Top

Published in:

Open Access 01-11-2018 | Original Article

Changes in iron metabolism during prolonged repeated walking exercise in middle-aged men and women

Authors: Rieneke Terink, D. ten Haaf, C. W. G. Bongers, M. G. J. Balvers, R. F. Witkamp, M. Mensink, T. M. H. Eijsvogels, J. M. T. Klein Gunnewiek, M. T. E. Hopman

Published in: European Journal of Applied Physiology | Issue 11/2018

Abstract

Purpose

The aim of the present study was to assess the effect of prolonged and repeated exercise on iron metabolism in middle-aged adults and to compare differences between sexes.

Methods

50 male (58.9 ± 9.9 year) and 48 female (50.9 ± 11.2 year) individuals were monitored on 4 consecutive days at which they walked on average 8 h and 44 min per day at a self-determined pace. Blood samples were collected 1 or 2 days prior to the start of the exercise (baseline) and every day immediately post-exercise. Samples were analysed for iron, ferritin, haemoglobin, and haptoglobin concentrations.

Results

Plasma iron decreased across days, while ferritin increased across days (both p < 0.001). Haptoglobin showed a decrease (p < 0.001) after the first day and increased over subsequent days (p < 0.001). Haemoglobin did not change after the first day, but increased during subsequent days (p < 0.05). At baseline, 8% of the participants had iron concentrations below minimum reference value (10 µmol/L), this increased to 43% at day 4. There was an interaction between sex and exercise days on iron (p = 0.028), ferritin (p < 0.001) and haemoglobin levels (p = 0.004), but not on haptoglobin levels.

Conclusion

This study showed decreases in iron, increases in ferritin, a decrease followed by increases in haptoglobin and no change followed by increases in haemoglobin. This is most likely explained by (foot strike) haemolysis, inflammation, and sweat and urine losses. These processes resulted in iron levels below minimum reference value in a large number of our participants.

Banzet S, Sanchez H, Chapot R, Bigard X, Vaulont S, Koulmann N (2012) Interleukin-6 contributes to hepcidin mRNA increase in response to exercise. Cytokine 58(2):158–161. https://doi.org/10.1016/j.cyto.2012.01.006 PubMedCrossRef

Bourque SP, Pate RR, Branch JD (1997) Twelve weeks of endurance exercise training does not affect iron status measures in women. J Am Diet Assoc 97(10):1116–1121. https://doi.org/10.1016/s0002-8223(97)00272-1 PubMedCrossRef

Buchman AL, Keen C, Commisso J, Killip D, Ou CN, Rognerud CL, Dennis K, Dunn JK (1998) The effect of a marathon run on plasma and urine mineral and metal concentrations. J Am Coll Nutr 17(2):124–127PubMedCrossRef

Buratti P, Gammella E, Rybinska I, Cairo G, Recalcati S (2015) Recent advances in iron metabolism: relevance for health, exercise, and performance. Med Sci Sports Exerc 47(8):1596–1604. https://doi.org/10.1249/mss.0000000000000593 PubMedCrossRef

Chiu YH, Lai JI, Wang SH, How CK, Li LH, Kao WF, Yang CC, Chen RJ (2015) Early changes of the anemia phenomenon in male 100-km ultramarathoners. J Chin Medl Assoc JCMA 78(2):108–113. https://doi.org/10.1016/j.jcma.2014.09.004 CrossRef

Convertino VA (2007) Blood volume response to physical activity and inactivity. Am J Med Sci 334(1):72–79. https://doi.org/10.1097/MAJ.0b013e318063c6e4 PubMedCrossRef

DellaValle DM (2013) Iron supplementation for female athletes: effects on iron status and performance outcomes. Curr Sports Med Rep 12(4):234–239. https://doi.org/10.1249/JSR.0b013e31829a6f6b PubMedCrossRef

Dellavalle DM, Haas JD (2012) Iron status is associated with endurance performance and training in female rowers. Med Sci Sports Exerc 44(8):1552–1559. https://doi.org/10.1249/MSS.0b013e3182517ceb PubMedCrossRef

DeRuisseau KC, Cheuvront SN, Haymes EM, Sharp RG (2002) Sweat iron and zinc losses during prolonged exercise. Int J Sport Nutr Exerc Metab 12(4):428–437PubMedCrossRef

Dill DB, Costill DL (1974) Calculation of percentage changes in volumes of blood, plasma, and red cells in dehydration. J Appl Physiol 37(2):247–248CrossRef

Egan LM, Watts PB, Silta BC (1987) Changes in serum haptoglobin as an acute response to a marathon road race. J Sports Sci 5(1):55–60. https://doi.org/10.1080/02640418708729764 PubMedCrossRef

Ganz T, Nemeth E (2006) Regulation of iron acquisition and iron distribution in mammals. Biochimica et biophysica acta 1763(7):690–699. https://doi.org/10.1016/j.bbamcr.2006.03.014 PubMedCrossRef

