The influence of the menstrual cycle on energy balance and taste preference in Asian Chinese women

The Effect of the Menstrual Cycle on Energy Intake: A Systematic Review and Meta-analysis

CONTEXT

Energy intake may differ across the menstrual cycle, with some studies identifying greater energy intake in the luteal phase (LP) compared with the follicular phase (FP) and others finding no clear differences. To date, no study has systematically synthesized the available data to draw more definite conclusions while considering any methodological inconsistencies between studies.

OBJECTIVE

The aim was to conduct a systematic review/meta-analysis in an effort to determine if there are differences in energy intake between the FP and LP.

DATA SOURCES

A systematic search strategy was developed and the search was conducted in 5 databases for studies that investigated any changes in energy intake across menstrual phases.

DATA EXTRACTION

Using Covidence, studies were identified and included if they contained individuals between the ages of 18 and 45 years, maintained an average body mass index (BMI) of 18.5-25 kg/m2, had no history of disordered eating, and included energy intake and menstrual cycle measurements in the FP and LP.

DATA ANALYSIS

Effect sizes were calculated for each study and a random-effects model was used to pool the results of each study.

RESULTS

Fifteen datasets were included consisting of 330 female participants with a mean age of 26 ± 4 years and mean BMI of 22.4 ± 2.3 kg/m2. Overall, there was a statistically significant difference (standardized mean difference = 0.69; P = .039) with increased energy intake in the LP compared with the FP (crude 168 kcal⋅d-1 average difference between phases).

CONCLUSION

Energy intake was found to be greater in the LP compared with the FP, providing insight into the effect of the menstrual cycle on energy intake. However, there were repeated methodological inconsistencies and future work should strive to utilize best practices for both energy intake measurement and menstrual phase specification.

Resting Energy Expenditure, Metabolic and Sex Hormones in Two Phases of the Menstrual and Hormonal Contraceptive Cycles

INTRODUCTION

Resting energy expenditure (REE) may fluctuate during the menstrual cycle (MC), due to the physiological effects of estradiol (E2) and progesterone. This study examined changes in REE and metabolic hormones (leptin, ghrelin, thyroid hormones), and dietary intake in two hormonally distinct groups, naturally menstruating women (NoOC) and women using monophasic combined oral contraceptives (COC).

METHODS

Measurements included REE by indirect calorimetry, body composition by bioimpedance, and blood samples for hormone analysis in the early follicular and midluteal phases of the MC in the NoOC group ( n = 38) or the active and inactive phases of the COC cycle (COC; n = 19). Participants recorded their food intake for 3 d after measurements. A secondary analysis was completed for the NoOC group without REE outliers (difference between measurements >1.5 × interquartile range, n = 4).

RESULTS

In the NoOC group, luteal phase REE was 40 kcal higher than follicular phase REE (95% confidence interval (CI), -2 to 82 kcal·d -1 , d = 0.20, P = 0.061). Leptin ( d = 0.35, P < 0.001), triiodothyronine (T3; d = 0.26, P = 0.05), and fat intake ( d = 0.48, P = 0.027) were higher, and thyroxine ( d = 0.21, P = 0.041) was lower in the luteal phase. After excluding outliers, REE was 44 kcal higher in the luteal phase than in the follicular phase (95% CI, 12-76 kcal·d -1 , d = 0.22, P = 0.007). In the COC group, the mean difference in REE was -2 kcal (95% CI, -82 to 79 kcal·d -1 ) between active and inactive phases, whereas T3 was higher in the inactive phase ( d = 0.01, P = 0.037).

CONCLUSIONS

REE increases only slightly from the follicular to the luteal phase but remains unchanged between COC phases. Increases in T3, leptin, and fat intake during the luteal phase might echo metabolic fluctuations that parallel female sex hormones during the MC.

