Gender effects are further complicated when one considers mental health benefits derived from physical activity. For example, males have lower heart rates when engaged in similar rates of exercise [ 16 , 44 ], higher VO2 max levels relative to body mass [ 45 , 46 ], higher red blood cells per unit volume of plasma, wider airways and greater lung diffusion capacity [ 47 ]. To conclude, males and females are predisposed to engage in different levels of intensity and type of physical activity. It is possible many of the behavioural and cognitive differences observed between males and females, such as verbal and visuo-spatial tasks [ 34 , 39 ] could be partly explained by the information above. However, differences between males and females emerge when physical activity increases beyond low intensity. However, the differential influences of sexrelated biological and genetic factors in response to environmental and cultural factors are largely ignored. It appears that by participating in lower intensity physical activity, women are likely to be better off in terms of their mental health. These questions become even more pertinent when considering that overall, most men have lower health status than women in spite of their overall higher level of physical activity [ 7 ].
Emerging evidence from some animal studies show that estrogen, progesterone and testosterone differentially mediate exercise response and consequently physical activity in males and females [ 16 , 52 , 53 ]. It appears that there is still a need to better understand the type of physical activity and the dose response to achieve significant reductions in many forms of cancers [ 30 ]. In summary, we argue that mental health related benefits can be achieved by women with moderate exercise, which seems to be their preferred level [ 31 ]. Gender differences in health benefits derived from exercise Gender differences exist in the benefits of different levels of physical activity specific to a range of poor health outcomes. When the prevalence of males and females for health outcomes and diseases associated with insufficient physical activity are compared, females are generally not more heavily represented, although they may show a different profile compared to males. She points out that many of the data on healthy humans came from Caucasian men, 18 to 20 years of age drawn from the military, athletic, or medical schools. The more aggressive forms are more likely to show reduced risk with physical activity. It appears that by participating in lower intensity physical activity, women are likely to be better off in terms of their mental health. It is already well established that both males and females gain the largest health benefit when activity increases from sedentary to low level intensity [ 18 - 20 ]. Although to date, no studies have directly linked these structural differences to physical activity levels, these are important links that need to be explored. Combined with these physical differences, male cardiovascular physiology also means they are more biologically capable of vigorous physical activity than females. At present, physical activity in both children and adults is measured using a wide range of both objective and subjective tools, therefore comparisons between studies are difficult. We recommend the use of gender-disaggregated statistics proactively in planning to gauge the extent to which women and men benefit from or are affected by policy. Repeatedly it has been shown that males and females differ in their attitudes and motivations towards sport and exercise across the life span [ 55 - 58 ]. There was little convincing evidence that vigorous activity provides more health benefits across the lifespan than moderate physical activity, particularly for females. Further it is not possible to fully understand these differences without addressing the current limitations in the valid and accurate measurement of physical activity. Summary Evidence that health benefits derived from physical activity differ for males and females according to level, mode and intensity was presented in this paper. Gender differences in biological structure and function Although it is generally assumed that physical activity level is under voluntary control, there are a number of biologically driven influences. As a result, the purpose of this paper is to draw on a broad range of literature in order to challenge the current view that males and females need to exercise at the same level and intensity to derive the same health benefits. In addition, it was shown that they also engage in, and respond to, physical activity opportunities in varying ways. When placed under cardiovascular stress, males respond by increasing vascular resistance, and consequently blood pressure, whereas women increase heart rate and are more at risk of fainting [ 16 ]. They propose that walking, in particular, may enable opportunities for social interaction and bonding which is highly valued among women. When interpreting physical activity related information, for example in the formation of guidelines, there needs to be consideration of different needs across the lifespan, as gender differences fluctuate with age. On the other hand, girls play less vigorously and are more likely to compete relationally, engage in play parenting [ 63 ], focus on turn-taking, orderly sequences, partial involvement or solitary activities [ 64 ]. Breast and endometrial cancer risks are reduced by many types of activity including household and recreational activity, with endometrial cancer risk showing a reduction with light to moderate activity [ 30 ]. To date, recommended levels of physical activity in many countries are the same for male and female children and adults. These performance differences are acknowledged by the gender-specific norms for exercise-related tests such as lung function values, VO2 norms, blood pressure and prediction of maximum aerobic power [ 48 ].
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