Statement of the Problem:

Cardiovascular disease is the under-recognized primary cause of death and disability in women worldwide, both in high- and low-income populations. One of its major risk factors is obesity, which is a major factor in the development of diabetes. Evidence suggests that obesity is increasing more in women than men. In turn, diabetes is itself a leading risk factor for CVD, with a greater effect on women than men. Nutrition is a basic issue in this chain of causality, and hence sex differences in nutrition are of fundamental importance. Methodology and Theoretical Orientation: Meta-analyses were used to identify sex differences in the obesity-diabetes-CVD triad. Cross-sectional data on over 200,000 people (52% women) in the UK Bio bank were used to explore sex differences in macronutrient intakes and adherence to dietary recommendations. Findings: Men had greater intakes of energy but were less likely to have energy intakes above the estimated average requirement compared with women. For all macronutrients, men had greater absolute intakes while women had greater intakes as a percentage of energy. Women were more likely to have intakes that exceeded recommendations for total fat, saturated fat and total sugar. Men were less likely to achieve the minimum recommended intakes for protein, polyunsaturated fat and total carbohydrate. Sex differences in dietary intakes were moderated by age and, to some extent, by socioeconomic status. Conclusion & Significance: There are significant sex differences in adherence to dietary recommendations, particularly for sugar. Dietary interventions and advice may need a specific focus on women, as part of a recommended life-course approach to women’s health (Bennett et al, BMJ Open, 2018).