Review and Summary: Up to Speed

Up to Speed Book Cover

Up to Speed is basically about why women get left out of exercise and sports science research. It kicks off by explaining how bias towards men has shaped sports and science. It’s kinda wild how guys have way more info about their bodies than women do. The book delves into stuff like how women are treated in sports, period talk, what women should eat, stamina, injuries, boobs, the gear we wear, and also stuff about being a teenager, pregnancy, after giving birth, and menopause. Christine Yu breaks down why there’s this big gap when it comes to sports knowledge.


The Gap

  • Current system of sports and science ignoring important biological, anatomical, and physiological differences between women and men can have real, negative implications outside the laboratory.
  • The very characteristics that scientists cast aside as no big deal—the menstrual cycle, hormones, the uterus, ovaries, breasts—are the reason women were marginalized and presumed to be unfit for sports, or at least in need of a segregated competition category.
  • Differences in biological sex aren’t the only reason women are marginalized. Gender plays a role too: the socially constructed identities and roles that determine how people perceive and present themselves and relate to others.
  • Our understanding of exercise science, sports nutrition, and injury prevention, and treatment is based on a model of men—one that treats male physiology and men’s developmental curve as the gold standard and doesn’t always investigate the important biological, anatomical, and physiological differences between women and men.

Challenges to study women athletes

  • Funding drives everything. With a funding pipeline and prevailing sociocultural norms set up to support and advance men, a paradigm developed: scientific research became centered on the “male specimen.”
  • Women are complicated. The biggest consideration is the menstrual cycle, the ebb and flow of female sex hormones, like estrogen and progesterone, that regulate the reproductive system. But these chemical messengers also influence a wide range of other physiological functions. These hormonal rhythms also change throughout a woman’s life.
  • Volunteer bias can play a role too. Women are more reluctant to participate in nutrition studies where they have to change the way they eat. With men, on the other hand, it’s just calories down the gob for them, and they sign up with minimal concerns.
  • The menstrual cycle—as well as hormonal contraceptive use and menopause hormone therapy—adds additional elements scientists need to control for in their research. body temperature changes throughout the month; it’s generally lower during the first part of the cycle, rises with ovulation, and remains elevated until it drops again at the next period.
  • Not every scientist wants to go through the hassle of pre-planning or taking extra steps to verify hormone and menstrual cycle status during the course of a research project.

The implications of excluding women from scientific research

  • We eliminate an important biological variable from cell, animal, and human studies. As a result, we don’t have a firm grasp on the scope of non-male-specific phenomena, the underlying mechanisms at play, or the true magnitude of differences—and similarities—between women and men.

The effect to women athletes by excluding women in research

  • While there were numerous positive health benefits of exercise, physicians also observed altered or delayed menstrual cycles in high school, college, and Olympic athletes compared to non-athletes, a condition then called athletic amenorrhea. These athletes also experienced a fair number of injuries, particularly stress fractures, which can be a sign of poor bone, menstrual, and nutritional health and can leave athletes at risk for additional fractures in the future.
  • The athletes who had low bone density and were getting stress fractures also weren’t eating enough food to keep up with the demands of their sport. Or they exhibited patterns of disorder eating. They tended to have problems with their menstrual cycle, too.

More than just hormonal

  • Alice Profé, a physician in Berlin and high-ranking member of the Central Commission on National and Youth Games: the perceived weakness in women wasn’t due to their reproductive biology or physiology alone—it was due to a multitude of external factors, such as restrictive clothing, lack of education, and insufficient physical activity.
  • Women’s bodies do differ from men’s primarily in relation to the reproductive system. But having a uterus, ovaries, breasts, and a wider pelvis doesn’t make someone weaker or any less suited for physical activity, and it doesn’t mean they shouldn’t have the same opportunity as men. Those differences just make them different.
  • The distinct physiological and biological characteristics of female and male bodies can lead to variations in size, biomechanics, and endurance and patterns of strength and weakness. It doesn’t necessarily mean one type of body is better than the other, but these attributes can fundamentally influence how the body feels and responds to exercise and a person’s lived experience of sports.

