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Sex Differences in Sport and Exercise
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CHAPTER 19 CHAPTER 19 OverviewOverview
• Body size and composition
• Physiological responses to acute exercise
• Physiological adaptations to exercise training
• Sport performance
• Special issues
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Introduction to Sex Differences in Introduction to Sex Differences in Sport and ExerciseSport and Exercise
• For decades, culture, athletic governing bodies, and PE curricula perpetuated the myth that girls and women should not compete in sport
• Last 30 to 40 years, girls and women have achieved great athletic feats– Sex differences in performance still exist– Separating biological versus other factors
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Table 19.1Table 19.1
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Body Size and CompositionBody Size and Composition
• Testosterone leads to– Bone formation, larger bones
– Protein synthesis, larger muscles
– EPO secretion, red blood cell production
• Estrogen leads to– Fat deposition (lipoprotein lipase)– Faster, more brief bone growth– Shorter stature, lower total body mass
– Fat mass, percent body fat
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Figure 19.1Figure 19.1
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Body Size and CompositionBody Size and Composition
• Distinct female fat deposition pattern
• Rapid storage on hips and thighs due to lipoprotein lipase activity
• Lipolytic activity makes regional fat loss more difficult
• Lipoprotein lipase , lipolysis during third trimester of pregnancy, lactation
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Physiological Responses Physiological Responses to Acute Exerciseto Acute Exercise
• Muscle strength differs between sexes– Upper body: women 40 to 60% weaker– Lower body: women 25 to 30% weaker– Due to total muscle mass difference, not difference
in innate muscle mechanisms
• No sex strength disparity when expressed per unit of muscle cross-sectional area
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Figure 19.2Figure 19.2
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Physiological Responses Physiological Responses to Acute Exerciseto Acute Exercise
• Causes of upper-body strength disparity– Women have more muscle mass in lower body– Women utilize lower body strength more– Altered neuromuscular mechanisms?
• Women: smaller cross-sectional areas
• Similar fiber-type distribution
• Research indicates women more fatigue resistant
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Figure 19.3Figure 19.3
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Physiological Responses Physiological Responses to Acute Exerciseto Acute Exercise
• Cardiovascular function differs greatly
• For same absolute submaximal workload– Same cardiac output– Women: lower stroke volume, higher HR
(compensatory)– Smaller hearts, lower blood volume
• For same relative submaximal workload– Women: HR slightly , SV , cardiac output
– Leads to O2 consumption
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Figure 19.4Figure 19.4
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Physiological Responses Physiological Responses to Acute Exerciseto Acute Exercise
• Women compensate for hemoglobin via (a-v)O2 difference (at submaximal intensity)– (a-v)O2 difference ultimately limited, too
– Lower hemoglobin, lower oxidative potential
• Sex differences in respiratory function– Due to difference in lung volume, body size– Similar breathing frequency at same relative
workload– Women frequency at same absolute workload
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Figure 19.5Figure 19.5
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Physiological Responses Physiological Responses to Acute Exerciseto Acute Exercise
• Women’s VO2max < men’s VO2max
• Untrained sex comparison unfair– Relatively sedentary nonathlete women– Relatively active nonathlete men
• Trained sex comparison better– Similar level of condition between sexes– May reveal more true sex-specific differences
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Figure 19.6Figure 19.6
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Figure 19.7Figure 19.7
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Physiological Responses Physiological Responses to Acute Exerciseto Acute Exercise
• Can scale VO2max to other body variables– Height, weight, FFM, limb volume– Sex difference minimized or gone with scaling
• Simulated women’s fat mass on men– Reduced sex differences in treadmill time,
submaximal VO2 (ml/kg), VO2max
– Women’s additional body fat major determinant of sex-specific difference in metabolic responses
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Physiological Responses Physiological Responses to Acute Exerciseto Acute Exercise
• Women’s lower hemoglobin limits VO2max
• Women’s lower cardiac output limits VO2max
– SVmax limited by heart size, plasma volume
– Plasma volume loading in women helps
– Submaximal absolute VO2: no sex difference in SV
• Sex differences in lactate, threshold– Peak lactate concentrations lower in women
– Lactate threshold occurs at same percent VO2max
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Physiological Adaptations Physiological Adaptations to Exercise Trainingto Exercise Training
• Body composition changes– Same in men and women
– Total body mass, fat mass, percent body fat
– FFM (more with strength vs. endurance training)
• Weight-bearing exercise maintains bone mineral density
• Connective tissue injury not related to sex
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Physiological Adaptations Physiological Adaptations to Exercise Trainingto Exercise Training
• Strength gains in women versus men– Less hypertrophy in women versus men, though
some studies show similar gains with training– Neural mechanisms more important for women
• Variations in weight lifted for equivalent body weight– For given body weight, trained men have more FFM
than trained women– Fewer trained women– Factors other than FFM?
