From Biological Foundations to Optimizing Performance and Health in Elite Female Winter Olympians

Area of Science:

• Sports Science
• Exercise Physiology
• Biomedical Science

Background:

• The Milano Cortina 2026 Olympics aim for unprecedented gender balance in winter sports.
• Existing scientific literature on elite female winter athlete training and health is insufficient.
• Biological sex differences emerge at puberty, impacting athletic performance.

Purpose of the Study:

• To review the biological basis of sex differences in athletic performance.
• To evaluate training and health considerations for female winter sport athletes.
• To provide evidence-based recommendations for enhancing performance and health.

Main Methods:

• Expert-led narrative review of scientific literature.
• Synthesis of biological factors influencing performance.
• Evaluation of training adaptations and health risks specific to female athletes.

Main Results:

• Significant sex-based differences in absolute performance exist due to biological factors like hemoglobin mass and muscle mass.
• When normalized, many physiological differences diminish, with hemoglobin and body fat percentage being key.
• Female athletes exhibit comparable physiological adaptations to men when training is individualized.
• Female athletes have higher risks of iron deficiency, relative energy deficiency in sport (REDs), and menstrual dysfunction.

Conclusions:

• Effective training principles are largely similar for male and female athletes post-puberty.
• Individualized and sport-specific training prescriptions are crucial.
• Integrated, sex-specific health monitoring and prevention strategies are essential for elite female athletes.
• Translating biological insights into practice can enhance performance and health for female Olympians.