CC_Nutrition

Tag: menstrualcycle

  • Nutrition for the Menstrual Cycle: Physiology-Based Fueling Strategies for Female Athletes

    Introduction: Why the Menstrual Cycle Matters in Sports Nutrition

    The menstrual cycle is a complex endocrine rhythm governed by the hypothalamic–pituitary–ovarian (HPO) axis. It produces cyclical fluctuations in oestrogen and progesterone that influence nearly every physiological system relevant to sport:

    • Substrate utilisation (fat vs carbohydrate oxidation)
    • Glycogen storage and insulin sensitivity
    • Thermoregulation and heat tolerance
    • Fluid balance and plasma volume
    • Neuromuscular function and connective tissue properties
    • Mood, appetite regulation, and central nervous system drive

    Despite this, the scientific literature consistently highlights that performance effects across the cycle are small, variable, and highly individual, largely due to methodological limitations in cycle tracking and hormone verification (Elliott-Sale et al., 2021).

    Therefore, the most effective approach is not rigid “cycle syncing”, but physiology-led, flexible nutrition periodisation.

    Endocrine Overview: What is Actually Changing?

    The menstrual cycle is typically 21–35 days and is divided into follicular and luteal phases, with ovulation occurring mid-cycle.

    Key hormones and their roles

    Oestrogen (17β-oestradiol)

    • Increases fat oxidation during submaximal exercise
    • Enhances insulin sensitivity
    • Supports endothelial function and blood flow
    • Influences neuromuscular efficiency and central fatigue tolerance

    Progesterone

    • Thermogenic effect (raises core temperature)
    • Increases ventilation (respiratory drive)
    • May increase protein catabolism and glycogen utilisation
    • Can reduce gastrointestinal motility

    (Oosthuyse and Bosch, 2010)

    Menstrual Phase (Day 1–5): Low Hormones, High Inflammatory Activity

    Physiology in detail

    The menstrual phase begins with endometrial shedding, triggered by a sharp decline in both oestrogen and progesterone. This withdrawal leads to:

    Inflammatory cascade

    • Increased prostaglandin production
    • Uterine smooth muscle contraction (cramping)
    • Elevated local inflammatory signalling

    Systemic effects

    • Reduced circulating oestradiol
    • Lower resting core temperature
    • Potential transient reductions in plasma volume
    • Increased perceived fatigue in some individuals

    Importantly, iron loss is the most nutritionally significant factor, especially in athletes with heavy menstrual bleeding or low ferritin status.

    Performance implications

    • No consistent reduction in maximal strength or aerobic capacity in controlled studies
    • Higher inter-individual variability in perceived exertion
    • Pain and fatigue can indirectly reduce training output

    (Elliott-Sale et al., 2021)

    Nutrition strategy (mechanistic focus)

    1. Iron restoration and oxygen transport support

    Menstrual bleeding increases iron turnover, and iron is essential for:

    • Haemoglobin (oxygen transport)
    • Myoglobin (muscle oxygen storage)
    • Mitochondrial electron transport chain enzymes

    Strategy:

    • Heme iron: red meat, liver, poultry
    • Non-heme iron: legumes, spinach, fortified grains
    • Combine with vitamin C to enhance ferric → ferrous conversion

    (Beard and Tobin, 2000)

    Performance rationale:
    Low ferritin reduces VO₂max, increases fatigue, and impairs endurance efficiency.

    2. Prostaglandin and inflammation modulation

    • Omega-3 fatty acids reduce inflammatory eicosanoid production
    • Polyphenols may reduce oxidative stress and perceived pain

    3. Energy stability

    • Maintain carbohydrate intake to support serotonin synthesis
    • Prevent hypoglycaemia-related fatigue amplification

    Follicular Phase (Day 1–13): Rising Oestrogen and Increasing Metabolic Efficiency

    Physiology in detail

    The follicular phase begins with menstruation and continues until ovulation. It is characterised by:

    • Gradual rise in oestradiol
    • Low progesterone
    • Improved insulin sensitivity
    • Increased glucose uptake efficiency in muscle tissue

    Oestrogen also enhances:

    • Lipolysis (fat mobilisation)
    • Glycogen sparing during submaximal exercise
    • Vascular dilation and blood flow

    (Oosthuyse and Bosch, 2010)

    Performance implications

    This phase is often associated (not universally) with:

    • Better tolerance to high-intensity training
    • Improved training adaptation potential
    • Lower perceived exertion in some athletes

    However, meta-analytical evidence shows no consistent performance advantage when hormone confirmation is used (McNulty et al., 2020).

