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Sex Differences in Fat Oxidation Depend on Age, Body Mass Index, and Exercise Modality: A Systematic Review and
Carlo Ferri-Marini1, Octavia G Garcia Murillo2, Danna A Corral-Castillo2,3
1Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
International Journal of Sport Nutrition and Exercise Metabolism
|January 22, 2026
Summary
This study found that while absolute maximal fat oxidation (MFO) is lower in females, relative MFO and FATmax show no significant sex differences. Exercise intensity and individual factors like BMI and age are key moderators of fat metabolism during exercise.
Area of Science:
- Exercise Physiology
- Metabolic Health
- Human Performance
Background:
- Sexual dimorphism in exercise metabolism is not fully understood.
- Maximal fat oxidation (MFO) and its associated exercise intensity (FATmax) are key indicators of metabolic flexibility.
- Previous assumptions about sex differences in fat oxidation require critical evaluation.
Purpose of the Study:
- To systematically review and meta-analyze current evidence on sexual dimorphism in MFO and FATmax.
- To identify key moderators influencing MFO and FATmax across different populations.
- To challenge existing assumptions regarding sex-based differences in exercise fat metabolism.
Main Methods:
- Systematic review and meta-analysis of studies published between January 2001 and April 2024.
- Inclusion of 36 studies (n=8,990) reporting sex-specific MFO and FATmax from indirect calorimetry during graded exercise tests.
- Data synthesis following PRISMA 2020 guidelines, registered in PROSPERO.
Main Results:
- Absolute MFO was significantly lower in females (-0.06 g/min).
- No significant differences were found in relative MFO or FATmax between sexes.
- Cardiorespiratory fitness, BMI, and exercise modality (treadmill associated with higher MFO) were significant moderators.
- Age demonstrated a curvilinear relationship with FATmax (p = .008).
Conclusions:
- The assumption of higher fat oxidation in women during exercise is questioned.
- Sex-based differences in fat metabolism are context-dependent and require individualized assessment.
- Further longitudinal research is needed to determine the cardiometabolic implications of these findings.
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