Iron Rules

“My teammate eats ice chips like crazy. Isn’t that a sign of being anemic?”

“Something must be wrong with me. I get out of breath just walking up a flight of stairs.”

“Should I eat lots of spinach to boost my iron intake, given that I’ve stopped eating red meat?”

Many of today’s rowers are eating little or no red meat (such as beef, lamb), which is one of the best sources of dietary iron. These athletes—in particular lightweight rowers who eat less food overall—are consuming simultaneously less iron.

Iron is a mineral found in the hemoglobin molecule inside red blood cells. It helps transport oxygen from your lungs to your muscles. Iron deficiency contributes to anemia, a major symptom of which is fatigue—whether rowing or climbing a flight of stairs.

Rowers with anemia may complain about lightheadedness, weakness, subpar performance, and yes, a desire to chew on ice. While fatigue can be caused also by lack of sleep, depression, stress, and calorie restriction, fatigue from an iron-deficient diet is common.

Iron-deficiency anemia is more prevalent among athletes than among the general population. That’s because athletes lose iron through heavy sweating, blood loss in urine and the intestinal tract, and damage to red blood cells caused by foot strikes while running. Female athletes lose blood through monthly menstruation; hence, women are more prone to anemia than men.

In a survey of 277 runners who participated in the Detroit Free Press marathon and half marathon (about 60 percent female; average age 40), about half the women and a sixth of the men had clinical iron deficiency. Fifteen percent of the women and three percent of the men had severe iron deficiency. Just think how much faster these athletes could have run! While rowers are not runners, anemia is prevalent among all endurance athletes.

What To Do

If you think you might be anemic, get your blood tested to rule out anemia (and remeasure it in six to eight weeks after treatment). The diagnostic criteria are:

—hemoglobin (the iron-containing molecule within the red blood cell) is less than 120 (female) or 130 (male) grams per liter.

—ferritin (a marker of iron stores) is less than 12 nanograms per milliliter (ferritin should be more than 30 to 40 nanograms per milliliter, if not higher).

—transferrin saturation (transferrin binds iron in the blood) is less than 16 percent.

Preventing and Resolving Anemia

If you limit your intake of iron-rich beef and lamb, be sure to consume alternate sources of iron, such as dark-meat chicken or turkey (legs, thighs), tuna, or salmon. About 40 percent of the heme-iron in animal protein is absorbed, compared to only five percent of the non-heme iron in plants.

Don’t count on plant sources of iron such as almonds, spinach, lentils, beans, and grains to satisfy your iron needs. Only about two percent of the iron in spinach might get absorbed. Despite Popeye’s claim that spinach made him strong to the finish, spinach is a poor source of absorbable iron. Combining heme-iron in animal protein with non-heme (plant) iron optimizes absorption. So add some tuna to your spinach salad, turkey to lentil soup, beef to chili.

If you’re a rower who “eats clean” and minimizes your intake of “white foods” (such as white bread, pasta and rice), take note: refined grains are enriched or fortified generally with iron. So eliminating enriched white bread and other refined grains reduces your intake of iron (as well as other added nutrients).

Enriched breakfast cereals such as Cheerios, Grape Nuts, and Kellogg’s Raisin Bran are good sources of iron. (By comparison, “all natural” cereals like granola or Puffins have no additives, which means they have no added iron.) To enhance the absorption of the iron in enriched cereals, include a source of vitamin C with the meal, such as an orange or orange juice, a clementine, or some strawberries.

Research indicates that iron tends to be absorbed better in the morning than in the evening, owing in part to the daily fluctuation of the hormone hepcidin. Hepcidin hinders iron absorption from the intestinal tract and is a key regulator of iron absorption. Hepcidin increases after exercise and is triggered by exercise’s inflammatory response.

Thus, to optimize your iron absorption, pay attention to when you eat iron-rich foods or take an iron supplement. A good time to consume iron or iron supplements is with an iron-rich breakfast either before or shortly after a workout, but not three to six hours afterward, when hepcidin peaks. This timing will optimize iron absorption as well as tolerance, since your body will tolerate iron supplements better when taken with food.

Iron Supplements

If you’re anemic, you want to boost your dietary iron intake. You will need also to take supplemental iron to correct the deficiency. Do not self-prescribe high doses of iron supplements.  Your doctor should recommend the dose best for your body. Taking too much iron puts some athletes at risk of iron overload, which can be dangerous.

Supplements come in two forms: ferrous iron (gluconate, sulphate, fumerate) and ferric iron (citrate, sulphate). Ferrous iron is better absorbed by the gut, but ferric iron settles better in the gut. Some rowers find that iron supplements contribute to nausea and constipation. If such is the case for you, experiment with different brands to find the supplement your body tolerates best. Slow-release ferrous sulphate and ferrous bisglycinate are popular choices. Taking an iron supplement every other day is as effective as taking it daily.

The Bottom Line

To iron out performance problems such as needless fatigue, be sure your diet supports your athletic goals. A registered dietitian who is a certified specialist in sports dietetics can teach you how to consume an optimal diet that helps you be strong to the finish—with or without spinach! 

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