Article RETRACTED due to malpractice  Hidden Iron Deficiency in High-Performance Adolescents: A Multi-Omics and Predictive Analytics Framework

Authors

  • Amal AlNatour Jordon

DOI:

https://doi.org/10.47197/retos.v82.119281

Keywords:

academic institutions, health and well-being

Abstract

Purpose: The research question of this study was to explore the multifaceted interaction between iron status, inflammation and aerobic performance in adolescent athletes as well as to establish a sophisticated, integrative model of early iron deficiency diagnosis and prediction of performance beyond conventional single-biomarker methods.

Methodology: The study utilized a longitudinal cohort design that included multidimensional data such as hematological (hemoglobin, ferritin), inflammatory (CRP, IL-6), physiological (VO 2max), nutritional (nutrition) and training load. Machine learning (Random Forest, XGBoost, neural networks) was used in conjunction with statistical analyses (multivariate regression, correlation analysis) to identify nonlinear relationships. To combine these variables into one predictive framework, a novel composite measure, the Iron Performance Index (IPI), was developed.

Findings: These findings revealed that hemoglobin and ferritin were major positive predictors of VO2max, while CRP and IL-6 showed significant negative associations, indicating the influence of inflammation on iron bioavailability and performance. The machine learning models had high predictive accuracy (up to 87%), high sensitivity (85.5%), and high specificity (95.2%). The most influential variables were ferritin, IL-6, VO2max, and hemoglobin, as identified by feature importance analysis. The IPI effectively measured the multidimensional reciprocality of the physiological system and better identified subclinical iron deficiency.

Conclusions: The results suggest that a dynamic interaction between iron metabolism and inflammation is the determinant of aerobic performance, not isolated biomarkers. The Iron Performance Index and the proposed integrative framework offer a more precise, holistic, and clinically meaningful method for monitoring athletes' health and optimizing performance, representing a significant improvement over traditional diagnostic practice.

References

Caleyachetty, R., Thomas, G. N., Kengne, A. P., Echouffo-Tcheugui, J. B., Schilsky, S., Khodabocus, J., & Uauy, R. (2018). The double burden of malnutrition among adolescents: Analysis of data from the Global School-Based Student Health surveys. The American Journal of Clinical Nutrition, 108(2), 414–424. https://doi.org/10.1093/ajcn/nqy105

Cohen, C. T., & Powers, J. M. (2024). Nutritional strategies for managing iron deficiency in adolescents: Approaches to a challenging but common problem. Advances in Nutrition, 15(5), 100215. https://doi.org/10.1016/j.advnut.2024.100215

Garcia-Casal, M. N., Pasricha, S.-R., Martinez, R. X., Lopez-Perez, L., & Peña-Rosas, J. P. (2021). Serum or plasma ferritin concentration as an index of iron deficiency and overload. Cochrane Database of Systematic Reviews, 5(5), CD011817. https://doi.org/10.1002/14651858.CD011817.pub2

Grosso, G., Laudisio, D., Frias-Toral, E., Barrea, L., Muscogiuri, G., Savastano, S., & Colao, A. (2022). Anti-inflammatory nutrients and obesity-associated metabolic inflammation: State of the art and future direction. Nutrients, 14(6), 1137. https://doi.org/10.3390/nu14061137

Heffernan, S. M., Horner, K., De Vito, G., & Conway, G. E. (2019). The role of mineral and trace element supplementation in exercise and athletic performance: A systematic review. Nutrients, 11(3), 696. https://doi.org/10.3390/nu11030696

Kardasis, W., Naquin, E. R., Garg, R., Arun, T., Gopianand, J. S., Karmakar, E., & Gnana-Prakasam, J. P. (2023). The IRONy in athletic performance. Nutrients, 15(23), 4945. https://doi.org/10.3390/nu15234945

Keller, K., Friedrich, O., Treiber, J., Quermann, A., & Friedmann-Bette, B. (2024). Iron deficiency in athletes: Prevalence and impact on VO₂ peak. Nutrition, 126, 112516. https://doi.org/10.1016/j.nut.2024.112516

Kuwabara, A. M., Tenforde, A. S., Finnoff, J. T., & Fredericson, M. (2022). Iron deficiency in athletes: A narrative review. PM&R, 14(5), 620–642. https://doi.org/10.1002/pmrj.12779