Relationships between Premenstrual Syndrome (PMS) and Diet Composition, Dietary Patterns and Eating Behaviors

Premenstrual Syndrome (PMS) is a disorder between gynecology and psychiatry which includes cognitive, affective, and somatic symptoms from mild to severe. The most severe form of PMS is premenstrual dysphoric disorder (PMDD) and it is considered a form of depressive disorder. An association between diet composition and the occurrence of PMS and its severity have been suggested. As such, this manuscript discusses the relationships between diet composition, dietary patterns and eating behaviors, and PMS. PubMed, Embase, Cochrane, and Web of Science databases were searched for related studies up to 18 January 2024. A text search with the following keywords singly or in combination was conducted: "Premenstrual syndrome", "Nutrition", "Diet composition", "Dietary patterns", and "Eating behaviors". Studies published so far showed that low intake of simple carbohydrates, fats, salt, and alcohol, and high of fresh, unprocessed foods rich in B vitamins, vitamin D, zinc, calcium, and omega-3 fatty acids may help prevent the onset of PMS and reduce the severity of its symptoms. However, further studies are needed to formulate definitive recommendations for the use of vitamins, micronutrients and other dietary ingredients supplementation in women with PMS to improve functioning, overall well-being, and physical health. Large, randomized, double-blind clinical trials across diverse populations are necessary to formulate clear recommendations for supplementation in women with PMS.

Menstrual cycle hormones and oral contraceptives: a multimethod systems physiology-based review of their impact on key aspects of female physiology

Hormonal changes around ovulation divide the menstrual cycle (MC) into the follicular and luteal phases. In addition, oral contraceptives (OCs) have active (higher hormone) and placebo phases. Although there are some MC-based effects on various physiological outcomes, we found these differences relatively subtle and difficult to attribute to specific hormones, as estrogen and progesterone fluctuate rather than operating in a complete on/off pattern as observed in cellular or preclinical models often used to substantiate human data. A broad review reveals that the differences between the follicular and luteal phases and between OC active and placebo phases are not associated with marked differences in exercise performance and appear unlikely to influence muscular hypertrophy in response to resistance exercise training. A systematic review and meta-analysis of substrate oxidation between MC phases revealed no difference between phases in the relative carbohydrate and fat oxidation at rest and during acute aerobic exercise. Vascular differences between MC phases are also relatively small or nonexistent. Although OCs can vary in composition and androgenicity, we acknowledge that much more work remains to be done in this area; however, based on what little evidence is currently available, we do not find compelling support for the notion that OC use significantly influences exercise performance, substrate oxidation, or hypertrophy. It is important to note that the study of females requires better methodological control in many areas. Previous studies lacking such rigor have contributed to premature or incorrect conclusions regarding the effects of the MC and systemic hormones on outcomes. While we acknowledge that the evidence in certain research areas is limited, the consensus view is that the impact of the MC and OC use on various aspects of physiology is small or nonexistent.

Dietary energy intake across the menstrual cycle: a narrative review

Females are often underrepresented in the scientific literature, but awareness of the need for female-specific research is increasing. Review articles have been published on the effects of the menstrual cycle on aspects of exercise performance and physiology, yet to date no research has reviewed the effect of menstrual cycle phase on dietary energy intake. Fluctuations in endogenous sex hormones across the menstrual cycle influence a range of physiological processes, including those involved in nutritional status. Observational research typically quantifies female athletes' nutritional intakes at a single time point; however, this may provide inaccurate information if dietary intake fluctuates across the menstrual cycle. Similarly, this may have implications for interventional research, where dietary intake is often poorly controlled or monitored. This review aimed to synthesize the published literature on dietary energy intakes of naturally menstruating females in various phases of the menstrual cycle. The review critiques the relevant literature in light of recent publications on good practice for female research, explores the impact of the menstrual cycle on energy intake, identifies gaps within the evidence base, and informs future research. Overall, energy intake appears to be lower in the follicular phase compared with the luteal phase, with a particular decrease in the days leading up to and including ovulation. The magnitude of these fluctuations is not yet clearly quantifiable and most likely varies, both between individuals, and from cycle to cycle. This review notes the lack of high-quality research investigating the energy intakes of females across the menstrual cycle, and the very limited data available for female athletes and others who undertake large amounts of physical activity. It also highlights the need for researchers to take into consideration anovulatory cycles and the potential effects of premenstrual disorders on dietary intake.

