DISCUSSION
fatigue, cardiac disease
CARDIAC DISEASE
In this study, we performed baseline and posttreatment evaluations on young basketball players focusing on their iron status and performance. We assessed the prevalence of ID at baseline according to age groups and found that IDNA is more prevalent in the younger age groups. We randomized IDNA athletes based on ferritin levels into iron and placebo groups. We administered oral iron supplementation for 3 months and found that this only affected ferritin levels but had no impact on sports performance.During the sports cardiology screening, no major underlying cardiac disease was verified. In our study, IDNA was very frequent, affecting 92% of our young basketball players. In parallel with our study, Shoemaker et al. found that ID rates in young athletes between the ages of 8 and 16, were similarly high. In their study, 65% of the boys and 86% of the girls had low ferritin levels, even though they used a much lower ferritin cut‐off value (30 μg/L).Most of the previous studies investigate the iron status of endurance athletes. However, this may be more important in tactical sports, where skills, speed, and decision making under fatigue, and stress are more prominent. Dubnov et al. examined the iron status of top‐level male and female basketball players (In young athletes, the rapid growth and development combined with increased physical activity predisposes children to develop ID. Due to the growing blood volume and muscle mass, they have an extra iron demand; hence identifying ID in this population is essential.In athletes, there is no widely accepted cut‐off value for ferritin and there is no guideline for iron supplementation dose and length. A meta‐analysis which included 17 studies found that low ferritin levels can be significantly increased with iron treatment. They mainly used the ferritin cut‐off <20 μg/L with a supplementation period of an average of 61 days. Most studies examined only female athletes.In our study, after the 3‐month supplementation the ferritin level was significantly higher in the iron group than in the placebo group, but only a small portion of the athletes (15%) reached our expected ferritin level. Several studies assessed the effect of oral iron supplementation on iron status laboratory parameters in athletes with IDNA. A meta‐analysis by DellaValle et al. has concluded that 6−8 weeks of at least 100 mg of iron‐sulfate supplementation improves the level of ferritin or prevents the further decline of ferritin level in female athletes.In our study, the maximal aerobic capacity increased in both the iron and the placebo groups without any difference after the supplementation between the iron and the placebo groups. This finding can be explained by the athletes' improved performance during the season.According to iron supplementation protocols, 6−12 weeks of oral iron supplementation is required to replenish the iron stores.In our study, there were no side effects of the iron supplementation. A study by McCormick et al. has examined the daily or alternate day oral iron supplementation effectiveness in runners.