Until recently, there was a lack of research on the unique nutritional needs of female athletes, and many of the recommendations prior had been similar to those of male athletes. What we know now is females face unpredictable and complex challenges due to hormone fluctuations and their menstrual cycle. In order to properly fuel a female for ultimate performance and recovery, it is vital to understand these considerations and tailor nutrition accordingly.
Consuming enough calories to meet the amount of calories burned is the most important consideration for female athletes. Without adequate calories, the risk of injury, fatigue, illness, and overall poor health and nutritional status increases.
Nutrient needs may vary based on different times of the female cycle. For example, protein needs and overall energy needs increase during the luteal phase due to the body preparing the endometrial lining.
Carbohydrates are the preferred fuel source for high-intensity exercise, so carbohydrate consumption is vital across all stages of the cycle.
Tracking your monthly cycle is a good place to start to determine overall physical symptoms (such as fatigue or GI distress) throughout each phase.
Micronutrients that may be low in female athletes can include iron, calcium and vitamin D.
Please note that individual needs vary, and most of this information is recommended for eumenorrheic women (with regular menstruation).
Overall caloric intake
Achieving adequate calorie or energy intake as a female athlete is vital to ensure proper mental and physical function. When calorie needs are not met, it can lead to an increased risk of injury, illness, fatigue, and poor recovery. In addition, nutrient timing is crucial to ensure adequate fueling pre- and post-exercise. Consuming food pre- and post-workout will support training, recovery, and daily caloric intake.
When female athletes are not consuming enough fuel to meet the demands of their training, this is known as low energy availability (LEA) and can lead to RED-S (relative energy deficiency in sport). This can affect the athletes’ overall health, performance, and recovery if not treated properly and within an adequate time frame. Individual caloric needs vary greatly based on the type and duration of exercise and overall metabolism.
RED-S is interrelated to another condition known as the female athlete triad, which includes irregular menstruation, disordered eating, and bone loss. Athletes who are more at risk of developing RED-S include those in a weight-class sport, high-intensity sport, and those who have a past history or currently struggle with disordered eating or eating disorders. Symptoms of RED-S include poor or decreased athletic performance, fatigue, weight loss, missed or irregular periods, frequent illness, and hair loss.
An extremely important macronutrient for female athletes is carbohydrates. Unfortunately, carbohydrates are criticized and considered “bad” in diet and wellness culture. Carbohydrates provide an excellent fuel source and contribute to overall daily caloric needs. It is recommended to consume 30–60 grams of carbohydrates/hour while exercising.
Some examples of intra-training carbs are fruit, energy gels or waffles, and fig bars. GI issues may occur, so it is wise to start at the lower end if symptoms arise. Carbohydrates are used as energy during high-intensity exercise, which makes replenishing carb stores after exercise so important. This will help with recovery and ensure carbs are readily available for future training sessions.
Although the data is limited, current recommendations are to consume 1.2 grams of carbohydrates per kilogram of body weight after exercise to replenish carb stores. For example, if you weigh 150 lbs (68 kg), you should aim for around 80 grams of carbohydrates after exercise.
If an athlete is not consuming enough protein, this can lead to muscle wasting and poor recovery and performance. Not only is overall protein consumption significant, but consuming adequate amounts specifically post workout is imperative as well.
Current research shows consuming 0.32–0.38 grams of protein/kg of body weight after exercise will aid in muscle recovery and building. For a 150 lb female athlete (68 kg) this equates to 22–25 grams of protein post workout.
Overall, no matter what sport you engage in, and whether it’s endurance, strength, or both, overall protein intake for all women should fall within 1.4–2.2 grams/kg per day. For a 150 lb (68 kg) female athlete, protein intake could range from 95–150 g per day. Progesterone can increase protein breakdown in the body, so it is recommended for athletes to increase protein intake by 12% during the luteal phase of their menstrual cycle.
By eating protein every 3–4 hours, athletes are more likely to hit their daily protein goals. Overall, protein intake should be spread out throughout the day for optimal effects.
Some micronutrients are extremely important for female athletes, including:
- Iron. Due to blood loss during the menstrual cycle, consuming foods high in iron and/or supplementing with iron may be beneficial. Consuming iron with vitamin C may help increase absorption. Food sources include red meat, beans, edamame, nuts, and fortified cereals.
- Calcium and vitamin D. Calcium and vitamin D are important for muscle and bone health. Food sources include fatty fish like salmon, eggs, dairy products, and beans; the best source of vitamin D is sunshine.
Nutritional need in follicular phase
The follicular phase includes the active bleeding phase.
- Iron-rich foods like green leafy vegetables, lean red meat, beans, and lentils.
- Vitamin C can help increase iron absorption from foods like citrus fruits, and red peppers.
- Omega-3 fatty acids can help reduce inflammation, which can include salmon, olive oil, nuts, and seeds.
Estrogen is high and progesterone is low towards end of this phase. Resting metabolic rate and energy intake typically at the lowest. This phase is supportive of intense exercise.
Nutritional needs in luteal phase
Progesterone is high during this phase. According to research, energy intake increases by ~150–300 calories per day. Increased protein intake (12% more than the typical daily goal) during this time may be beneficial. Sleep quality may be reduced, so you may be more fatigued. Premenstrual symptoms may be apparent toward the end of this phase. Dark chocolate, fruit, and nuts can help satisfy some of the sweet and salty cravings. It is important to drink enough water to help with possible boating.
Recommendations for female athletes
Here are some of the nutritional considerations and hacks to keep in mind when performing a sport:
- Cycle tracking. Due to the individualized and overall complicated process of the female cycle, it is recommended to track your cycle and any pertinent symptoms. Tracking GI issues is important as well here. Doing this will help you recognize trends and build awareness around personalized needs.
- Prepping and planning. Planning ahead by having adequate meals and snacks readily available will help reduce the risk of underfueling, which can affect overall performance and recovery. Be well prepared by ensuring the kitchen is stocked. Make the time to prep quality meals and plan ahead for pre- and post-exercise snacks.
- Low-volume foods. Because it may be difficult to reach the recommended calorie and macro goals, try consuming lower volume/calorically dense foods. If you are training at high intensities and over long durations, a good rule of thumb is to make ¼ of your plate fruits and veggies, ½ of your plate starchy carbs, ¼ of your plate a protein source, and add in fat sources like nuts, oils, and avocado.
- Supplementation. Work with a medical professional to determine deficiencies and the best course of action. Research shows that creatine may also be beneficial for female athletes.
It should be noted that fueling strategies are individualized due to genetics, age, differences in menstrual cycles, lifestyle factors, preferences, and the different types and levels of sport. Nutrient recommendations are simply guidelines, and it is important to consult with a healthcare professional before making extreme dietary changes.
- Journal of the International Society of Sports Nutrition. International society of sports nutrition position stand: nutritional concerns of the female athlete.
- Gatorade Sports Science Institute. The Female Athlete: Energy and Nutrition Issues.
- Boston Children’s Hospital. Relative Energy Deficiency in Sport.
- Cleveland Clinic. Nutrition and Exercise Throughout Your Menstrual Cycle.
- Journal of the International Society of Sports Nutrition. Sex differences and considerations for female specific nutritional strategies: a narrative review.