Modest changes in dietary intake across the menstrual cycle: implications for food intake research

Oligofructose-Enriched Inulin Consumption Acutely Modifies Markers of Postexercise Appetite

Enhancing the effectiveness of exercise for long-term body weight management and overall health benefits may be aided through complementary dietary strategies that help to control acute postexercise energy compensation. Inulin-type fructans (ITFs) have been shown to induce satiety through the modified secretion of appetite-regulating hormones. This study investigated the acute impact of oligofructose-enriched inulin (OI) consumption after exercise on objective and subjective measures of satiety and compensatory energy intake (EI). In a randomized crossover study, following the completion of a 45 min (65-70% VO2peak) evening exercise session, participants (BMI: 26.9 ± 3.5 kg/m2, Age: 26.8 ± 6.7 yrs) received one of two beverages: (1) sweetened milk (SM) or (2) sweetened milk + 20 g OI (SM+OI). Perceived measures of hunger were reduced in SM+OI relative to SM (p = 0.009). Within SM+OI, but not SM, plasma concentrations of GLP-1 and PYY were increased and acyl-ghrelin reduced from pre-exercise to postexercise. EI during the ad libitum breakfast in the morning postexercise tended to be lower in SM+OI (p = 0.087, d = 0.31). Gastrointestinal impacts of OI were apparent with increased ratings of flatulence (p = 0.026, d = 0.57) in participants the morning after the exercise session. Overall, the ingestion of a single dose of OI after an exercise session appears to induce subtle reductions in appetite, although the impact of these changes on acute and prolonged EI remains unclear.

Determinants and Assessment of Menstrual Blood Flow

Purpose of review

a)The modifiable and non-modifiable determinants and the currently available methods of assessment of menstrual blood flow will be discussed, with the goal of helping healthcare providers, researchers, and those interested in public health.

Recent findings

b)Several factors can impact menstruation. The determinants include modifiable factors such as smoking, nutrition, exercise, stress, weight fluctuation, and benign gynecologic diseases, and non-modifiable factors such as age, race, and the individual's genes. The intertwined dynamic among these determinants needs more critical attention. Currently, the methods for the assessment of menstruation all have advantages and disadvantages, often with a tradeoff between practicality and accuracy.

Summary

c)Considered by many as the fifth vital, menstruation provides a window to an individual's general health. The discussion of its determinants and assessment can be more appropriate for individual contexts, especially from a public health perspective as it can improve the reproductive health of the population.

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.

Micronutrient intake and premenstrual syndrome in female collegiate athletes

BACKGROUND

In non-athletic populations micronutrient consumption is associated with premenstrual syndrome (PMS). PMS can be a debilitating condition for female athletes as it may affect their performance and training. This study investigated potential differences in select micronutrients' intake in female athletes with or without PMS.

METHODS

Participants were thirty NCAA Division I eumenorrheic female athletes ages 18-22 years not using oral contraceptives. Participants were classified with or without PMS using the Premenstrual Symptoms Screen tool. Participants completed dietary logs (two weekdays and one weekend day) one week before their projected menstruation. Logs were analyzed for caloric, macronutrient, food sources, and vitamin D, Mg, and Zn intake. Non-parametric independent T-Tests determined differences in the median and Mann-Whitney U tests determined differences in the distribution between groups.

RESULTS

23% of the 30 athletes showed PMS. There were no significant (P>0.22) for all comparisons) differences between groups for daily kilocalories (2150 vs. 2142 kcals), carbohydrates (278 vs. 271g), protein (90 vs. 100.2g), fats (77 vs. 77.2g), grains (224.0 vs. 182.6g), dairy (172.4 vs. 161.0g). vegetables (95.3 vs. 263.1g), or fruits (204.1 vs. 156.5g). A statistical trend (P=0.08) indicated differences in vitamin D intake (39.4 vs. 66.0 IU), but not for Mg (205.0 vs. 173.0 mg), or Zn (11.0 vs. 7.0mg) between groups.

CONCLUSIONS

No association was found between Mg, and Zn intake and PMS. However, lower vitamin D intake tended to be associated with presenting PMS in female athletes. Further studies should include vitamin D status to clarify this potential association.

Impact of nutritional diet therapy on premenstrual syndrome

Premenstrual syndrome (PMS) is one of the most common disorders faced by women of reproductive age. More than 200 symptoms of varying severity associated with PMS have been identified. Because of the broad spectrum of action of PMS and its impact on quality of life, symptom relief is the main challenge of treating PMS and premenstrual dysphoric disorder (PMDD). The review aims to analyze and identify the potential impact of dietary and nutritional therapies on PMS and, respectively, for its better management. The study was conducted by accessing Internet databases such as PubMed, ScienceDirect, and Scopus and using relevant keywords such as PMS, symptoms, dietary patterns (DPs), macro and micronutrients, and supplements. The results showed that diet is an essential modulating factor in reducing and managing PMS symptoms. But research on the actual effect of foods and nutrients on PMS is sparse, sporadic, and studied with insufficient scientific rigor. No correlations were identified between the consumption of macronutrients and PMS: protein, fat, carbohydrates, and fiber, but the effectiveness of micronutrients, especially calcium, magnesium, vitamin D, B vitamins, and herbal supplements, was demonstrated. Researchers remain unanimous that the evidence is insufficient and limited to support their use as an effective treatment. Nevertheless, the results could contribute to providing quality information to help women and girls make evidence-based decisions regarding premenstrual health and the adoption of dietary and nutritional therapies.

Association between Dietary Habits and Severity of Symptoms in Premenstrual Syndrome

BACKGROUND

Premenstrual syndrome (PMS) is a set of physical, psychological, and emotional symptoms that occur during the luteal phase of the menstrual cycle. The etiopathogenesis of this condition is not fully understood, and several studies suggest a possible role of environmental factors, such as diet. The aim of this work was to investigate the relationship between dietary habits and the occurrence and severity of PMS.

METHODS AND RESULTS

Forty-seven women were enrolled in the study. Participants were asked to complete the Daily Record of Severity of Problems (DRSP) to diagnose PMS and to complete a three-day food record during the perimenstrual phase. Thirty women completed the study (16 with PMS and 14 controls). An analysis of the food diaries revealed no differences between the women with PMS and the control subjects in terms of total energy intake (1649 vs. 1570 kcal/day), diet composition, and the consumption of macro- or micronutrients, except for copper, whose consumption was higher in women with PMS than in the control subjects (1.27 ± 0.51 vs. 0.94 ± 0.49 mg/d, p < 0.05).

CONCLUSIONS

The data presented here are very preliminary, and only a significant difference in copper intake was found when comparing women with PMS and controls. Larger studies are needed to better define how diet may contribute to the exacerbation of the psychological and somatic symptoms associated with PMS and whether PMS itself may influence macro- or micronutrient intake by changing dietary habits.