Oversimplification of Sex Chromosomes

  • Biological sex involves more than just chromosomes and genes. When we separate bodies into categories like female and male, we tend to group them based on physical features like external genitalia (which is how doctors assign sex to babies at birth, rather than basing it on their chromosomes) and secondary sex characteristics like the presence of breasts, wider hips, and facial hair. But there are other features we can’t see that also influence biology and physiology—internal genitalia (like the uterus and vagina or prostate gland and vas deferens), gonads (like the testes and ovaries), the types of hormones the body produces, and the body’s ability or inability to respond to those hormones.
  • What’s traditionally considered biological sex actually exists along a spectrum and there’s a lot of diversity in the actual physical expression of these characteristics. For each of the areas related to biological sex, the body can go down different paths.

Period power

  • The menstrual cycle can tell about much more than just fertility. It can be a useful indicator of a person’s overall health and should be considered a vital sign, much like body temperature, pulse, breathing rate, and blood pressure. A normal, functioning menstrual cycle is a way of saying a person has a healthy endocrine system.
  • Indication of irregularity can be an early warning signs that something is a miss
  • Athletes who didn’t menstruate spent more days injured and ran less total mileage compared to their counterparts who had a normal cycle.


  • The belief that a slim, lean physique is a competitive advantage pervades in endurance sports (like rowing, running, and cycling), weight-class sports (like wrestling or judo), aesthetic sports (like dance, figure skaitng, and gymnastics), and fitness writ large. Add in society’s obsession with diet culture and its accompanying anti-fat bias, and there’s tremendous pressure to conform to a specific idea of what an athlete should look like rather than asking whether they’re eating enough and often enough.
  • When women follow general sports nutrition advice, they may or may not experience the same benefits and results reports in the studies or among men.
    • Reason: could be as simple as differences in body size and composition.
    • Women are typically smaller than men and have less lean body mass, recommendations may need to be scaled or adjusted. Or it could be the influence of the different hormonal environments in women’s and men’s bodies → affect factors like metabolism, fluid retention, recovery, and performance.
  • When the body doesn’t have enough energy to fuel itself, it quickly switches to conservation mode, diverting resources away from nonessential functions and have downstream effects:
    • Decreases in coordination, endurance performance muscle strength, and training response along with increased injury risk, impaired judgement, irritability and depression.
    • Energy deficient athletes with amenorrhea demonstrated slower reaction times, lower muscular strength, and decreased endurance compared to those with normal menstrual cycles and sufficient energy levels.
  • When women under fuel:
    • susceptible to lower bone mineral density, altered bone architecture, and weaker bone tissue.
    • increase the rate of bone breakdown in women, even if their menstrual cycles appear normal.
    • lead to higher levels of cholesterol and triglycerides in the blood, changes that can make an athlete’s bloodwork resemble someone who is postmenopausal and at risk for heart disease.
  • Underfuel men → poor bone health, low testosterone, and low sperm count.

Intermitten Fasting

  • Restricting calories and forcing the body to adapt to a state of stress → better fat burners → lose weight.
  • Imposes conditions similar to a long run ride, restricting eating to specific time periods can train the body to utilize fat more efficiently. When it comes to women, the thinking goes one step further: since women tend to carry more body fat than men, they potentially have more stored fuel to use.
  • Most studies that demonstrated health benefits were conducted in animals or with human participants who weren’t active. When researchers took a closer look at the impact of intermittent fasting on high-intensity, endurance, and resistance exercise:
    • Half of the studies showed no significant difference between exercising in a fasted vs fed state.
    • Women responded differently than men. men performed better when they fasted before endurance training while the opposite was true for women. They performed better when they ate before exercise.
  • men athletes can get away with period of not eating, women are more sensitive to a downturn in nutrition:
    • It has to do with reproduction:
      • Becoming pregnant and carrying a baby isn;t ideal if there isn’t enough food aroud. When energy availability is low, the body’s hormone levels adjust and dampen the menstrual cycle. add in a workout session and it can lead to overtraining, fatigue, and injury.
      • After a fasted cardio session: women showed a higher level of stress and inflammation as well as signs of muscle tissue damage and breakdown → counterproductive in the long-term. Even skipping breakfast can create enough of an energy deficit to harm health and performance.

