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Controlled feeding trial Published October 2001. The journal issue carries no day of the month.

The sex difference in carbohydrate loading was a dosing error

AI narration, generated on first listen
Journal
European Journal of Applied Physiology 85(6):533 to 538
Authors
James AP, Lorraine M, Cullen D, Goodman C, Dawson B, Palmer TN, Fournier PA
Institution
the University of Western Australia
Published
1 October 2001
Source
PMID 11718281 · DOI 10.1007/s004210100499
Design
Endurance trained women and men ingested 12 grams of carbohydrate per kilogram of lean body mass per day in conjunction with stopping their daily training. Muscle glycogen was measured before and after three days on the diet. The women were studied twice, in the post menstrual and pre menstrual phases of the menstrual cycle.
Sample
Endurance trained female and male athletes, with the women tested in two phases of the menstrual cycle.

Why they ran it

A well cited trial had reported that women do not have the capacity to accumulate supranormal muscle glycogen. The authors noticed that in that trial the carbohydrate given to the women, relative to body mass, was much lower than what the men received, because the dose had been set as a percentage of what each person already ate.

Their stated primary aim was to re examine the question with the two groups fed comparable amounts of carbohydrate.

Drawn from the paper's introduction.

Endurance trained women and men were fed 12 grams of carbohydrate per kilogram of lean body mass per day for three days while stopping their usual training.

In the women, muscle glycogen rose from 108 to 193 millimoles per kilogram of wet weight in the post menstrual phase, and from 111 to 202 in the pre menstrual phase. In the men it rose from 109 to 183.

The authors conclude that female athletes do have the capacity to accumulate supranormal muscle glycogen, and that when trained men and women are fed comparable amounts of carbohydrate relative to lean body mass there is no sex related difference in that capacity.

The numbers

Women, post menstrual phase108 (15) to 193 (14) mmol/kg wet weight
Women, pre menstrual phase111 (16) to 202 (20) mmol/kg wet weight
Men109 (27) to 183 (25) mmol/kg wet weight
Carbohydrate dose12 g/kg lean body mass per day for 3 days
Sex related difference in loading capacitynone found

Why this might happen

Proposed by the authors This is the explanation the authors offer in their discussion. This study did not test it.

The explanation the authors offer is arithmetic rather than physiological. Prescribing carbohydrate as a percentage of what someone already eats hands a smaller absolute dose to the smaller person, and in the earlier trial the women's intake relative to body mass was much lower than the men's.

Change the denominator to lean body mass, so that both groups receive a comparable amount of carbohydrate for the muscle they are actually carrying, and the reported difference between the sexes does not appear.

Drawn from the paper's introduction and conclusions.

What this does not show

  • It does not show that the two studies disagree about physiology. It shows they used different doses. This trial did not re run the earlier protocol alongside its own, so the comparison between them is made across two papers rather than inside one.
  • No performance outcome, again. Muscle glycogen only. Whether the extra glycogen changed anything either group could do was not measured.
  • Two menstrual phases is a description, not a hormonal test. The women were tested post menstrual and pre menstrual and loaded in both. Nothing here isolates what any particular hormone is doing to glycogen storage.
  • Lean body mass is one candidate denominator, not the proven right one. The trial shows that the sex gap closes when the dose is set per kilogram of lean mass with adequate energy. It does not establish that lean mass is the correct denominator in general, only that habitual energy share is a poor one.

Where this leaves us

The claim that women cannot carbohydrate load, which came out of a widely cited trial and travelled a long way on its own, does not survive changing the denominator of the dose. This contradicts the earlier finding, and the later meta analysis reads it the same way, noting that the one study reporting a sex difference had given the women far less energy.

Endurance trained women and men fed 12 grams of carbohydrate per kilogram of lean body mass per day for three days while not training.

A single trial feeding both denominators, by percentage of habitual energy and by lean mass, in the same participants, which would put the two prescriptions side by side for the first time.

Caveats worth holding

  • The number of participants in each group is not stated in the abstract.
  • Wet weight units, with standard deviations in brackets.
  • Training was stopped rather than a depleting bout being performed, so this is a taper protocol and not a classical depletion protocol.
  • The comparison with the earlier trial is indirect. Different laboratories, different participants, different diets and twenty years apart.

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