Factors Associated with the Prevalence and Severity of Menstrual-Related Symptoms: A Systematic Review and Meta-Analysis

This study aimed to identify factors associated with the prevalence and severity of menstrual-related symptoms. The protocol was registered in PROSPERO (CRD42021208432). We conducted literature searches of PubMed and Ichushi-Web and used the Jonna Briggs Institute critical appraisal checklist to assess the quality. Of the 77 studies included in the meta-analysis, significant odds ratios (ORs) were obtained for eight factors associated with primary dysmenorrhea (PD): age ≥ 20 years (OR: 1.18; 95% confidence interval [CI]: 1.04−1.34), body mass index (BMI) < 18.5 kg/m2 (OR: 1.51; 95% CI: 1.01−2.26), longer menstrual periods (OR: 0.16; 95% CI: 0.04−0.28), irregular menstrual cycle (OR: 1.28; 95% CI: 1.13−1.45), family history of PD (OR: 3.80; 95% CI: 2.18−6.61), stress (OR: 1.88; 95% CI: 1.30−2.72), sleeping hours < 7 h (OR: 1.19; 95% CI: 1.04−1.35), and bedtime after 23:01 (OR: 1.30; 95% CI: 1.16−1.45). Two factors were associated with severity of PD (moderate vs. severe): BMI < 18.5 kg/m2 (OR: 1.89; 95% CI: 1.01−3.54) and smoking (OR: 1.94; 95% CI: 1.08−3.47). PD severity (mild vs. severe) and prevalence of premenstrual syndrome were associated with BMI < 18.5 kg/m2 (OR: 1.91; 95% CI: 1.04−3.50) and smoking (OR: 1.86; 95% CI: 1.31−2.66), respectively. The identified risk factors could be utilized to construct an appropriate strategy to improve menstrual symptoms and support women’s health.

Food preferences throughout the menstrual cycle - A computer-assisted neuro-endocrino-psychological investigation

BACKGROUND

As eating behavior changes in relation to the menstrual cycle and weight changes with menopausal transition, ovarian hormones appear to be involved in regulating eating behavior. However, observations are contradictory and are difficult to compare, due to methodological problems related to nutritional epidemiology. To better understand the relationship between ovarian steroid hormones and eating behavior, our study evaluates women's responses to visual food cues at different points in the menstrual cycle with their specific serum estrogen/progesterone levels and women's responses in the case of strong estrogen changes in the context of fertility treatments.

METHODS

We collected data from 129 women, 44 of whom received in vitro fertilization (IVF) at the Department of Reproductive Endocrinology, University Hospital Zurich. A total of 85 women with natural cycles were recruited at the University Hospital Zurich (n = 37) and at the Hannover Medical School (n = 48). Our observational study used 4 different measurement time points across the natural cycle and 2 measurement time points in women with supraphysiological estradiol levels during fertility treatments. Using a second cycle, we then tested our results for replication. At these predefined time points, women were shown pictures of 11 categories of food, with 4 items for each category and blood samples for measurement of hormone levels were taken. Food preferences registered at the time of the investigation were indicated on a visual analogue scale (0-100).

RESULTS

We did not find any statistically significant association between women's serum hormone levels and the rating of visually presented food, either during the menstrual cycle or during fertility treatments after controlling for multiple testing (all p > 0.005). Ratings for fruits, vegetables, and carbohydrates showed a significant linear decline throughout the first menstrual cycle (p < 0.01), which did not replicate in the second cycle (p > 0.05). In contrast, the ratings for sweets showed a significant linear decline in both cycles (both p < 0.01), with a mean rating of 54.2 and 48.8 in the menstrual phase of the first and second cycle, respectively, to a mean rating of 47.7 and 43.4 in the premenstrual phase of the first and second cycle, respectively. During fertility treatments, no food rating showed a significant change (all p > 0.05). Mood such as negative and positive affects did not influence ratings for visual food cues neither throughout the menstrual cycles nor during fertility treatment.

CONCLUSIONS

Serum levels of estradiol and progesterone do not correlate with food ratings in women, even when estradiol levels are above the physiological level of a natural menstrual cycle. Since, except for sweets, significant changes in food ratings in a first cycle did not replicate in a second menstrual cycle, significant findings from the literature based on animal or human studies focusing on a single-cycle have to be interpreted with caution.

The effects of Transcranial Direct Current Stimulation on food craving and food intake in individuals affected by obesity and overweight: a mini review of the magnitude of the effects

Obesity represents one of the wellness diseases concurring to increase the incidence of diabetes, cardiovascular diseases, and cancer. One of the main perpetuating factors of obesity is food craving, which is characterized by an urgent desire to eat a large and various amount of food, regardless of calories requirement or satiety signals, and it might be addressed to the alteration of the dorsolateral prefrontal cortex (DLPFC) activity. Despite most of the gold-standard therapies focus on symptom treatment only, non-invasive brain stimulation techniques such as transcranial direct current stimulation (tDCS) could help treat overeating by modulating specific neural pathways. The current systematic review was conducted to identify whether convergent evidence supporting the usefulness of tDCS to deal with food craving are present in the literature. The review was conducted by searching articles published up to January 1^st 2022 on MEDLINE, Scopus and PsycInfo databases. We included studies investigating the effects of tDCS on food craving in subjects affected by overweight and obesity. According to eligibility criteria, 5 articles were included. Results showed that tDCS targeting left DLPFC with unipolar montage induced ameliorating effects on food craving. Controversial results were shown for the other studies, that might be ascribable to the use of bipolar montage, and the choice of other target areas. Further investigations including expectancy effect control, larger sample sizes and follow-up are needed to support more robust conclusions. To conclude, tDCS combined with the use of psychoeducative intervention, diet and physical activity, might represents a potential to manage food craving in individuals with overweight and obesity.

Individual characteristics, including olfactory efficiency, age, body mass index, smoking and the sex hormones status, and food preferences of women in Poland

Background

Food choices made by most people mainly depend on food preferences. Knowing how certain factors affect food preferences can help dietitians working with women to understand the relationship between individual factors and the challenges faced by the women in changing eating habits. The aim of the study was to examine the food preferences of women and to assess the impact of the sense of smell, age, body mass index (BMI), smoking and hormonal status (phase of the menstrual cycle, hormonal contraception) on the declared pleasure derived from eating various types of food.

Methods

A total of 190 women living in the Górnośląsko-Zagłębiowska Metropolis in Poland aged 18-75 (19.29-26.71 RNO) years participated in the study. The collected survey data included age, BMI, smoking, phase of the menstrual cycle and hormonal contraception. Olfactory sensitivity was measured by T08 olfactometer. Additionally, food preferences were assessed, using 24 different food types, which were presented as pictures. To evaluate food preferences 10 cm visual analogue scale was used.