The Ketogenic Diet

  • Eat mostly fat, a smidgen of protein, and barely any carbs (<50 g a day).
  • Causes a downturn in nutrition that shifts the body into survival mode.
  • forces the body to switch from using sugar and starch as fuel to using fat. Some of that fat is transformed into ketones, which can cross the blood-brain-barrier and supply the brain with energy in the absence of glucose.
  • women may also need more carbohydrates to keep the endocrine system humming.

Priority should be building a strong base of calories to avoid long periods of time where energy supply dips into the red

The Adolescence Years, Ensuring Athletic Resilience and Health

  • Critical tome in a youth’s relationship with athletics and physical activity. Yet there’s often a disconnect between the unique physiology of maturing kids–and what their bodies need during this time to be strong and healthy–and the increasing expectations of athletic training and performance in a system that’s becoming more competitive. This is especially true for girls, whose needs are often misunderstood and overlooked.
  • During adolescence: bone mineralization can’t keep up with bone growth → leaving the skeleton temporarily more fragile
  • Boys emerge from puberty with a more “athletic” build. They’re leaner and stronger, largely due to androgens like testosterone flooding the body, and they accumulate bone mass at a greater rate compared to girls.
  • Estrogen, which are released during menstruation, are essential to building and protecting bone mass → the age at which a young person begins to menstruate and the regularity of the cycle can affect long-term bone health.
  • While hormones may play a role in those changes, girls don’t get the same strength and conditioning opportunities that boys do. They’re not taught that strength training will build the resiliency they need to progress in their physical activity and build the resiliency they need to progress in their physical activity and sports.
  • Coaches can create individualized strength training and conditioning programs designed to shore up weakness at different stages of maturity. Encouraging athletes to focus on developing gross motor skills and strength before they enter puberty can help prevent the changes in biomechanics and neuromuscular control from being as disruptive. This is particularly important for growing girls, who are more susceptible to injury during this time.

Fitness in Pregnancy and Postpartum

  • Exercise during pregnancy, unless you have a medical contraindication or a medical reason why you shouldn’t exercise, is safe and beneficial.
    • Exercise lowers the odds of conditions like gestational diabetes and preeclampsia without increasing the likelihood of miscarriage, low birth weight, preterm birth or labor, or other birth complications.
  • Physiological, hormonal, and anatomical changes that accompany pregnancy don’t disappear immediately after birth. it can take a year or more for the body to return to normal, depending on a person’s birth experience, recovery, nutrition, and breastfeeding status.
  • Along with the pelvic floor, pregnancy disrupts the body’s core
  • The 6-week clearance for exercise is an arbitrary time point, not a definitive milestone. That clearance is really a clearance of infections and post-delivery complications, It’s not a clearance for activity. At that point, not all bodies will be ready to handle the load and impact of activities like running or high-intensity fitness class. It can take 4-6 months for the largest pelvic floor muscle, and the connective tissue and nerves associated with it, to heal.

Menopause Transition

  • Around the mid 40s, the ovaries start to run out of viable follicles (the structure that contains the maturing egg and releases it during ovulation), which throws off the production of estrogen and progesterone and begins the menopause transition
  • The physiological shifts are due to a combination of multiple factors: some related to age and affect everyone, some specific to the hormonal changes that accompany the menopause transition.
  • Menopause tend to use and burn less energy than they did previously. they have lower resting metabolic rate, expend less energy during the day, and don’t engage in as much as physical activity as they used to. The body becomes more insulin resistant due to falling estrogen and it no longer processes carbohydrates efficiently → accumulation of fat around the midsection and wild blood sugar highs and lows → cause cycles of hunger and exhaustion and makes fueling workouts, recovery, and everyday life tricky
  • Maintaining a regular exercise habit can prepare the body as well as offset the symptoms that come with the menopause transition
  • Physical activity buffered them from some of the age- and menopausal-related slowdown. The more active people were during peri- and post-menopause, the better they performed on tests of muscle strength and power compared to their less active counterparts

Author: Christine Yu

Publication date: 16 May 2023

Number of Pages: 336 pages


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