Portions selected to stave off hunger are reduced when food is presented in an 'unusual' food-to-mealtime context: An implication for implicit satiety drivers

Research suggests that the role of expected satiety in influencing portion-size selection is reduced when food is presented in unusual food-to-mealtime contexts; however, the underlying mechanism has not been explored. Other research has revealed that different implicit satiety drivers (e.g., to stop momentary hunger or obtain complete fullness) are associated with different perceived levels of stomach fullness, portion-size selections and can change on instruction. The current study explored whether changes in expected satiety and ideal portions in congruous vs incongruous contexts can be explained by changes in implicit satiety drivers. Another aim was to investigate a previous exploratory finding suggesting that portions selected to stave off hunger are reduced when foods are presented in unusual food-to-mealtime contexts. At two trials (breakfast/lunch), participants (n = 40) selected a portion of typical lunch (pasta) and breakfast (porridge) foods via a psychophysical computer-based method 1) to stave off hunger for 5 h, and 2) as an ideal portion. Participants also indicated their perceived level of stomach fullness associated with 1) each portion, and 2) five implicit satiety drivers. Results revealed that a smaller average portion was selected to stave off hunger in incongruous (vs congruous) food-to-mealtime contexts (531 ± 229 vs 575 ± 236 kcal) (p = 0.008). This suggests that expected satiety is influenced by momentary context; foods are perceived to be more satiating when consumed in unusual (vs usual) contexts. Results also showed that implicit satiety drivers are malleable in regard to the portion size associated with a perceived level of stomach fullness and that this can vary contextually. These findings provide initial evidence to explain the psychological mechanism underlying the contextual differences observed in portion-size selections. Future work should explore longer-term impacts of consuming foods in unusual contexts.

Sakarinin İştah, Enerji Alımı ve Serum Ghrelin Üzerinde Etkisi Var mı? Sağlıklı Erkeklerde Randomize, Kontrollü, Çapraz Bir Çalışma

Amaç: Günümüzde şeker yerine enerji içermeyen yapay tatlandırıcılar yaygın olarak kullanılmaktadır. Ancak bilinenin aksine yapay tatlandırıcıların metabolizmayı çeşitli yönlerden etkilediği düşünülmektedir. Bu çalışmanın amacı sakarinin serum ghrelin düzeyi, iştah ve besin tüketimi üzerindeki etkilerini değerlendirmektir. Metod: Randomize, kontrollü ve çapraz olarak yapılan çalışmaya 20-29 yaşları arasında dokuz sağlıklı erkek katılmıştır. Her katılımcıya 300 ml su, 75 gram sakaroz içeren 300 ml su ve 240 miligram sakarin içeren 300 ml su verilmiştir. Başlangıç, 30., 60., 90., 120. ve 180. dakikalarda iştahı değerlendirmek için Görsel Analog Skala uygulanmış ve ghrelin analizi için kan örnekleri alınmıştır. Yüzsekseninci sonra katılımcılar ad libitum beslenmişler ve her uygulama günün sonuna kadar 24 saatlik diyet besin tüketim kaydı tutmuşlardır. Bulgular: Altmışıncı ve 120. dakikalarda sadece su ve sakarinli içeceklerde ortalama ghrelin düzeyi sükroz içeren içeceğe kıyasla daha yüksektir (p

Females with Diabetes Mellitus Increased the Incidence of Premenstrual Syndrome

Background: Premenstrual syndrome (PMS) is a multifactorial disorder caused by hormone and autonomic imbalance. In our study, hyperglycemia-induced insulin secretion increased progesterone secretion and progressive autonomic imbalance. The young patients with diabetes mellitus (DM) revealed hypo-parasympathetic function and hypersympathetic function compared with nondiabetic controls. Young female patients with DM with higher blood sugar and autonomic malfunction may be associated with PMS. However, there is a lack of evidence about DM in females related to PMS. We evaluated female patients with DM who subsequently followed PMS in a retrospective cohort study. Methods: We retrieved data from the National Health Insurance Research Database in Taiwan. Female patients with DM between 20 and 50 years old were assessed by the International Classification of Disease, 9 Revision, Clinical Modification (ICD-9-CM) disease code of 250. Patients who were DM-free females were fourfold matched to the control group by age and disease index date. The ICD-9-CM disease code of 625.4 identified the incidence of PMS followed by the index date as events. The possible risk factors associated with PMS were detected with a Cox proportional regression. Results: DM was a significant risk factor for PMS incidence with an adjusted hazard ratio of 1.683 (95% confidence interval: 1.104−2.124, p < 0.001) in females after adjusting for age, other comorbidities, season, urbanization status of patients and the hospital status of visiting. Conclusions: This study noted an association between DM and PMS in female patients. Healthcare providers and female patients with DM must be aware of possible complications of PMS, aggressive glycemic control, decreased hyperglycemia and autonomic dysfunction to prevent this bothersome disorder.

