Women and men are not equal when it comes to sport and some of its benefits. The 150 minutes of moderate to intense physical activity recommended to prevent the onset or progression of coronary heart disease benefit women up to three times more than men, conclude new research published in Nature Cardiovascular Research.
While the physiological causes of this difference are still being explored, its very existence calls for a reworking of the recommendations in order to personalize them according to sex.
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Women need half as much physical activity for the same benefit
530 minutes per week, or about 1 hour and 15 minutes per day: this is the average amount of time a man should spend engaging in moderate to intense physical exercise if he wants to reduce his risk of developing coronary heart disease by 301%. Generally caused by the obstruction of the coronary arteries (leading to the heart) by a buildup of fatty deposits, coronary heart disease is the second leading cause of death in France.
For a woman, reducing her risk of developing this condition by 30% will require on average only 250 minutes of exercise per week, less than half! In 2024, a study had already demonstrated a significant difference between the sexes in all-cause mortality. Women benefited from maximum survival with 150 minutes of physical activity per week, compared to 300 for men.
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A tripled benefit in women suffering from coronary artery disease
This doubling of the benefit is confirmed with regard to the risk of developing coronary heart disease, and becomes even more impressive when focusing on people who already suffer from it. Female patients with coronary heart disease who met the guideline recommendation of 150 minutes of exercise per week saw their risk of mortality decrease threefold compared to men." he explained to Science and Future Jiajin Chen, the lead author of this work and a researcher at Xiamen University (China). We were very surprised. »
This study, based on data from over 85,000 people in the vast UK Biobank database, reveals a significant bias in the benefits derived from physical activity. Among participants meeting the activity levels recommended by the guidelines (150 minutes per week), women experienced a relative reduction of 22 % in the risk of coronary heart disease incidence, compared to 17 % in men“, points out Jiajin Chen.
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Hormones or muscle composition? Mechanisms to explore
Physiologically, the reasons for this difference between the sexes are unknown. However, researchers have put forward several hypotheses. The first involves estrogen, a hormone produced in greater quantities by women during their menstrual cycle, which can promote the loss of body fat during exercise. A study has shown that estrogen supplementation can increase lipid oxidation in men during exercise, which is known to improve clinical outcomes in cases of coronary heart disease." explains Jiajin Chen. Other studies will need to look into this point, especially since the present study mainly included menopausal women.
The second hypothesis, which can be combined with the first, is based on muscle composition. Muscles are composed of two types of muscle fibers: slow-twitch fibers (type 1) are primarily associated with endurance and posture, while fast-twitch fibers (type 2) provide strength and power. Men generally have a higher percentage of type 2 muscle fibers, while women's skeletal muscles are dominated by type 1 fibers, resulting in differences in muscle metabolism.“,” comments Jiajin Chen. “In particular, women seem to have a greater capacity to metabolize (use) fats during exercise.”
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Consider gender in physical activity recommendations
These results are important because current recommendations are based on data collected from the entire population. Our results indicate that the cardiovascular benefits of physical activity differ according to sex, suggesting the potential value of sex-specific and individualized approaches for the prevention and management of coronary heart disease.“, points out Jiajin Chen.
Especially since women, who would benefit the most, are less physically active than men. Globally, the prevalence of insufficient physical activity was 5 percentage points higher in women than in men (33.8 % vs 28.7 %)", the researchers write in the publication. Jiajin Chen also hopes that their work will encourage women to engage in physical activity. »
It remains to address the reasons that keep women away from sport, as discussed in an editorial in the magazine The Lancet Public Health describes as numerous and complex"Among them are gender norms that instill from childhood a lack of confidence and enjoyment in sports, less funding and access to women's sports, and the lack of time for adult women who combine paid employment, domestic and parental tasks.
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