Amber Harrison- HPN 1 Graduate
Key points
· The menstruating female body has 3 phases of her cycle, each phase differing with hormonal changes.
· Follicular- which is the first day of menses when the females period arrives. Days 0-5 where we have low levels of oestrogen and progesterone, then estrogen begans to rise.
· Ovulation- the process in which a mature egg is released from the ovary. At ovulation, you have peak oestrogen,
· luteal phase- the follicle that burst and released the egg (during ovulation) develops into a small yellow structure, or cyst, called the corpus luteum. The corpus luteum secretes progesterone and estrogen that cause the uterine lining, or endometrium, to thicken and be able to nourish a fertilized egg. This phase releases predominantly progesterone with a small amount of oestrogen.
In brief
From my own personal experience and those of my clients I have found menstruating women have times throughout their cycle that they find themselves noticing increases in their appetite and/or cravings for more food than normal. This often shows up premenstrual and at the early stage of the follicular phase when they start menstruating. Whether that be carbohydrates or Fats, there isn’t a clear macronutrient in the research that is shown to be more common than the other. This is an interesting area because if a female is aiming for changes in body composition this is an area that may need to be thought about in their programming. There potentially is a phase/phases where woman do need to be eating more energy and not restricting themselves to physically and psychologically keep well and thrive.
In depth
In the luteal phase of the menstrual cycle it appears that women’s EI (energy intake) and EE (energy expenditure) are higher than in the follicular phase. Additionally, women more frequently experience food cravings, particularly for foods high in carbohydrate and fat, in the luteal phase. This indicates that it may be worth taking the underlying physiological mechanisms related to each menstrual phase into account in weight management attempts. (1)
The menstrual cycle presents itself as a unique model for regulating food intake and craving. The findings of the present study suggest that, during the menstrual cycle, the participants presented alterations in food craving, with a higher desire for caloric foods, as well as for foods rich in fats, sugars and salt during the LP compared with the FP, thus identifying PMS as a possible determinant of dietary desires in women of childbearing age. (2)
Adult female rats and mice as well as women eat less during the peri-ovulatory phase of the ovarian cycle (estrus in rats and mice) than other phases, an effect under the control of cyclic changes in estradiol secretion. Women also appear to eat more sweets during the luteal phase of the cycle than other phases, possibly due to simultaneous increases in estradiol and progesterone. (3)
Total energy intake has been shown to vary during the menstrual cycle, the highest intakes usually being observed premenstrual (luteal phase). This phenomenon has been demonstrated both in primates and in human studies. This has direct implications for food intake and appetite research, and implies that cycle phase should be considered in studies that assess female participants. The variation in dietary intake across the menstrual (4)
Menstrual cycle dependent changes in women and in rhesus monkeys documented by food diaries or food weighing indicate that food intake is reduced in the periovulatory phase and increased during the luteal phase. Food intake normalized to the day of the luteinizing hormone surge in rhesus monkeys. Food intake reaches a low point around the time of ovulation when estrogen is elevated and progesterone is low and increases following ovulation when progesterone is dominant. Increased food intake premenstrual has been documented in women diagnosed with premenstrual dysphoric syndrome (5)
Female university students are among those most affected by PMS. The rate of PMS is known to be high among this group, and adversely affects their quality of life. Premenstrual syndrome (PMS) is a cyclical late luteal phase disorder of the menstrual cycle whereby the daily functioning of women is affected by emotional and physical symptoms substantially interfering with her quality of life. Generally, mild premenstrual symptoms were the most frequently reported. Overall, the most frequently reported premenstrual symptoms were depressed mood (95%), lethargy/fatigue/decreased energy (92%), muscle, joint, abdominal and back pain (89.3%), feelings of anger (85.7%) and craving for certain foods (84.7%). During the luteal phase and a few days into menstruation, many females crave certain foods. In the present study, craving for sweets such as chocolate, cake, Eastern sweets (Kunafa and Baklava) was commonly reported by study participants (about 71%). This is consistent with research on food craving during the menstrual cycle, with foods rich in sugar, fat, and salt, such as snacks, chocolate, pastries, and desserts were higher during the premenstrual period (6)