Results

The most liked foods were: fruits (M = 8.81, SD = 1.67), sweet desserts (M = 8.44, SD = 2.30), vegetables and salads (M = 8.08, SD = 2.24), chocolate (M = 7.84, SD = 2.76), and poultry (M = 7.30, SD = 2.47). The least liked foods were: salty products (M = 4.98, SD = 3.03), milk soup (M = 3.30, SD = 3.13), and seafood (M = 2.99, SD = 3.28). The influence of the analyzed factors on the degree of liking six food types was shown. Women with better ability to name scents preferred sausages/ham and beef/pork. Women with a higher BMI had lower preference for jellybeans and broth. Women who were heavier smokers had lower preference for milk soup. In women using hormonal contraception, pleasure from eating sausages and ham was higher than compared to women in all phases of the monthly cycle. In women in the follicular phase the pleasure from eating pasta was lower when compared to women in the ovulatory phase, the luteal phase and those using hormonal contraception. In women in the ovulatory phase the pleasure from eating candies and jellybeans was lower when compared to women in the follicular phase, the luteal phase and those using hormonal contraception. In women in the ovulatory phase, also pleasure from eating broth was lower when compared to women in the luteal phase and those using hormonal contraception.

Conclusions

Among women in Poland, the top five preferred food types are fruits, sweet desserts, vegetables/salads, chocolate and poultry. To confirm the extent to which the declared pleasure derived from eating these food types translates into health condition, further research on the consumption of these food types is necessary. The impact of the sense of smell, BMI, smoking, or menstrual cycle phase and hormonal contraception on the declared pleasure derived from eating was observed for six out of twenty-four food types. The hormonal status was the factor most significantly influencing food preferences.

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.

The importance of estradiol for body weight regulation in women

Obesity in women of reproductive age has a number of adverse metabolic effects, including Type II Diabetes (T2D), dyslipidemia, and cardiovascular disease. It is associated with increased menstrual irregularity, ovulatory dysfunction, development of insulin resistance and infertility. In women, estradiol is not only critical for reproductive function, but they also control food intake and energy expenditure. Food intake is known to change during the menstrual cycle in humans. This change in food intake is largely mediated by estradiol, which acts directly upon anorexigenic and orexigenic neurons, largely in the hypothalamus. Estradiol also acts indirectly with peripheral mediators such as glucagon like peptide-1 (GLP-1). Like estradiol, GLP-1 acts on receptors at the hypothalamus. This review describes the physiological and pathophysiological mechanisms governing the actions of estradiol during the menstrual cycle on food intake and energy expenditure and how estradiol acts with other weight-controlling molecules such as GLP-1. GLP-1 analogs have proven to be effective both to manage obesity and T2D in women. This review also highlights the relationship between steroid hormones and women's mental health. It explains how a decline or imbalance in estradiol levels affects insulin sensitivity in the brain. This can cause cerebral insulin resistance, which contributes to the development of conditions such as Parkinson's or Alzheimer's disease. The proper use of both estradiol and GLP-1 analogs can help to manage obesity and preserve an optimal mental health in women by reducing the mechanisms that trigger neurodegenerative disorders.

Lower Energy-Dense Ready Meal Consumption Affects Self-Reported Appetite Ratings with No Effect on Subsequent Food Intake in Women

Slimming World (SW), a commercial weight management organisation, has designed a range of low energy-dense ready meals (LEDRMs) in line with their programme. This randomised crossover study compared commercially available equicaloric ready meals differing in energy density on satiety and food intake. It was hypothesised that the LEDRM would reduce energy intake (EI) whilst increasing fullness and reducing hunger compared to higher energy-dense ready meal (HEDRM, control). A total of 26 female participants (aged 18–65 years; body mass index of 28.8 ± 3.0 kg·m⁻²) attended two test days. The participants ate a standard breakfast, and four hours later, ate either a LEDRM or HEDRM at lunch. EI was measured four hours later at an ad libitum tea. Satiety measurements were recorded throughout the day using visual analogue scales and a weighed food diary was completed for the remainder of the day. The results revealed that the LEDRM reduced hunger and increased fullness (both p < 0.001). There was no difference in EI at the evening meal between the ready meals (p > 0.05), however, during the whole LEDRM testing day, the participants consumed significantly less fat (7.1%) and saturated fat (3.6%) (both p < 0.01), but significantly more carbohydrates, sugars, fibre, protein, and salt (all p < 0.01). The results indicate that the participants felt more satiated after consuming ready meals of the same energy content but larger portion size. Despite no significant difference in short-term EI between the ready meals, the results indicated that the LEDRM produced beneficial subjective satiety responses and, therefore, can help to improve the nutritional content of meals i.e., reduce saturated fat consumption.

The Specificities of Elite Female Athletes: A Multidisciplinary Approach

Female athletes have garnered considerable attention in the last few years as more and more women participate in sports events. However, despite the well-known repercussions of female sex hormones, few studies have investigated the specificities of elite female athletes. In this review, we present the current but still limited data on how normal menstrual phases, altered menstrual phases, and hormonal contraception affect both physical and cognitive performances in these elite athletes. To examine the implicated mechanisms, as well as the potential performances and health risks in this population, we then take a broader multidisciplinary approach and report on the causal/reciprocal relationships between hormonal status and mental and physical health in young (18-40 years) healthy females, both trained and untrained. We thus cover the research on both physiological and psychological variables, as well as on the Athlete Biological Passport used for anti-doping purposes. We consider the fairly frequent discrepancies and summarize the current knowledge in this new field of interest. Last, we conclude with some practical guidelines for eliciting improvements in physical and cognitive performance while minimizing the health risks for female athletes.

Association of fine-particulate and acidic-gas air pollution with premenstrual syndrome risk

OBJECTIVE

Air pollution had been reported to be associated with the reproductive health of women. However, the association of particulate matter (PM) and acid gases air pollution with premenstrual syndrome (PMS) warrants investigation. This study investigated the effects of air pollution on PMS risk.

POPULATION

We combined data from the Taiwan Air Quality-Monitoring Database and the Longitudinal Health Insurance Database. In total, an observational cohort of 85 078 Taiwanese women not diagnosed as having PMS.

METHODS

Air pollutant concentrations were grouped into four levels based on the concentration quartiles of several types of air pollutants.

MAIN OUTCOME MEASURES

We then applied univariable and multivariable Cox proportional hazard regression models to assess PMS risk in association with each pollutant type.

RESULTS

Women exposed to Q4-level SO2 exhibited a 7.77 times higher PMS risk compared with those to Q1-level SO2 (95% confidence interval [CI] = 6.22-9.71). Women exposed to Q4-level NOx exhibited a 2.86 times higher PMS risk compared with those exposed to Q1-level NOx (95% CI = 2.39-3.43). Women exposed to Q4-level NO exhibited a 3.17 times higher PMS risk compared with women exposed to Q1-level NO (95% CI = 2.68-3.75). Finally, women exposed to Q4-level PM with a ≤2.5-µm diameter (PM2.5) exhibited a 3.41 times higher PMS risk compared with those exposed to Q1-level PM2.5 (95% CI = 2.88-4.04).

