Iron-deficiency anemia: small trial suggests HIIT may benefit balance

Exercise added to iron treatment

The study included women aged 18 to 25 with iron-deficiency anemia. Participants were randomly assigned to a group of 16 women combining exercise and iron supplementation, or a group of 17 women receiving iron alone.

The program lasted eight weeks. It involved very low-volume high-intensity interval training, or HIIT, using plyometric exercises. The abstract does not provide enough detail about the frequency, session duration or exercise content to describe a reproducible program.

The researchers measured hemoglobin, ferritin, muscular endurance, reaction time and postural control. Balance was assessed on a platform in different positions, with eyes open or closed, on a firm or foam surface. Final measurements were taken 72 hours after the last session.

An advantage that holds up on only some tests

Both groups improved their postural performance during the study. However, the exercise group showed greater improvements under several assessment conditions, as well as in hemoglobin and muscular endurance.

The important caveat concerns the multiple statistical comparisons. After Bonferroni correction, intended to limit chance-positive findings when multiple tests are performed, only two between-group differences remained significant for postural control: standing on both feet on foam with eyes open, and standing in a semi-tandem position on foam with eyes closed.

The abstract does not provide the absolute magnitudes of the improvements or their uncertainty intervals. A statistically significant difference is therefore not enough here to establish a noticeable change in everyday life. No reduction in falls is reported.

What this trial tells us

This trial suggests that adding exercise to iron treatment could improve some aspects of balance in young women with iron-deficiency anemia. It does not show that HIIT replaces treatment for the deficiency: all participants received iron.

Improvements in hemoglobin, endurance and postural control were observed in parallel. This does not demonstrate that one explains the others. Nor does the study design allow the contribution of high intensity to be separated from that of plyometric exercises.

With a small sample and follow-up limited to eight weeks, these findings cannot be directly generalized to people without anemia, men or other age groups. The abstract does not detail adverse effects, and funding and conflicts of interest have not been checked. This encouraging signal therefore does not, on its own, amount to a recommendation to do HIIT if you have anemia.

What we can take away

Adding exercise to iron treatment appears to improve some balance measures in this small trial. The size of the benefit in everyday life, its persistence and the program’s safety remain to be clarified.