Sex differences and considerations for female specific nutritional strategies: a narrative review

Abstract

Although there is a plethora of information available regarding the impact of nutrition on exercise performance, many recommendations are based on male needs due to the dominance of male participation in the nutrition and exercise science literature. Female participation in sport and exercise is prevalent, making it vital for guidelines to address the sex-specific nutritional needs. Female hormonal levels, such as estrogen and progesterone, fluctuate throughout the mensural cycle and lifecycle requiring more attention for effective nutritional considerations. Sex-specific nutritional recommendations and guidelines for the active female and female athlete have been lacking to date and warrant further consideration. This review provides a practical overview of key physiological and nutritional considerations for the active female. Available literature regarding sex-specific nutrition and dietary supplement guidelines for women has been synthesized, offering evidenced-based practical information that can be incorporated into the daily lives of women to improve performance, body composition, and overall health.

Keywords: Dietary supplement; Female; Human performance; Macronutrients; Menstrual cycle; Women’s health.

Fig. 1

Female sex hormones fluctuate cyclically and predictably throughout the menstrual cycle. Estradiol is the primary estrogen secreted, and it is depicted as estrogen in this figure. The phases are defined as follows: EF = early follicular; EL = early luteal; FSH = follicle stimulating hormone; LF = late follicular; LL = late luteal; MF = mid follicular; ML = mid luteal. This diagram was adapted from Oosthuyse & Bosch (2010) [25]

Fig. 2

Nutritional needs throughout the menstrual cycle may change based on physiological implications from estrogen and progesterone. Key metabolic adaptations are described for the follicular and luteal phases

Fig. 3

Application for a 20-year-old female who is a soccer player. She is 165.0 cm tall and currently weighs 60 kg. She often experiences fatigue after a game (muscle soreness) and wants to improve her nutritional strategies to enhance performance (sprint speed and endurance). Using the Harris-Benedict equation, her basal metabolic rate (BMR) was determined to be approximately 1430 kcal/day. Considering she is active, her total daily energy expenditure was estimated at approximately 2217–2467 kcal/day by multiplying BMR by an activity coefficient of 1.55–1.725 (one soccer game). A possible macronutrient distribution for performance is 60% carbohydrates (~ 5.6 g/kg), 20% protein (~ 1.9 g/kg), and 20% fat (~ 0.9 g/kg), which was utilized in the proposed meal plan for a game day

Fig. 4

Application for a 38-year-old female whose primary goal is weight loss. She is 161.5 cm tall and currently weighs 86.4 kg, which places her in the obese category based on a BMI of 33 kg/m². Her current goal weight is 77 kg, which would ultimately reduce her BMI to 29.6 (overweight). Using the Harris-Benedict equation, her basal metabolic rate (BMR) was determined to be approximately 1580 kcal/day. Considering she is moderately active; her total daily energy expenditure was approximately 2175 kcal/day by multiplying BMR by an activity coefficient of 1.375. Because her goal is weight loss, her calorie intake has been reduced by 10% to ultimately reach a hypocaloric intake of 1960 kcal/day during her follicular phase. Because energy expenditure is increased by 2.5–11% in the luteal phase, her energy balance requirement of 2175 kcal/day was increased by 5% for a baseline intake of 2285 kcal/day. Similarly, this value was reduced by 10% (2056 kcal/day) in order to ensure a caloric deficit for weight loss. A potential macronutrient distribution for weight loss was set at 40% carbohydrates (~ 2.4 g/kg), 30% protein (~ 1.8 g/kg), and 30% fat (~ 0.8 g/kg), which was utilized in designing the follicular proposed meal plan. As a result of increased protein and fat oxidation during the luteal phase, which is accompanied by a desire to eat saltier and sweeter foods, this distribution was altered slightly to 36% carbohydrates, 32% protein, and 32% fat in the luteal phase [128]