Fueling Considerations in the Female Athlete

Explore the unique nutritional needs of female athletes to optimize performance and maintain health.

Understanding the Nutritional Needs of Female Athletes

Female athletes have taken center stage this year with athletes like Simon Biles, Ilona Maher, and Katie Ledecky sweeping the competition in the Olympics. It has been amazing to watch female athletes compete and succeed at high levels. No doubt this plays a major role in inspiring young women to participate in sport and competition. As more and more girls are participating in sports we also see pressure to look a certain way or fit a certain body type as it pertains to sport.

As a performance based physical therapist, I often ask my athletes what they typically eat when training for a competition or when they have an injury. I am still surprised and how often I get negative food myths. Often I hear

"I need to watch my weight"

"I know I am training for a competition, but I don't want to increase my calories".

"If I increase my calories, i'm afraid I will gain weight"

I hear this mostly from women, although men can be pressured to look a certain way as well. Here I would like to dispel some of those myths surrounding nutrition for the female athlete and recognize when we are falling short. 

Key Macronutrients: An Overview

Proper nutrition is crucial for optimizing performance, recovery, and overall health. It's important for female athletes to consume a balanced diet that includes a variety of nutrients. This includes adequate calories to meet energy demands, as well as sufficient vitamins and minerals to support bodily functions and prevent deficiencies.

Proteins, carbohydrates, and fats are the three primary macronutrients that fuel athletic performance. Each plays a distinct role in the body: Proteins are essential for muscle repair and growth and are vital to any training program. Carbohydrates are the body's primary source of energy. Athletes consume carbs so they can maintain energy levels throughout training and competition. Fats are necessary for hormone production and overall health and can make better, stronger, athletes.

For active female athletes, the recommendation is 16-30 calories per pound of bodyweight (this varies dependent on sport) So for example a 130 lb female. x16 calories= 2,080 calories to maintain her bodyweight. I can tell you that after I started asking people about their diets, most of my female clients are eating far less than 2,000 calories a day. 

Now I know what you're thinking. "So what? Why should I care?" Simplistically stated, underfueling can cause long term effects on the athlete that can be detrimental to not only their performance, but their health. 

The Impact of Underfueling on Athletic Performance

When there is not enough available energy in our body we underperform. We can directly see a correlation in the speed or accuracy of skills or techniques in practice, competition, or games. Underfueling also can lead to chronic fatigue, injuries, delayed healing, and dizziness, headaches. As parents, coaches, and physical therapist we should be screening our females for the "Female Athlete Triad". 

Athletes who may have RED-S or the female triad by experience or demonstrate the following

• Decreased muscle strength
• Decreased endurance
• Recurrent injury
• Decreased training response
• Impaired judgement
• Decreased coordination
• Decreased concentration
• Weight loss

What is Female Athlete Triad?

The Female Athlete Triad is a syndrome that includes three interrelated conditions: energy deficiency, menstrual disturbances, and decreased bone mineral density. It's critical to address these issues promptly to prevent long-term health consequences. Often times the menstrual disturbances can be the most obvious indicator. Having a female athlete who stops menstruating while training is not normal. That is a direct sign she is under fueled and her body is no longer able to perform a normal physiological process.

Athletes may not always fit the "female triad model" and will demonstrate what we call Relative Energy Deficiency in Sport (RED-S) extends beyond the Female Athlete Triad, encompassing a broader range of health and performance issues related to inadequate energy intake. Symptoms can include decreased endurance, increased injury risk, and impaired judgment.

Strategies to manage the Female Athlete Triad and RED-S include ensuring adequate caloric intake, monitoring menstrual health, and supporting bone health through proper nutrition and, if necessary, medical intervention. We need monitoring by healthcare professionals, and education for athletes and coaches about the importance of balanced nutrition for our female athletes. 

Bottom line: Athletes need to eat!

Anyone who plays a sport, participates in competitions, or exercises daily needs adequate fuel. Everyone is different in the amount of food they consume, the type of nutrients they need, or even what type of food they feel safe with or enjoy. Addressing nutritional concerns is often a multidisciplinary approach taken by by the individual, their family/friends, and coaches, trainers, and/or nutritionist.

If you think you're eating enough or in a balanced way I challenge you to track your food intake for a week. If nothing else, you have a good baseline and understanding of current habits. I ask my clients to do this as well and they are often surprised by what they find. 

If you're suspicious you or an athlete you work with may be underfueling or experiencing RED-S or the female triad I recommend finding a professional to work with. This should be a trusted medical professional who has certifications and training in sports and nutrition.  In the meantime, I also urge you to celebrate your body for what it can do and what it provides. We can all stand to be a little nicer to our bodies and make sure they get the proper food and fuel they deserve.

References:

Grabia M, Perkowski J, Socha K, Markiewicz-Żukowska R. Female Athlete Triad and Relative Energy Deficiency in Sport (REDs): Nutritional Management. Nutrients. 2024 Jan 25;16(3):359. doi: 10.3390/nu16030359. PMID: 38337644; PMCID: PMC10857508.

Athlete nutritional guidelines. (n.d.). Dartmouth College Athletics. https://dartmouthsports.com/sports/2019/3/18/210545801

Five signs your young athlete may be underfueling. (n.d.). Scottish Rite for Children. https://scottishriteforchildren.org/news-items/five-signs-your-young-athlete-may-be-underfueling