Obese Women Have a High Carbohydrate Intake without Changes in the Resting Metabolic Rate in the Luteal Phase

Hormonal changes are caused by the menstrual cycle phases, which influence resting metabolic rate and eating behavior. The aim of the study was to determine resting metabolic rate (RMR) and its association with dietary intake according to the menstrual cycle phase in lean and obese Chilean women. This cross-sectional analytical study included 30 adult women (15 lean and 15 with obesity). Body composition was measured with a tetrapolar bioelectrical impedance meter. Nutritional status was determined by adiposity. A 24-h recall of three nonconsecutive days verifies dietary intake. The RMR was measured by indirect calorimetry. All measurements were performed in both the follicular and luteal phases of the menstrual cycle. Statistical analyses were performed with STATA software at a significance level, which was α = 0.05. The RMR (β = 121.6 kcal/d), temperature (β = 0.36 °C), calorie intake (β = 317.1 kcal/d), and intake of lipids (β = 13.8 g/d) were associated with the luteal phase in lean women. Only extracellular water (β = 1.11%) and carbohydrate consumption (β = 45.2 g/d) were associated in women with obesity. Lean women showed increased RMR, caloric intake, and lipid intake during the luteal phase. For women with obesity, carbohydrate intake increased but not RMR.

Effect of Obesity Surgery on Taste

Obesity surgery is a highly efficacious treatment for obesity and its comorbidities. The underlying mechanisms of weight loss after obesity surgery are not yet fully understood. Changes to taste function could be a contributing factor. However, the pattern of change in different taste domains and among obesity surgery operations is not consistent in the literature. A systematic search was performed to identify all articles investigating gustation in human studies following bariatric procedures. A total of 3323 articles were identified after database searches, searching references and deduplication, and 17 articles were included. These articles provided evidence of changes in the sensory and reward domains of taste following obesity procedures. No study investigated the effect of obesity surgery on the physiological domain of taste. Taste detection sensitivity for sweetness increases shortly after Roux-en-Y gastric bypass. Additionally, patients have a reduced appetitive reward value to sweet stimuli. For the subgroup of patients who experience changes in their food preferences after Roux-en-Y gastric bypass or vertical sleeve gastrectomy, changes in taste function may be underlying mechanisms for changing food preferences which may lead to weight loss and its maintenance. However, data are heterogeneous; the potential effect dilutes over time and varies significantly between different procedures.

Finding the Sweet Spot: Measurement, Modification, and Application of Sweet Hedonics in Humans

Sweetness is a sensation that contributes to the palatability of foods, which is the primary driver of food choice. Thus, understanding how to measure the appeal (hedonics) of sweetness and how to modify it are key to effecting dietary change for health. Sweet hedonics is multidimensional so can only be captured by multiple approaches including assessment of elements such as liking, preference, and consumption intent. There are both innate and learned components to the appeal of sweet foods and beverages. These are responsive to various behavioral and biological factors, suggesting the opportunity to modify intake. Given the high amount of added sugar intake in the United States and recommendations from many groups to reduce this, further exploration of current hypothesized approaches to moderate sugar intake (e.g., induced hedonic shift, use of low-calorie sweeteners) is warranted.

Effect of menstrual cycle on resting metabolism: A systematic review and meta-analysis

Background

The need to control for the potential influence of menstrual cycle phase on resting metabolism (RMR) places a burden on research participants who must self-report onset of menstruation and researchers who must schedule metabolic testing accordingly.

Purpose

To systematically review and analyze existing research to determine the effect of menstrual cycle on RMR.

Methods

We searched PubMed, CINAHL, MEDLINE, SPORTDiscus, and Scopus databases using the search terms “menstrual cycle and metabolic rate” and “menstrual cycle and energy expenditure.” Eligibility criteria were English language, single-group repeated measures design, and RMR as either a primary or secondary outcome. Risk of bias was assessed based on study sample, measurement, and control of confounders. Differences between the follicular and luteal phases of the menstrual cycle were analyzed using the standardized mean difference in effect size.

Results

Thirty English-language studies published between 1930 and December 2019 were included in the systematic review, and 26 studies involving 318 women were included in the meta-analysis. Overall, there was a small but significant effect favoring increased RMR in the luteal phase (ES = 0.33; 95% CI = 0.17, 0.49, p < 0.001).

