Date
4-29-2026
Department
School of Health Sciences
Degree
Doctor of Philosophy in Health Sciences (PhD)
Chair
Ruth Rasmussen
Keywords
adolescent athletes, anemia, hemoglobin, iron intake, cross-country runners, nutrition education, nutrition knowledge
Disciplines
Medicine and Health Sciences
Recommended Citation
Hardy, Phillip L., "The Impact of Nutritional Education on Hemoglobin Levels in Adolescent Cross-Country Runners" (2026). Doctoral Dissertations and Projects. 8193.
https://digitalcommons.liberty.edu/doctoral/8193
Abstract
Iron deficiency and anemia have been documented in adolescent endurance athletes, particularly female runners, due to increased physiological demands during growth and sustained training stress. However, limited research has examined seasonal hemoglobin progression in high school cross-country athletes while simultaneously examining outcomes during participation in structured nutrition education. Therefore, the purpose of this longitudinal quantitative study was to examine hemoglobin levels, dietary iron intake, and nutrition knowledge among adolescent cross-country runners across a competitive season during participation in a four-session, nutrition education program delivered from August 2025 through November 2025. Participants included 44 high school runners from northwest Georgia who were assessed at pre-season, mid-season, and post-season. Hemoglobin concentration was measured using capillary blood sampling, dietary iron intake was assessed through self-reported dietary analysis, and nutrition knowledge was measured using the General and Sports Nutrition Knowledge Questionnaire (GeSNK). Repeated-measures analysis, correlation analysis, and regression procedures were conducted to evaluate seasonal change and variable relationships. Anemia prevalence increased among female athletes across the season, while male anemia remained minimal. Dietary iron intake demonstrated a meaningful association with hemoglobin concentration at mid-season and post-season but not at baseline. Group-level hemoglobin values remained stable across the season following the intervention. Nutrition knowledge increased from pretest to posttest. These findings indicate that structured nutrition education improved knowledge but was not associated with measurable seasonal changes in hemoglobin concentration. Continued longitudinal monitoring and expanded intervention strategies are recommended to further examine iron-related risk in adolescent endurance populations.
