Iron2026-05

Iron Deficiency in Vegetarian Athletes: A Narrative Review.

Luna Fernando, Rossi Eugenio Viviani, Moreno Miguel López, Heim Tomás et al. — Current nutrition reports

Summary

This review explored whether vegetarian athletes are more prone to iron deficiency. It found that while plant-based iron is less readily absorbed, vegetarian athletes often consume sufficient iron, and their bodies can adapt. Therefore, they are not necessarily at greater risk, but careful dietary planning is still important, especially for high-performance individuals.

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Key points

Vegetarian athletes do not consistently show a higher prevalence of iron deficiency compared to those who eat meat.
Their bodies can adapt to lower iron availability from plant foods by enhancing absorption efficiency.
Individualized and evidence-based dietary planning is crucial for high-performing vegetarian athletes.
More research is needed, especially for elite and female athletes, to draw firm conclusions.

What the study looked at

This review investigated whether vegetarian athletes face a higher risk of iron deficiency compared to athletes who consume meat. Researchers conducted a narrative review, which means they gathered and analyzed existing scientific literature on iron status in vegetarian athletes. They considered various types of vegetarian diets, including vegan, lacto-ovo, and lacto-vegetarian. The review concluded that current studies do not consistently show a higher prevalence of iron deficiency among vegetarian athletes. Despite the lower bioavailability of non-heme iron from plants, many vegetarian athletes consume adequate total iron, and their bodies can develop adaptive mechanisms, such as improved absorption efficiency, to maintain iron balance. However, the authors noted that differing study methods and limited data on elite or female athletes prevent definitive conclusions. The overall finding suggests that vegetarian athletes are not inherently at greater risk, but personalized nutritional strategies are vital for optimal performance, particularly in competitive settings.

Dietary takeaway

Vegetarian athletes should prioritize iron-rich plant foods like lentils, beans, spinach, and fortified cereals, and pair them with vitamin C sources such as citrus fruits or bell peppers to enhance iron absorption. While this review suggests vegetarian athletes aren't automatically at higher risk, individual needs vary significantly. Remember, this is one review summarizing existing research, and more studies are needed to draw firm conclusions for all athletes.

Abstract

PURPOSE OF REVIEW: The increasing adoption of vegetarian dietary patterns among athletes (including lacto-ovo, lacto-, ovo-vegetarian, and vegan diets) has prompted growing interest in their potential effects on health and sports performance. Iron status remains one of the key nutritional concerns in this context, given the lower bioavailability of non-heme iron and the higher physiological demands of exercise. This review aims to synthesize and critically evaluate current evidence on the prevalence, consequences, adaptive responses, and management of iron deficiency in vegetarian athletes. RECENT FINDINGS: Available studies do not consistently indicate a higher prevalence of iron deficiency among vegetarian athletes compared with omnivores. Despite lower iron bioavailability, total dietary iron intake in vegetarians often equals or exceeds that of omnivores, and several adaptive mechanisms (such as enhanced absorption efficiency and reduced iron losses) may help preserve iron balance. Nevertheless, methodological heterogeneity across studies and the limited inclusion of elite or female athletes constrain firm conclusions. Current data suggest that vegetarian athletes are not inherently at greater risk of iron deficiency. However, in high-performance settings, individualized and evidence-based dietary planning remains essential to ensure optimal iron status and sustain athletic performance. Future research should clarify the interplay between diet composition, adaptive physiology, sex, and training load in determining iron metabolism among vegetarian athletes.

View on PubMed →DOI: 10.1007/s13668-026-00765-1