NUTRITION FOR FEMALE ATHLETES

Special considerations for female athletes in outdoor recreation revolve around hormone fluctuation during the menstrual cycle. It has been reported that only 3% of sport science research has used females as participants. The menstrual cycle is divided into two large phases, the follicular phase and luteal phase, which energy utilization, appetite and energy intake can vary greatly depending on the phase of the athlete’s menstrual cycle. Research using females participants is more complex due to fluctuations in hormones, but more research examining the separate phase of the menstrual cycle is being complete every year on the effect of the menstruation cycle on women's performance. Previous studies have reported increase appetite and calorie intake during the end of the follicular phase and less of an appetite during the follicular phase. Estrogen and progesterone levels reverse after ovulation and can change performance markers and muscle recovery of female athletes. More research in exercise physiology and nutrition needs to be completed looking specifically analyzing female athletes ( Black et al., 2020).

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Female Athlete Future Research

Dr. Stacy Simms is one of the leading physicians and researchers on nutrition and training plans for female athletes. Based on evidence-based research, if female athletes understand their menstrual cycles and energy utilization they can enhance their performance and training during the follicular phase of their menstrual cycles and allow their body to rest and recovery during the luteal phase when progesterone levels are elevated

"Women are not small men!"

Menstrual Cycles

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How Can The Menstrual Cycle Effect Athletic Performance?

1. Injury Prevalence
2. Hormone levels
3. Thermoregulation
4. Fuel Metabolism
5. Water Retention
(Holtzman & Ackerman, 2021)

How Can Low Energy Availability Affect Sport Performance?

Low energy availability ( LEA) is common among female athletes. There is a prevalence of as high as 69% of athletes in individual sports. Many times this is not intentional restriction of eating or an eating disorders. Female athletes may restrict intake of food for perceived performance enhancement, aesthetics, specific diets, or gastrointestinal issues around multi-day training and high volume sessions. Athletes are unaware of how many calories they should be consuming during high volume training periods. During high volume periodization athlete’s need to educated on proper increases of their calorie intake to match energy expenditure (Black et al., 2020).

Restrictive eating disorder in sports ( RED-S) or low energy availability can result in bone, endocrine, immunological, cardiovascular, gastrointestinal, and psychological problems. LEA can cause hormonal disruptions which lead to reductions in resting metabolic rates. The body is store energy which causes long term decrease in performance and health

( Black et al., 2020).

During heavy training load days or periods calorie intake may need to increase by 30-50% per day to each optimal energy availability.
If athletes need to loose weight, short-term calorie deficit do not affect long term health of the athletes. Ideally, athletes should be loosing weight during the off-season or pre-season before heavy training loads.
Appetite does not always increase with training load, so plan your meals and food intake to match training loads not necessarily appetite.
Athletes can increase calorie intake by adding nutritional dense and calorie dense foods. Adding liquid calories immediately after training can improve energy intake and recovery (Black et al., 2020).

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Nutrition Considerations

Supplementation

Mineral deficiency and supplementation should be monitored by a physician or sports dietitian.

Omega-3:1.2g per day for vitamin absorption and calcium absorption for bone health.
Iron: Deficiency is reported among 15-25% of women. Women can be iron deficient or iron deficient with anemia. Endurance training can cause anticipant depletion and erythrocyte damage. Heavy menstrual bleed can also cause acute anemia or pseudo-anemia. Restrictive diets, especially those who do not eat red meats may cause low ferritin levels.
- Anemia is decreased red blood cell mass or hemoglobin levels
  - Mild anemia is hemoglobin 11.0-11.9 ng-dL
  - Moderate anemia is hemoglobin 8.0-10.9 ng-dL
  - Severe anemia is hemoglobin < 8.0 ng-dL
Calcium: The most conclusive way to measure calcium is through food intake.
- Female athletes should consume 1500 mg per day to optimize bone health.
  - Calcium intake should be spread out through out the day, because female athletes can only absorb 500mg at one time.
Vitamin D: Athletes who live in northern hemisphere or wear long sleeves are at risk for vitamin D deficiency. Vitamin D improves calcium absorption.
- To optimize bone health Vitamin D levels should be measured at 25-OH-vitamin D levels or higher
  - Supplementation is 1000-2000 IU vitamin D3 per day.