Hematological findings obtained by screening topathletes during training in The Neterlands reveal an occurrence of iron-deficient anemia of 2% in male and 2.5% in female athletes. In addition, 3% of the athletes have mild anemia without signs of iron depletion. Moreover, iron depletion without anemia as well as latent iron deficiency without anemia was present in 3, respectively 5% of male athletes and in 5, respectively 15% of female athletes. It is suggested that shortage of iron in food cannot be responsible for the frequent occurrence of iron depletion, and that nonnutritional factors or nutritional factors other than iron, i.e. a fat rich diet, probably play a role in iron utilization of healthy people.

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In a longitudinal study of growth from age 9 up to 17 of apparently healthy boys and girls in the Netherlands, hemoglobin, serum iron and iron binding capacity has been studied. Iron deficient anemia did not occur in boys at subsequent ages 9, 13 and 17. In girls, the incidence of anemia increased from 1 % at age 9 to 7% at age 17. Iron depletion without anemia occurs rather often during puberty in boys. In girls, iron depletion occurs more often in the postpubertal period than in the (pre-) pubertal period. Noniron deficient anemia (low Hb, with normal serum iron and normal saturation percentages) occurs often during puberty (about 10%), either related to retardation of growth and development or to infection. It is discussed to what extent the frequent occurrence of latent or overt iron depletion in healthy children may be due to ‘iron-hunger’ because of high requirements during growth, nonnutritional factors, or nutritional factors other than iron in food.

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Dutch adolescent boys attending high-school and technical institutions and young male adults have on average less body fat, but also less muscle tissue than have their North American counterparts of the same age and from corresponding population groups. In the 15-year-old Dutch group under consideration, creatinine excretion is lower than in a corresponding American group.