Antioxidant rich, probiotic raw carrot cake slices

Last week, I shared all about the powders of antioxidants for fighting oxidative stress in endometriosis.

Why?

Because oxidative stress is higher in people with endo, and it’s a key driver of endo growth. It’s a process that kicks off an inflammatory cascade that allows endo to flourish - but the good news is, research has shown that diet and supplements can lower the levels of oxidative stress in people with endo (and as a result, pain). Not just in the blood stream, but where it matters most - in the pelvis, where it’s wreaking havoc.

One of the best ways to do this, is by supplying the body with antioxidants. Nutrients that lower oxidative stress.

So, this week, inspired by the approach of Easter, I wanted to give you guys a taste of spring, with a side of endo kick ass.

Easter can be a time of delicious indulgences, but unfortunately, those indulgences often have a lot of sugar and processed ingredients, which can cause oxidative stress levels to rise.

But why should everyone else have all the fun? I wanted to give you guys some spring treats that don’t just protect you from oxidative stress, but also actively help you to lower them too.

And so, these raw carrot cake bars were born.

Now, before we dive in, I am not saying you can’t go and enjoy an Easter egg - but my work is about providing you with options to help you manage endo, and reducing oxidative stress through nutrition is one of those ways. Perhaps you still enjoy some chocolate, but you bring these carrot cake slices to the gathering too.

This recipe is…

High in vitamin A from the apricots and carrot, providing nearly 30% of your UK RDA (AI generated). Various studies have shown an association between low vitamin A intake and endometriosis risk. Researchers believe that low vitamin A levels may be involved in the pathogenesis (development) of endo, as the active form of vitamin A has anti-prolific and anti-oestrogenic properties, halting growth of endo tissue. Whilst there are other factors that could be affecting our levels of active vitamin A, nutritional intake is one of them and the research has shown that these levels can be altered, having a significant impact on oxidative stress markers in the body and in the pelvic area, due to vitamin A’s antioxidant properties.

High in vitamin E, mainly from the sunflower seeds and almond butter, but also some from the apricots, and a few other ingredients give it a little boost too! Here’s a fun fact - just 30g of almonds or sunflower seeds can provide nearly 50% of your RDA, hence why they are star players in this recipe. In fact, each cake slice comes in at just under 50% of your (UK) RDA!

So, why do we want more antioxidant vitamin E in our diet? A recent meta-analysis of over 589 participants, concluded that vit E supplementation can reduce period pain, pain with sex, daily pelvic pain and even improve quality of life with endometriosis patients. And a systematic review and meta-analysis of eight studies and over 1000 people concluded that vitamin E significantly reduced period pain and could be used as a treatment for dysmennorhea. But it’s not just supplements that help - food helps too! One study found people with endo had a 40% reduced intake of vitamin E, but levels increased after following a high antioxidant diet, and oxidation levels reduced by 20%!

High in vitamin C (potentially!). The basic recipe offers only around 2% of your RDA of vit C, but vit see is a powerful antioxidant, which was studied alongside vit A and E for endo, so I wanted to offer you guys a way to boost it.

Enter acerola cherry. Acerola cherry is absolutely brimming with vitamin C, and just 1 tsp of the powder can provide up to 1000mg of vit C (depending on the brand and formulation, and btw, that’s not an affiliated/sponsored link!). So, if you’d like, you could add 1 tsp into this mix, and that literally gives you 100% of your UK RDA (40mg per slice).

So, what’s the benefit of vit C here?

Research has shown that people with endo have a 30% reduced intake of vitamin C in comparison to those without, and that a high antioxidant diet which included adequate intake of vitamin C, A and E, over three months, significantly improved vitamin C levels and antioxidants levels, and reduced markers of inflammatory oxidative stress.

To add to that, a study on humans with endo showed that consuming a bar fortified with both vitamin C and vit E daily, for six months, reduced oxidative stress markers in people with endo.

I’ve added a word of warning regarding the acerola cherry in the section below.

Great for fighting oestrogen dominance.

This recipe provides 10g flax seed per bar. Flax seeds are rich in a type of fibre called viscous fibre, which creates a gel-like substance in the gut, and bulks out bowel movements, improving regularity and treating constipation. This is absolutely essential for the last step in clearing out oestrogen - we want to be having at least one bowel movement a day to keep oestrogen at a healthy level.

Why? Well, when oestrogen is hanging out in the gut, not going anyway, it can be reabsorbed, creating higher levels of oestrogen once again.

This is especially true if we have elevated levels of an enzyme called beta glucuronidase, that can be high in people with endo, and recirculates oestrogen. The good news? Eating a diet rich in fibre (which flax seed offers in great amounts) helps to lower levels.

Flax seeds have also been shown to improve the metabolism of oestrogen through the liver, by increasing the amount of healthy oestrogen waste products (known as metabolites) and reducing the amount of the more potent, harmful ones, which can cause more oestrogenic activity.

