High Prevalence of Poor Iron Status Among 8- to 16-Year-Old Youth Athletes: Interactions Among Biomarkers of Iron, Dietary Intakes, and Biological Maturity

Marni E. Shoemaker, Zachary M. Gillen, Brianna D. McKay, Karsten Koehler, Joel T. Cramer

Research output: Contribution to journalArticle


Objective: The purpose of this study was to determine the prevalence of poor iron status in young athletes throughout the stages of iron deficiency and assess sex differences with iron deficiency in relation to growth and development and dietary intake. Methods: A cross-sectional analysis evaluated young male and female athletes (n = 91) between the ages 8 and 16 years. Anthropometric assessments, body composition, dietary intakes, and blood samples measuring ferritin, soluble transferrin receptor (sTfR), and hemoglobin (Hb) were examined. Prevalence was calculated as percentages, and independent samples t tests examined sex differences. Pearson product-moment correlation coefficient analyses quantified relationships among variables for the composite sample and each sex separately. Results: Iron depletion (low ferritin) was present in 65% and 86%, low iron levels (sTfR) in 51% and 68%, and anemia (low Hb) in 46% and 53% of the males and females, respectively. As iron deficiency progressed from low ferritin to high sTfR to anemia, prevalence decreased in both sexes, but always remained higher in females. Males were greater than females for weight, arm muscle size, and ferritin concentrations, while females were greater than males for biological maturity (p ≤ 0.05). Dietary iron intake was moderately to highly correlated (r = 0.543–0.723, p ≤ 0.05) with growth and development in females, but not males. Conclusions: Prevalence of poor iron status was higher than expected, particularly in adolescent females. Since rapid growth combined with sports participation may create high demands for iron bioavailability, emphasis may need to be placed on dietary iron intake for young athletes, particularly females.

Original languageEnglish (US)
Pages (from-to)155-162
Number of pages8
JournalJournal of the American College of Nutrition
Issue number2
StatePublished - Feb 17 2020



  • Iron deficiency
  • adolescent athletes
  • children
  • dietary iron
  • sports nutrition

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

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