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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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“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]
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BackgroundResultMcManus, L., Faria, V. S., Scriney, M., & Egan, B. (2025) · Science and Medicine in Football · doi:10.1080/24733938.2025.2501809 · Cited by 2
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
“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
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
“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
“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
“%) 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 3
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
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
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
“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
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
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
“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
Gassner, M., Diewald, J., Leichtfried, L., Zeller, L., Ryan, S., Wagner, K.-H., & König, D. (2026) · Sports · doi:10.3390/sports14050168 · Cited by 1
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
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
“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
“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
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
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
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
“[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
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
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
THOMPSON, K. M., Mendrek, A., Paludo, A. C., Adamo, K. B., & SILVA, D. F. D. (2026) · The Journal of Sports Medicine and Physical Fitness · doi:10.23736/s0022-4707.25.17445-8
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
Morton, S. E. J., Forrest, L. J., Kavaliauskas, M., Easton, C., Rumley, K., & Macpherson, T. W. (2026) · Sports Medicine - Open · doi:10.1186/s40798-026-01001-4
“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
Metadata
- 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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