    Nutrition strategy (performance periodisation model)

    1. Carbohydrate periodisation (key lever)

    Improved insulin sensitivity supports:

    • Higher glycogen synthesis rates
    • More efficient glucose uptake (GLUT-4 activity)

    Application:

    • Higher carbohydrate availability around key training sessions
    • Fuel harder sessions more aggressively

    2. Protein synthesis optimisation

    Muscle protein synthesis is not cycle-dependent in a clinically meaningful way, but adequate intake remains essential:

    • 1.6–2.2 g/kg/day protein
    • 0.3–0.4 g/kg per meal

    (Phillips and Van Loon, 2011)

    3. Training adaptation window

    This phase may be optimal for:

    • Strength development blocks
    • High-intensity interval training
    • Volume progression phases

    Ovulatory Phase (Day ~12–16): Hormonal Peak and Transition Stress Point

    Physiology in detail

    Ovulation is triggered by an LH surge, preceded by peak oestradiol levels. This results in:

    • Follicle rupture and oocyte release
    • Short-term inflammatory response
    • Rapid hormonal transition (oestrogen → progesterone shift begins)
    • Slight thermoregulatory variability

    (Oosthuyse and Bosch, 2010)

    Performance considerations

    Research findings are mixed:

    • Some studies show small improvements in power output
    • Others show no meaningful change
    • Variability is largely due to individual response differences

    (Elliott-Sale et al., 2021)

    Nutrition strategy

    1. Oxidative stress buffering

    Hormonal peaks may increase reactive oxygen species in some contexts:

    • Polyphenols (berries, green tea, cocoa)
    • Omega-3 fatty acids

    2. Hydration and plasma stability

    • Maintain sodium and fluid balance
    • Support cardiovascular stability during training

    3. Energy consistency

    Avoid under-fuelling during hormonal transition phases due to:

    • Increased physiological variability
    • Potential appetite fluctuations

    Luteal Phase (Day 16–28): Elevated Metabolic Demand and Thermoregulatory Stress

    Physiology in detail

    The luteal phase is dominated by progesterone, which drives:

    Metabolic effects

    • Increased resting metabolic rate (~2–10%)
    • Increased oxygen consumption at rest
    • Greater carbohydrate oxidation during exercise

    Thermoregulatory effects

    • Increased core temperature (~0.3–0.5°C)
    • Reduced heat dissipation efficiency
    • Increased sweat rate variability

    Neurometabolic effects

    • Increased ventilation rate
    • Higher perceived exertion
    • Potential serotonin fluctuations influencing appetite

    (Smith and Steege, 2003)

    Performance implications

    • Increased strain in hot environments
    • Higher carbohydrate dependency during exercise
    • Greater perception of effort at same workload

    However, when energy intake is matched, performance decrements are not consistently observed (McNulty et al., 2020).

