Auditing the Representation of Female Versus Male Athletes in Sports Science and Sports Medicine Research: Evidence-Based Performance Supplements.

Kathryn E Ackerman,Alannah K A Mckay,Louise M Burke,Kirsty J Elliott-Sale,Megan Kuikman,Rachel Harris,Ella S Smith,Trent Stellingwerff

doi:10.3390/nu14050953

Abstract

Although sports nutrition guidelines promote evidence-based practice, it is unclear whether women have been adequately included in the underpinning research. In view of the high usage rates of performance supplements by female athletes, we conducted a standardised audit of the literature supporting evidence-based products: β-alanine, caffeine, creatine, glycerol, nitrate/beetroot juice and sodium bicarbonate. Within 1826 studies totalling 34,889 participants, just 23% of participants were women, although 34% of studies included at least one woman. Across different supplements, 0–8% of studies investigated women exclusively, while fewer (0–2%) were specifically designed to compare sex-based responses. The annual publication of female-specific studies was ~8 times fewer than those investigating exclusively male cohorts. Interestingly, 15% of the female participants were classified as international/world-class athletes, compared with 7% of men. Most studies investigated performance outcomes but displayed poorer representation of women (16% of participants), whereas health-focussed studies had the greatest proportion of female participants (35%). Only 14% of studies including women attempted to define menstrual status, with only three studies (~0.5%) implementing best practice methodologies to assess menstrual status. New research should target the efficacy of performance supplements in female athletes, and future sports nutrition recommendations should specifically consider how well female athletes have contributed to the evidence-base.

Highlights

Female-only studies increased in number over the previous eight years (Figure 2C), this reflected a general increase in the literature, with male-only studies remaining ~9 times higher than women-only cohorts
Our audit demonstrates the poor representation of female athletes in the performance supplement literature
This bias is compounded by the inadequate classification and control of menstrual status in 99.5% of studies

Summary

Introduction

Female-targeted research related to sports science/sports medicine (SSSM) has failed to mirror the increase in participation and popularity of women’s sport [1]. While many aspects of women’s sport gain parity with their male counterparts, audits show a substantial under-representation of women as study participants, with female-only projects accounting for just 4–13% of all studies [2,3,4,5,6]. Of the multiple explanations [1], the complexity of female physiology represents a long-standing challenge, with the additional intricacy, time and expense involved in study designs being a deterrent to many researchers. The practical result of female under-representation in SSSM research is that most guidelines for training and nutrition strategies to optimise performance are underpinned by research conducted in men, without consideration of issues associated with the application to female athletes

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Discussion

Conclusion