Auditing the Representation of Female Versus Male Athletes in Sports Science and Sports Medicine Research: Evidence-Based Performance Supplements
Open accessAbstract
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.
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More than half (65.4%) of collegiate female athletes are using either traditional or non-traditional sports supplements at least one time per month.
“Research on collegiate female athletes suggests that more than half (65.4%) are using either traditional (single and multivitamin/mineral supplements) or non-traditional (herbals, botanicals, and other biologic and nutrient) sports supplements at least one time per month [283].”
From International society of sports nutrition position stand: nutritional concerns of the female athlete (2023) · cites this paper as [283]
The Introduction reports high supplement-use rates among national-to-Olympic athletes and says women report slightly higher use when sex-specific figures are available. It does not report a 65.4% rate for collegiate female athletes, monthly use, or the stated traditional and non-traditional supplement categories. (LLM, conf=0.83)
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“Given the pitfalls in reproducibility of research findings [143], and potentially divergent effects based on sex [144] and athletic ability [145], many areas discussed would benefit from additional study, especially across a broader range of participant types.”
To the extreme! How biological anthropology can inform exercise physiology in extreme environments
Niclou, A. M., Sarma, M. S., Lévy, S., & Ocobock, C. J. (2023) · Comparative Biochemistry and Physiology Part A Molecular & Integrative Physiology · doi:10.1016/j.cbpa.2023.111476 · Cited by 9 · see citing works
Sport supplementation in competitive swimmers: a systematic review with meta-analysis
Domínguez, R., López-León, I., Moreno-Lara, J., Rico, E., Sánchez-Oliver, A. J., Sánchez-Gómez, Á., & Pecci, J. (2025) · Journal of the International Society of Sports Nutrition · doi:10.1080/15502783.2025.2486988 · Cited by 7 · see citing works
“Given the underrepresentation of female participants in studies investigating the effects of SS on sports performance [97], as well as the lack of precise sex-specific results, it is imperative for future research to focus on examining the ergogenic properties of SS with consideration for the sex…”
Foo, W. L., Tester, E., Close, G. L., Areta, J. L., & Morton, J. P. (2025) · Sports Medicine · doi:10.1007/s40279-025-02224-3 · Cited by 7 · see citing works
“These findings are consistent with previous audits, which also indicated that most participants were classified within Tier 0 (sedentary), Tier 1 (recreationally active) and Tier 2 (developmental/ trained) categories [20, 22, 23, 26, 27].”
InfluentialMenstrual Cycle and Athletic Status Interact to Influence Symptoms, Mood, and Cognition in Females
Ronca, F., Watson, E., Metcalf, I., & Tari, B. (2025) · Sports Medicine - Open · doi:10.1186/s40798-025-00924-8 · Cited by 10 · see citing works
Whitfield, J., Egan, B., Coso, J. D., Derave, W., Saunders, B., & Burke, L. M. (2025) · International Journal of Sport Nutrition and Exercise Metabolism · doi:10.1123/ijsnem.2025-0111 · Cited by 11 · see citing works
Self-citationVascular adaptation to exercise: a systematic review and audit of female representation
Thompson, S. L., Brade, C. J., Henley-Martin, S. R., Naylor, L. H., & Spence, A. L. (2024) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00788.2023 · Cited by 7 · see citing works
Willems, M. E. T., Blacker, S. D., Montanari, S., & Cook, M. D. (2024) · Current Developments in Nutrition · doi:10.1016/j.cdnut.2024.104523 · Cited by 6 · see citing works
Cook, M. D., Shan, Y., & Willems, M. E. T. (2025) · International Journal of Sport Nutrition and Exercise Metabolism · doi:10.1123/ijsnem.2024-0108 · Cited by 6 · see citing works
Dow, E., Hernandez, M. I., & Johnston, C. S. (2025) · Physiological Reports · doi:10.14814/phy2.70219 · Cited by 6 · see citing works
Tan, R., Baranauskas, M. N., Karl, S. T., de Zevallos, J. O., Shei, R., Paris, H. L. R., Wiggins, C. C., & Bailey, S. J. (2023) · Nitric Oxide · doi:10.1016/j.niox.2023.05.003 · Cited by 7 · see citing works
Hamstring-to-Quadriceps Strength Ratios in Women Team Sport Athletes: A Systematic Review
Korpinen, M. M., Trieschock, D., Fields, J. B., Jagim, A. R., Almonroeder, T. G., & Jones, M. T. (2024) · Strength and conditioning journal · doi:10.1519/ssc.0000000000000867 · Cited by 5 · see citing works
“The data should be filtered to remove noise, and PTs should be re-ported during the isokinetic phase, in which the subject reaches constant velocity.”
