Body Weight Changes During the Menstrual Cycle among University Students in Ahvaz, Iran
Mohammad Hossein Haghighizadeh,
Weight changes during menstrual cycle may be a cause of concern
about body weight among most women. Limited data are available linking menstrual
cycle and body weight changes. The aim of this study was to examine the relationship
between menstrual cycles and body weight changes among university students in
Ahvaz, Iran. This cross-sectional study was conducted on 50 Iranian female students
aged 18-24 years. Anthropometric indices were measured according to standard
protocols. During a complete menstrual cycle, weights of participants were measured
each morning. Seventy eight percent of participants had normal weight (Body
Mass Index: 18.5-24.9 kg m-2). Body weight increased only slightly
during the three days before beginning of the menstruation. By using repeated-measures
ANOVA, no statistically significant differences were found in weigh during menstrual
cycle (p-value = 0.301). No statistically significant changes were found in
body weight during women's menstrual cycle in a group of healthy non-obese Iranian
young women. Further studies on overweight and obese women are suggested.
Received: November 25, 2013;
Accepted: January 24, 2014;
Published: February 12, 2014
Obesity is one of the major public health problems in the developed and developing
countries and is an independent risk factor for chronic diseases including hypertension,
Cardiovascular Diseases (CVD), type 2 diabetes mellitus and certain cancers
(Anonymous, 1998). In the United States obesity has
increased more than 20% in the past decade. More than 35% of American adults
are obese (Flegal et al., 2002; Ogden
et al., 2012). In Iran, the prevalence of overweight and obesity
is 42.8 and 11.1% in men and 57 and 25.2% in women, respectively (Janghorbani
et al., 2007). Many people in the world attempt to lose weight, or
to prevent weight gain or sustain initial weight lose. Dietary modification,
physical activity and healthy eating behavior are effective strategies for the
prevention and management of obesity. According to the data of the National
Health Interview Survey which included 32 440 Americans, 24% of the male and
38% of the female populations were trying to lose weight, respectively (Kruger
et al., 2004). Generally, in women population, the number trying to
lose weight is more than men. Approximately one-fourth of women in the United
States of America with normal weight (BMI<25) as well as 58% of obese females
(BMI<30) were trying to lose weight. It seems that women are more dissatisfied
with their body appearance than men (Poppitt et al.,
1994; Kruger et al., 2004; Davidsen
et al., 2007). Bendixen et al. (2002)
in an observational study have shown a direct significant relationship between
BMI and weight loss attempt. Weight-loss attempt in women (61%) was more frequent
than men (32%). Losing weight may be more difficult in women than men. In addition
during weight management programs women lose less weight. It may partly be due
to metabolic differences between genders (Sartorio et
al., 2005; Anderson et al., 2007). The
female sex hormones significantly affect womens weight and body composition.
The reproductive hormones control the menstrual cycle in women and it can affect
energy intake, energy expenditure and fat storage (Poppitt
et al., 1994). The influences of hormonal changes throughout the menstrual
cycle on weight loss in women are not clear. An increase in food intake has
been shown to be influenced by the hormonal changes within the menstrual cycle
and may account for an increase in body weight and body fat (Davidsen
et al., 2007). Energy intake and energy expenditure are increased during
luteal phase of the menstrual cycle. In this phase women have more eager to
consume high carbohydrate and high fat foods compared to the follicular phase
(Tarasuk and Beaton, 1991; Danker-Hopfe
et al., 1995; Li et al., 1999). Based
on the available evidence women in the luteal phase of the menstrual cycle have
higher intakes of energy as much as 90-500 kcal day-1, compared with
the follicular phase (Dalvit, 1981; Tarasuk
and Beaton, 1991; Martini et al., 1994;
Barr et al., 1995; Li
et al., 1999; Cross et al., 2001; Pelkman
et al., 2001). These changes may cause an increase in energy intake
and may lead to weight gain and increase the risk of overweight or obesity in
women during the reproductive age.
The influence of menstrual cycle on body composition has have investigated
in few studies (Eck et al., 1997; Kirchengast
and Gartner, 2002). Golub et al. (1965)
reported weigh changes of sixty-nine females; 43.5% of them experienced their
highest weight during the first days of menstruation and 20% experienced their
highest weight prior to menstruation (Watson and Robinsonm,
1965) reported an increase in body weight during the first half of menstruation.
Many females are concerned about their body weight. Weight changes during a
womans menstrual cycle may be a cause of concern especially for those
who are trying to reduce their weight (Malinauskas et
al., 2006; Anderson et al., 2007). To
our knowledge, there is no study regarding the relationship between menstrual
cycles and body weight changes in Iran. Therefore, in the present study, the
changes in body-weight during the menstrual cycle among female university students
in Ahvaz, Iran were studied.
MATERIALS AND METHODS
Participants of present study were 50 female students who were living in Golestan
dormitory of Ahvaz Jundishapour University of medical sciences. Ahvaz is located
in the southwest of Iran. Participants were selected by cluster random sampling
method. They were in the age range of 19-24 years. Written informed consents
were obtained from all participants.
Weight of participants during a complete menstrual cycle was measured each
morning (between 8 -10 a.m.) by using a digital scale (Seca Corp, Hamburg, Germany)
with an accuracy of 100 g and was done with minimal clothing and without shoes.
Height was measured by using inflexible tape while subjects were standing erect
in the normal position of shoulders and without shoes and recorded to the nearest
0.1 cm. To reduce measurement error, all measurements were performed by one
trained dietitian. Body mass index (BMI) was calculated by dividing weight (in
kilograms) by height squared (in meters squared).
