By Sarah O'Neill, Feb 24 2017 03:16PM
I recently contributed to a piece in Women's Health on iron-deficiency anaemia (Something weighing down your workout? WH March 2017 issue p.67-70), a condition that affects as many as 12-15% women aged 15-50 according to the WHO (World Health Organisation) and is the most common nutritional deficiency in the world. However in many cases it goes undiagnosed, and, as I told Women's Health, is particularly prevalent amongst women frequently training at intensity. This is because training increases red blood cell production (increasing your iron needs) plus you lose iron both in your sweet and through something beautifully termed 'foot strike haemolysis' whereby blood cells and capillaries in the feet are damaged by running and jumping, creating a higher turnover of red blood cells. Running puts a force of 2.5 times your body weight on the soles of your feet (why I'm also always banging on about refreshing your trainers regularly...)
Unfortunately many of us put those feelings of depletion down to a hard session and busy lifestyle, but for as many as 22% of both elite and recreational athletes there's something more serious going on. Moreover, data suggests 50% of women with heavy periods are likely to be iron-deficient, so if you're both a heavy exerciser with heavy periods it's definitely worth getting checked out.
So what should you look out for?
- headaches, dizziness
- pale skin
- shortness of breath
- racing heart
- cold hands and feet
- poor concentration
- restlessness including restless legs (or 'eebjabs' as my mother calls them...not a scientifically validated term...)
- sore tongue, cracks around the mouth
- hair loss
- frequent infections (iron plays a MASSIVE role in the immune system)
If a number of these symptoms resonate with you it might be time to pop to see your GP for a blood test. Recreational athletes need 1.3 - 1.7 times more iron than the general population, and living with iron-deficiency anaemia can mean you're failing to progress in your training, or hit new PBs. It can also mean you're struck with every bug going around, and struggling to shift these infections, leaving you yet more run down.
Treatment for iron-deficiency anaemia is often with something called ferrous sulphate, a form of iron we can readily use. However around 1/3 people don't tolerate these tablets well and can develop gastrointestinal symptoms such as constipation, diarrhoea or stomach pains. There's a lot we can do with diet, however, and it's always worth modifying your plate before your pills, unless your levels call for immediate medical intervention.
Due to Popeye we all mistakenly believe spinach to be our mightiest source of iron, however iron is much more readily accessible in its haem format, which comes from all meat and fish, with seafood such as oysters and clams also an amazing source. Venison is in fact richer in iron than beef and lower in fat, if you're a game fan, although liver is the still our best source (ick).
Vegetarians need 1.8 times more iron than meat-eaters as non-haem iron from plants is less bioavailable (readily absorbed and accessed by the body). However you can increase absorption by coupling your iron source with vitamin-C rich foods. For our veggies the best sources are legumes (particularly kidney beans), grains, nuts, seeds (especially pumpkin) and green leafy veg. Kale, brussel sprouts and broccoli all contain good levels of iron AND vitamin C so you're getting the ideal combo there. Otherwise adding in red or green peppers or consuming them with a glass of OJ (or better still a fresh orange, strawberries, grapefruit, kiwi of guava) will assist non-haem iron absorption.
It's also worth noting that inflammation in the body post-workout blocks the iron absorption pathway for several hours afterwards. So before chowing down on a humungous steak it's worth hopping in an ice bath (or use cooling pads). Spend maximum 10 minutes in there, but anything from around 6 minutes will do the trick. Also avoid drinking tea or coffee with your meals which can impair iron absorption - best to wait at least an hour after eating.
It's essential when you start an exercise programme to think about your diet, and this is why all our clients get the opportunity to undergo a nutrition review from the outset. Over nutrition can scupper the effects of your training by not allowing you to change your body shape in the way you desire. However under-nutrition in any area (and most specifically iron) can also mean that exercise pushes the body into a deficiency state, which can have detrimental effects on your health.