Data suggest an increased intake of protein, specifically animal protein, as well as an increase in food cravings, during the luteal phase of the menstrual cycle. These data support the hypothesis that progesterone may stimulate, and estrogen may suppress appetite during the cycle. These findings highlight the need to consider menstrual cycle phase when assessing relationships with protein intake, as well as cravings and appetite, among premenopausal women. These results are not inconsistent with an increase in total energy intake during the mid-luteal phase though this measure was not found to be significantly increased in this study. We did however observe a significant increase in reported appetite, sweet cravings, chocolate cravings, salty cravings, and other food cravings during the late luteal phase, which is consistent with findings of increased cravings in several other studies. These observations of increased cravings during the late luteal phase were not paralleled by significant increases in total energy intake. (7)
Conclusion
In conclusion, the hormonal changes during the three phases of the menstrual cycle have effect on female’s appetite. It shows that premenstrual (late luteal phase) is when appetite is at its strongest and cravings are high also leading into the start of their menstrual cycle then their appetite balances out close to ovulation. The research shows that it isn’t clear that it is a particular macro nutrient. Most of the research is showing the highest cravings and appetite is at the later end of the luteal phase, leading into the start of the follicular phase and appetite is at its lowest around the time of ovulation. The research is on the slim side and it would be great to see some more research happen in this area in the years to come. However, it is all looking very similar for most to have increases in appetite during the late luteal phase. This really does show that when any research is done on females regarding nutrition, the phase of the menstrual cycle they are in may need to be taken into account. The changes and surges of the different hormones during the menstrual cycle does play a part in a female’s appetite whether that be increase in food consumption or a lot of these studies have shown an increase in food cravings.
References
(1) L Davidsen, B Vistisen, A Astrup Impact of the menstrual cycle on determinants of energy balance: a putative role in weight loss attempts. International journal of obesity [Internet] 2007 [cited 2007 06 04]; 31 (12):1777-85. Available from https://www.nature.com/articles/0803699.pdf
(2) Souza LB, Martins KA, Cordeiro MM, Rodrigues YD, Rafacho BP, Bomfim RA. Do food intake and food cravings change during the menstrual cycle of young women?. Revista Brasileira de Ginecologia e Obstetrícia.[Internet} 2018 [citied 2018 ]; 40(11) 686-92.
Available from https://www.scielo.br/j/rbgo/a/mFL8XS8w6PJSfDNzqpq8rcj/?format=html&lang=en
DOI: https://doi.org/ 10.1055/s-0038-1675831
Available from https://pubmed.ncbi.nlm.nih.gov/7560543/ DOI: 10.1016/0165-0327(95)00013-d
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(4) Bryant M, Truesdale KP, Dye L. Modest changes in dietary intake across the menstrual cycle: implications for food intake research. British journal of nutrition. [Internet] 2007 [ Citied 2006 Nov];96(5):888-94. Available from https://www.cambridge.org/core/services/aop-cambridge-core/content/view/B631CF8325F5DC136A680707C5111135/S0007114506003084a.pdf/div-class-title-modest-changes-in-dietary-intake-across-the-menstrual-cycle-implications-for-food-intake-research-div.pdf DOI: 10.1017/BJN20061931
(5) Van Vugt DA Brain imaging studies of appetite in the context of obesity and the menstrual cycle. Hum. Reprod. Update [Internet] 2009 [citied 2010 Jan 1] 16, (3): 276–292. Available from https://academic.oup.com/humupd/article/16/3/276/640665?login=true DOI:10.1093/humupd/dmp051
(6) Hashim MS, Obaideen AA, Jahrami HA, Radwan H, Hamad HJ, Owais AA, et al. Premenstrual syndrome is associated with dietary and lifestyle behaviors among university students: A cross-sectional study from Sharjah, UAE. Nutrients. [ Internet] 2019 [Citied 2019 Aug];11(8):1939. Available from https://www.mdpi.com/2072-6643/11/8/1939
(7) Gorczyca AM, Sjaarda LA, Mitchell EM, Perkins NJ, Schliep KC, Wactawski-Wende J, et al. Changes in macronutrient, micronutrient, and food group intakes throughout the menstrual cycle in healthy, premenopausal women. European journal of nutrition. [Internet] 2016 Apr 1;55(3):1181-8.
Available from https://link.springer.com/article/10.1007%2Fs00394-015-0931-0
DOI:10.1007/s00394-015-0931-0.