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Figure 19.8Figure 19.8
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Physiological Adaptations Physiological Adaptations to Exercise Trainingto Exercise Training
• Cardiorespiratory changes not sex specific
• Aerobic, maximal intensity– Qmax due to SVmax ( preload, contractility)
– Muscle blood flow, capillary density
– Maximal ventilation
• Aerobic, submaximal intensity– Q unchanged
– SV, HR
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Physiological Adaptations Physiological Adaptations to Exercise Trainingto Exercise Training
• VO2max changes not sex specific– ~15 to 20% increase
– Qmax, muscle blood flow
– Depends on training intensity, duration, frequency
• Lactate threshold
• Blood lactate for given work rate
• Women respond to training like men do
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Sport PerformanceSport Performance
• Men outperform women by all objective standards of competition– Most noticeable in upper-body events– Gap narrowing
• Women’s performance drastically improved over last 30 to 40 years– Leveling off now– Due to harder training
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Figure 19.9Figure 19.9aa
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Figure 19.9Figure 19.9bb
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Figure 19.9Figure 19.9cc
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Figure 19.9Figure 19.9dd
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Figure 19.9Figure 19.9ee
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Figure 19.9Figure 19.9ff
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Special IssuesSpecial Issues
• Menstruation, menstrual dysfunction
• Pregnancy
• Osteoporosis
• Eating disorders
• Environmental factors
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Special Issues: MenstruationSpecial Issues: Menstruation
• Normal menstrual function– Menstrual (flow) phase– Proliferative phase (estrogen)– Ovulation—follicle stimulating hormone (FSH),
luteinizing hormone (LH)– Secretory phase (estrogen, progesterone)
• Cycle length ~28 days, can vary
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Figure 19.10Figure 19.10
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Special Issues: MenstruationSpecial Issues: Menstruation
• No reliable data indicate altered athletic performance across menstrual phases
• No physiological differences in exercise responses across menstrual phases
• World records set by women during every menstrual phase
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Special Issues:Special Issues:Menstrual DysfunctionMenstrual Dysfunction
• Menarche: first menstrual period– May be delayed in certain sports (e.g., gymnastics)– Delayed menarche: after age 14
• Delayed-menarche athletes self-select?– Sport may not delayed menarche– Small, lean athletic girls (delayed menarche
candidates) may gravitate to sport
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Special Issues:Special Issues:Menstrual DysfunctionMenstrual Dysfunction
• Menstrual dysfunction– Seen more in lean-physique sports– Eumenorrhea: normal– Oligomenorrhea: irregular– Amenorrhea (primary, secondary): absent– Can affect 5 to 66% of athletes
• Menstrual dysfunction ≠ infertility
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Special Issues:Special Issues:Menstrual DysfunctionMenstrual Dysfunction
• Secondary amenorrhea—caused by energy deficit (inadequate caloric intake)– LH pulse frequency
– T3 secretion
– Estrogen, progesterone– May also involve GnRH, leptin, cortisol
• As long as caloric intake adequate, exercise does not secondary amenorrhea
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Special Issues:Special Issues:Pregnancy ConcernsPregnancy Concerns
1. Acute reduction in uterine blood flow (shunt to active muscle) fetal hypoxia
2. Fetal hyperthermia from increase in maternal core temperature
3. Maternal CHO usage , thereby CHO availability to fetus
4. Miscarriage, final outcome of pregnancy
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Special Issues:Special Issues:Pregnancy ResearchPregnancy Research
• Uterine blood flow may not hypoxia– Uterine (a-v)O2 difference may compensate
– Fetal HR due to maternal catecholamines
• Fetal hyperthermia: unresolved
• CHO availability: unresolved
• Miscarriage, final pregnancy outcome– Data scarce, conflicting– Many studies show favorable (or no) effects
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Special Issues:Special Issues:Pregnancy RecommendationsPregnancy Recommendations
• Mild-to-moderate exercise 3 times/week
• No supine exercise after first trimester
• Stop when fatigued
• Non-weight-bearing exercise preferable
• No risk of falling, loss of balance, etc.