Discussion

Limitations include risk of bias regarding measurement of both menstrual cycle and RMR. Sample sizes were small and studies did not report control of potential confounders. Sub-group analysis demonstrated that in more recent studies published since 2000, the effect of menstrual phase was reduced and not statistically significant (ES = 0.23; 95% CI = -0.00, 0.47; p = 0.055). Until larger and better designed studies are available, based on our current findings, researchers should be aware of the potential confounding influence of the menstrual cycle and control for it by testing consistently in one phase of the cycle when measuring RMR in pre-menopausal women.

Effects of the Menstrual Cycle on Running Economy: Oxygen Cost Versus Caloric Cost

Purpose: This study investigated the effects of the menstrual cycle on running economy (RE). Method: Eleven eumenorrheic female athletes (mean age: 21.18 ± 3.65 years, height: 170.2 ± 6.6 cm, VO₂max: 49.25 ± 9.15 mL·kg^-1·min^-1, and menstrual cycle: 29.8 ± 0.98 days) were tested for anthropometric variables, physiological responses (oxygen consumption [VO₂], blood lactate [LA], heart rate [HR], and respiratory exchange ratio [RER]) at rest and while running. The RE was measured at speeds of 75%, 85%, and 95% of the lactate threshold at 3.5 mmol·L^-1 during the follicular (FP) and luteal phases (LP) of the menstrual cycle. The RE was evaluated as oxygen consumption (mL·kg·min^-1 [O_{2C_}min], mL·kg^-1·km^-1 [O_{2C_}km]) and caloric unit cost (kcal·kg^-1·km^-1 [E_C]) during both phases. Results: There were no significant differences in body composition or resting physiological measurements between the LP and FP (p > .05). Physiological responses measured during RE tests were similar in both phases (p > .05). The RE measured as O_{2C_}min, O_{2C_}km, and E_C was significantly lower during the LP than during the FP (p < .05). The RE defined as O_{2C_} min significantly increased with speed (p < .05), but RE defined as O_{2C_}km and E_C was unaffected by speed increment (p > .05). Conclusions: The RE is better in the LP than the FP and is independent of running speed when RE is evaluated as O_{2C_}km and E_C. The menstrual cycle had no effect on body composition and physiological variables measured at rest.

Does basal metabolic rate drive eating rate?

There have been recent advances in our understanding of the drivers of energy intake (EI). However, the biological drivers of differences in eating rate (ER) remain less clear. Studies have reported that the fat-free mass (FFM) and basal metabolic rate (BMR) are both major components that contribute to daily energy expenditure (EE) and drive EI. More recently, a number of observations report that higher ER can lead to greater EI. The current study proposed that adults with a higher BMR and higher energy requirements would also exhibit higher ERs. Data on BMR, FFM, and ER were collected from 272 Chinese adults (91 males and 181 females) in a cross-sectional study. Analysis showed significant positive associations between BMR and ER (r_s = 0.405, p < 0.001), and between FFM and ER (r_s = 0.459, p < 0.001). BMR explained about 15% of the variation in ER which was taken to be metabolically significant. This association provides metabolic explanation that the differences in an individual's BMR (hence energy requirements) may be correlated with ERs. This merits further research.

Effect of Roux-en-Y gastric bypass and sleeve gastrectomy on taste acuity and sweetness acceptability in postsurgical subjects

OBJECTIVE

Data on taste acuity after bariatric surgery are scarce, and taste perception after sleeve gastrectomy, to our knowledge, has never been investigated. The objective of this work was to retrospectively compare taste acuity and sweetness acceptability after Roux-en-Y gastric bypass and sleeve gastrectomy.

METHODS

Subjects with a postoperative period ≥6 mo were recruited (between January and June 2012) for a non-randomized, observational study. Subjects completed sensory evaluation sessions consisting of measurement of detection thresholds for bitterness and sweetness (N = 21), saltiness and sourness (N = 19), and sweetness acceptability (N = 19). Significance was established with Tukey's honest significant difference test and analysis of variance using the SAS GLM procedure.

RESULTS

Sourness threshold was significantly higher among subjects who had undergone Roux-en-Y gastric bypass (P = 0.0045). No other differences were obtained for the other thresholds or sweetness acceptability (P > 0.05).

CONCLUSIONS

Further randomized studies are needed to clarify these differences.