Sex differences in absolute and relative changes in muscle size following resistance training in healthy adults: a systematic review with Bayesian meta-analysis

Background Muscle hypertrophy may be influenced by biological differences between males and females. This meta-analysis investigated absolute and relative changes in muscle size following resistance training (RT) between males and females and whether measures of muscle size, body region assessed, mu...

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Main Authors: Martin C. Refalo, Greg Nuckols, Andrew J. Galpin, Iain J. Gallagher, D. Lee Hamilton, Jackson J. Fyfe
Format: Article
Language:English
Published: PeerJ Inc. 2025-02-01
Series:PeerJ
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Online Access:https://peerj.com/articles/19042.pdf
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author Martin C. Refalo
Greg Nuckols
Andrew J. Galpin
Iain J. Gallagher
D. Lee Hamilton
Jackson J. Fyfe
author_facet Martin C. Refalo
Greg Nuckols
Andrew J. Galpin
Iain J. Gallagher
D. Lee Hamilton
Jackson J. Fyfe
author_sort Martin C. Refalo
collection DOAJ
description Background Muscle hypertrophy may be influenced by biological differences between males and females. This meta-analysis investigated absolute and relative changes in muscle size following resistance training (RT) between males and females and whether measures of muscle size, body region assessed, muscle fibre type, and RT experience moderate the results. Methods Studies were included if male and female participants were healthy (18–45 years old) adults that completed the same RT intervention, and a measure of pre- to post-intervention changes in muscle size was included. Out of 2,720 screened studies, 29 studies were included in the statistical analysis. Bayesian methods were used to estimate a standardised mean difference (SMD), log response ratio (lnRR) with exponentiated percentage change (Exp. % Change of lnRR), and probability of direction (pd) for each outcome. Results Absolute increases in muscle size slightly favoured males compared to females (SMD = 0.19 (95% HDI: 0.11 to 0.28); pd = 100%), however, relative increases in muscle size were similar between sexes (Exp. % Change of lnRR = 0.69% (95% HDI: −1.50% to 2.88%)). Outcomes were minimally influenced by the measure of muscle size and not influenced by RT experience of participants. Absolute hypertrophy of upper-body but not lower-body regions was favoured in males. Type I muscle fibre hypertrophy slightly favoured males, but Type II muscle fibre hypertrophy was similar between sexes. Conclusion Our findings strengthen the understanding that females have a similar potential to induce muscle hypertrophy as males (particularly when considering relative increases in muscle size from baseline) and findings of our secondary analyses should inform future research that investigates sex differences in highly trained participants and muscle fibre type-specific hypertrophy.
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spelling doaj-art-dbf856c9d64840b59318c009c4abd6262025-08-20T02:45:46ZengPeerJ Inc.PeerJ2167-83592025-02-0113e1904210.7717/peerj.19042Sex differences in absolute and relative changes in muscle size following resistance training in healthy adults: a systematic review with Bayesian meta-analysisMartin C. Refalo0Greg Nuckols1Andrew J. Galpin2Iain J. Gallagher3D. Lee Hamilton4Jackson J. Fyfe5Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, AustraliaStronger by Science LLC, Raleigh, NC, United States of AmericaParker University, Human Performance Center, Dallas, TX, United States of AmericaCentre for Biomedicine and Global Health, Napier University, Edinburgh, United KingdomInstitute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, AustraliaInstitute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, AustraliaBackground Muscle hypertrophy may be influenced by biological differences between males and females. This meta-analysis investigated absolute and relative changes in muscle size following resistance training (RT) between males and females and whether measures of muscle size, body region assessed, muscle fibre type, and RT experience moderate the results. Methods Studies were included if male and female participants were healthy (18–45 years old) adults that completed the same RT intervention, and a measure of pre- to post-intervention changes in muscle size was included. Out of 2,720 screened studies, 29 studies were included in the statistical analysis. Bayesian methods were used to estimate a standardised mean difference (SMD), log response ratio (lnRR) with exponentiated percentage change (Exp. % Change of lnRR), and probability of direction (pd) for each outcome. Results Absolute increases in muscle size slightly favoured males compared to females (SMD = 0.19 (95% HDI: 0.11 to 0.28); pd = 100%), however, relative increases in muscle size were similar between sexes (Exp. % Change of lnRR = 0.69% (95% HDI: −1.50% to 2.88%)). Outcomes were minimally influenced by the measure of muscle size and not influenced by RT experience of participants. Absolute hypertrophy of upper-body but not lower-body regions was favoured in males. Type I muscle fibre hypertrophy slightly favoured males, but Type II muscle fibre hypertrophy was similar between sexes. Conclusion Our findings strengthen the understanding that females have a similar potential to induce muscle hypertrophy as males (particularly when considering relative increases in muscle size from baseline) and findings of our secondary analyses should inform future research that investigates sex differences in highly trained participants and muscle fibre type-specific hypertrophy.https://peerj.com/articles/19042.pdfSex differenceMuscle hypertrophyGender differenceMuscle sizeResistance training
spellingShingle Martin C. Refalo
Greg Nuckols
Andrew J. Galpin
Iain J. Gallagher
D. Lee Hamilton
Jackson J. Fyfe
Sex differences in absolute and relative changes in muscle size following resistance training in healthy adults: a systematic review with Bayesian meta-analysis
PeerJ
Sex difference
Muscle hypertrophy
Gender difference
Muscle size
Resistance training
title Sex differences in absolute and relative changes in muscle size following resistance training in healthy adults: a systematic review with Bayesian meta-analysis
title_full Sex differences in absolute and relative changes in muscle size following resistance training in healthy adults: a systematic review with Bayesian meta-analysis
title_fullStr Sex differences in absolute and relative changes in muscle size following resistance training in healthy adults: a systematic review with Bayesian meta-analysis
title_full_unstemmed Sex differences in absolute and relative changes in muscle size following resistance training in healthy adults: a systematic review with Bayesian meta-analysis
title_short Sex differences in absolute and relative changes in muscle size following resistance training in healthy adults: a systematic review with Bayesian meta-analysis
title_sort sex differences in absolute and relative changes in muscle size following resistance training in healthy adults a systematic review with bayesian meta analysis
topic Sex difference
Muscle hypertrophy
Gender difference
Muscle size
Resistance training
url https://peerj.com/articles/19042.pdf
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