Single versus split dose of iron optimizes hemoglobin mass gains at 2106 m altitude

Journal article


Hall, Rebecca, Peeling, Peter, Nemeth, Elizabeta, Bergland, Dan, McCluskey, Walter T. P. and Stellingwerff, Trent. (2019). Single versus split dose of iron optimizes hemoglobin mass gains at 2106 m altitude. Medicine and Science in Sports and Exercise. 51(4), pp. 751-759. https://doi.org/10.1249/MSS.0000000000001847
AuthorsHall, Rebecca, Peeling, Peter, Nemeth, Elizabeta, Bergland, Dan, McCluskey, Walter T. P. and Stellingwerff, Trent
Abstract

Purpose
To determine if a single versus a split equivalent daily dose of elemental iron was superior for hemoglobin mass (Hbmass) gains at altitude while minimizing gastrointestinal (GI) discomfort.

Methods
Twenty-four elite runners attended a 3.1 ± 0.3 wk training camp (Flagstaff, AZ; 2106 m). A two-group design, randomized and stratified to baseline Hbmass, sex, and ferritin (>30 μ·L−1), was implemented daily as: 1) single dose of 1 × 200 mg (pm only, SINGLE) versus 2) split dose of 2 × 100 mg (am and pm; SPLIT) elemental iron (ferrous fumarate). The Hbmass and venipuncture assessments were completed upon arrival and departure (±2 d) from camp for ferritin, hepcidin, and erythroferrone (ERFE) concentrations. Validated food frequency, GI distress, menstrual blood loss (MBL) and training questionnaires were implemented throughout. Univariate analysis was used to compare Hbmass, with baseline ferritin, dietary iron intake, MBL, and training volume used as covariates.

Results
Both conditions increased Hbmass from baseline (P < 0.05), with SINGLE (867.3 ± 47.9 g) significantly higher than SPLIT (828.9 ± 48.9 g) (P = 0.048). The GI scores were worse in SINGLE for weeks 1 and 2 combined (SINGLE, 18.0 ± 6.7 points; SPLIT, 11.3 ± 6.9 points; P = 0.025); however, GI scores improved by week 3, resulting in no between-group differences (P = 0.335). Hepcidin significantly decreased over time (P = 0.043) in SINGLE, with a nonsignificant decrease evident in SPLIT (~22%). ERFE significantly decreased in both groups (~28.5%; P < 0.05). No between-group differences existed for ERFE, hepcidin, food frequency, MBL, or daily training outcomes (P > 0.05).

Conclusions
A single nightly 200-mg dose of elemental iron was superior to a split dose for optimizing Hbmass changes at altitude in runners over an approximately 3-wk training camp.

Keywordssupplementation; erythropoiesis; elite runners; middle-distance; long-distance
Year2019
JournalMedicine and Science in Sports and Exercise
Journal citation51 (4), pp. 751-759
PublisherLippincott Williams & Wilkins
ISSN0195-9131
Digital Object Identifier (DOI)https://doi.org/10.1249/MSS.0000000000001847
Research or scholarlyResearch
Page range751-759
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
OnlineApr 2019
Publication process dates
Deposited03 Sep 2021
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