Caffeine’s influence on vertical jump height: a real-life collegiate student-athlete approach
Papadakis, Z., Panoutsakopoulos, V., Schwarz, A. V., & António, J. (2025) · Journal of the International Society of Sports Nutrition · doi:10.1080/15502783.2025.2501063 · Cited by 9 · see citing works
“…factors may influence physical performance, including strength, power, and neuromuscular efficiency, due to cyclical hormonal fluctuations that impact carbohydrate and fat oxidation, and potentially caffeine metabolism, thus affecting both intra-session trial and overall jump performance [75,77].”
Adams, W. M., Anderson, T., Post, E. G., Christopher, S. M., McKay, A. K. A., Donaldson, A. T., Galán-López, N., Finnoff, J. T., Carter, S., & Taylor, L. K. (2025) · International Journal of Sports Physiology and Performance · doi:10.1123/ijspp.2024-0461 · Cited by 4 · see citing works
Self-citationBone Quality in Competitive Athletes: A Systematic Review.
Burt, L. A., Wyatt, P. M., Morrison, A., & Boyd, S. K. (2023) · PubMed Central · Cited by 4 · see citing works
Female Athletes Report Positive Experiences as Research Participants
Smith, E. S., McKay, A. K. A., Ackerman, K. E., Elliott-Sale, K. J., Stellingwerff, T., Harris, R., & Burke, L. M. (2025) · International Journal of Sport Nutrition and Exercise Metabolism · doi:10.1123/ijsnem.2024-0182 · Cited by 4 · see citing works
Self-citationDoes sex of the jockey influence racehorse physiology and performance
Schrurs, C., Dubois, G., Erck, E. V., & Gardner, D. S. (2022) · PLoS ONE · doi:10.1371/journal.pone.0273310 · Cited by 4 · see citing works
Vicente-Salar, N., Crespo, M., Pluim, B. M., Fernández-Fernández, J., Stroia, K. A., Ellenbecker, T. S., Rivas, D. S., Coso, J. D., Moreno-Pérez, V., Hainline, B. W., et al. (2025) · International Journal of Sport Nutrition and Exercise Metabolism · doi:10.1123/ijsnem.2025-0001 · Cited by 3 · see citing works
Self-citationNavarro, P. E., Díaz, C. G., Pérez, R. G., Gil‐Izquierdo, Á., García, C. J., Giménez-Monzó, D., Perales, A., & Sanz, J. M. M. (2025) · Nutrients · doi:10.3390/nu17162706 · Cited by 3 · see citing works
“Its usefulness Female athletes may respond differently to creatine or β -alanine supplementation depending on hormonal status, yet most studies include mostly male participants [42].”
Can Dietary Supplements Support Muscle Function and Physical Activity? A Narrative Review
Brough, L., Rees, G., Drummond‐Clarke, L., McCallum, J. E., Taylor, E., Kozhevnikov, O., & Walker, S. (2025) · Nutrients · doi:10.3390/nu17213495 · Cited by 3 · see citing works
“Only 8% of studies have been conducted exclusively on females when evaluating dietary supplements and exercise adaptations [36].”
Нагорна, В., Sencha-Hlevatska, K. V., Fehr, D., Bonmarin, M., Korobeynikov, G., Mytko, A., & Lorenzetti, S. (2026) · Sports · doi:10.3390/sports14010007 · Cited by 3 · see citing works
“Hormonal fluctuations across the menstrual cycle significantly influence strength, endurance, coordination, and recovery, necessitating tailored training approaches to enhance performance and reduce injury risk [1–7].”
InfluentialAdamczewski, J., Szymocha, M., Główka, N., Adrian, J., & Durkalec-Michalski, K. (2026) · International Journal of Sports Physiology and Performance · doi:10.1123/ijspp.2025-0447 · Cited by 3 · see citing works
Mendes, G. L., Oliveira, H. A., dos Reis, A. S., Nakamoto, F. P., Staibano, A., Alvares, L. A. M., Ferreira, R. E. S., dos Santos, R. V. T., & Quaresma, M. V. L. D. S. (2025) · Nutrition and Health · doi:10.1177/02601060241307981 · Cited by 4 · see citing works
“In fact, several studies did not employ hormonal methods, as described by Smith et al. (2022).”
InfluentialRowland, S. N., Boit, M. D., Tan, R., Heaney, L. M., & Bailey, S. J. (2025) · Experimental Physiology · doi:10.1113/ep092415 · Cited by 3 · see citing works
“A common reason cited for exclusion of females from research is the complexity of accounting for the menstrual cycle or contraceptive use (Smith et al., 2022).”
