constitution, "Old Ironsides"
                            February 2012   Boston, MA

As we head into the Base time of year for most endurance athletes, I have seen a few issues seem to be trending the last few years for endurance athletes in the region which I operate my business out of.

Amongst the issues is lack of proper nutrition (total calories in), hydration during cold rides, and perhaps the most surprising: athletes apparently being Iron-deficient.

Right now I want to focus on Anemia and Iron deficiency, as this can REALLY derail ones training for a year, or more, should it go undiagnosed for a few months, and especially if it goes on until mid-build.

If you have more questions about Iron-Deficiency or Anemia, please contact your doctor, or Sports Dietician. If you don't have a dietician, I recommend Kim Schwabenbauer of Fuel Your Passion. She is not only a (my) sports dietician, but also a professional triathlete who races for a great cause, Ballou Skies Charities, and she is a phenomenal source of knowledge. She understand the treacheries of training and racing, and has a great perspective on things.

The below questions were composed from my own knowledge, and a few of the quality sports nutrition books that I have found (Monique Ryan's "Sports Nutrition for Endurance Athletes", Nancy Clark's Sports Nutrition Guidebook", and Chris Carmichael's "Food for Fitness" --Chris is NOT a Sports Dietician, but the book is well put together), and is a small bit of the information that I talk about with Human Vortex Training Athletes whom are suspected of possibly experiencing effects of Iron-Deficiency, or anemia, before sending them over to either their PCP, Kim S., or their Sports Dietician.

Due to the nature of sports nutrition and the mass amounts of research being done, it is possible that some of the information below is outdated. Again, I am not a Dietician. The information below is not intended to diagnose, cure, or prevent any disease, or other health issues. It is here to serve as base knowledge to help the endurance athlete community to become more aware of how their diet affects their training and racing, and most importantly, their overall health.


If you suspect that you may have Iron-Deficiency Anemia, I strongly urge you to talk to your Primary Care Physician, or your sports dietician, ASAP.

                                                   
          Photo from :  http://www.english-online.at/biology/blood/blood-supply-and-blood-diseases.htm

What is Iron-Deficiency Anemia, and how does it affect me?
Iron-Deficiency Anemia defines that the body is unable to supply or carry enough oxygen to the muscles, or the body's cells. This can lead to feelings of fatigue throughout one's day, or during workouts. Some of the more common complaints heard by active individuals are "I can't seem to find the energy to workout like I used to" or "I feel so tired during my workouts".

A little about Iron...
Iron is a Micro-mineral, otherwise known as a "Trace element", which are present in the tissues of the body in small amounts, but have crucial roles in human nutrition. Iron is needed to form the Oxygen-Transporting compounds Hemoglobin & Myoglobin.
Iron Absorption is ultimately controlled by the amount that is already in storage in the body (as Ferritin, & Hemosiderin), due to the lack of an effective mechanism to expel excess Iron. However, absorption rates of Iron from ingested foods rarely exceed 10-15% of TOTAL PRESENT IN THE FOOD. (This means if you eat something that contains 30% of your daily value, you're most likely only absorbing 3-4.5% of your daily value!) This is a mechanism that helps the body maintain a relatively regular level of Iron storage.

What does this mean to me as an endurance athlete?
It is important to eat a balanced diet, ensuring that you intake adequate amounts of Iron. Although the best sources of Iron are meat, fish, poultry, legumes and dark leafy green vegetables, Iron is commonly added to help fortify foods such as breakfast cereals, and grain products.

What are the best sources of Iron? Can I absorb more from one food or another?
The most easily absorbed type of Iron is "heme" Iron, which is found in meats and other foods of animal origin. "Non-Heme" Iron can be found in fruits and vegetables, as well as cereals. Non-heme iron absorption can be enhanced by consuming vitamin C along with it.

I'm a vegetarian, am I at a higher risk of developing Iron-Deficiency Anemia?
As far as conventional wisdom goes, unfortunately yes. Vegetarian endurance athletes, and vegetarians in general are considered to be at a higher risk of developing Iron-Deficiency Anemia. However, there are a few things that one can do to help you attain enough Iron from your diet. Some of which include: Proper dietary planning, consciously eating fruits and vegetables high in Iron, eating Iron-fortified grain products, and even adding Vitamin C to vegetables by squeezing lemon or orange juice on them before eating.
There is a lot of new information coming out about vegans/vegetarians and Iron-Deficiency Anemia. If you are a vegetarian/vegan endurance athlete, I recommend consulting with a sports dietician.

I heard that I can lose Iron through sweat, is this true?
Although Iron loss through sweat is low (often the concentration is 0.2 mg/L of sweat), it can lead to Iron Deficiency in athletes with marginal Iron intake. This type of occurrence is more often associated with athletes who participate in long-duration activities, as they can sweat up to 2 Liters or more per hour.

I met with a dietician, and they told me that my Iron levels are low, but I have been taking in enough Iron in my diet...What's going on?!?!
You may have what is called "Dilutional Pseudoanemia. This occurs due to the increase in blood volume due to exercise, more often intensive in nature, which may result in a temporary dilution of the red blood cells. Ask your Dietician or Doctor about doing test for Iron at the END of a recovery week during the Pre-season (Base), Season (x2 Build & Peak), and Off (Transition)-season. Also, having a yearly blood panel is also a good idea to track your overall vitamin and mineral intakes to help ensure you have a sound, well rounded diet.

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