The relatively low iron intake may contribute to the low body iron status found in many women in Europe [ 8 ]. In European countries and within the European Union, there is a definite need for development and implementation of common standardized dietary methods [ 66 ] and for standardization of food composition tables as recently introduced by EFSA [ 76 ].
It is also important to obtain consensus on the use of the different DRVs [ 61 ] and to implement the use of uniform statistical methods in order to obtain reliable intercountry comparisons of dietary intakes of macro- and micronutrients. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Article of the Year Award: Outstanding research contributions of , as selected by our Chief Editors. Read the winning articles. Journal overview. Special Issues. Academic Editor: Luigi Schiavo. Received 07 Jan Revised 05 May Accepted 26 May Published 13 Jun Abstract Objective. Introduction In healthy humans, the body iron input is generated by gastrointestinal absorption of dietary iron [ 1 ].
Results Most reports were in English language, but we managed to interpret reports published in Dutch, Finnish, French, German, Hungarian, Icelandic, and Spanish languages. MAX — Fraction of 35—44 6 days food diary — MAX — Fraction of 45—60 6 days food diary — Table 1.
Dietary iron intake in nonpregnant women of predominantly reproductive age in 29 European countries. For comparison, in some countries, iron intake in postmenopausal women is shown as well. Table 2. Association between nutrient density for iron and dietary iron intake arranged according to the magnitude of nutrient density. Table 3. Dietary iron intake in nonpregnant women of predominantly reproductive age in 29 European countries, arranged according to median or mean iron intake.
Table 4. References G. Anderson and D. Hallberg, L. Nilsson, A. Milman, N. Rosdahl, N. Lyhne, T. Milman, M. Kirchhoff, and T. Milman, P. Pedersen, T. Byg, N. Graudal, and K. Milman, C. Taylor, J. Merkel, and P. S—S, Blanquer, A. Ribas-Barba et al.
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Mensink, M. Burger, R. Beitz, Y. Henschel, and B. What Do We Eat Today? Report of Results, Part 2. Greiner et al. Lugasi, E. Sarkadi Nagy, A. Zentai et al. Nagy, Z. Sarkadi, and E. View at: Google Scholar H. Thorgeirsdottir, H. Valgeirsdottir, and I. View at: Google Scholar C. Leclercq, D.
Arcella, R. Piccinelli, S. Sette, C. Iron is a mineral, and its main purpose is to carry oxygen in the hemoglobin of red blood cells throughout the body so cells can produce energy. Iron also helps remove carbon dioxide. When the body's iron stores become so low that not enough normal red blood cells can be made to carry oxygen efficiently, a condition known as iron deficiency anemia develops.
When levels of iron are low, fatigue, weakness and difficulty maintaining body temperature often result. Other symptoms may include:. Even though iron is widely available in food, some people, like adolescent girls and women ages 19 to 50 years old may not get the amount they need on a daily basis. It is also a concern for young children and women who are pregnant or capable of becoming pregnant.
Babies need iron for brain development and growth. Log transformation was applied to variables that were not normally distributed. Boxplots were used to check for possible outliers. Dietary confounders were assessed using baseline, mid-point and end means values applying repeated measures one-way ANOVA test. Descriptive statistics and differences in mean values of investigated factors were tested by Pearson's where no account for possible confounders is needed and Partial Correlation with the presence of confounders and Paired-sample t-test to determine the statistical significance effect of pre- and post-intervention.
These tests were applied for the haematological data at baseline and end. Baseline dietary intakes for macro- and micronutrients were compared to dietary recommendations using One-sample t-test. Characteristics of the participants are shown in Table 1. The mean age of participants was 32 years. The subjects were within the normal BMI range and engaged in regular exercise regime, mostly running.
No case of dietary underreporting was evident in the sample. Energy and nutrient intakes are presented in Figure 1. Female runners achieved the recommendations for total energy and protein. Fibre intakes were satisfactory. Total fat and saturated fatty acids intake was above the recommended value at the expense of carbohydrate intake, which was significantly lower than the recommendation.
Female runners exceeded the recommendations for Vitamin C, B-group vitamins, calcium and zinc. Comparison of mean daily energy, macro- and micro-nutrient intake of female runners and dietary reference values. Comparison of individual daily dietary iron intake in female runners and dietary reference values. The intake of total dietary iron increased significantly, from Teff bread provided 7.
Table 4 shows correlations between changes in iron indices during intervention period, baseline iron status and other intervention variables.