    Nutrition strategy (key performance phase)

    1. Energy availability adjustment (critical)

    Due to increased metabolic rate:

    • +90–300 kcal/day (individualised)
    • Prioritise energy availability for recovery and adaptation

    2. Carbohydrate emphasis (glycogen reliance increases)

    Progesterone increases glucose utilisation during exercise:

    • Maintain consistent carbohydrate intake
    • Prioritise pre- and post-training fuelling

    3. Micronutrient and neurotransmitter support

    Magnesium

    • Muscle relaxation
    • Sleep quality
    • Neuromuscular regulation

    Vitamin B6

    • Neurotransmitter synthesis (serotonin, dopamine pathways)
    • Mood regulation support

    4. Gastrointestinal management

    Progesterone slows GI transit:

    • Reduce excessive fibre pre-training
    • Choose low-FODMAP carbohydrate sources if needed
    • Avoid large high-fat meals close to exercise

    5. Thermoregulation strategy

    • Increased fluid and sodium intake in hot conditions
    • Cooling strategies for endurance sessions

    Critical Scientific Perspective: What the Evidence Actually Shows

    Despite strong physiological mechanisms, the current consensus is:

    Menstrual cycle phase effects on performance are small, inconsistent, and highly individual when rigorous study designs are used (Elliott-Sale et al., 2021).

    Key limitations in research

    • Lack of hormone confirmation (many studies rely on calendar tracking)
    • Small sample sizes
    • High inter-individual variability
    • Confounding from training status, nutrition, and sleep

    Applied Summary

    Menstrual phase

    Focus: iron + inflammation + energy stability

    Follicular phase

    Focus: carbohydrate availability + training progression

    Ovulation

    Focus: hydration + antioxidant support + consistency

    Luteal phase

    Focus: increased energy intake + carb support + thermoregulation

    Conclusion

    The menstrual cycle is best understood not as a limitation, but as a dynamic physiological framework influencing metabolism and recovery capacity.

    The strongest applied nutrition model is:

    • Maintain energy availability across all phases
    • Adjust carbohydrate intake to metabolic demand
    • Support iron status and micronutrient needs
    • Individualise based on symptoms and training load

    This approach aligns with current sports science consensus and avoids overinterpretation of cycle-based performance claims.

    References

    Beard, J.L. and Tobin, B. (2000) ‘Iron status and exercise’, The American Journal of Clinical Nutrition, 72(2), pp. 594S–597S.

    Elliott-Sale, K.J., McNulty, K.L., Ansdell, P., et al. (2021) ‘Methodological considerations for studies in the menstrual cycle in female athletes’, Sports Medicine, 51(4), pp. 843–861.

    McNulty, K.L., Elliott-Sale, K.J., Dolan, E., et al. (2020) ‘The effects of menstrual cycle phase on exercise performance in eumenorrheic women: a systematic review and meta-analysis’, Sports Medicine, 50, pp. 1813–1827.

    Oosthuyse, T. and Bosch, A.N. (2010) ‘The effect of the menstrual cycle on exercise metabolism: implications for exercise performance in eumenorrheic women’, Sports Medicine, 40(3), pp. 207–227.

    Phillips, S.M. and Van Loon, L.J.C. (2011) ‘Dietary protein for athletes: from requirements to optimum adaptation’, Journal of Sports Sciences, 29(S1), pp. S29–S38.

    Smith, R.L. and Steege, J.F. (2003) ‘The menstrual cycle and exercise performance’, Clinical Sports Medicine, 22(3), pp. 351–372.

  • Behaviour Change and Nutrition: The Key to Consistency

    Whether you’re aiming to build muscle, lose fat, or enhance performance, your nutrition habits are just as important as your training program. But sticking to a diet plan whether it’s a bulking phase, a cutting cycle, or performance nutrition can be harder than hitting a heavy squat. The real challenge isn’t knowing what to eat; it’s changing your behaviour to make it happen consistently.

    This is where behaviour change science comes in. Grounded in psychology, behaviour change strategies can help gym goers, athletes and well honestly, anyone! overcome common barriers like poor planning, low motivation, and decision fatigue turning good intentions into real results.

    Why Motivation Alone Isn’t Enough

    You might start a new meal plan feeling motivated and ready. But motivation fluctuates. To stay consistent long-term, you need more than willpower you need systems and strategies.

    According to the COM-B model, behaviour is driven by three things: Capability, Opportunity, and Motivation (Michie et al., 2011). In a gym context, this might look like:

    Capability: Do you have the cooking skills and nutrition knowledge? Opportunity: Is your environment helping or hindering your eating goals? Motivation: Are you clear on why you’re doing this?