Statistical analyses were performed with the Statistical Package for Social
Sciences version 20 (SPSS Inc, Chicago, IL). Descriptive statistics were used
for reporting the mean and standard deviation. Mean and standard deviation of
average weights of 1-3, 4-6, 7-9, 10-19 and the last three days of one menstrual
cycle are reported here. Repeated-measures ANOVA was used to test for statistically
significant changes in weigh during menstrual cycle.
Frequency distribution of age groups and BMI categories (underweight, normal
weight, overweight) are shown in Table 1. It seems that more
than half of participants were aged 20 to 22 years old. The sample as a whole
was young (21.4±1.19 year). More than 70% of participants had normal weight
(BMI 18.5-24.9 kg m-2). The average BMI was 21.4±2.7 kg m-2.
Means and standard deviations of weights during menstrual cycle are shown in
Table 2. Body weight increased only slightly during the three
days before beginning of the menstruation. By using repeated-measures ANOVA,
no statistically significant differences were found in weigh during menstrual
cycle (p-value = 0.301).
||Frequency distribution of age (year) and BMI (kg m-2)
of female university students in Ahvaz, Iran (N = 50)
|1Overweight: 24.99≤BMI≤29.99 kg m-2
||Changes in weight (kg) during menstrual cycle in female university
students in Ahvaz, Iran (N= 50)
DISCUSSION AND CONCLUSION
In the present study, we found that weight had no significant change during
menstrual cycle days among a group of Iranian adult young students. Few studies
have been conducted on the influence of menstrual cycle on body composition.
In Byrd and Thomas (1983) study twelve females were
assessed three different times during each menstrual cycle for a total of six
measurements within two periods. They reported fluctuations in body composition
among the women but since the participants did not weigh every day, peak weight
gains may not have been detected (Byrd and Thomas, 1983).
The menstrual cycle has been reported to influence water retention and thus
weight gain in most women however, the results of studies are not consistence.
Golub et al. (1965) reported among sixty -nine
females who kept daily records of their body weight for four months, 20% women
experienced their highest weight prior to menstruation while 43.5% of them experienced
their highest weight during the first days of menstruation. On the contrary,
the results of study, on thirty patients in a clinical setting, illustrated
that the group as a whole did not experience weight gain prior to menstruation.
Each participant was weighed daily for three months. Control groups (33% of
the patients) were restricted to hospital living conditions and meals. Case
group (67% of participants) experienced a slight change in body weight during
the menstrual cycle which may have been attributed to the unrestricted living
conditions outside the hospital. The control group was reported to experience
a slight increase in weight (<500 g) five days prior to the onset of menses.
Similarly, a fluctuation in daily weight of 0.59 to 2.07 kg in women throughout
the menstrual cycle with an increase in weight prior to menstruation was reported
by Watson and Robinson et al. (1965) In similar
study with the same subjects, (Watson and Robinsonm, 1965)
mentioned an elevated in body weight during the first half of menstruation with
a decrease in body weight near the end of menstruation.
Obviously reproductive hormones control the menstrual cycle in women and may
cause changes in their energy metabolism and appetite (Poppitt
et al., 1994). These changes coordinate to changes in energy intake,
expenditure and storage and may contribute to weight gain during woman's menstrual
cycle (Poppitt et al., 1994). According to the
available reports, reproductive hormones may be strong mediators of eating behavior
in women that may influence the outcome of a weight loss attempt (Davidsen
et al., 2007). Women in the luteal phase of the menstrual cycle had
higher intakes of energy compared with the follicular phase although these increases
have not always been statistically significant (Dalvit,
1981; Tarasuk and Beaton, 1991; Martini
et al., 1994; Barr et al., 1995; Li
et al., 1999). In addition; women have more eager to consume high carbohydrate
and high fat foods in the luteal phase (Tarasuk and Beaton,
1991; Danker-Hopfe et al., 1995; Li
et al., 1999). These changes may cause an increase in energy intake
and may lead to weight gain or fail of a weight loss program.
Based on the available evidence, change in appetite regulation occurs during
the menstrual cycle. This change in appetite has been related to glucose homeostasis
which may be an important determinant of eating behavior in women during menstrual
cycle (Bisdee et al., 1989). Therefore, increases
in carbohydrate, fat and protein consumption during the luteal phase may be
reflected from a general increase in appetite (Abraham
et al., 1981; Martini et al., 1994).
Carbohydrate craving especially chocolate cravings seems to be more frequent
in the luteal phase than any other time of menstrual cycle (Rozin
et al., 1991; Hetherington and MacDiarmid, 1993;
Li et al., 1999).
Also, women tend to consume high-fat food in the luteal phase (Johnson
et al., 1994; Pelkman et al., 2001).
These could result in an excessive intake of calories during luteal phase and
consequently affect weight (Davidsen et al., 2007).
In present study body weight increased slightly during the three days before
beginning of the menstruation (end days of luteal phase), although this increase
was not statistically significant. This finding is in accordance to previous
studies. Although, we did any mention about their dietary food intake during
In conclusion, the menstrual cycle should be taken attention as a factor in
the physiology of energy balance and weight change in premenopausal women. Increasing
energy intake and food cravings, particularly for high carbohydrate and high
fat foods, in the luteal phase may lead to weight gain and may fail the outcome
of a weight loss programs. Considering these changes during woman's menstrual
cycle may help to enhance efficacy of weight loss program and to improve adherence
of weight management programs. So, further longitudinal studies among overweight
and obese women are required. It is also suggested that future studies may need
to broaden the age range of the participants and monitor dietary habits and
The source of data used in this study was from a research project and financial
support was provided by Ahvaz Jundishapur University of Medical Science (Grant
No. D-88019). We also would like to thank the participants of our study for
their enthusiastic support.
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