Finally, flax contains lignans, plant compounds that have mild oestrogen-like effects, but are no where near as potent as oestrogen. Structurally, they mimic oestrogen and so can bind to oestrogen receptors. Think of a receptor as the lock, and oestrogen as they key, when we turn the lock, an oestrogen activity like thickening of the uterine lining, is triggered. This can actually reduce the impact of high oestrogen levels, but also support low levels, in menopause, for example.

In fact, one study showed that the participants who consumed 10g fresh, ground flax seeds (uncooked), daily for three cycles had longer luteal phases and a higher progesterone to oestrogen ratio in the luteal phase as well.

Now, this is what the research shows, but everyone is individual, so if you find flax seeds make you feel more oestrogen dominant, please listen to your body, and I advise you listen/or read this and this, for more info on how to use flax for your body and endo.

Now, the study that showed improved oestrogen metabolites used 25g of milled flax seed per day for 16 weeks. I can’t cram that much flax into each bar, so if you want to top up your levels further, you can add extra flax to oatmeal, yoghurt or smoothies. Though remember, 10g per day was still shown to improve oestrogen dominance, so you might find that the amount in the bars is enough for you.

A great source of prebiotics to boost short chain fatty acids and support the gut microbiome.

Pretty much every ingredient in this recipe provides prebiotics - fibre that our good gut bugs like to munch on, fuelling a balanced and healthy microbiome. When bacteria eat prebiotic fibres, they produce short chain fatty acids, short chain fatty acids are types of gut friendly fats that play a major role in our gut and overall health - and may be low in people with endo.

The prebiotic stars of the show in this recipe are beta glucan and resistant starch, coming from the oat bran.

Resistant starch is a type of starch that resists digestion in the small intestine and makes its way to the large intestine, to be eaten by our good gut bugs, and resistant starch is a particular super hero for producing butyrate, a type of fatty acid.

Butyrate plays a role in keeping gut inflammation down, healing leaking gut, stabilising blood sugar and also, inhibiting the inflammatory reaction to LPS, that triggers endo growth. In mice, treatment with butyrate actually reduced the growth rate of endo lesions due to its protective effects against LPS. Butyrate actually inhibits these reactions, and was shown in mice models to reduce the growth of lesions. Learn more about butyrate and endo here.

Beta-glucan is a type of soluble fibre, and one of the best sources of beta-glucan is oats. Beta-glucan, particularly from oats, has been shown to significantly increase the short chain fatty acid propionate.

Propionate plays a role in helping to keep our blood sugar levels stable. Endo is associated with blood sugar issues, so supporting these levels with sufficient propionate may be helpful.

Propionate also has a significant anti-inflammatory effect systemically throughout the body. In fact, it can help inhibit inflammatory cytokines which are linked to endo progression, however, its effects are less potent. Learn more about endo and propionate here.

High in omega 3 fatty acids from the flax and walnuts. Studies have shown a link with low omega 3 and endometriosis risk, and higher levels of omega 3 intake with a reduced risk of endo.

Omega 3 can help modulate the amount of inflammatory prostaglandins we make - and it’s these prostaglandins that fuel endo growth and pain. A type of omega 6 called omega-6 fatty acid arachidonic acid makes the inflammatory endo fertilisers prostaglandin E2 and prostaglandin F2α (don’t be afraid of omega 6, we need some of these prostaglandins, they just need to be balanced), but omega 3 makes anti-inflammatory prostaglandins. What we eat and how much omega 3 we consume can literally raise or lower these prostaglandins as well as other inflammatory compounds that are involved in endo progression.

Research has also demonstrated reduced pain with endometriosis with omega 3 incorporated into diet and/or via supplements.

Rich in gut supportive probiotics from the yoghurt and cream cheese. Good quality yoghurt and cream cheese, that contain live cultures, provide our gut microbiome with new and healthy bacteria, to help top up and diversify our own. Because research suggests that people with endo may have gut inflammation, high levels of unhealthy gut bacteria and low levels of beneficial bacteria, restoring the microbiome is essential to endo belly and endo management overall.

Blood sugar balancing to help prevent oxidative stress and hormonal imbalances.

The sweetener in this recipe is dried apricots, which yes - come with so many benefits like high levels of vit A and fibre, however, dried fruit is a known blood sugar spiker, which we want to prevent. Keeping blood sugar levels stable helps to prevent oxidative stress, which leads to more inflammation in the body and that may trigger further pain and symptoms. Additionally, constant blood sugar swings can take their toll on hormones, leading to issues like elevated androgens (think testosterone), which can affect ovulation and cycle length. Blood sugar swings may also cause oestrogen excessor dominance and low progesterone if ovulation is interrupted or stopped entirely.

