Female Athletes at Higher Risk for Nutritional Deficiencies

Woman football player
For a number of reasons, female athletes may face higher risk of nutritional deficiencies.

Photo and Co / The Image Bank / Getty Images

Key Takeaways

  • A new study suggests female athletes may be at higher risk for nutritional deficiencies.
  • Falling short on recommended vitamins and minerals may raise health risks for these athletes, and affect reproductive and bone health.
  • Turning to experts like registered dietitians can be helpful for creating realistic, effective nutrition plans.

Many female athletes may have a higher risk of health problems, which is tied to a general lack of knowledge about nutrition needs among athletes as well as coaches and sports team specialists, new research published in 2020 in the Journal of Women's Health suggests.

Reviewing 11 studies done over the past 20 years on athletes over age 13, researchers found a significant gap in understanding about how these women should be fueling themselves to meet the demands of the sports they play. Not only can that affect their overall performance, but it can also set them up for serious health concerns in the long term, according to study author Mary Downes Gastrich, PhD, EdD, associate professor at Rutgers University Medical School.

The review notes these athletes have higher risk of:

  • Disordered eating
  • Low energy availability
  • Vitamin and mineral deficiencies
  • Eating disorders
  • Bone health issues
  • Reproductive issues
  • Metabolism problems
  • Lowered immune system function
  • Poor protein synthesis
  • Lower cardiovascular health
  • Lower psychological health

Deficiencies that are most likely to occur from exercise-related stress and inadequate dietary intakes include zinc, magnesium, B vitamins, calcium, and vitamin D, Gastrich says. The last two, especially, can cause lifelong issues since those are required for bone health, which means female athletes may suffer more stress fractures and be at risk for osteoporosis as they age.

Although the studies reviewed indicated that these athlete may have optimal intakes of protein, they tended to fall short on carbohydrates and fats.

Factors for Nutritional Shortfalls

Although lack of enough evidence-based nutrition information is a factor for why female athletes may not be getting what they need, there are other issues at play here, says Gastrich. Poor time management plays a role—for instance, being too rushed to eat a full meal, or not taking time for grocery shopping—as does food availability.

For example, the USDA has noted that the U.S. has more than 6,500 "food deserts"—urban and rural areas where healthy food is more difficult to obtain.

The results of the recent research should be a wake-up call for athletes, coaches, and trainers, believes celebrity trainer Jillian Michaels, who suggests turning to experts like registered dietitians when putting together nutrition plans.

"Any serious athlete needs to work with only the most highly educated professionals," she says. "Food is a very powerful thing. The way we eat affects everything, from our mood and immunity to our longevity and athletic performance. This is not to be trifled with or done via a Google search. Athletic coaches shouldn't be functioning in a vacuum on this issue or presuming they have knowledge they simply don't."

Athletes themselves often get their nutrition information from social media or fitness websites, adds Shena Jaramillo, RD, a registered dietitian specializing in sports nutrition and eating disorders. Much of this material may be created for male athletes, she says, and can also include sources that aren't credible.

Shena Jaramillo, RD

This can lead to women rigorously following a nutrition plan that's full of harmful information. Added to that, they often restrict foods in a way that can lead them deficient, such as cutting calories too low or avoiding even healthy fats as a way to try and meet societal weight expectations.

— Shena Jaramillo, RD

Unfortunately, these type of issues can be higher in specific sports such as gymnastics, figure skating, ballet, distance running, and diving, according to Gastrich. That's likely because sports like these emphasize low body weight as a performance driver, which can lead to inadequate calorie consumption and disordered eating. Stress can exacerbate this situation, and cause even more health concerns.

If you're an athlete struggling with these issues, or the parent of a young female athlete who may need help, consider talking with your primary care doctor about options and referrals. There is also an eating disorder helpline run by the National Alliance on Mental Illness: 1-800-950-6264, or text "NAMI" to 741741.

What This Means For You

Factors like time management and a dearth of solid nutrition information can be solved fairly easily with some lifestyle tweaks aimed at better scheduling and reliability on expert guidance. But with issues like disordered eating, body image, and eating disorders, it's very important to seek professional help like a therapist or counselor.

5 Sources
Verywell Fit uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Gastrich MD, Quick V, Bachmann G, Moriarty AM. Nutritional Risks Among Female Athletes. J Womens Health (Larchmt). 2020;29(5):693-702. doi:10.1089/jwh.2019.8180

  2. Ackerman KE, Misra M. Bone health and the female athlete triad in adolescent athletes. Phys Sportsmed. 2011;39(1):131-41. doi:10.3810/psm.2011.02.1871

  3. United States Department of Agriculture. Characteristics and Influential Factors of Food Deserts. August 2012.

  4. Coelho GM, Gomes AI, Ribeiro BG, Soares Ede A. Prevention of eating disorders in female athletes. Open Access J Sports Med. 2014;5:105-13. doi:10.2147/OAJSM.S36528

  5. Lock J. Treatment of adolescent eating disorders: Progress and challenges. Minerva Psichiatr. 2010;51(3):207-216.

By Elizabeth Millard
Elizabeth Millard is a freelance journalist specializing in health, wellness, fitness, and nutrition.