Anemia in Female Collegiate Athletes: Association with Hematological Variables, Physical Activity and Nutrition

Aims: The current study aims to clarify the prevalence of anemia in collegiate athletes in relation to various hematological variables, physical activity and nutrient intake.
Study Design: A cross sectional, retrospective study.
Place and Duration of Study: This study was done at two universities in Nara, Japan, between April and September, 2013.
Methodology: Fifty-eight female athletes and 65 female non-athletes were enrolled. Hematological variables, physical activities based on the definition of the International Physical Activity Questionnaire, and nutrients intake using one week’s dietary records were measured.
Results: The prevalence of anemia (<12 g/dl of hemoglobin) and hypoferritinemia (<12 ng/ml of ferritin) was comparable between athlete and non-athlete groups. Reticulocytes percentages or haptoglobin levels were statistically higher or lower respectively, in the athlete group. There was no statistical difference in the intake of micronutrients related to erythropoiesis between the two groups. Multiple regression analysis revealed that hemoglobin levels were significantly associated with an irregular menstruation status in both groups, and were associated with the physical activity only in the athlete group.
Conclusion: Although the prevalence of anemia in female collegiate athletes is identical to that of non-athletes, they may be at risk for anemia when their strength of physical activity will increase. Since the signs of hemolysis are more common in the athlete group, a measure of minimizing hemolysis such as the introduction of a pad on the sole of the foot may be considered to prevent the occurrence of overt anemia.