    Addressing all three areas sets you up for long-term adherence not just short-term compliance.

    Habit Formation and Meal Consistency

    For athletes and recreational lifters, habit formation is key. The Health Action Process Approach (HAPA) highlights the difference between intention and action. You might plan to prep meals or hit your macros but without planning, tracking, and adjusting, those intentions often fall flat (Schwarzer, 2008).

    Using tools like MyFitnessPal (or other apps), food scales, and prep routines helps build consistency. Research shows that self-monitoring—tracking what you eat—is one of the most powerful predictors of success in fat loss and muscle gain (Chen et al., 2023).

    Digital Tools for Diet Adherence

    A 2023 meta-analysis confirmed that using nutrition tracking apps significantly improves dietary behaviours and outcomes in people aiming to lose fat or gain lean mass (Chen et al., 2023). These tools don’t just count calories they give real-time feedback, help you spot trends, and reinforce accountability.

    Other behaviour change techniques (BCTs) proven to support gym-related goals include:

    SMART goal-setting (Specific, Measurable, Achievable, Relevant, Time-bound)

    If then planning (e.g., “If I get hungry post-workout, then I’ll have a protein shake”)

    Social support (training partners or online communities)

    Why Most Meal Plans Fail (And How to Fix It)

    Many people fall off their meal plans not because they’re “lazy” or “undisciplined,” but because their approach doesn’t match their lifestyle or values. According to the Theory of Planned Behaviour (TPB), intentions alone aren’t enough people must also believe they have control over their environment and the ability to follow through (Ajzen, 1991).

    That’s why environmental restructuring like prepping meals in advance, keeping snacks out of sight, or having protein options ready post-training is critical. Your environment should make the right choice the easy choice.

    The Bigger Picture: Stress, Sleep, and Social Support

    Behaviour change science also reminds us that diet doesn’t happen in isolation. Poor sleep, stress, or a lack of social support can derail even the best plan. The Science of Behavior Change (SOBC) program by NIH highlights how self-regulation, stress management, and habit loops can be modified to enhance results (NIH, 2023).

    In other words, you don’t need to grind harder you need to train smarter, eat smarter, and structure your environment and mindset for success.

    Conclusion

    If you’ve ever struggled to stay consistent with your nutrition while training hard, you’re not alone and you’re not lacking discipline. You’re just missing the behaviour change strategies that align your habits with your goals.

    By applying science-based models like COM-B, HAPA, and TPB, and using tools like tracking apps, habit systems, and structured planning, you can finally bridge the gap between training and nutrition and unlock your full potential in the gym.

    If you want structured support to improve nutrition behaviour change and long term performance, get in touch

    Contact me

    References

    Ajzen, I., 1991. The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50(2), pp.179–211.

    Chen, J., Cade, J.E. and Allman-Farinelli, M., 2023. The effectiveness of nutrition apps in improving dietary behaviours and health outcomes: a systematic review and meta-analysis. Public Health Nutrition, 26(1), pp.1–12.

    Greaves, C.J., Sheppard, K.E., Abraham, C., Hardeman, W., Roden, M., Evans, P.H. and Schwarz, P., 2011. Systematic review of reviews of intervention components associated with increased effectiveness in dietary and physical activity interventions. BMC Public Health, 11(1), p.119.

    Lee, R.M., Fischer, C., Caballero, P., and Andersson, E., 2022. Behaviour change nutrition interventions and their effectiveness: a systematic review of global public health outcomes. PLOS Global Public Health, 2(9), p.e0000401.

    Michie, S., Atkins, L., and West, R., 2014. The Behaviour Change Wheel: A Guide to Designing Interventions. London: Silverback Publishing.

    Michie, S., van Stralen, M.M. and West, R., 2011. The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implementation Science, 6(1), p.42.

    NIH Common Fund, 2023. Science of Behavior Change (SOBC). [online] Available at: https://commonfund.nih.gov/science-behavior-change-sobc [Accessed 18 May 2025].

