Do you crave chocolate when you are hormonal? If so, you aren't alone! I consulted professor of psychology and neuroscience, Dr. Amy Jo Stavnezer, to help demystify this process.
Dr. Albers: Why does “that time of the month” seem to intensify chocolate cravings?
Dr. Amy Jo Stavnezer: Slightly less than half of the American women studied in dozens of articles on craving, report intensifying chocolate cravings during the perimenstrual days (a few days before through the first few day or two of menses). The other half of the women studied also typically experience chocolate cravings, but they are not reliably paired with their menstrual cycle. Remember, chocolate is the most highly craved food item reported by Americans (as if you didn’t already know that)!
Dr. Albers: So why do these women experience an increased craving?
Dr. Amy Jo Stavnezer: The first obvious reason is hormone fluctuation. Estrogen and progesterone (the two main hormones released by the female gonads) have an impact on nearly every organ system in the body: bone, skin, eyes, hair, immune activity, digestion, brain, blood, other hormone systems and of course, reproduction. In addition, there is a 3 to 6-fold change in the level of estrogen and approximately a 4-fold change in the level of progesterone within every regular menstrual cycle, imagine your body weight changing by that ratio! However, the information already presented suggests that gonadal hormones can not be the entire reason for the increased craving, as only half of the women studied show this behavior. In addition, taking progesterone supplements to reduce fluctuations does not decrease craving and perimenstrual craving is more prevalent in American (40%) than Spanish (4%) women, but hormone levels vary across a menstrual cycle despite your birth continent (Zellner and colleagues, Appetite, 2004).
Dr. Albers: When do hormone levels change?
Dr. Amy Jo Stavnezer: Though each woman’s monthly cycle is slightly unique, there are many similarities. Physicians and researchers ‘start’ each cycle on the first day of menstruation and then name four distinct time frames that follow:
1. Menses: assuming an egg is not fertilized, the lining of the uterus is shed in 4-7 days of bleeding. During this time levels of both estrogen and progesterone are low.
2. Follicular phase: during the early portion of each cycle, a few follicles (eggs) in the ovary begin to develop. This phase ends at ovulation. During this phase estrogen levels rise, but progesterone levels remain low.
3. Ovulation: when the egg is released from the ovary into the fallopian tube. Estrogen levels decrease rapidly during this phase.
4. Luteal phase: during this late portion of the cycle the egg moves into the uterine environment and the remaining egg sac (termed the corpus luteum) releases high levels of progesterone to prepare for implantation (causes the rise in basal body temperature noted if you are trying to conceive). During this phase progesterone and estrogen are elevated. If fertilization of the egg does not take place, hormone levels drop and menses begins.
Dr. Albers: Do cravings mimic the hormonal pattern?
Dr. Amy Jo Stavnezer: Not exactly. Women who crave chocolate during the perimenstrual phase are experiencing this craving when both levels of estrogen and progesterone are at their lowest—not when they are changing. Even more interesting, most women stop craving chocolate just at the start of menses (again no hormone change). This has led researcher Julia Hormes to conclude that the chocolate craving might actually be a response to the stress of the oncoming bleeding, and that chocolate is a culturally reinforced way to deal with that stressor. Lastly, 80% of menopausal women still report chocolate cravings despite no longer having menstrual cycles or significant variability in their hormone levels over the course of a month (Hormes & Rozin, Appetite, 2009).
Dr. Albers: If it’s not hormonal changes, then what is it?
Dr. Amy Jo Stavnezer: In our last conversation we discussed that chocolate craving seems to be a learned behavior. Of course we like the mouth-feel, aroma and taste of chocolate from the first glorious bite—the high-fat, high-calorie combination fulfills a hedonistic desire that has been essential for survival through food scarcity. But throughout our lives as Americans we also learn that chocolate is positive, paired with reward and to an extent, a culturally accepted high-fat, high-calorie indulgence. That pleasure does lead to a release in dopamine, the main reward chemical in the brain, but there is no evidence indicating a direct hormonal or physiological cause of chocolate cravings. Yes, some women do experience a level of mood alteration (or whatever you might label it), abdominal bloating, headaches or cramping around perimenstruation and this may be enough to tax the central executive to the point where further decisions are compromised. But, this is likely to be a small overall percentage.
As American women, we learn that the undesirable aspects of our periods are widely appreciated, experienced by others, and that it is okay to give into a craving while we are in the midst of PMS (diagnosed or perceived). This is an interesting double standard in a culture that also teaches a very high percentage of women to restrict their intake of high-calorie, high-fat snacks. Our culture sets the stage for cravings, in a sense, by consistently presenting the message of dietary restraint, but then providing frequent holidays and circumstances where increased caloric intake is the norm. Experience teaches us that “that time of the month” is a set of special circumstances when giving into a chocolate craving will be met with understanding rather than guilt and shame. And that’s a pretty good reason to eat something so luscious.
Dr. Albers: Are there cross cultural differences?
Dr. Albers: Are there cross cultural differences?
Dr. Amy Jo Stavnezer: There have been very few cross-cultural studies of chocolate craving published, despite the fact that we know which countries eat the most. As reported in ConfectionaryNews.com, Switzerland, Ireland and the UK took the top spots for chocolate consumption per capita in 2012. One interesting study did compare American and Spanish university students. There were two findings that I found telling about our relationship with chocolate here in the US. It seems that we choose to enjoy chocolate at different times of the day, and likely for different reasons. Spanish students reported that their strongest cravings for chocolate were ‘after eating’ and ‘during exams or studying’, while American students craved chocolate ‘at night’. The students were also asked to list any chocolate-holiday relationships. Over 90% of the American respondents provided a chocolate-holiday relationship, where only 50% of the Spaniards did the same; that is clear evidence of culture-specific training. The first three listed for Americans were: Easter, Valentine’s Day and Christmas; and for Spaniards: Christmas, weekends or bad weather days, and Easter (Osman & Sobal, Appetite, 2006). I’d love to see more studies of this type with Swiss, Irish and English participants, as there are interesting cultural/media differences between those countries that all have a high acceptance level for eating chocolate.
Dr. Albers: So what’s the punch line to all of this?
Dr. Amy Jo Stavnezer: The good news is that the cravings that take place around menses are no different than those experienced on any other day. They are not brought on for differing reasons and can be fought off by all of the skills that you have from reading Dr. Albers’ books. Be mindful, don’t restrict yourself to only the holidays or time of the month that our culture says are okay to indulge. Eat slowly when you do choose to enjoy chocolate, and go take a walk/run/flight of stairs. Exercise can decrease bloating, fatigue and the moodiness that can arise during ‘that time of the month.’ It also alleviates stress and that mental fog that occurs when our cognitive load is too high. Exercise increases the release of dopamine, endorphins (your body’s natural painkillers), and epinephrine (chemical transmitter in the brain) and increases your metabolism.
When you crave chocolate—around your period, after a stressful day at work, or as a reward for a job well done—own it, accept it, be mindful of it.
Dr. Albers: Thank you Dr. Amy Jo Stavnezer for your insights!
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Dr. Albers is a psychologist at the Cleveland Clinic and author of six books on mindful eating. Check out her new book, EatQ, which helps you make healthy food decisions and stick to them! www.eatq.com