How Much of HERStory is in the HIStory of the International Journal of Sports Medicine?
Jetté, S., & Hagberg, J. M. (2025) · International Journal of Sports Medicine · doi:10.1055/a-2751-8538 · Cited by 3 · see citing works
Nutrition in Women at High Altitude: A Scoping Review—UIAA Medical Commission Recommendations
Andjelkovic, M. S., Paal, P., Kriemler, S., Mateikaitė-Pipirienė, K., Rosier, A. J., Beidleman, B. A., Derstine, M., Hefti, J. P., Hillebrandt, D., Horáková, L., et al. (2023) · High Altitude Medicine & Biology · doi:10.1089/ham.2023.0047 · Cited by 3 · see citing works
“The lack of sex-specific reporting and the lack of female participants in studies of nutrition at high altitude are like the sex discrepancies in sports nutrition research (Smith et al., 2022) and emphasize the need for more work in this area.”
Sports Supplement Consumption in 316 Federated Female Road Cyclists
García-Durán, J., González-Jurado, J. A., & Sánchez-Oliver, A. (2024) · Nutrients · doi:10.3390/nu16152563 · Cited by 4 · see citing works
“Recently, a standardized audit of the literature assessed the representation of various recognized sports supplements (such as beta-alanine, caffeine, creatine, glycerol, nitrates/beet juice, and sodium bicarbonate) concerning female athletes [22].”
BackgroundResultMcManus, L., Faria, V. S., Scriney, M., & Egan, B. (2025) · Science and Medicine in Football · doi:10.1080/24733938.2025.2501809 · Cited by 2 · see citing works
Abreu, M., Nakamura, F. Y., Carvalho, T., Silva, D., Vasconcellos, F. V. D. A., & Afonso, J. R. (2025) · Journal of Functional Morphology and Kinesiology · doi:10.3390/jfmk10030270 · Cited by 2 · see citing works
“The predominance of male-focused research is problematic given the rapid growth of women’s soccer [29].”
Walton, H., McCarthy-Ryan, M. F., Shill, I., Turner, A. P., Emery, C. E., & Palmer, D. (2025) · Journal of science and medicine in sport · doi:10.1016/j.jsams.2025.08.013 · Cited by 2 · see citing works
Burke, L. M., Merrell, L. H., Heikura, I. A., Civil, R., Sharma, A. P., Leckey, J. J., & McKay, A. K. A. (2025) · British Journal Of Nutrition · doi:10.1017/s0007114525105084 · Cited by 2 · see citing works
“We also note the involvement of female athletes within the cohort, contributing to the call for their increased participation in sports science investigations (24) although without opportunity to examine any specific sex-related issues in the current study design.”
Self-citationMaculewicz, E., Mastalerz, А., Mróz, A., Johne, M., Krawczak, K., Pabin, A., Garbacz, A., Komar, K., Massidda, M., Šťastný, P., et al. (2025) · Genes · doi:10.3390/genes16101160 · Cited by 2 · see citing works
“There is overwhelming evidence that women are underrepresented in the field of sports science [46–49].”
Auditing the representation of elite female players in football performance and injury research
Clausen, E., Flood, T. R., Kryger, K. O., Lewin, G., McCall, A., Stebbings, G. K., & Elliott-Sale, K. J. (2025) · Science and Medicine in Football · doi:10.1080/24733938.2025.2577442 · Cited by 2 · see citing works
“%) is lower than that reported in other recent audits across broader sports science topics using the same audit tool ~11% (Kuikman et al. 2023), ~13% (Kelly et al. 2024), and ~23% (Smith et al. 2022b).”