CONCLUSIONS

High incidences of PMS were noted in women who lived in areas with higher concentrations of SO2, NOx, NO, NO2 and PM2.5.

Influence of postexercise fasting on hunger and satiety in adults

Research demonstrates that exercise acutely reduces appetite by stimulating the secretion of gut-derived satiety hormones. Currently there is a paucity of research examining the impact of postexercise nutrient intake on appetite regulation. The objective of this study was to examine how postexercise fasting versus feeding impacts the postexercise appetite response. In a randomized crossover intervention, 14 participants (body mass index: 26.9 ± 3.5 kg·m^-2; age: 26.8 ± 6.7 years) received 1 of 2 recovery beverages: (i) water control (FAST) or (ii) sweetened-milk (FED) after completing a 45-min (65%-70% peak oxygen uptake) evening exercise session (∼1900 h). Energy intake was assessed through a fasted ad libitum breakfast meal and 3-day food diaries. Perceived appetite was assessed using visual analogue scales. Appetite-regulating hormones glucagon-like peptide-1 (GLP-1), peptide tyrosine-tyrosine (PYY), and acyl-ghrelin were assessed pre-exercise, 1 h after exercise, and the morning following exercise. FAST increased subjective hunger compared with FED (P < 0.05). PYY and GLP-1 after exercise were decreased and acyl-ghrelin was increased in FAST, with these differences disappearing the day after exercise (P < 0.05). Ad libitum energy intake at breakfast the following morning did not differ between trials. Overall, in the absence of postexercise macronutrient consumption, there was a pronounced increase in objective and subjective appetite after exercise. The orexigenic effects of postexercise fasting, however, were not observed the morning following exercise. Novelty Postexercise fasting leads to reduced GLP-1 and PYY and increased hunger. Reduced GLP-1 and PYY after exercise is blunted by postexercise nutrient intake. Energy intake the day after exercise is not influenced by postexercise fasting.

Association Between Smoking and Premenstrual Syndrome: A Meta-Analysis

Results of basic science studies demonstrate shared actions of endogenous neuroactive steroid hormones and drugs of abuse on neurotransmission. As such, premenstrual syndrome (PMS) may be associated with smoking, however, results from studies examining this relationship have been mixed. Following PRISMA guidelines, we extracted unique studies examining the relationship between smoking and PMS. We used the escalc () function in R to compute the log odds ratios and corresponding sampling variance for each study. We based quality assessment on the nature of PMS diagnosis and smoking estimation, confounding adjustment, participation rate, and a priori specification of target population. Our final sample included 13 studies, involving 25,828 study participants. Smoking was associated with an increased risk for PMS [OR = 1.56 (95% CI: 1.25-1.93), p < 0.0001]. Stratified by diagnosis, the effect size estimate was higher for Premenstrual Dysphoric Disorder (PMDD) [OR = 3.15 (95% CI: 2.20-4.52), p < 0.0001] than for PMS [OR = 1.27 (95% CI: 1.16-1.39), p < 0.0001]. We review some of the basic mechanisms for the observed association between smoking and PMS. Given nicotine's rewarding effects, increased smoking behavior may be a mechanism to alleviate affective symptoms of PMS. However, smoking may lead to worsening of PMS symptoms because nicotine has effects on neurocircuitry that increases susceptibility to environmental stressors. Indeed, prior evidence shows that the hypothalamic-pituitary-adrenal (HPA) axis is already sub-optimal in PMS, hence, smoking likely further deteriorates it. Combined, this complicates the clinical course for the treatment of both PMS and Tobacco Use Disorder in this population.

Adolescents with premenstrual syndrome: not only what you eat but also how you eat matters!

Background Current literature suggests that diet is involved in either the development of premenstrual syndrome (PMS) or contributes to symptom severity, but to date, there are no studies evaluating eating attitudes of adolescents with PMS. The aim of this study was to evaluate dietary intake and eating attitudes in adolescents with PMS. Methods This study was conducted with 383 adolescents (214 with and 169 without PMS), aged 13-19 years. PMS was diagnosed using the premenstrual syndrome scale (PMSS). The Food Frequency Questionnaire (FFQ) and 24-h dietary recall were used to assess dietary intake. The Eating Attitudes Test-26 (EAT-26) and Three Factor Eating Questionnaire-Revised 18 (TFEQ-R18) were used to evaluate eating attitudes. Anthropometrical measurements and bone mineral content were measured. Results PMS prevalence was 55.9% according to PMSS subscales. Disordered eating attitudes determined by EAT-26 was detected in 23.8% in the PMS group and 11.8% of the control group (p<0.05). In the PMS group, total TFEQ-R18 score, emotional eating behavior and uncontrolled eating behavior scores were significantly higher (p<0.001). Whereas no significant difference in dietary intake, anthropometrical measurements or bone mineral content was observed between the two groups. Conclusions This is the first study documenting that not dietary intake but eating attitudes can be associated with PMS in adolescents. It is important to understand the relationship between disordered eating behaviors and PMS as both conditions may trigger the other.

The Impact of Menstrual Cycle Phases on Cardiac Autonomic Nervous System Activity: An Observational Study Considering Lifestyle (Diet, Physical Activity, and Sleep) among Female College Students

Studies examining the impact of menstrual cycle phases on the cardiac autonomic nervous system have produced inconsistent results. This study aimed to investigate this relationship, controlling for the confounding effects of diet, physical activity, and sleep, which can be affected by the menstrual cycle. Fifteen female college students with regular menses were enrolled. Data regarding 24-h heart rate variability (HRV), dietary intake, eating behavior, menstrual distress, and sleep and activity parameters were obtained during the follicular and luteal phases. Power spectral analysis of HRV was used to calculate low-frequency (0.04-0.15 Hz, LF), high-frequency (>0.15 Hz, HF), and total spectral power (TP). Cardiac sympathetic and parasympathetic nervous system activity indicators were evaluated as LF/HF and HF/TP, respectively. Intake of protein and fat, as well as total sleep time and number of awakenings, were higher in the luteal phase than in the follicular phase (p<0.05). Tendencies for increased mean activity counts, emotional eating scores, and behavioral change scores in the Menstrual Distress Questionnaire were observed in the luteal phase (p<0.10). Although LF/HF was higher in the luteal phase (p=0.036), the relationship was weakened after controlling for diet, physical activity, and sleep (p=0.113). Our findings suggest that altering sympathetic nervous system activity during the menstrual cycle was not independent from major lifestyle factors (diet, physical activity, and sleep). Menstrual cycle phase and changes of these parameters should be considered when assessing the cardiac autonomic function among menstruating woman.

