By Hannah E. Cabre
Reviewed by; John Baur, PT, DPT, OCS, FAAOMPT
Cabre’s narrative review examines how nutrition guidance for strength and conditioning athletes should be adapted for adult, premenopausal cisgender female athletes. The central argument is that sports nutrition practice has advanced faster than the female-specific evidence base. Although women now make up a large share of collegiate sport participation, many calorie, carbohydrate, protein, fat, and supplement recommendations are still extrapolated from studies in men. The review warns that this gap encourages oversimplified advice, including social-media “cycle syncing” claims, and may contribute to inconsistent fueling recommendations that place female athletes at risk for inadequate intake.1
The article first explains that women respond strongly to resistance training. Absolute strength gains are often lower than men’s because of differences in muscle mass and contractile properties, but relative improvements in strength and hypertrophy can be similar, and in some studies greater, in women. Physiologically, women generally have more type I fibers, greater oxidative capacity, better fatigue resistance, and greater reliance on fat oxidation than men, whereas men tend to have greater glycolytic capacity. Estrogen and progesterone fluctuate across the menstrual cycle and can alter substrate use, energy expenditure, recovery, and fluid balance. However, recent evidence suggests that resistance-exercise-stimulated muscle protein synthesis is not meaningfully changed by menstrual cycle phase, so phase-based protein strategies are not supported.
Energy availability is presented as the foundation of health and performance. The review emphasizes Relative Energy Deficiency in Sport (REDs), defined as a mismatch between energy intake and exercise expenditure that can impair metabolism, reproductive function, bone, immune, cardiovascular, and musculoskeletal health. Low energy availability in women is identified as less than 30 kcal per kilogram of fat-free mass per day, while approximately 45 kcal/kg fat-free mass/day is suggested to avoid low energy availability. The author notes that estimating calories for resistance training is difficult because anaerobic work is hard to capture, wearable devices are often inaccurate, and predictive equations should match the athlete’s age, body size, activity level, and life stage. Pregnancy and lactation require special attention because energy and nutrient demands increase, and training may need modification.
For carbohydrates, the review balances performance needs with female-specific metabolism. Carbohydrate remains the primary fuel for high-intensity activity, yet female strength athletes may use less muscle glycogen during resistance exercise than men. Therefore, carbohydrate loading is not automatically necessary. A practical range of 3-7 g/kg/day is recommended depending on training volume, intensity, and daily activity, with 30-60 g/hour during sessions if fatigue limits performance. Carbohydrate supplements can help when food intake is insufficient, but they should not crowd out protein.
Dietary fat is framed as essential for energy density, hormonal function, inflammation control, and recovery. Because women rely more heavily on fat metabolism, adequate fat may be especially important in strength and conditioning contexts. The review recommends at least 15%, and ideally about 20%, of total calories from fat, with approximately 1 g/kg/day during weight maintenance and lower ranges only when supervised fat loss is appropriate. Unsaturated fats and omega-3 intake are emphasized, while trans fats and excessive saturated fats should be limited.
Protein guidance is similar to male athlete recommendations because available evidence suggests comparable protein turnover and muscle protein synthesis responses. Female strength athletes should consume at least 1.5 g/kg/day, within the broader 1.4-2.0 g/kg/day sports nutrition range. The article highlights the value of distributing high-quality protein across the day, targeting essential amino acids and roughly 2.5 g leucine per serving, and consuming 0.32-0.38 g/kg before and after resistance training. A small pre-sleep protein serving may reduce overnight breakdown.
The supplement section focuses on caffeine, creatine monohydrate, and protein powders. Caffeine may support aerobic and anaerobic performance at 3-6 mg/kg about 60 minutes before exercise, although menstrual cycle and contraceptive effects require more study. Creatine is presented as well supported and potentially valuable for women, improving high-intensity power, fatigue measures, cognition, mood, and luteal-phase fluid balance without clear evidence of phase-related weight gain. Protein powders can help meet daily needs when whole foods are limited, especially whey or casein sources rich in leucine.
Overall, the article calls for evidence-based, individualized practice rather than rigid sex stereotypes. Coaches, dietitians, and health practitioners should monitor energy availability, menstrual and pregnancy-related changes, training demands, hunger, fatigue, and recovery. The review’s limitation is the limited female-specific evidence, including small samples, inconsistent menstrual-cycle tracking, and underrepresentation of elite athletes. Its practical contribution is a cautious framework that supports performance while prioritizing long-term health.1
Reference
- Cabre HE. Optimizing performance and health: nutrition considerations for female athletes in strength and conditioning. Strength Cond J. 2025;47(6):619-629.