    Schwarzer, R., 2008. Modeling health behavior change: How to predict and modify the adoption and maintenance of health behaviors. Applied Psychology, 57(1), pp.1–29.

  • Contraceptives and Weight Gain in Women: What Does the Science Say?

    Introduction

    The relationship between contraceptive use and weight gain has been a topic of debate for decades. Many women report weight changes after starting hormonal contraceptives, but is there scientific evidence to support this? This blog post reviews the current literature on how different types of contraceptives may influence body weight and composition.

    Types of Contraceptives and Their Potential Impact on Weight

    1. Combined Oral Contraceptives (COCs)

    COCs contain both estrogen and progestin and are one of the most commonly used contraceptive methods. Early versions of the pill contained high doses of estrogen, which were linked to water retention and weight gain (Lopez et al., 2016). However, modern low-dose formulations appear to have minimal effects on weight. A Cochrane review analyzing 49 trials found no significant evidence that COCs cause clinically meaningful weight gain (Lopez et al., 2016).

    2. Progestin-Only Pills (POPs)

    Progestin-only pills (also called the “mini-pill”) are sometimes preferred for women who cannot take estrogen. Limited evidence suggests that POPs do not significantly contribute to weight gain. However, some studies report increased appetite as a side effect, which could indirectly influence weight (Berenson et al., 2009).

    3. Injectable Contraceptives (Depo-Provera)

    Depot medroxyprogesterone acetate (DMPA), commonly known as Depo-Provera, has the strongest link to weight gain. Studies show that women using DMPA for a year or longer tend to gain an average of 2–3 kg, with some individuals experiencing even greater increases (Berenson et al., 2009). This weight gain is likely due to increased appetite and fat accumulation rather than water retention.

    4. Hormonal Implants and IUDs

    Implants (e.g., Nexplanon) and hormonal intrauterine devices (IUDs) release progestin over an extended period. Some research indicates that implants may lead to modest weight gain, whereas hormonal IUDs generally do not cause significant changes (Modesto et al., 2015). However, individual responses vary.

    5. Non-Hormonal Contraceptives

    Barrier methods (e.g., condoms, diaphragms) and copper IUDs do not influence hormones and therefore do not contribute to weight changes.

    Potential Mechanisms Behind Contraceptive-Related Weight Gain

    Several theories explain why some women experience weight gain while using hormonal contraceptives:

    • Increased appetite: Some progestins can stimulate appetite, leading to higher caloric intake.
    • Fluid retention: Estrogen can cause mild water retention, but this is typically temporary.
    • Changes in metabolism: Some evidence suggests that contraceptives might slightly alter metabolism and fat distribution.

    Individual Variability and Lifestyle Factors

    It’s important to recognize that weight gain while using contraceptives is not universal. Lifestyle factors, including diet, exercise, and genetics, play a significant role in weight changes. Some women may gain weight due to life-stage factors rather than the contraceptive itself.

    Conclusion

    The belief that all contraceptives cause weight gain is a common misconception. While some methods, particularly DMPA injections, have been linked to increased weight, others (such as COCs and IUDs) show minimal or no significant effects in most women. Women concerned about weight changes should discuss contraceptive options with their healthcare provider to find a method that best suits their needs.

    References

    • Berenson, A. B., Rahman, M., & Wilkinson, G. S. (2009). Weight gain among adolescents using depot medroxyprogesterone acetate versus oral contraceptives. Pediatrics, 124(2), e281-e289.
    • Lopez, L. M., Edelman, A., Chen, M., & Otterness, C. (2016). Progestin‐only contraceptives: effects on weight. Cochrane Database of Systematic Reviews, 2016(8).
    • Modesto, W., de Nazaré Silva dos Santos, P., Correia, V. M., Borges, J. C., Bahamondes, L., & Bahamondes, M. V. (2015). Body weight and composition in users of levonorgestrel-releasing intrauterine system. Contraception, 91(6), 495-500.