Explanation
The hematocrit-to-hemoglobin ratio is a measure of cardiovascular health and hydration status. (source, source, source)
Low
A low hematocrit/hemoglobin ratio can stem from physiological factors linked to bone marrow and kidney function red blood cell production, as these are critical components in determining hematocrit levels. From a nutritional perspective, suboptimal intake and utilization of essential nutrients like iron, vitamin B12, and folate can hinder red blood cell formation and influence this ratio. (source, source, source, source)
Optimization
Avoid alcohol: Alcohol consumption is associated with decreased hematocrit. (source). Alcohol impairs the production of red blood cells by negatively affecting how bone marrow responds to erythropoietin, the hormone responsible for stimulating red blood cell production. (source) Alcohol can also directly damage the cell membrane of red blood cells and inhibit the absorption of folate and B vitamins, both of which are directly involved in healthy red blood cell formation. (source, source, source) Recommendation: Monitor alcohol intake. Try to limit consumption to one or two drinks daily, with the goal of less than three per week.
Avoid smoking: Smokers have been shown to have higher hemoglobin levels. (source) Smoking reduces the amount of oxygen available to body tissues, causing a cascade of events that accelerates red blood cell production and increases hemoglobin levels. (source) Avoiding smoking will decrease hemoglobin concentrations. Recommendation: If a smoker, take the steps to quit. If not, avoid areas where secondhand smoke is present.
High
A high hematocrit/hemoglobin ratio can result from physiological factors affecting the kidneys and bone marrow, which play roles in red blood cell production. Nutritionally, inadequate intake of fluids and essential nutrients like iron can also influence this ratio. (source, source, source)
Optimization
Train regularly: Athletes have been shown to have decreased hematocrit. (source) Exercise training increases blood volume over time, due to increased water intake and decreased urine output, resulting in decreased hematocrit levels. (source) Recommendation: Follow a structured training program that exerts your body through multiple resistance and aerobic intensities. This includes a structured aerobic program that ensures at least 150 minutes of moderate intensity (50 to 70% max heart rate) or 75 minutes of high intensity (75% max heart rate or greater) a week and a structured resistance training program with moderate to heavy loads at least twice a week for resistance training. The final set of each resistance training exercise should be taken within two repetitions of failure.
