Prevalence of iron deficiency among university kendo practitioners in Japan: an observational cohort study
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RESEARCH ARTICLE
Open Access
Prevalence of iron deficiency among university kendo practitioners in Japan: an observational cohort study Takahiro Nabeyama1* , Yosuke Suzuki2, Kana Yamamoto2,3,4, Michiko Sakane5, Yoichiro Sasaki6, Haruka Shindo6, Morihito Takita2,3 and Masahiro Kami2
Abstract Background: Iron deficiency is widely recognized as being the cause of anemia in athletes, although iron status in athletes of Kendo, a traditional Japanese martial art based on swordsmanship and practiced as an educational sport, has not been widely investigated. Methods: We performed a health assessment on anemia and serum ferritin levels, along with nutrient intake evaluation, for Kendo practitioners in a university in Japan. Results: A total of 56 Kendo practitioners (39 male and 17 female) aged between 18 and 23 years participated in the study. No individuals exhibited WHO-defined anemia (less than 13 or 12 g/dL of hemoglobin levels in male or female), while hypoferritinemia (less than 30 ng/mL) was found in seven (41%) females but not in males. Significantly higher body mass index was found in the female athletes with hypoferritinemia compared to females with normo-ferritinemia in sub-analysis (median [interquartile range]; 25.6 [24.2, 26.9] versus 22.6 [21.7, 24.1], respectively. p < 0.05). No significant differences in the intake of iron were registered between males and females (with and without hypoferritinemia) using data from a food-frequency questionnaire survey. Conclusion: No apparent anemia was found in adolescent Kendo practitioners, although this study confirmed the presence of hypoferritinemia in several female athletes. Careful follow-up, involving both clinical and nutritional assessment, will be necessary for them to prevent progression into anemia. A future study with larger cohorts in multiple sites is warranted to assess the prevalence of iron deficiency for validation and, if necessary, to devise a strategy for improving the iron status in Kendo athletes. Keywords: Anemia, Martial art, Ferritin, Nutrient intake
Background Anemia occurs when the number of red blood cells and, consequently, their oxygen-carrying capacity in a human body is insufficient to meet the body’s physiological needs. Athletes experience three kinds of anemia [1]. Socalled ‘sports anemia’ is a false condition resulting from * Correspondence: [email protected] 1 Faculty of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8574, Japan Full list of author information is available at the end of the article
an expansion of blood plasma volume as an adaptation for aerobic fitness [2]. Exertional hemolysis and resultant fatigue is a clinically insignificant condition because it is mild, rarely depletes iron, and seldom causes anemia [3]. Iron deficiency, however, has long been recognized as a problem among athletes, and there have been many suggestions for its etiology [4]. It is a true anemia, a common cause of fatigue and lowered performance in female athletes, but rarely occu
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