The changes in iron status parameters were correlated with reduced baseline iron tissue supply. Because of compliance issues, the intervention period varied across this cohort 4 to 6 weeks. Despite the increased interest in nutrition amongst athletes and the well documented importance of a balanced diet in athletic performance, research suggests that many athletes might be consuming diets that are less than optimal [ 28 ],[ 29 ].
This trend was also observed in the present study. Most of micronutrient intakes were observed to be above reference nutrient intake RNI , with the exception of Vitamin A and iron. This trend is in agreement with most of other researchers [ 30 ],[ 31 ], who also reported most of macro- and micronutrient intakes to be above recommended values with the exception of iron.
The mean intake iron in this study was This corresponds to the other authors' reported iron intakes of Taking into account that the iron requirement for female runners may be higher than general population [ 35 ], the baseline observations from the current study indicate that dietary iron intakes in this population are far from adequate. As a result of the intervention, the dietary iron intake increased to However, the improvements in iron status were observed at a statistically non-significant level Table 3.
Nevertheless, within-subject variation, measured as coefficient of variance, showed that iron tissue supply parameters sTRF and sTsfR improved at a notably greater increment when compared to the intrinsic error. This indicates that the changes were due to the intervention. However, this was not observed in iron tissue parameters sFer which indicates the change must have been notably influences by the within-subject variation.
The lack of significant change in iron status in the current study may be attributed to several factors. One plausible explanation would be that mean serum ferritin baseline value showed iron-repletion state sFer Researchers have demonstrated an inverse relationship between iron absorption and serum ferritin [ 36 ].
Hence, it may be possible that the subjects in this study had sufficient iron stores at baseline, which would explain the lack of significant effect of increased dietary iron intake on overall iron status.
A study using a heme iron-based crisp bread dietary intervention in women of reproductive age showed a significant improvement in serum ferritin after 12 weeks of daily 35 mg of dietary iron intake [ 17 ]. A longitudinal study by Tsalis et al. The participants in Tsalis et al. Hence, similar baseline iron status of these studies cohorts may explain the lack of iron therapy effect in both studies.
Another reason for the lack of notable changes in iron status might be due to the dietary iron bioavailability. However, researchers suggest that around two thirds of dietary non-haem iron was incorporated into the red blood cells RBC after 2 weeks of consumption in participants with sufficient iron stores [ 37 ]. Therefore, non-haem iron derived from an iron-rich bread product in this study during 6-week intervention period would have been sufficient for the iron uptake and utilisation.
Nevertheless, cereal products provide a less absorbable form of non-haem iron compared to animal sources, which contain haem iron [ 38 ]. Therefore, the lack of the effect on iron status may suggest lower iron bioavailability in Teff bread used in the present study.
Ishizaki et al. Despite the lack of significant changes in haematological indices, the study findings showed some important correlations between baseline iron status and favourable outcomes of the intervention.
The iron status of iron-depleted participants showed the greatest improvements in haematological parameters during the intervention Table 4. This was indicated by the correlations between changes in tissue iron supply parameters sTFR and sTsfR and the highest initial values of these haematological indices, showing inadequate iron supply at baseline.
This can be explained by the homeostatic body iron metabolism control as the absorption of dietary iron is increased with compromised iron status [ 39 ],[ 40 ]. This is in agreement with the findings of the present study in which female runners with a compromised iron status pre-intervention improved their haematological indices the most.
The increment in iron storage was positively correlated with changes in dietary iron intake, even when controlling for initial iron status Table 4. This suggests that iron stores were increased more in runners, who increased their dietary iron intake the most regardless of their baseline iron status.
This also indicates that dietary iron was incorporated into body iron stores. Hence, even a modest increase in dietary iron from The present study revealed inadequate dietary iron intake in the cohort of female runners studied. The dietary intervention showed significant improvements in total iron intake and a modest improvement in iron status. Further research using larger groups of participants is needed to confirm if dietary intervention through a dietary change can significantly improve iron status and consequently exercise performance.
Nevertheless, taking into account the research design and sample size limitations, the current study findings show a positive but modest improvement in iron status as a result of dietary iron intervention.
Curr Sports Med Rep. Article PubMed Google Scholar. Beard J, Tobin B: Iron status and exercise. Am J of Clin Nutr. CAS Google Scholar. Eur J Appl Physiol. J Sports Sci. Article Google Scholar. J Nutr Sci Vitaminol. Br J Haematol. Med Sci Sports Exerc.
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