Objective and Subjective Eating Speeds Are Related to Body Composition and Shape in Female College Students

Eating speed reportedly relates to body composition and shape. Little is known about the relationship between the objectively assessed eating speed and the body composition and shape. This study examined relationships between eating speed as assessed both objectively and subjectively, and body composition and shape. The following variables of body composition and shape were measured in 84 female college students: body mass, relative body fat mass (%Fat), body mass index (BMI), and circumferences of the waist, abdomen and hip. After measuring the body composition and shape, subjects consumed a 174-kcal salmon rice ball. The following chewing variables were measured by observing videotape recordings of the subjects' faces: number of chews per bite, total number of chews, total meal duration, number of bites, and chewing rate. The subjects were categorized into three groups (fast, moderate and slow) according to their own subjective assessments of the actual eating speed. In objective assessments of the eating speed, the total number of chews and the total meal duration were significantly negatively correlated with the body mass, %Fat, BMI, and circumferences of the waist, abdomen and hip. In subjective eating-speed assessments, the body mass, %Fat, BMI, and circumferences of the waist, abdomen and hip were greater in the fast eating group than in the slow eating group. Both the objectively and subjectively assessed eating speeds are related to the body composition and shape. The present study supports that fast eating may relate to gains in body mass and/or fat mass.

Premenstrual syndrome and alcohol consumption: a systematic review and meta-analysis

OBJECTIVE

Premenstrual syndrome (PMS) is a very common disorder worldwide which carries an important economic burden. We conducted a systematic review and a meta-analysis to assess the role of alcohol in the occurrence of PMS.

METHODS

We searched MEDLINE, EMBASE, the five regional bibliographic databases of the WHO, the Proceedings database and the Open Access Thesis and Dissertations (OATD) from inception to May 2017. We also reviewed the references of every article retrieved and established personal contact with researchers to trace further publications or reports. We did not include any language limitations. Studies were included if: (1) they presented original data from cohort, case-control or cross-sectional studies, (2) PMS was clearly defined as the outcome of interest, (3) one of the exposure factors was alcohol consumption, (4) they provided estimates of odds ratios, relative risks, or any other effect measure and their confidence intervals, or enough data to calculate them.

RESULTS

We identified 39 studies of which 19 were eligible. Intake of alcohol was associated with a moderate increase in the risk of PMS (OR=1.45, 95% CI: 1.17 to 1.79). Heavy drinking yielded a larger increase in the risk than any drinking (OR=1.79, 95% CI: 1.39 to 2.32).

DISCUSSION

Our results suggest that alcohol intake presents a moderate association with PMS risk. Future studies should avoid cross-sectional designs and focus on determining whether there is a threshold of alcohol intake under which the harmful effect on PMS is non-existent.

Nitric oxide-heat shock protein axis in menopausal hot flushes: neglected metabolic issues of chronic inflammatory diseases associated with deranged heat shock response

BACKGROUND

Although some unequivocal underlying mechanisms of menopausal hot flushes have been demonstrated in animal models, the paucity of similar approaches in humans impedes further mechanistic outcomes. Human studies might show some as yet unexpected physiological mechanisms of metabolic adaptation that permeate the phase of decreased oestrogen levels in both symptomatic and asymptomatic women. This is particularly relevant because both the severity and time span of hot flushes are associated with increased risk of chronic inflammatory disease. On the other hand, oestrogen induces the expression of heat shock proteins of the 70 kDa family (HSP70), which are anti-inflammatory and cytoprotective protein chaperones, whose expression is modulated by different types of physiologically stressful situations, including heat stress and exercise. Therefore, lower HSP70 expression secondary to oestrogen deficiency increases cardiovascular risk and predisposes the patient to senescence-associated secretory phenotype (SASP) that culminates in chronic inflammatory diseases, such as obesities, type 2 diabetes, neuromuscular and neurodegenerative diseases.

OBJECTIVE AND RATIONALE

This review focuses on HSP70 and its accompanying heat shock response (HSR), which is an anti-inflammatory and antisenescent pathway whose intracellular triggering is also oestrogen-dependent via nitric oxide (NO) production. The main goal of the manuscript was to show that the vasomotor symptoms that accompany hot flushes may be a disguised clue for important neuroendocrine alterations linking oestrogen deficiency to the anti-inflammatory HSR.

SEARCH METHODS

Results from our own group and recent evidence on hypothalamic control of central temperature guided a search on PubMed and Google Scholar websites.

OUTCOMES

Oestrogen elicits rapid production of the vasodilatory gas NO, a powerful activator of HSP70 expression. Whence, part of the protective effects of oestrogen over cardiovascular and neuroendocrine systems is tied to its capacity of inducing the NO-elicited HSR. The hypothalamic areas involved in thermoregulation (infundibular nucleus in humans and arcuate nucleus in other mammals) and whose neurons are known to have their function altered after long-term oestrogen ablation, particularly kisspeptin-neurokinin B-dynorphin neurons, (KNDy) are the same that drive neuroprotective expression of HSP70 and, in many cases, this response is via NO even in the absence of oestrogen. From thence, it is not illogical that hot flushes might be related to an evolutionary adaptation to re-equip the NO-HSP70 axis during the downfall of circulating oestrogen.

WIDER IMPLICATIONS

Understanding of HSR could shed light on yet uncovered mechanisms of menopause-associated diseases as well as on possible manipulation of HSR in menopausal women through physiological, pharmacological, nutraceutical and prebiotic interventions. Moreover, decreased HSR indices (that can be clinically determined with ease) in perimenopause could be of prognostic value in predicting the moment and appropriateness of starting a HRT.

Chewing gum decreases energy intake at lunch following a controlled breakfast

The impact of chewing gum on fasting appetite or meal intake has not been studied. We tested the hypothesis that chewing gum would decrease lunch intake after a controlled breakfast, and reduce hunger in fasting and fed states. Seventeen males and sixteen females (21.4 ± 6.3y, BMI 23.8 ± 2.7 kg/m²) participated in a randomized crossover study in which subjects chewed sugar-free gum a total of 1 h on the test day (GC), and did not chew gum on a control day (NG). The 1 h of gum chewing included 20 min while fasting, and two 20-min sessions between breakfast and lunch. Subjects rated their appetite and mood on visual analog scales. After completing the fasting measures, subjects consumed a breakfast shake containing 30% of their measured resting energy expenditure. Three hours later they consumed an ad libitum lunch with water. Fasting ratings of hunger were lower in GC than NG (t = 2.66, p = 0.01). Subjects consumed significantly less pasta (41 g, 68 kcals, t = 2.32, p = 0.03) during GC than NG. In conclusion, gum chewing decreased fasting hunger ratings and lunch energy consumed. Chewing gum may be a useful tool impacting energy balance in this population. Longer studies, especially in other populations, will be required.

