Analysis of Serum Ferritin Levels in a Group of Elite Ballet Dancers

Introduction: Iron plays a significant role in energy production. However, it is not uncommon for athletes to be diagnosed with iron deficiency (ID), suggesting a correlation between performance and iron regulation. As a result, the International Olympic Committee has recommended iron screenings during health evaluations for elite athletes. Furthermore, athletes participating in esthetic sports are at increased risk for suboptimal iron intake due to disordered eating. Therefore, the purpose of this study was to investigate the distribution of serum ferritin (SF) in a cohort of elite ballet dancers and determine associations between vitamin D, anthropometric measures, stress injury, and dietary preferences. Methods: Electronic health records of 40 elite ballet dancers (22 female, 18 male), age 19 to 38 years old, from the 2020 to 2021 pre-participation physical screening were examined. Chi squared comparisons were calculated to evaluate the association between SF and additional variables (ie, gender, age, height, weight, body mass index, vitamin D, stress injury history, and dietary preferences). SF values were compared to published normal and athletic population data. Results: 58.97% of participants displayed normal or above SF values (>50 ng/ml), while 41.02% displayed minimal (<50 ng/ml) to depleted (<0.12/ng/ml) SF values. Approximately, 68% of the female dancers were ID and did not meet the minimal value needed for athletes. Females were more likely to have lower SF distributions (x² [4] = 15.6377, P =.004) compared to male dancers. Additionally, dancers who reported dietary preferences (ie, vegetarian) were more likely to display lower SF distributions (x²[4] = 13.3366, P =.010). Conclusion: Over half of the female elite ballet dancers were ID which is consistent with current research. Females were at a significant higher risk compared to male dancers who reported dietary preferences. These findings suggest iron screenings should be considered in elite dancer populations.