PMS and Your Diet: Food Cravings & Weight Loss (cont.)
The bloating that often goes with PMS also sabotages a diet, says Stephen Goldstein, MD, an obstetrician-gynecologist at New York University. "A woman steps on the scale and freaks out. And some people's response to being bloated and having to loosen their belt is to drown themselves in an ice cream sundae."
And what do we break down and eat when those cravings hit? Chocolate is No. 1 on the hit parade, followed generally by other sweets, Goldstein says. Salty foods, particularly chips, are a distant third.
"You never find anything nutritious on the A-list," agrees Wurtman, noting that women rarely come in complaining of cravings for fish, fruits, and vegetables. "If it's a dieting no-no, you can bet the PMS mind is saying, 'Yes, yes,'" she says.
Hormones to Blame
The hormonal ebbs and spikes that occur throughout a woman's cycle are the major culprits in PMS. As levels of estrogen go up and down, so do levels of the stress hormone cortisol, explains Pamela Peeke, MD, MPH, author of Fight Fat After 40 and assistant professor of medicine at the University of Maryland School of Medicine in Baltimore. "It's a very potent little partnership. The body wants to keep them aligned."
And when cortisol levels are high enough, the body turns on its fight-or-flight response, a woman becomes more metabolically charged, and her appetite is stimulated. This, in turn, causes a woman to seek out carbs and fat, "the actual fuels of the fight-and-flight response," Peeke says.
Whether a woman will crave sweets or croissants, though, depends on yet another player: the brain chemical serotonin, she says. Most women with PMS experience a drop in serotonin levels, which triggers cravings for carbs because the body uses carbs to make serotonin.
"If cortisol is high and serotonin is low, you'll seek carbs and fats, but really heavy duty on the simple carbs -- sugar-based sweets like chocolate bars," Peeke says. The reason: Simple sugars are metabolized more quickly than complex carbs, so they offer a quick serotonin fix.
If cortisol is way up but serotonin is relatively normal, a woman is more likely to crave a fat-carb combo without a huge sweet component, such as a bagel laden with cream cheese, Peeke says.
The Blood-Sugar Connection
Other research has linked PMS to a state of low blood sugar, or hypoglycemia, in the second half of the menstrual cycle, says Susan M. Lark, MD, a clinician in Los Altos, Calif., and author of Premenstrual Syndrome Self-Help Book: A Woman's Guide to Feeling Good All Month. "Women in these studies experienced a significant drop in blood sugar after eating, accompanied by edginess and irritability," Lark says. "Then within an hour or two, they are hungry again and craving more food."
Whether it's blood sugar, cortisol, or serotonin levels that are out of whack, experts say, eating huge servings of ice cream, chocolate, and chips are not the only way to bring levels backs into check -- in fact, they are the worst way. Proper nutrition and lifestyle habits will achieve the same thing, with long-lasting results.
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