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Special Issues:Special Issues:Pregnancy RecommendationsPregnancy Recommendations
• Ensure adequate caloric intake
• Dress and hydrate to avoid heat stress
• Prepregnancy exercise routine should be gradually resumed postpartum
• No scuba diving
• Benefits > risks if cautiously undertaken
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Table 19.2Table 19.2
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Special Issues:Special Issues:OsteoporosisOsteoporosis
• Osteopenia versus osteoporosis– Risk greater in women especially after menopause– Slowed and retarded by weight-bearing exercise
• Major contributing factors– Estrogen deficiency– Inadequate calcium intake– Inadequate physical activity– Amenorrhea, anorexia nervosa
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Figure 19.11Figure 19.11aa
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Figure 19.11Figure 19.11bb
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Figure 19.12Figure 19.12
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Special Issues:Special Issues:OsteoporosisOsteoporosis
• Estrogen supplementation– Originally prescribed to reverse osteoporosis– Higher risk of cancer, stroke, heart attack
• Bisphosphonates– Antiresorptive medication– May slow, stop bone degeneration
• Preventive – Diet, lifestyle
– Ca2+, vitamin D intake– Exercise, maintain eumenorrhea
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Special Issues:Special Issues:Eating DisordersEating Disorders
• Anorexia nervosa– Refusal to maintain minimal normal weight– Distorted body image, fear of fatness– Amenorrhea
• Bulimia nervosa– Recurrent binge eating– Lack of control during binges– Purging behaviors (vomiting, laxatives, diuretics)
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Special Issues:Special Issues:Eating DisordersEating Disorders
• Young women at highest risk
• Eating disorder versus disordered eating
• Worse in certain sports– Appearance sports: diving, figure skating, ballet– Endurance sports: distance running, swimming– Weight-class sports: jockeys, boxing, wrestling– Perfectionists, competitive, under tight control
• Self-reporting underestimates prevalence
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Special Issues:Special Issues:Eating DisordersEating Disorders
• Eating disorders considered addictions– Behavior reinforced by media, parents, coaches– Very difficult to treat– Often accompanied by denial– Life threatening, expensive to treat
• Must seek out trained clinical specialist
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Table 19.3Table 19.3
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Special Issues:Special Issues:Female Athlete TriadFemale Athlete Triad
• Syndrome of interrelated conditions– Energy deficit secondary amenorrhea low
bone mass– Disordered eating may (not) be involved
• Three disorders can occur alone or in combination, must be addressed early
• Treatment: caloric intake, activity (in some cases)
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Special Issues:Special Issues:Environmental FactorsEnvironmental Factors
• Heat stress issues– Women: sweat production– No sex differences in thermal tolerance
• Cold stress issues– Women: better insulated ( subcutaneous fat)– Men: better shivering thermogenesis ( FFM)
• Altitude stress issues– VO2max decreases
– No sex differences in altitude tolerance