Have We Considered Women in Current Sports Nutrition Guidelines?

The need to address the underrepresentation of female athletes in sports nutrition research is receiving substantial attention from practitioners and academics alike. To systematically and efficiently direct priorities for future research activities, we have developed a protocol to “audit” the current literature across various areas of sports nutrition research. This process provides detailed information regarding the quantity, quality, and nature of existing research including women. We have conducted such audits across the areas of dietary performance (auditPERF) and medical (auditMED) supplements, both acute and chronic carbohydrate (CHO) fueling strategies (auditCHOAC and auditCHOCH), as well as protocols for heat adaptation (auditHEAT). Women accounted for between 11% and 23% of the total participant count across these themes, with the exception of auditMED where female participants dominated (71%). Across all audits, few studies compared responses between the sexes or investigated sex-specific differences. Furthermore, methodological consideration of menstrual status was poor, with only 0.25% of studies implementing best practice recommendations and 79% of studies failing to classify menstrual status entirely. Females were most poorly represented in studies examining sports performance outcomes, and few studies involved elite female athletes (national/international level) within participant cohorts. Our findings demonstrate an overall lack of female-specific considerations in the literature underpinning the current guidelines in the areas of dietary performance/medical supplementation, CHO fueling, and heat adaptation. As such, current guidelines may not reflect optimal practice for female athletes. New research should therefore implement female-specific methodological considerations, with particular attention to menstrual status, before these current sports nutrition guidelines can be applied to female athletes with complete confidence.