Obesity Clinical Trial
Official title:
Evaluation of the Association Between the Menstrual Cycle and Weight Loss in Healthy, Overweight Premenopausal Women - A 6-Month Intervention
Achievement and maintenance of weight loss in obese individuals has proven difficult. Many
hypotheses have suggested potential biological mechanisms to explain why weight loss
attempts often fail, and the surrounding obesogenic environment also seems an obvious
candidate. Among the biological factors proposed is gender, and weight loss trials have
frequently shown that females are less successful than males at losing weight and at
maintaining weight loss.
Women's weight is influenced by the menstrual cycle, in which changes in hormonal levels and
interactions work to modulate fertility. These hormones control the menstrual cycle and
coordinate the required changes in energy intake, expenditure, and storage, whilst preparing
the body for pregnancy every month. As reproduction is a primary biological function, these
hormones may be such strong mediators of eating behavior that they influence the outcome of
a weight loss attempt. The menstrual cycle should therefore be taken into consideration as a
factor in the physiology of energy balance in premenopausal women.
The cycle can be divided into three phases: menstruation or early follicular phase (days
1-5), late follicular phase that lasts until ovulation (~days 6-14, and the luteal phase
(days 15-28).
Studies have shown that in the luteal phase of the menstrual cycle, women's energy intake
and energy expenditure are increased and women experience more frequent cravings for foods,
particularly those high in carbohydrate and fat, than during the follicular phase. A trend
towards reduced carbohydrate utilization and increased fat oxidation in the luteal phase has
also been reported, together with prolonged time to exhaustion when exercising at submaximal
intensities. This suggests that the potential of the underlying physiology related to each
phase of the menstrual cycle may be worth considering as an element in strategies to
optimize weight loss.
In 2010 the investigators carried out a 90-day randomized, controlled pilot study in order
to gain feedback on and assess acceptance of the meal and exercise plans being used and to
observe if less control visits than planed in the main study were sufficient to achieve good
compliance. Twenty eight were sreened and 24 were included. Subjects were randomized to
either program A (given meal and exercise plans in relation to phases of their menstrual
cycles) or Program B (a reduced calorie diet, calorie-matched to program A). The pilot study
showed that Group A (The Menstralean group) tended to have a greater average weight loss at
60 days (-5.29 vs -3.57 kg, p = 0.06) and 90 days (-4.22 vs -2.75 kgs, p = 0.2) compared to
the control groups. There was a dropout rate of 27%. This was primarily due to an inadequate
number of control visits and contact with the subjects. Thus the Menstralean program seems
to have the potential to enhance weight loss in overweight and obese women. However, the
main study has to be carried out with more subjects in each group in a longer duration and
with more support and contact with the subjects.
The aim of the present trial is to examine the impact of the menstrual cycle on weight loss
attempts in healthy overweight (BMI > 27 kg/m2) premenopausal women (18-40 years) randomized
to two different weight management programs for a period of 6 months.
n/a
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label
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