Self-citationSendra‐Pérez, C., Martínez, A. E., & Priego‐Quesada, J. I. (2025) · Sensors · doi:10.3390/s25216798 · Cited by 2 · see citing works
Tan, R., Baranauskas, M. N., Karl, S. T., de Zevallos, J. O., Shei, R., Paris, H. L. R., Wiggins, C. C., & Bailey, S. J. (2023) · Nitric Oxide · doi:10.1016/j.niox.2023.06.004 · Cited by 2 · see citing works
Directions for Future Studies to Determine Dietary Nitrate Efficacy in Female Athletes
Carvalho, A. P. M., Duarte, B., Elliott-Sale, K. J., & Saunders, B. (2023) · Translational Journal of the American College of Sports Medicine · doi:10.1249/tjx.0000000000000235 · Cited by 2 · see citing works
Self-citationRigney, G. H., Dugan, J. E., Bishay, A. E., Jo, J., Jonzzon, S., Williams, K. L., Zuckerman, S. L., & Terry, D. P. (2025) · Clinical Journal of Sport Medicine · doi:10.1097/jsm.0000000000001338 · Cited by 1 · see citing works
“Food First,” Not “Food Only” in Competitive Sports: A Mini-Review
Schek, A. (2025) · The Open Sports Sciences Journal · doi:10.2174/011875399x378498250508065801 · Cited by 1 · see citing works
Ferreira, S. S., Fernandes, L. G., Martins, P. N., Sampaio, A. R., Nunes, N. A., Clemente, F. M., Abade, E., & Ferreira, R. M. (2026) · International Journal of Sports Science & Coaching · doi:10.1177/17479541251414956 · Cited by 1 · see citing works
Willems, M. E. T., Wannasorn, S., Leelitthum, K., Ajjimaporn, A., & Nana, A. (2026) · European Journal of Applied Physiology · doi:10.1007/s00421-026-06215-8 · Cited by 1 · see citing works
“The majority of supplementation studies to examine exercise effects have focused on men, highlighting the need for more research involving female participant (Smith et al. 2022).”
How Much of HERstory is in the HIStory of Medicine and Science in Sports and Exercise?
Jetté, S., & Hagberg, J. M. (2026) · Translational Journal of the American College of Sports Medicine · doi:10.1249/tjx.0000000000000349 · Cited by 1 · see citing works
Gassner, M., Diewald, J., Leichtfried, L., Zeller, L., Ryan, S., Wagner, K.-H., & König, D. (2026) · Sports · doi:10.3390/sports14050168 · Cited by 1 · see citing works
Unlocking human potential: A centennial journey and transformation of exercise physiology
Hu, X., Liu, R., Wang, C., Shi, H., Zhu, L., & Duan, R. (2026) · Advanced Exercise and Health Science · doi:10.1016/j.aehs.2026.04.001 · Cited by 2 · see citing works
Tan, Z. S., Burns, S. F., Lee, Y. X., & Goodwill, A. M. (2026) · Frontiers in Nutrition · doi:10.3389/fnut.2026.1817134 · Cited by 1 · see citing works
“This issue was further highlighted in an audit by Smith and colleagues (22) on the representation of female athletes in sports science and medicine research, where more than half of the caffeine studies included in the audit (k = 858) consisted of male participants only.”
Gibbs, B., Eleftheriadou, A., Saleet, J., Tanaka, M. J., Li, X., & Al-Hourani, K. (2026) · Bone & Joint Open · doi:10.1302/2633-1462.75.bjo-2025-0127.r1 · Cited by 1 · see citing works
“15 Additionally, as a result of the aforementioned higher risks and complications surrounding female ACL injuries, it is important to consider females as a distinct group from males.”
Ritta, G. B. D. S., Soares, L. M. B., Abreu, A. C. P., Mendes, G. F., Saunders, B., & Reis, C. E. G. (2026) · International Journal of Sport Nutrition and Exercise Metabolism · doi:10.1123/ijsnem.2026-0022 · Cited by 1 · see citing works
Willems, M. E. T., Nana, A., Hiranphan, P., Wannasorn, S., Ramyarangsi, P., & Ajjimaporn, A. (2026) · Frontiers in Sports and Active Living · doi:10.3389/fspor.2026.1818132 · Cited by 1 · see citing works
Bridging the gap: multi-omic insights into exercise responses in postmenopausal women
Aiyanna, R. K., Wang, S., Grolaux, R., Reisman, E. G., Jones, B., & Eynon, N. (2026) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00172.2026 · Cited by 1 · see citing works
Der „Gender Data Gap“ und geschlechtsspezifische physiologische Unterschiede im Sport
Zimmel, H., & Bischoff, L. L. (2023) · B&G Bewegungstherapie und Gesundheitssport · doi:10.1055/a-2023-9468 · Cited by 1 · see citing works
“[6] zeigen, wie unterrepräsentiert Frauen hier sind, obwohl Athletinnen diese Ergänzungsmittel häufig einnehmen.”
BackgroundThe Perception of Sports Nutrition for Thai National Youth Athletes
Kaewchuay, S., Inthiraj, A., & To-aj, O. (2023) · Annals of Applied Sport Science · doi:10.61186/aassjournal.1234 · Cited by 1 · see citing works
Have We Considered Women in Current Sports Nutrition Guidelines?