Consuming Almonds vs. Isoenergetic Baked Food Does Not Differentially Influence Postprandial Appetite or Neural Reward Responses to Visual Food Stimuli

Nuts have high energy and fat contents, but nut intake does not promote weight gain or obesity, which may be partially explained by their proposed high satiety value. The primary aim of this study was to assess the effects of consuming almonds versus a baked food on postprandial appetite and neural responses to visual food stimuli. Twenty-two adults (19 women and 3 men) with a BMI between 25 and 40 kg/m² completed the current study during a 12-week behavioral weight loss intervention. Participants consumed either 28 g of whole, lightly salted roasted almonds or a serving of a baked food with equivalent energy and macronutrient contents in random order on two testing days prior to and at the end of the intervention. Pre- and postprandial appetite ratings and functional magnetic resonance imaging scans were completed on all four testing days. Postprandial hunger, desire to eat, fullness, and neural responses to visual food stimuli were not different following consumption of almonds and the baked food, nor were they influenced by weight loss. These results support energy and macronutrient contents as principal determinants of postprandial appetite and do not support a unique satiety effect of almonds independent of these variables.

Is Sweet Taste Perception Associated with Sweet Food Liking and Intake?

A range of psychophysical taste measurements are used to characterize an individual’s sweet taste perception and to assess links between taste perception and dietary intake. The aims of this study were to investigate the relationship between four different psychophysical measurements of sweet taste perception, and to explore which measures of sweet taste perception relate to sweet food intake. Forty-four women aged 20–40 years were recruited for the study. Four measures of sweet taste perception (detection and recognition thresholds, and sweet taste intensity and hedonic liking of suprathreshold concentrations) were assessed using glucose as the tastant. Dietary measurements included a four-day weighed food record, a sweet food-food frequency questionnaire and a sweet beverage liking questionnaire. Glucose detection and recognition thresholds showed no correlation with suprathreshold taste measurements or any dietary intake measurement. Importantly, sweet taste intensity correlated negatively with total energy and carbohydrate (starch, total sugar, fructose, glucose) intakes, frequency of sweet food intake and sweet beverage liking. Furthermore, sweet hedonic liking correlated positively with total energy and carbohydrate (total sugar, fructose, glucose) intakes. The present study shows a clear link between sweet taste intensity and hedonic liking with sweet food liking, and total energy, carbohydrate and sugar intake.

Comparison between the lifestyles of university students with and without premenstrual syndromes

Introduction

Premenstrual syndrome is a common disorder in reproductive age and it is associated with decreased quality of life in women. In view of various factors contributing to outbreak of PMS (premenstrual syndrome) among women, the present study intended to compare lifestyles of university students with and without premenstrual syndromes living in dormitories of Qazvin University of Medical Sciences in 2015.

Methods

The descriptive cross-sectional study recruited 200 university students with and without PMS from students living in dormitories. Data were collected using questionnaires of premenstrual symptoms, questionnaires for diet, perceived stress, and unhealthy behavior. Data were analyzed using descriptive statistics, independent samples t-test, Mann-Whitney, Chi-square, and logistic regression in SPSS version 23.

Results

The results showed that nutrition style (p=0.001), perceived stress (p=0.001), and exposure to passive tobacco smoke (p=0.001) were different between the two groups. Logistic regression analysis showed that nutrition style (p=0.001, OR=0.861), exposure to passive tobacco smoke (p=0.008, OR=2.059), and stress (p=0.001, OR=1.088) were different in both groups.

Conclusion

The research results proved that lifestyle, especially healthy eating habits, and decreasing stress and unhealthy behavior can influence PMS. Therefore, interventions are recommended to improve PMS symptoms.

Non-invasive Prefrontal/Frontal Brain Stimulation Is Not Effective in Modulating Food Reappraisal Abilities or Calorie Consumption in Obese Females

Background/Objectives: Previous studies suggest that non-invasive transcranial direct current stimulation (tDCS) applied to the prefrontal cortex modulates food choices and calorie intake in obese humans.

Participants/Methods: In the present fully randomized, placebo-controlled, within-subject and double-blinded study, we applied single sessions of anodal, cathodal, and sham tDCS to the left dorsolateral prefrontal cortex (DLPFC) and contralateral frontal operculum in 25 hungry obese women and investigated possible influences on food reappraisal abilities as well as calorie intake. We hypothesized that tDCS, (i) improves the ability to regulate the desire for visually presented foods and, (ii) reduces their consumption.

Results: We could not confirm an effect of anodal or cathodal tDCS, neither on the ability to modulate the desire for visually presented foods, nor on calorie consumption.

Conclusions: The present findings do not support the notion of prefrontal/frontal tDCS as a promising treatment option for obesity.

Flavor pleasantness processing in the ventral emotion network

The ventral emotion network–encompassing the amygdala, insula, ventral striatum, and ventral regions of the prefrontal cortex–has been associated with the identification of emotional significance of perceived external stimuli and the production of affective states. Functional magnetic resonance imaging (fMRI) studies investigating chemosensory stimuli have associated parts of this network with pleasantness coding. In the current study, we independently analyzed two datasets in which we measured brain responses to flavor stimuli in young adult men. In the first dataset, participants evaluated eight regular off the shelf drinking products while participants evaluated six less familiar oral nutritional supplements (ONS) in the second dataset. Participants provided pleasantness ratings 20 seconds after tasting. Using independent component analysis (ICA) and mixed effect models, we identified one brain network in the regular products dataset that was associated with flavor pleasantness. This network was very similar to the ventral emotion network. Although we identified an identical network in the ONS dataset using ICA, we found no linear relation between activation of any network and pleasantness scores within this dataset. Our results indicate that flavor pleasantness is processed in a network encompassing amygdala, ventral prefrontal, insular, striatal and parahippocampal regions for familiar drinking products. For more unfamiliar ONS products the association is not obvious, which could be related to the unfamiliarity of these products.

Change in women's eating habits during the menstrual cycle

OBJECTIVES

During the menstrual cycle, the influence of hormonal variations on dietary habits in women has been suggested by several studies. In this context, our work aimed to assess the spontaneous food intake and the anthropometric parameters of women at different periods of their menstrual cycles.

METHODS

This prospective study included 30 healthy women with regular periods (28 to 30 days), aged between 18 and 45. We assessed the spontaneous food intake and the anthropometric measurements (weight and waist circumference) of the participants, during the follicular, peri-ovulatory and luteal phases of their menstrual cycles.

RESULTS

Our results showed a slight but significant increase in body weight during the luteal phase (P=0.022) and the follicular phase (P=0.017) compared with the peri-ovulatory phase, without any significant change in waist circumference. The caloric intake increased during the peri-ovulatory (P<0.001) and the luteal phases (P<0.001), compared with the follicular phase, with a significant increase in carbohydrate (P<0.001), lipid (P=0.008) and protein (P=0.008) intake.

CONCLUSIONS

Our study showed a significant decrease in women's weight during the peri-ovulatory phase, with a significant increase in caloric intake during the luteal phase of the menstrual cycle. Divergent results have been reported by other authors and the physiopathology of these changes is still poorly understood.

Estradiol, SHBG and leptin interplay with food craving and intake across the menstrual cycle

OBJECTIVE

To understand the association between ovarian hormones, non-acute satiety hormones and craving calorie dense foods in the luteal phase.