Leung, A. K. C., Lam, J. M., Wong, A. H. C., Hon, K. L., & Li, X. (2024). Iron deficiency anemia: An updated review. Current Pediatric Reviews, 20(3), 339–356. https://doi.org/10.2174/1573396320666230727102042

Monyeki, M. A., Veldsman, T., Coetzee, B., Sparks, M., Moss, S. J., Pienaar, C., Swanepoel, M., Malan, L., & Kruger, H. S. (2024). Relationships between iron status and selected physical fitness components of South African adolescents. Children, 11(6), 659. https://doi.org/10.3390/children11060659

Pedlar, C. R., Newell, J., & Lewis, N. A. (2019). Blood biomarker profiling and monitoring for high-performance physiology and nutrition: Current perspectives, limitations and recommendations. Sports Medicine, 49(Suppl 2), 185–198. https://doi.org/10.1007/s40279-019-01158-x

Safiri, S., Kolahi, A.-A., Noori, M., Nejadghaderi, S. A., Karamzad, N., Bragazzi, N. L., Sullman, M. J. M., Abdollahi, M., Collins, G. S., Kaufman, J. S., & Grieger, J. A. (2021). Burden of anemia and its underlying causes in 204 countries and territories, 1990–2019. Journal of Hematology & Oncology, 14(1), 185. https://doi.org/10.1186/s13045-021-01202-2

Semenova, E. A., Miyamoto-Mikami, E., Akimov, E. B., Al-Khelaifi, F., Murakami, H., Zempo, H., Kostryukova, E. S., Kulemin, N. A., Larin, A. K., Borisov, O. V., Miyachi, M., Popov, D. V., Boulygina, E. A., Takaragawa, M., Kumagai, H., Naito, H., Pushkarev, V. P., Dyatlov, D. A., Lekontsev, E. V., & Ahmetov, I. I. (2020). The association of HFE gene polymorphism with endurance athlete status. European Journal of Applied Physiology, 120(3), 665–673. https://doi.org/10.1007/s00421-020-04306-8

Shoemaker, M. E., Gillen, Z. M., McKay, B. D., Bohannon, N. A., Gibson, S. M., Koehler, K., & Cramer, J. T. (2019). Sex-specific relationships among iron status biomarkers and athletic performance in adolescent athletes. Journal of the International Society of Sports Nutrition, 16, 42. https://doi.org/10.1186/s12970-019-0306-7

Sim, M., Garvican-Lewis, L. A., Cox, G. R., Govus, A., McKay, A. K. A., Stellingwerff, T., & Peeling, P. (2019). Iron considerations for the athlete: A narrative review. European Journal of Applied Physiology, 119(7), 1463–1478. https://doi.org/10.1007/s00421-019-04157-y

Tarancon-Diez, L., Genebat, M., Roman-Enry, M., Vázquez-Alejo, E., Espinar-Buitrago, M. S., Leal, M., & Muñoz-Fernandez, M. Á. (2022). Threshold ferritin concentrations reflecting early iron deficiency. Nutrients, 14(22), 4739. https://doi.org/10.3390/nu14224739

Tomkinson, G. R., Lang, J. J., Tremblay, M. S., Dale, M., LeBlanc, A. G., Belanger, K., Ortega, F. B., & Léger, L. (2017). International normative 20 m shuttle run values. British Journal of Sports Medicine, 51(21), 1545–1554. https://doi.org/10.1136/bjsports-2016-095987

Welde, B., Morseth, B., Handegård, B. H., & Lagestad, P. (2020). Effect of sex, BMI and physical activity on peak oxygen uptake among adolescents. Frontiers in Sports and Active Living, 2, 78. https://doi.org/10.3389/fspor.2020.00078

Young, I., Parker, H. M., Rangan, A., Prvan, T., Cook, R. L., Donges, C. E., Steinbeck, K. S., O’Dwyer, N. J., Cheng, H. L., Franklin, J. L., & O’Connor, H. T. (2018). Association between haem and non-haem iron intake and serum ferritin. Nutrients, 10(1), 81. https://doi.org/10.3390/nu10010081

Downloads

Published

05-05-2026

Issue

Section

Retraction of articles

How to Cite

Amal AlNatour. (2026). Article RETRACTED due to malpractice  Hidden Iron Deficiency in High-Performance Adolescents: A Multi-Omics and Predictive Analytics Framework. Retos, 82. https://doi.org/10.47197/retos.v82.119281