Gilligan DR, Altschule MD (1950) March hemoglobinuria in a woman. N Engl J Med 243(24):944–948. https://doi.org/10.1056/195012142432402 PubMedCrossRef

Hornbostel H (1970) Recent information on march hemoglobinuria. Dtsch Med Wochenschr 95(9):458–461. https://doi.org/10.1055/s-0028-1108484 PubMedCrossRef

Kell DB (2009) Iron behaving badly: inappropriate iron chelation as a major contributor to the aetiology of vascular and other progressive inflammatory and degenerative diseases. BMC Med Genom 2:2. https://doi.org/10.1186/1755-8794-2-2 CrossRef

Kell DB, Pretorius E (2014) Serum ferritin is an important inflammatory disease marker, as it is mainly a leakage product from damaged cells. Metallomics Integr Biometal Sci 6(4):748–773. https://doi.org/10.1039/c3mt00347g CrossRef

Latunde-Dada GO (2013) Iron metabolism in athletes–achieving a gold standard. Eur J Haematol 90(1):10–15. https://doi.org/10.1111/ejh.12026 PubMedCrossRef

Lukaski HC (2004) Vitamin and mineral status: effects on physical performance. Nutrition (Burbank, Los Angel Cty Calif) 20(7–8):632–644. https://doi.org/10.1016/j.nut.2004.04.001 CrossRef

McClung JP (2012) Iron status and the female athlete. J Trace Elements Med Biol Organ Soc Miner Trace Elements (GMS) 26 (2–3):124–126. https://doi.org/10.1016/j.jtemb.2012.03.006 CrossRef

McClung JP, Martini S, Murphy NE, Montain SJ, Margolis LM, Thrane I, Spitz MG, Blatny JM, Young AJ, Gundersen Y, Pasiakos SM (2013) Effects of a 7-day military training exercise on inflammatory biomarkers, serum hepcidin, and iron status. Nutrition J 12(1):141. https://doi.org/10.1186/1475-2891-12-141 CrossRef

McInnis MD, Newhouse IJ, von Duvillard SP, Thayer R (1998) The effect of exercise intensity on hematuria in healthy male runners. Eur J Appl Physiol Occup Physiol 79(1):99–105PubMedCrossRef

Mihara M, Hashizume M, Yoshida H, Suzuki M, Shiina M (2012) IL-6/IL-6 receptor system and its role in physiological and pathological conditions. Clin Sci (Lond, Engl: 1979) 122(4):143–159. https://doi.org/10.1042/cs20110340 CrossRef

Nemeth E, Tuttle MS, Powelson J, Vaughn MB, Donovan A, Ward DM, Ganz T, Kaplan J (2004) Hepcidin regulates cellular iron efflux by binding to ferroportin and inducing its internalization. Science 306(5704):2090–2093. https://doi.org/10.1126/science.1104742 PubMedCrossRef

Orino K, Lehman L, Tsuji Y, Ayaki H, Torti SV, Torti FM (2001) Ferritin and the response to oxidative stress. Biochem J 357(Pt 1):241–247PubMedPubMedCentralCrossRef

Pattini A, Schena F, Guidi GC (1990) Serum ferritin and serum iron changes after cross-country and roller ski endurance races. Eur J Appl Physiol Occup Physiol 61(1–2):55–60PubMedCrossRef

Peeling P, Dawson B, Goodman C, Landers G, Trinder D (2008) Athletic induced iron deficiency: new insights into the role of inflammation, cytokines and hormones. Eur J Appl Physiol 103(4):381–391. https://doi.org/10.1007/s00421-008-0726-6 PubMedCrossRef

Peeling P, Dawson B, Goodman C, Landers G, Wiegerinck ET, Swinkels DW, Trinder D (2009a) Cumulative effects of consecutive running sessions on hemolysis, inflammation and hepcidin activity. Eur J Appl Physiol 106(1):51–59. https://doi.org/10.1007/s00421-009-0988-7 PubMedCrossRef

Peeling P, Dawson B, Goodman C, Landers G, Wiegerinck ET, Swinkels DW, Trinder D (2009b) Effects of exercise on hepcidin response and iron metabolism during recovery. Int J Sport Nutr Exercise Metabolism 19(6):583–597CrossRef

Peeling P, Sim M, Badenhorst CE, Dawson B, Govus AD, Abbiss CR, Swinkels DW, Trinder D (2014) Iron status and the acute post-exercise hepcidin response in athletes. PLoS One 9(3):e93002. https://doi.org/10.1371/journal.pone.0093002 PubMedPubMedCentralCrossRef

Reinke S, Taylor WR, Duda GN, von Haehling S, Reinke P, Volk HD, Anker SD, Doehner W (2012) Absolute and functional iron deficiency in professional athletes during training and recovery. Int J Cardiol 156(2):186–191. https://doi.org/10.1016/j.ijcard.2010.10.139 PubMedCrossRef