METHODS

17 premenopausal women, mean age 23.2 y, mean BMI 22.4kg/m(2) with regular menstrual cycles were studied during late follicular (FP) and luteal phases (LP). Estradiol, progesterone, DHEAS, SHBG, insulin and leptin, were measured in fasting samples. The validated Food Craving Inventory was used to record the types of foods volunteers habitually ate - rich in fat, carbohydrate or sweet taste, as well as craved during the LP of their menstrual cycle.

RESULTS

Estradiol was inversely associated with leptin in FP (r=-0.62, p=0.01). Leptin was inversely associated with habitual intake of sweet foods, in both phases (FP: r=-0.64, p=0.01; LP: r=-0.63, p=0.01). SHBG in LP was positively associated with craving sweet and carbohydrate rich foods. Hierarchical cluster analysis revealed two groups of women, one with high estradiol, high estradiol/leptin ratio, high sweet and carbohydrate cravings (p<0.05); the other group had lower estradiol, lower estradiol/leptin ratio, and reported less craving.

CONCLUSIONS

The estradiol-leptin axis may be a determinant of luteal phase craving and habitual food intake in menstruating women.

CLINICAL TRIAL REGISTRATION NUMBER

NCT01407692.

The Effect of Depo Medroxyprogesterone Acetate (DMPA) on Cerebral Food Motivation Centers: A Pilot Study using Functional Magnetic Resonance Imaging

OBJECTIVE

The primary objective is to examine activation of food motivation centers in the brain before and 8 weeks after depo medroxyprogesterone acetate (DMPA) administration.

STUDY DESIGN

This prospective experimental pilot study examined the effects of DMPA on food motivation centers utilizing functional magnetic resonance imaging (fMRI) in eight nonobese, ovulatory subjects. fMRI blood oxygen level dependent (BOLD) signal was measured using a 3-Tesla Scanner while participants viewed images of high-calorie foods, low-calorie foods and nonfood objects. fMRI scans were performed at baseline and 8 weeks after participants received one intramuscular dose of DMPA 150 mg. fMRI data were analyzed using the FMRIB Software Library. Changes in adiposity and circulating leptin and ghrelin levels were also measured.

RESULTS

There was a greater BOLD signal response to food cues in brain regions associated with food motivation (anterior cingulate gyrus, orbitofrontal cortex) 8 weeks after DMPA administration compared to baseline (z>2.3, p<.05 whole-brain analysis clustered corrected). No statistically significant change was detected in circulating leptin or ghrelin levels or fat mass 8 weeks after DMPA administration.

CONCLUSION

Analysis of differences in food motivation may guide the development of interventions to prevent weight gain in DMPA users.

IMPLICATIONS

These data support a neural origin as one of the mechanisms underlying weight gain in DMPA users and may guide future research examining weight gain and contraception.

Expression of melanocortin receptors in human endometrium

STUDY QUESTION

Are melanocortin receptors (MCR1-5) expressed in the endometrium?

SUMMARY ANSWER

MCR1-5 are expressed in endometrium to varying degrees, with MC2R, MC3R and MC5R being the most abundant and the majority of expression being observed in glandular epithelium.

WHAT IS KNOWN ALREADY

Women with Addison's disease who were being administered synthetic ACTH reported menstrual complications as a side effect. There is no previous literature on expression of the melanocortin receptors within the endometrium, and therefore whether ACTH may directly affect the endometrial vasculature.

STUDY DESIGN, SIZE, DURATION

Endometrial biopsies were taken from hysterectomy specimens in control women without endometrial pathology (n = 4 for each of proliferative and late-secretory phases). Biopsies were formalin fixed and embedded in paraffin wax. Decidual samples (n = 7) were cultured in a range of concentrations of synthetic ACTH for 3 days before being formalin fixed and embedded in paraffin wax.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Endometrial paraffin embedded sections were immunostained for MCR1-5 and assessed using a modified quickscore with luminal epithelium, glandular epithelium, stromal cells, endothelial cells and vascular smooth muscle cells all being assessed separately. Cultured decidual biopsy paraffin embedded sections were immunostained for H-caldesmon and the number of layers of vascular smooth muscle cells surrounding the vessel assessed.

MAIN RESULTS AND THE ROLE OF CHANCE

All five melanocortin receptors were shown to be immunolocalised to the endometrium, with MC5R, MC2R and MC3R being the most abundant and limited immunostaining being observed for MC1R and MC4R. Treatment of decidual biopsies with synthetic adrenocorticotropin (ACTH) resulted in loss of vascular integrity.

LIMITATIONS, REASONS FOR CAUTION

This is an observational study and does not definitively demonstrate a link between synthetic ACTH administration and menstrual complications.

WIDER IMPLICATIONS OF THE FINDINGS

This is the first study to demonstrate widespread expression of melanocortin receptors within the endometrium. Further study is required to determine the role of this hormone family in endometrial function.

STUDY FUNDING/COMPETING INTEREST(S)

The work was part funded by MRC grant G09000001. The authors have no competing interests to declare.

TRIAL REGISTRATION NUMBER

Not applicable.

Chewing gum increases energy expenditure before and after controlled breakfasts

Chewing has been associated with improved satiation and satiety, but little is known about the metabolic impact of gum chewing. We tested the hypothesis that gum chewing would increase energy expenditure (EE) and reduce respiratory exchange ratio (RER) before and after a controlled test meal. Seventeen males and 13 females (age 21.5 ± 6.6 years, body mass index 23.9 ± 2.8 kg/m(2)) participated in a randomized crossover study in which subjects chewed sugar-free gum for a total of 1 h (3 sessions of 20 min) on the test day (GC) and did not chew gum on a control day (NG). EE and RER were measured by indirect calorimetry after an overnight fast. Subjects consumed a breakfast shake containing 30% of their measured energy needs, and then postprandial EE and RER were measured for 3 h. Blood glucose (GLC) was measured in the fasting and postprandial states at regular intervals. Fasting EE was higher during GC (1.23 ± 0.04 kcal/min; 1 kcal = 4.2 kJ) than during NG (1.17 ± 0.04 kcal/min; p = 0.016). Postprandial EE was also higher during GC (1.46 ± 0.05 kcal/min) than during NG (1.42 ± 0.05 kcal/min; p = 0.037). Fasting and postprandial RER and GLC did not differ between GC and NG. The findings demonstrate that GC is associated with higher fasting and postprandial EE without altering blood glucose or substrate oxidation as measured by RER. These data suggest that gum chewing potentially could influence short-term energy balance in this population; however, longer-term research is needed.

Blood glucose levels, insulin concentrations, and insulin resistance in healthy women and women with premenstrual syndrome: a comparative study

Objective

To compare the blood glucose levels, insulin concentrations, and insulin resistance during the two phases of the menstrual cycle between healthy women and patients with premenstrual syndrome (PMS).

