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RDW, or red cell distribution width, is a measure of the size variation of red blood cells. Variability in size may be associated with an increased risk of cardiovascular complications. (source, source)
Generally, low red cell distribution width (RDW) is considered a sign of good health. RDW can be influenced by physiological factors related to the bone marrow, where red blood cells are produced, and nutritional factors affecting overall blood cell health. (source)
Optimization
Low RDW levels usually do not require any specific treatment unless it is associated with a specific illness. There is no suggested nutritional, lifestyle, or supplement-based intervention.
High red cell distribution width (RDW) can be influenced by physiological factors related to bone marrow, where red blood cells are produced. Nutritional deficiencies, particularly in nutrients like iron, vitamin C, and folate, can impact red blood cell production and result in elevated RDW levels. (source, source, source, source)
Prioritize vitamin C-rich foods: High RDW has been associated with low vitamin C. (source) Vitamin C is an antioxidant that protects red blood cells from damage, which reduces cell size variability and thus RDW. (source) Recommendation: Consume at least one serving of foods high in vitamin C daily.
One serving examples: Red Bell Peppers (chopped) (1 cup), Strawberries (8 medium strawberries), Orange (1 medium orange), Grapefruit (½ large grapefruit), Citrus Juice (100%) (½ cup)
Avoid alcohol: Alcohol consumption is associated with higher measures of RDW. (source) Alcohol changes the structure of red blood cells which is reflected in RDW measurements. (source, source, source) Limiting the intake of alcohol reduces RDW. Recommendation: Monitor alcohol intake. Try to limit consumption to one or two drinks daily, with the goal of less than three per week.
Resistance training: Resistance training was shown to decrease RDW. (source) Resistance training increases blood flow which aids in the production of healthy red blood cells. Additionally, it stimulates the hormone erythropoietin, which signals the bone marrow to produce more red blood cells, thereby decreasing RDW. (source) Recommendation: Follow a structured resistance training program with moderate to heavy loads at least two times a week. The final set of each exercise should be taken within two repetitions of failure.
Avoid smoking: Smokers have been shown to have elevated RDW. (source) Smoking causes oxidative stress, which leads to a variation in red blood cell size and ultimately raises RDW levels. (source) Avoiding smoking will normalize RDW. Recommendation: If a smoker, take the steps to quit. If not, avoid areas where secondhand smoke is present.
Prioritize sleep: Sleep duration has been shown to be associated with RDW. (source) Sleep disturbance is associated with increased inflammation and oxidative stress, which negatively affects red blood cell production and increases RDW. (source, source) Prioritizing sleep will positively affect RDW. Recommendation: Strive to get 8 to 10 hours of sleep for optimal recovery and adaptation.
Supplement with vitamin C: Low vitamin C levels have been associated with high RDW. (source) Vitamin C is an antioxidant that protects red blood cells from damage, which decreases cell size variability. (source) Supplementation with vitamin C reduces RDW. Recommendation: Supplement with at least 100 mg of vitamin C daily.