Smith, E. S., & Burke, L. M. (2024) · Nutrition Today · doi:10.1097/nt.0000000000000692 · Cited by 1 · see citing works
Self-citationNytt fra internasjonal forskning
Norum, M. (2024) · Norsk tidsskrift for ernæring · doi:10.18261/ntfe.22.3.10
Engineering for Women in Sport-Editorial
Webster, J. A. (2024) · Proceedings of the Institution of Mechanical Engineers Part P Journal of Sports Engineering and Technology · doi:10.1177/17543371241302916
Hearn, A. N., Parker, J. K., Hicks, K. M., & Fernandes, J. F. T. (2024) · Women in Sport and Physical Activity Journal · doi:10.1123/wspaj.2024-0079
Brecha de género en nutrición deportiva. Un camino todavía por recorrer.
Domínguez, R., Pérez‐López, A., Pérez‐Esteve, É., Pérez-Armijo, P., Bonilla, D. A., Kammar‐García, A., Troncoso-Pantoja, C., Fernández-Villa, T., Apolinar‐Jiménez, E., Gamero, A., et al. (2024) · Revista Española de Nutrición Humana y Dietética · doi:10.14306/renhyd.28.4.2367
The Role of Nutrition in Applied Physiology
López‐Samanes, Á. (2025) · Nutrients · doi:10.3390/nu17071227
Nuzzo, J. L. (2025) · AJP Advances in Physiology Education · doi:10.1152/advan.00196.2024
Sex of researchers and study participants in Research Quarterly, 1930-1979Preprint
Nuzzo, J. L. (2025) · doi:10.51224/srxiv.567
Hottenrott, L. (2025) · Springer eBooks · doi:10.1007/978-3-642-27830-3_183-1
Нагорна, В., Sencha-Hlevatska, K. V., Fehr, D., Bonmarin, M., Korobeynikov, G., Mytko, A., & Lorenzetti, S. (2026) · Zürcher Hochschule für Angewandte Wissenschaften digital collection (Zurich University of Applied Sciences) · doi:10.21256/zhaw-34890
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Vieira, Y. L. D. M., CAMPOS, A. V., LOPES, A. C., SANTOS, N. S. D., SANTOS, M., Bernardes, B. T., Drummond, L. R., de Lacerda, L. T., ANDRADE, M. J., Marchini, J. S., et al. (2026) · Gazzetta Medica Italiana Archivio per le Scienze Mediche · doi:10.23736/s0393-3660.25.06051-6
Further insights into HERstory in the HIStory of the Journal of Applied Physiology
Jette, S., & Hagberg, J. M. (2026) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00368.2025
de Brito, C. L., Leal, T. C., Silva, M. A. C., Junqueira, N. D., Rodrigues, A., Ferreira, J. M., Malechesk, G. F., Filho, L. F. P. D. S., Noal, B., Ferreira, R. E. S., et al. (2026) · Nutrire · doi:10.1186/s41110-026-00474-3
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“Comparable to many areas of sports science [155, 156], females are currently under-represented in XCS research (see Sect.”
Hottenrott, L. (2026) · Springer eBooks · doi:10.1007/978-3-032-05988-8_183
- Authors
- Smith, E. S., McKay, A. K. A., Kuikman, M., Ackerman, K. E., Harris, R., Elliott-Sale, K. J., Stellingwerff, T., & Burke, L. M.
- Affiliations
- Australian Catholic University (AU)
- Boston Children's Hospital (US)
- Female Athlete Performance and Health Initiative, Australian Institute of Sport, Canberra, ACT 2617, Australia
- Nottingham Trent University (GB)
- University of Victoria (CA)
- Corresponding author
- Smith, Ella S.
- ORCID
- Venue
- Nutrients
- Publisher
- MDPI AG
- Published
- 2022-02-23
- Volume
- 14
- Issue
- 5
- Pages
- 953
- ISSN
- 2072-6643 (ISSN-L)
- PMC
- PMC8912470
- OpenAlex
- W4213430488
- Cited by
- 113
- References
- 44
- Citations by year
- 2026: 32 · 2025: 33 · 2024: 20 · 2023: 24 · 2022: 4
- FWCI
- 17.88
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Nutrients (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Nottingham Trent University's Institutional Repository (Nottingham Trent Repository) (acceptedVersion)
- e-space (Manchester Metropolitan University) (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- UVic’s Research and Learning Repository (University of Victoria) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Sex and Gender in Healthcare
- Social Sciences › Gender Studies › Sports, Gender, and Society
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
- Keywords
- female athletes, sex differences in research, sports nutrition, gender representation in research, beta-alanine, caffeine, creatine, glycerol, nitrate, beetroot juice, sodium bicarbonate, menstrual status, evidence-based practice
- MeSH terms
- Female, Humans, Male, Sports, Sports Medicine, Nutrition Policy, Dietary Supplements, Athletes
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