Exercise science and sports medicine have historically relied on male-dominated research populations, resulting in a persistent “male-default” framework that shapes training, nutrition, and injury-prevention recommendations. This project investigates the extent to which this bias limits the validity and applicability of exercise science for women. Using a structured literature review and quantitative synthesis, peer-reviewed studies, meta-analyses, and consensus statements were analyzed across four domains: (1) representation of female participants, (2) physiological differences, (3) injury and training considerations—particularly the Female Athlete Triad and Relative Energy Deficiency in Sport (RED-S), and (4) metabolic and nutritional differences. 

Findings demonstrate that women remain underrepresented in exercise science research, comprising approximately one-third of study participants, and are substantially underrepresented in performance nutrition and supplementation studies. At the same time, consistent evidence supports meaningful sex-based differences in endocrine function, substrate utilization, and injury risk. Female athletes show greater reliance on lipid oxidation during endurance exercise and are disproportionately affected by conditions linked to low energy availability, contributing to elevated risks of bone stress injuries and other health complications. Despite these established differences, many studies fail to control for female-specific variables such as menstrual status, limiting the precision of current recommendations. 

These findings suggest that sex bias in exercise science is not solely an issue of representation, but a limitation in scientific validity. Improving outcomes for women requires both increased inclusion in research and the development of methodologies that accurately account for female physiology. This project highlights the need for a more inclusive and evidence-based framework to ensure that exercise science is both accurate and applicable across populations.

• To what extent does the male-default framework in exercise science limit the accuracy and applicability of training, injury prevention, and metabolic recommendations for women?

  • To what extent are women underrepresented in exercise science research, and how does this affect the evidence base?

  • What sex-based physiological differences exist that may influence performance and training adaptations?

  • How do sex-specific factors, such as the Female Athlete Triad and RED-S, impact injury risk and training outcomes in women?

  • How do metabolic and nutritional differences between men and women influence the effectiveness of current exercise and nutrition recommendations?

This project used a structured literature review and quantitative synthesis to examine sex bias in exercise science and sports medicine research. Peer-reviewed journal articles, systematic reviews, meta-analyses, consensus statements, and large-scale research audits were selected for their relevance to four primary domains: female representation in exercise science research, physiological sex differences, injury and training implications (with an emphasis on the Female Athlete Triad and RED-S), and metabolic/nutritional differences. Sources were identified through prior literature review, database searches, and foundational publications in the field, including ACSM consensus statements, methodological papers on research involving women, and sport nutrition research by Dr. Louise Burke and colleagues. Quantitative data extracted from the literature included participant sex distribution, prevalence of male-only versus female-only study designs, performance differences, injury risk ratios, substrate utilization differences, and methodological indicators such as menstrual status classification and sex-disaggregated analysis. These findings were then organized into thematic categories and compared across studies to identify consistent quantitative patterns and research gaps.

This study identified consistent quantitative patterns across all four domains analyzed, demonstrating both the underrepresentation of women in exercise science research and meaningful sex-based differences that affect training, injury risk, and metabolic outcomes. 

In terms of representation, large-scale research audits show that women comprise approximately 34–36% of study participants, while men account for 64–66%, with male-only studies (≈31%) far outnumbering female-only studies (≈6%). This disparity is further amplified in specialized areas such as performance nutrition and supplementation, where female participation drops to approximately 16–23%, and fewer than 15% of studies including women adequately define menstrual status, with less than 1% applying gold-standard hormonal methodology. 

Physiological findings consistently demonstrate sex-based differences in performance and adaptation, with males typically outperforming females by approximately 10–30% in strength, endurance, and power tasks. These differences are largely driven by variations in muscle mass, hemoglobin concentration (≈10–12% lower in females), and endocrine factors. Metabolic analyses further show that women exhibit greater reliance on lipid oxidation and reduced carbohydrate utilization during moderate-intensity exercise, indicating distinct substrate utilization patterns. 

Injury-related data reinforce the significance of these differences. Female athletes demonstrate approximately 2–9 times greater risk of ACL injury, as well as increased susceptibility to bone stress injuries, particularly in the presence of low energy availability. Within the framework of the Female Athlete Triad and RED-S, athletes classified as moderate-to-high risk show approximately 2–4 times greater incidence of bone stress injuries, with a substantial proportion of female athletes exhibiting at least one Triad component. 

Finally, findings in metabolic and nutritional research highlight both physiological differences and critical research gaps. Female athletes remain significantly underrepresented in fueling studies, and even when included, key variables such as menstrual cycle phase, hormonal status, and energy availability are often not controlled. As a result, many existing nutritional recommendations are effectively male-derived, limiting their precision when applied to women.

The findings of this study suggest that sex bias in exercise science is not solely an issue of representation, but a limitation in scientific validity that affects the accuracy and applicability of research findings for women. 