Methods

From January of 2011 to the August of 2012, a descriptive cross-sectional study was performed among students in the School of Medicine of Jahrom University of Medical Sciences. We included 30 students with the most severe symptoms of PMS and 30 age frequency-matched healthy controls. We analyzed the serum concentrations of glucose, insulin, and insulin resistance by using the glucose oxidase method, radioimmunometric assay, and homeostasis model assessment of insulin resistance equation, respectively.

Results

No significant differences between the demographic data of the control and PMS groups were observed. The mean concentrations of glucose of the two study groups were significantly different during the follicular and luteal phases (p=0.011 vs. p<0.0001, respectively). The amounts of homeostasis model assessment of insulin resistance of the two study groups were significantly different in the luteal phase (p=0.0005).

Conclusion

The level of blood glucose and insulin resistance was lower during the two phases of the menstrual cycle of the PMS group than that of the controls.

Effects of a novel propionate-rich sourdough bread on appetite and food intake

BACKGROUND

There is evidence linking oral propionate to a reduction in food intake, which could confer functional food properties in the fight against obesity. However, propionate is typically volatile with a pungent smell and taste and so incorporating into foods naturally, at levels acceptable to the consumer is a novel approach.

SUBJECTS/METHODS

Twenty healthy, young, normal weight unrestrained eaters underwent an acute feeding study using a palatable sourdough and an identical control bread of a similar palatability, in a randomized cross-over balanced design for the assessment of appetite and energy intake.

RESULTS

No difference in energy intake of an ad libitum test meal, 180 min after the bread-based breakfast or in energy and macronutrient intake over the entire 24 h period was found between breads. Visual analogue scale ratings for appetite were not influenced by bread type, except the desire to eat something sweet. Elevated plasma insulin concentrations were observed following the propionate-rich sourdough breakfast (P=0.033 no effects of treatment on postprandial glycaemia were found.

CONCLUSIONS

These findings suggest propionate-rich sourdough bread does not influence appetite and food intake unlike larger doses of the food preservative N-propionate.

Sex hormones, appetite and eating behaviour in women

Sex hormones play essential roles in the regulation of appetite, eating behaviour and energy metabolism and have been implicated in several major clinical disorders in women. Estrogen inhibits food intake, whereas progesterone and testosterone may stimulate appetite. This review describes recent findings concerning interactions between sex hormones and neuroendocrinological mechanisms in the control of appetite and eating in women. Furthermore, we are gaining insights into the roles played by sex hormones in the development of eating disorders and obesity. For instance, androgens may promote bulimia by stimulating appetite and reducing impulse control, a proposal supported by the observation that antiandrogenic treatment attenuates bulimic behaviour. Androgens are also involved in the pathophysiology of abdominal obesity in women. On the other hand, hormone replacement therapy with estrogen counteracts the weight gain and accumulation of abdominal fat associated with the menopausal transition. In conclusion, sex hormones and/or agents that exhibit similar activities may provide novel strategies for the treatment of eating disorders and android obesity, two of the most serious health problems for women today.

Fighting food temptations: the modulating effects of short-term cognitive reappraisal, suppression and up-regulation on mesocorticolimbic activity related to appetitive motivation

The premise of cognitive therapy is that one can overcome the irresistible temptation of highly palatable foods by actively restructuring the way one thinks about food. Testing this idea, participants in the present study were instructed to passively view foods, up-regulate food palatability thoughts, apply cognitive reappraisal (e.g., thinking about health consequences), or suppress food palatability thoughts and cravings. We examined whether these strategies affect self-reported food craving and mesocorticolimbic activity as assessed by functional magnetic resonance imaging. It was hypothesized that cognitive reappraisal would most effectively inhibit the mesocorticolimbic activity and associated food craving as compared to suppression. In addition, it was hypothesized that suppression would lead to more prefrontal cortex activity, reflecting the use of more control resources, as compared to cognitive reappraisal. Self-report results indicated that up-regulation increased food craving compared to the other two conditions, but that there was no difference in craving between the suppression and cognitive reappraisal strategy. Corroborating self-report results, the neuroimaging results showed that up-regulation increased activity in important regions of the mesocorticolimbic circuitry, including the ventral tegmental area, ventral striatum, operculum, posterior insular gyrus, medial orbitofrontal cortex and ventromedial prefrontal cortex. Contrary to our hypothesis, suppression more effectively decreased activity in the core of the mesocorticolimbic circuitry (i.e., ventral tegmental area and ventral striatum) compared to cognitive reappraisal. Overall, the results support the contention that appetitive motivation can be modulated by the application of short-term cognitive control strategies.

Eating disorder pathology and menstrual cycle fluctuations in eating variables in oral contraceptive users and non-users

Food intake and food cravings fluctuate across the menstrual cycle in women who are not using oral contraceptives (OCs), however less is known about cyclical variations in eating variables in women using OCs. Furthermore, few studies have examined the relationship between eating disorder pathology and menstrual cycle fluctuations in eating behaviors. In the present study, we examined self-report, retrospective ratings of food cravings intensity, hunger level, and amount eaten across the menstrual cycle in 67 non-OC users and across exogenous hormone regimens in 81 OC users. We also investigated the relationship between eating disorder pathology and cyclical fluctuations in eating variables. The results indicated that OC users and non-OC users report similar levels of food cravings and amount eaten across cycle phases, with food cravings and reported amount eaten elevated during the week prior to menses/hormone withdrawal bleeding and during the week of menses/hormone withdrawal bleeding. However, OC users reported elevated hunger during both the week prior to hormone withdrawal bleeding and during hormone withdrawal bleeding, whereas non-OC users reported an elevation in hunger level only during the week prior to menses. Fear of fatness and other eating disorder pathology variables were significantly associated with increases in food cravings, hunger level and reported amount eaten the week prior to menses in non-OC users, but not in OC users. These findings suggest that future studies should examine the potential role of menstrual cycle-related fluctuations in eating variables on the development of eating disorders.

[Influence of premenstrual syndrome and oral contraceptive effects on food choice during the follicular and luteal phase of the menstrual cycle]

BACKGROUND AND OBJECTIVE

Food intake and motivation for food varies according to the phase of the menstrual cycle. These changes seem to be more marked in women with premenstrual syndrome (PMS) and may be modified by the use of oral contraceptives (OC). This study examined the effect of menstrual cycle, PMS and OC use on the intake and hedonic rating of sweet and savory snack foods.

MATERIAL AND METHODS

Fifty-five women were recruited and assigned to either a PMS group or a control group. In addition, based on OC use, the women were assigned to an OC-user or non-user group. During the luteal and follicular phases, the participants were asked to consume and rate sweet and savory snacks.

RESULTS

The luteal phase induced greater caloric intake from sweet foods. PMS sufferers did not consume significantly more calories in either phase. There was a significant interaction between phase, flavor, PMS status and OC use. OC users consumed more calories from sweet foods in the follicular phase.

CONCLUSIONS

Food intake is increased in the luteal phase. This effect was modulated by both PMS and OC use. OC use seems to eliminate cyclic fluctuations in caloric intake.