Rocker L, Hinz K, Holland K, Gunga HC, Vogelgesang J, Kiesewetter H (2002) Influence of endurance exercise (triathlon) on circulating transferrin receptors and other indicators of iron status in female athletes. Clin Lab 48(5–6):307–312PubMed

Roecker L, Meier-Buttermilch R, Brechtel L, Nemeth E, Ganz T (2005) Iron-regulatory protein hepcidin is increased in female athletes after a marathon. Eur J Appl Physiol 95(5–6):569–571. https://doi.org/10.1007/s00421-005-0055-y PubMedCrossRef

Sandstrom G, Borjesson M, Rodjer S (2012) Iron deficiency in adolescent female athletes—is iron status affected by regular sporting activity? Clin J Sport Med 22(6):495–500. https://doi.org/10.1097/JSM.0b013e3182639522 PubMedCrossRef

Schaer DJ, Vinchi F, Ingoglia G, Tolosano E, Buehler PW (2014) Haptoglobin, hemopexin, and related defense pathways—basic science, clinical perspectives, and drug development. Front Physiol 5:415. https://doi.org/10.3389/fphys.2014.00415 PubMedPubMedCentralCrossRef

Singh R, Sirisinghe RG (1999) Haematological and plasma electrolyte changes after long distance running in high heat and humidity. Singap Med J 40(2):84–87

Skarpanska-Stejnborn A, Basta P, Trzeciak J, Szczesniak-Pilaczynska L (2015) Effect of intense physical exercise on hepcidin levels and selected parameters of iron metabolism in rowing athletes. Eur J Appl Physiol 115(2):345–351. https://doi.org/10.1007/s00421-014-3018-3 PubMedCrossRef

Sullivan SN (1986) Gastrointestinal bleeding in distance runners. Sports Med (Auckl NZ) 3(1):1–3CrossRef

Tan D, Dawson B, Peeling P (2012) Hemolytic effects of a football-specific training session in elite female players. Int J Sports Physiol Performance 7(3):271–276CrossRef

Tanaka H, Monahan KD, Seals DR (2001) Age-predicted maximal heart rate revisited. J Am Coll Cardiol 37(1):153–156PubMedCrossRef

Taylor C, Rogers G, Goodman C, Baynes RD, Bothwell TH, Bezwoda WR, Kramer F, Hattingh J (1987) Hematologic, iron-related, and acute-phase protein responses to sustained strenuous exercise. J Appl Physiol (Bethesda, Md: 1985) 62(2):464–469CrossRef

Telford RD, Sly GJ, Hahn AG, Cunningham RB, Bryant C, Smith JA (2003) Footstrike is the major cause of hemolysis during running. J Appl Physiol (1985) 94(1):38–42. https://doi.org/10.1152/japplphysiol.00631.2001 CrossRef

Trumbo P, Yates AA, Schlicker S, Poos M (2001) Dietary reference intakes: vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. J Am Diet Assoc 101(3):294–301. https://doi.org/10.1016/s0002-8223(01)00078-5 PubMedCrossRef

Weight LM, Alexander D, Jacobs P (1991) Strenuous exercise: analogous to the acute-phase response? Clin Sci (Lond Engl: 1979) 81(5):677–683CrossRef

Wilkinson JG, Martin DT, Adams AA, Liebman M (2002) Iron status in cyclists during high-intensity interval training and recovery. Int J Sports Med 23(8):544–548. https://doi.org/10.1055/s-2002-35528 PubMedCrossRef

Title: Changes in iron metabolism during prolonged repeated walking exercise in middle-aged men and women
Authors: Rieneke Terink
D. ten Haaf
C. W. G. Bongers
M. G. J. Balvers
R. F. Witkamp
M. Mensink
T. M. H. Eijsvogels
J. M. T. Klein Gunnewiek
M. T. E. Hopman
Publication date: 01-11-2018
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Applied Physiology / Issue 11/2018
Print ISSN: 1439-6319
Electronic ISSN: 1439-6327
DOI: https://doi.org/10.1007/s00421-018-3961-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Changes in iron metabolism during prolonged repeated walking exercise in middle-aged men and women

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 11/2018

Pulsatile interaction between the macro-vasculature and micro-vasculature: proof-of-concept among patients with type 2 diabetes

Cerebral oxygenation declines but does not impair peak oxygen uptake during incremental cycling in women using oral contraceptives

The effect of exhaustive exercise on the choice of technique and physiological response in classical roller skiing

A multiscale model for the simulation of cerebral and extracerebral blood flows and pressures in humans

Elevated arterial lactate delays recovery of intracellular muscle pH after exercise

Effects of endurance training on neuromuscular fatigue in healthy active men. Part I: Strength loss and muscle fatigue