Structural equation modeling of food craving across the menstrual cycle using behavioral, neuroendocrine, and metabolic factors

Abstract

Objective: To identify associations between circulating endocannabinoids and craving during the luteal phase of the menstrual cycle. This report is a secondary analysis of a trial registered in NCT01407692.

Methods: Seventeen premenopausal women were studied during the follicular and luteal phases of their menstrual cycle. Previously we had reported fasting plasma estradiol, progesterone, leptin associations with luteal phase cravings for carbohydrate, fat, sweet-rich foods, and eating behavior. Here, we measured fasting plasma endocannabinoids (ECs) endocannabinoid-like substances (ECLs), and postprandial metabolic responses to a mixed meal challenge. Structural equation modeling was used to evaluate relationships between measured variables and cravings.

Results: Oleoylethanolamide (OEA) and postprandial lipids were inversely associated with craving sweet-rich foods, while progesterone was positively associated (RMSEA = 0.041, χ2 p: 0.416 i.e. hypothetical and physiological models not different). OEA, progesterone and disinhibition were positively associated with craving carbohydrates (RMSEA: <0.001, χ2 p: 0.919). ECs and ECLs combined were stronger predictors of craving than clinical metabolic parameters, ECs only, satiety hormones or gonadocorticoids.

Conclusions: Our theoretical model suggests that ECs and ECLs influence craving. Since these metabolites can be modulated via dietary fat intake, they could be potential targets to alter menstrual cycle cravings.

Keywords: Endocannabinoids; Menstrual cycle craving; Oleoylethanolamide; Progesterone.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1:

The Spearman’s rank correlation analyses irrespective of phase for hormones and endocannabinoids (i.e. using data from both phases) are presented. The color scale orange and purple are used to indicate positive and inverse associations respectively that show a trend (0.1>p>0.05, rho: (+/−) 0.29–0.33) or are significant (p (+/−) 0.34) in an n = 17 women.

Figure 2:

Follicular phase SEM path diagram, depicting role of endocannabinoids ovarian and satiety hormones, clinical variables and eating behaviors in craving sweet-tasting foods in the luteal phase in n = 17 women. The boxes are measured variables, circles are latent variables, and the final predictor variable is craving (in this case - carbs). The width of the colored arrows indicate the strength of the association, grayed out arrows indicate no association, and the double ended black arrows between the (latent) circles indicate positive (solid lines) or inverse (dotted lines) covariance. This model was identified with endocannabinoid like chemicals (OEA), ovarian hormones (progesterone), and eating behaviors (disinhibition) positively contributing to craving carbohydrates. A

Figure 3:

Follicular phase SEM path diagram, depicting role of endocannabinoids ovarian and satiety hormones, clinical variables and eating behaviors in craving sweet-tasting foods in the luteal phase in n = 17 women. The boxes are measured variables, circles are latent variables, and the final predictor variable is craving (in this case - sweets).The width of the colored arrows indicate the strength of the association, grayed out arrows indicate no association, and the double ended black arrows between the (latent) circles indicate positive (solid lines) or inverse (dotted lines) covariance. This model was identified with endocannabinoids (OEA) and eating behaviors (disinhibition) positively contributing to craving sweet foods, while ovarian hormones (progesterone) and clinical parameters (2hPP TG, 1hPP HDL, 1hPP Glucose, Fasting glucose and HOMA-IR) contributed inversely to craving sweet-foods. A 0.041 RMSEA, with 0.959 CFI and 0.943 TLI, and p value of 0.416 indicates good model fit.

Figure 4:

Follicular phase SEM path diagram, depicting role of endocannabinoids, ovarian and satiety hormones, clinical variables and eating behavior in craving sweet-tasting foods in the luteal phase in n = 17 women. The boxes are measured variables, circles are latent variables, and the final predictor variable is craving (in this case - sweets).The width of the colored arrows indicate the strength of the association, grayed out arrows indicate no association, and the double ended black arrows between the (latent) circles indicate positive (solid lines) or inverse (dotted lines) covariance. This model was identified with endocannabinoid like chemicals (OEA), endocannabinoids (AEA), and clinical parameters (2h PP TC) contributing positively to craving sweet-foods. A

Figure 5:

A graphical representation of the proposed hypothetical metabolic-neuroendocrine framework involved in craving behaviors during the luteal phase of the menstrual cycle in normal healthy women.