This is a continuation post from Female Specific Health Insights Every Woman Should Know (Part 1). This series stems from my own frustration with the prominence of poor and biased research and advice for women’s health in sport, nutrition, and lifestyle. The recommendations here are based on my own interpretation of recent literature and I encourage you to do your own research as well to inform and empower your own healthy lifestyle choices.

Without further ado, here are three more female-specific health insights.

Please note that in this article the words female/male and woman/man refer to people with female/male reproductive organs or sex defined at birth.

Give your body enough fuel and don’t cut out carbs or fat

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We’ve already talked about the importance for women to consume adequate protein, which many women unintentionally under-consume (see Female Specific Health Insights Every Woman Should Know (Part 1)), but what about the other macronutrients: carbohydrates and fat?

Nowadays, increasingly more women intentionally restrict their dietary intake to meet societal beauty standards and/or to reach a “normal” weight. While maintaining a healthy body composition (which accounts for muscle/bone/fluid and is more predictive of health outcomes than BMI or weight) does benefit long-term health, significantly restricting caloric intake or dramatically reducing carbohydrates or fats can be detrimental to women’s reproductive health, bone density, performance, and metabolic health.

Especially in active women, under fuelling or overly restricting macronutrients can lead to low energy availability (LEA) or relative energy deficiency in sport (RED-S), a concept recently introduced by the International Olympic Committee which outlines 10 health consequences including detriment to most vital organs and systems, and 10 performance consequences including decreased endurance and strength performance, and increased injury risk in response to LEA. Recent literature shows that ~80% of pre-elite and elite athletes have at least 1 symptom of RED-S - almost double the instance in men - a shocking statistic that highlights that active women are not providing their bodies with adequate fuel.

LEA, a state in which the body does not have enough energy to maintain optimal health, is often caused by restriction or under-consumption of carbohydrates, especially before, during, or after exercise or stressful situations when it is most important. Carbohydrates provide glucose to fuel the brain and body, and women are more sensitive to and more prone to low blood sugar than men due to their hormonal differences. Furthermore, women have an overall higher tolerance for carbohydrates than men, though it should be noted that this begins to decline after menopause (which we’ll talk about a little later in this article). So all those studies on men which show favourable health outcomes of extremely low carbohydrate diets (including keto) are likely not so healthy for women after all! While carbohydrate needs will vary depending on activity levels and life stages, aiming to gain at least 30% of your overall calories from carbs is ideal for most women. Carbs from natural and whole sources - which include potatoes, root vegetables, squash, whole grains (rice, oats, buckwheat, whole-grain bread), high-quality dairy products, and fruit - will have the best effect on the body.

On the other hand, low-fat diets have also long been promoted as a means of maintaining health and managing weight, but recent research shows that they aren’t healthy in the long-term, especially for women. Healthy fats, such as those found in avocados, nuts, seeds, and oily fish, are essential for various physiological functions, including hormone production, brain health, and the absorption of fat-soluble vitamins. Studies have shown that incorporating adequate amounts of healthy fats into the diet can support hormone balance, reduce the risk of cardiovascular disease, and contribute to overall health and vitality. These positive health outcomes are even more noticeable in post-menopausal women due to their lower hormone levels.

The key takeaway here is that eating a full, balanced diet including protein, carbohydrates, and fat is really important for women in order to maintain long-term health and energy. These macronutrients actually work together: for example, pairing your carbohydrates with protein and fat improves absorption, mitigates blood sugar spikes/drops, and extends satiety. Therefore, rather than solely focusing on reducing intake from one macronutrient or cutting calories too low all together, women should prioritise the consumption of nutrient-rich sources of whole carbohydrates, healthy fats, and bioavailable protein to support optimal health and well-being.

Prioritise making time to rest and recover

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In today's fast-paced world, women often juggle multiple roles and responsibilities, leaving little time for rest and recovery. However, prioritising rest and recovery is crucial for women's overall health and well-being. Adequate rest allows the body to repair tissues, regulate hormone levels, and restore energy levels, all of which are particularly important for women due to their unique physiological needs. Research suggests that chronic stress and insufficient rest can negatively impact women's hormonal balance, leading to irregular menstrual cycles, fertility issues, and an increased risk of conditions such as polycystic ovary syndrome (PCOS) and hormonal imbalances. Moreover, lack of sleep and chronic stress have been associated with an increased risk of mental health disorders, including depression and anxiety, which disproportionately affect women. Therefore, integrating adequate rest and recovery into busy schedules is essential for women to maintain hormonal balance, support mental well-being, and optimise overall health. If you need some suggestions on how to make that happen, check out the article Stressed Out? These Science Backed Tools Can Help.

Don't be afraid to change things up as your body changes

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As women progress through different stages of life, such as pregnancy or menopause, it becomes crucial for them to adapt their nutrition, training, and lifestyle accordingly to support their changing bodies effectively. During pregnancy, nutritional needs shift significantly to accommodate the growing fetus and ensure maternal health. Adequate intake of essential nutrients such as folate, iron, calcium, and omega-3 fatty acids becomes paramount for fetal development and maternal well-being. Contrary to popular belief, exercise is healthy and beneficial for most women during pregnancy, except for certain cases where chronic medical conditions are involved. To stay active during pregnancy, women may need to modify their exercise routines (for example, including lower-impact activities and avoiding exercises that require them to lie flat on their back after the first trimester to ensure safety).

Menopause also brings about hormonal changes that can impact metabolism, bone health, and cardiovascular health. Adjustments in dietary habits, such as increasing calcium and vitamin D intake to support bone health, and incorporating resistance training exercises to maintain muscle mass and bone density, become essential during this phase. Incorporating adequate protein (2.2-2.4 grams per kg of body weight) is crucial leading up to and after menopause to maintain bone and muscle health. Women may also become slightly less tolerant to carbohydrate metabolism during this time due to reduced estrogen, making it important to pair carbs with protein and fats, and opt for whole food sources of carbohydrates when possible. Furthermore, lifestyle modifications including stress management techniques, regular physical activity, and adequate sleep can help alleviate menopausal symptoms such as hot flashes and mood swings. By recognizing and responding to the specific nutritional, training, and lifestyle needs that arise during pregnancy and menopause, women can optimise their health and well-being throughout these transformative life stages.

Continue to empower yourself with research

These health insights for female bodies are based on my examination of the scientific literature alongside research that I’m involved with in my Ph.D. I would highly encourage you to do your own research as well, and be critical about how the research was conducted and who it involved.

I can’t emphasise enough the importance of additional research that considers and understands sex-specific factors in nutrition, exercise, and aging so that both women and men can be properly informed and supported for optimal health.

Interested in reading more about women’s health? Check out Mythbusting in Women’s Health and Why it Matters, and the first article in this series, Female-Specific Health Insights Every Woman Should Know (Part 1).