Much of what we think of as healthy lifestyle habits are based primarily on male data published by men. A 2023 study published in the journal Sports Medicine showed that when looking at over 11 consensus statements from around the world including 100 million participants, 91% of the first authors were men, less than 30% of participants in the research were female. These statements inform national guidelines, medical practices, and make the headlines regarding what we should eat and how we should exercise. This matters because a growing body of evidence indicates that there are significant physiological differences between sexes in response to exercise, nutrition, and recovery.
Before we dive in, it’s worth addressing that many women approach health largely from a weight-loss or “the thinner the better” perspective, and our society and media platforms are largely to blame. However, body composition including strong muscles and good energy availability are crucial for long-term health, and all bodies wear these pillars of health differently. Negative body image can seriously harm both physical and mental health, and it’s important to emphasize that strong, healthy, and beautiful bodies exist in many different shapes and sizes.
Now let’s get into it, here are some critical insights based on current research that every woman show know.
Please note that in this article the words female/male and woman/man refer to people with female/male reproductive organs and/or sex defined at birth.
Eating enough protein is super important (and you probably aren’t eating enough)
Protein is essential to build and maintain bones, muscles, hormones, and enzymes. Adequate protein is especially important for women due to our hormonal fluctuations, which can make us more inclined to break down muscle tissue at different stages of our menstrual cycle and menopause.
Notably, during the luteal phase, the second half of the menstrual cycle (~2 weeks before your period), progesterone rises and breaks down protein as the body shifts resources towards building a uterine lining. Consuming adequate protein during this time is crucial to maintain healthy reproductive function as well as protect our muscles and bones. Furthermore, during menopause, estrogen fluctuates and declines, making it more difficult to maintain muscle and bone, and consuming more protein can mitigate this effect.
Dr Sims, an expert in women’s exercise physiology, recommends 1.7 to 2.4 grams of protein per kg of body weight per day for active pre-menopausal women, and 2.2 to 2.4 grams per kg for women in menopause. For absorption, it’s best to spread out our protein intake throughout the day and incorporate some soon after a workout. For most women, this involves aiming for 30 grams of protein at each meal and snack by incorporating foods like eggs, dairy products, meat, fish, legumes, nuts and seeds, tofu, or protein powder.
Lift heavy weights to stay strong and active long-term
A physically active lifestyle is really important for long-term health, and higher muscle mass in women and men has been shown to increase health outcomes across the board. Interestingly, muscle composition differs between men and women and therefore may benefit from different types of training. Studies have shown that women have a significantly greater density and volume of mitochondria in muscle and have ~30% higher mitochondrial respiratory rates compared to men. As a result, low intensity/zone 2 training does not improve muscle quality in women like it does in men - that’s not to say that it’s bad, just that women can often see a greater increase in performance by incorporating resistance training and short bursts of high intensity interval training. This is the case because high-load and high-intensity exercises are more effective at increasing muscle power and speed in already mitochondria-rich tissue. Furthermore, muscle mass and bone density begin to decline rapidly leading up to and after menopause due to a steep reduction in estrogen, however this can be combatted with strength training and adequate protein intake.
As a result, women can really benefit from strength training with heavier weights and lower reps (i.e. ~3 sets of 6 or fewer reps) for optimal performance and healthy ageing. To achieve adequate muscle stress to stimulate muscle repair (necessary to increase muscle strength), these low rep ranges need to feel as heavy as you can manage while still maintaining good form, which is heavier than most women are used to. If you’re new to resistance training, it’s best to start with mobility and body weight exercises and progressively build to heavier weights. This type of progressive overload can be incorporated into lifts such as squats, deadlifts, lunges, and large compound movements that target major muscle groups and move through a full range of motion.
Fasting (especially fasted exercise) can be detrimental to women’s health
Intermittent fasting is a popular diet, celebrated for improving mental focus, performance, and weight loss, however from a physiological standpoint it just isn’t healthy for most active women.
While intermittent fasting may have a place treating metabolic disease in a sedentary population, when paired with exercise it’s actually detrimental to hormone regulation and long-term body composition, especially in women. One reason for this is that kisspeptin neuropeptides are disrupted during intermittent fasting and low carbohydrate diets. Kisspeptin is responsible for endocrine and reproductive regulation which is far more sensitive in females than males and affects metabolism, appetite regulation, and body composition. Fasting can throw all of these functions out of whack resulting in glucose resistance, fatigue, and disrupted menstrual cycles. This is especially the case when exercising in a fasted state since stress hormones like cortisol rise much higher than normal and stay elevated which suppresses sex hormones, increases the deposition of abdominal fat, and reduces your ability to relax. Instead, the body turns to metabolizing high-energy tissue such as muscle and bone. This is even more harmful to menopausal women who already have low sex hormones and are predisposed to the loss of lean muscle mass.
Women need to be very careful with restricting their food for long periods of time (greater than ~12 hours). Instead, prioritize adequate fuel before and after exercise that incorporates proteins and carbohydrates for effective recovery and balanced hormones.
Empower yourself with research
These health guidelines for women are based on my own examination of existing research, and I would highly encourage you to do your own research as well, and to be critical about how the research was conducted and who it involved. Going forward, we need more studies on females and by females to better understand optimal nutrition, exercise, and lifestyle factors in women’s health.
Interested in reading more about women’s health? Check out the article Mythbusting in Women’s Health and Why it Matters, and stay tuned for Female-Specific Health Insights Every Woman Should Know (Part 2).