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Iron Deficiency and the Role of Nutrition among Female Military Recruits

ISRAELI, ERAN1,2; MERKEL, DRORIT3; CONSTANTINI, NAAMA4; YANOVICH, RAN5,6; EVANS, RACHEL K.7; Shahar, DANIT8; Moran, DANIEL S.5,6

Medicine & Science in Sports & Exercise: November 2008 - Volume 40 - Issue 11 - pp S685-S690
doi: 10.1249/MSS.0b013e31818946ae
November Supplement

The impact of iron deficiency is considerable when enhanced physical fitness is required. Female military recruits represent a unique population faced with intense physical and cognitive demands.

Purpose: To examine the prevalence of iron deficiency and the impact of dietary habits among female recruits in the Israel Defense Forces.

Methods: Three hundred and forty-eight recruits completed the study (188 female combatants, 58 male combatants, and 92 noncombat females). Dietary intake was assessed using a Food Frequency Questionnaire. Blood samples were collected for complete blood cell count, iron indices, and vitamin B12. The common definitions for anemia and iron store deficiency were used as follows: hemoglobin <12 g·dL−1 for females and <14 g·dL−1 for males; serum ferritin <12 mg·dL−1.

Results: The prevalence of iron deficiency and iron deficiency anemia was 29.8% and 12.8%, respectively, among female combatants. Similar data were found among noncombat females (27.2% and 17.4%, respectively) as compared with 5.2% and 0% among males. No significant difference in iron or total calorie intake was detected between subjects with iron deficiency (with or without anemia) when compared with subjects with normal iron status in the same study group. Plant sources constituted 85% of dietary iron source for females, in comparison to 73% for males. The contribution of red meat to the daily iron intake was 2% for females and 20% for males.

Conclusions: A high prevalence of iron deficiency was found among female recruits. Coupled with the iron loss during menstruation, inadequate iron intake may have a permissive role for iron deficiency in female recruits and is an important issue facing females in the military.

1Division of Medicine, Department of Gastroenterology, Hebrew University-Hadassah Medical Center, Jerusalem, ISRAEL; 2Medical Corps, Israel Defense Forces, Tel-Hashomer, ISRAEL; 3Sheba Medical Center, Tel-Hashomer, ISRAEL; 4Department of Orthopedics, Hebrew University-Hadassah Medical Center, Jerusalem, ISRAEL; 5Heller Institute of Medical Research, Sheba Medical Center, Tel-Hashomer, ISRAEL; 6Sackler Faculty of Medicine, Tel Aviv University, ISRAEL; 7US Army Research Institute of Environmental Medicine, Natick, MA; and 8The S. Daniel Abraham International Center for Health and Nutrition, Ben-Gurion University of the Negev, Beer-Sheva, ISRAEL

Address for correspondence: Eran Israeli, M.D., Department of Gastroenterology, Hadassah Medical Center, POB 12000, Jerusalem, 91120, Israel; E-mail: eran-i@bezeqint.net.

©2008The American College of Sports Medicine