The persistent underrepresentation of women in research directly contributes to gaps in knowledge, particularly in areas requiring sex-specific considerations such as metabolism, hormonal regulation, and injury risk. Even when women are included, methodological limitations, such as inadequate control of menstrual status or insufficient statistical power, further restrict the ability to draw meaningful conclusions. As a result, “sex-neutral” recommendations often reflect male-derived evidence rather than truly generalizable science. 

At the same time, the data demonstrate that sex-based differences are both measurable and practically significant. Differences in substrate utilization, endocrine function, and injury susceptibility indicate that training, nutrition, and recovery strategies may not produce equivalent outcomes across sexes. However, the current evidence base is not yet sufficiently developed to support fully individualized, sex-specific guidelines in all domains. 

This tension highlights a key issue: the absence of definitive sex-specific recommendations does not indicate the absence of meaningful differences; rather, it reflects limitations in research design, representation, and methodological rigor. In this context, the reliance on male-default evidence creates a gap between what is known about female physiology and what is applied in practice. 

These findings support the conclusion that improving outcomes for women requires a dual approach: increasing female representation in research and improving the methodological quality of studies involving women. This includes designing studies that account for hormonal variability, adequately powering analyses for sex differences, and prioritizing female-specific research questions. 

Ultimately, addressing sex bias in exercise science is necessary not only for equity but for producing accurate, applicable, and evidence-based recommendations that improve health, performance, and long-term outcomes for women.

This project demonstrates that sex bias in exercise science is not merely an issue of representation, but a limitation in scientific validity that affects the accuracy and applicability of research findings for women. Across multiple domains, women remain underrepresented in study populations and are often insufficiently characterized when included. At the same time, consistent evidence supports meaningful sex-based differences in physiology, metabolism, and injury risk, particularly within the context of energy availability and hormonal regulation.

The combination of underrepresentation and methodological limitations contributes to a gap between what is known about female physiology and what is applied in practice. As a result, many training, nutrition, and injury-prevention recommendations are effectively derived from male-based evidence and may not fully translate to female populations. Importantly, the absence of definitive sex-specific guidelines does not indicate the absence of meaningful differences, but rather reflects the need for more rigorous and representative research.

Addressing this issue requires a shift in how exercise science is conducted and applied. Increasing female participation in research, improving study design to account for female-specific variables, and translating evidence into accessible, evidence-based practice are essential steps toward improving health and performance outcomes for women. Ultimately, correcting sex bias is necessary for ensuring that exercise science fulfills its role as a precise, inclusive, and evidence-based discipline.

Future research should prioritize both increased representation and improved methodological rigor in studies involving female participants. This includes designing studies that are adequately powered to detect sex differences, as well as consistently reporting sex-disaggregated data. Greater attention should be given to controlling for female-specific variables, including menstrual cycle phase, hormonal contraception, pregnancy, postpartum status, and menopause, to better understand how these factors influence training adaptations, recovery, and performance outcomes.

Longitudinal and intervention-based studies are particularly needed to examine how sex-specific variables impact real-world training and injury prevention over time. In the area of sports nutrition, more research is required to evaluate whether existing carbohydrate, protein, and supplementation guidelines are equally effective for women, given differences in substrate utilization and energy availability.

Additionally, future work should explore the integration of physiological research with applied environments, including fitness settings, coaching practices, and educational systems. This includes examining how evidence is translated into practice, how misinformation spreads in fitness culture, and how access to accurate, evidence-based guidance can be improved.

Overall, advancing this field requires a shift from treating women as a secondary population to prioritizing female physiology as essential to the development of accurate and generalizable exercise science.

I would like to express my sincere appreciation to Dr. Helaine Alessio, Dr. Paul Reidy, Dr. Alex Claiborne, and Dr. Kyle Timmerman for their continued feedback, guidance, and support throughout this project. I am also especially thankful to Mr. Brady Hall for his mentorship and encouragement from the very beginning.

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Career & Self-Development

• Demonstrated initiative by conducting independent research beyond coursework

• Sought mentorship and incorporated faculty feedback to refine research

Critical Thinking

• Analyzed and synthesized quantitative data across multiple studies

• Evaluated methodological limitations and identified gaps in current research

Communication

• Translated complex scientific findings into accessible, visual formats

• Presented research in a structured, evidence-based format for diverse audiences

Equity & Inclusion

• Investigated disparities in representation within exercise science research

• Advocated for more inclusive and accurate scientific practices

This project was conducted as a literature-based review and quantitative synthesis using previously published, peer-reviewed research. No human subjects, identifiable data, or experimental procedures were involved. Therefore, this study did not require Institutional Review Board (IRB) approval in accordance with federal guidelines for research involving human participants.

All sources were obtained through credible academic journals and publicly available materials, and findings were reported with attention to accuracy, proper citation, and ethical use of information. This project adheres to academic standards of integrity, including appropriate attribution of all referenced work.