So, to reduce the impact on blood sugar, I’ve included other ingredients rich in fat, fibre and protein such as the nuts, seeds, carrots and yoghurt. Additionally, I made sure to include flax seeds not just because they support hormones, but because flax seeds provide viscous fibre, a type of soluble fibre that forms a gel in the gut, and is particularly beneficial for blood sugar because it slows down digestion of glucose.

Important notes to help you tailor this recipe to your own body and needs (and tastebuds!)

Acerola cherry is acidic (plus flavour considerations)

Acerola cherry is naturally acidic, like oranges, so if you have interstitial cystitis and get bladder irritation from citrus fruits, you might find acerola bothers you - but it is blended up with a tonne of other ingredients which can help neutralise the acid, so see how you feel.

Additionally, if you have histamine issues or oral mouth ulcers, the acid may also bother you, but again, it is mixed with other ingredients, so see how you get on.

Acerola cherry is also quite tart and fruity - which you may love for this recipe, but it’s really down to personal taste!

If you don’t do well on acidic fruits but still want to pump up the vit C, try baobab powder. It’s still high in vit C (just not as high) and is less acidic (but still a little) - you’ll need a bit more than the acerola cherry to meet significant amounts of vit C, so try 2 tsps and see how that tastes (it’s sharp and citrusy).

Dairy

Some people with endo don’t do well on certain types of dairy, or dairy full stop, you can find out more about this here. However, probiotic dairy, like yoghurt, comes with significant benefits for gut health, inflammation and even hormones, and you may find you tolerate it if you tweak the type of dairy, for example, swapping cow’s yogurt for sheep, or lactose yoghurt for lactose free. Definitely check out this series on dairy to understand all of the pros and cons and whether it’s right for you.

If don’t do well on dairy, that’s fine! The protein content of this recipe will be lower, but you’ll still get lots of lovely probiotics. Just make sure you go for a good quality yoghurt and cream cheese with live cultures. These links are not sponsored, but I like Coyo and Nush.

Is this recipe low FODMAP?

Every ingredient in this recipe apart from the apricots is low FODMAP per serve.

Cream cheese is low FODMAP at 40g per serve, and Greek yoghurt is low FODMAP at 23g per serve, so both come in at under these per slice, however, if you’re intolerant to lactose, swapping for lactose free or dairy free can help ease bloating and gut reactions. You’ll be able to keep within low FODMAP serves with lactose free versions, but if you’re going dairy free, be sure to check the ingredients for high FODMAPs, like chicory syrup or fibre, and cashews. See Monash University app for good dairy free alternatives that are also low FODMAP.

With the apricots, if you find you reaction, you can swap them for dates, but keep in mind that it will lower the vit A content quite a bit.

Histamines, IC and spice blends

Some people with interstitial cystitis and/or histamine issues can’t tolerate spices very well. If that’s you, reduce the spice blend to an amount you can tolerate, or omit entirely and focus on flavours you know you can handle, such as vanilla. Unfortunately, it won’t have that classic carrot cake spice, but it’ll still be delicious and rich in nutrients.

Further resources

If you’re struggling with your endo nutrition or gut health, you might find my courses and one to one coaching helpful. You can find out more here. I’ve also got endless podcast episodes on gut health and blood sugar.  

To understand more about the low FODMAP diet, start here.

Method:

• Grate your carrots, either with a handheld grater or in a food processor, and emptying into a bowl and set aside.

• If you have a coffee grinder, freshly grind your flax and sunflower seeds. If you don’t have a coffee grinder, use milled flax and don’t worry about grinding the sunflower seeds - it just makes them easier to blend in.

• In a food processor, pulse the oats, flax, sunflower seeds and walnuts until they reach a fine crumb. Tip into the bowl with the carrots.

• Blend the almond butter and apricots well. They won’t form a paste/liquid, but will form large crumbs of ‘dough’ that can be squashed and holds together.

• Add the rest of the ingredients and pulse a few times to mix, and then blend. It’ll take a while to come together and get smooth - eventually, it should form a ball as it blends, that texture wise is almost like chewy caramel or toffee. It should hold together and you should be able to mould it with your hands.

• Press down into a small tupperware or baking tin - I used a 20cm by 15cm glass tupperware. You can use a small glass to roll it flat if desired.

• Refrigerate for 30 minutes.

• Whilst it chills, make your yoghurt and cream cheese whip.

• Clean out your food processor, and using the regular S blade (you don’t need a special whipping attachment), whip the yoghurt and cream cheese, or just yoghurt, with vanilla powder, the seeds from one vanilla pod or extract. At first, it won’t look like it’s changing, but give it about two minutes, and it’ll become thick and fluffy. If you’d prefer to skip this step, you can just use a very thick, high fat Greek yoghurt for the topping.

• After the cake mix has chilled, remove from the fridge and using a spatula or the back of a spoon, spread your whipped topping evenly. Sprinkle with crushed walnuts if desired. Return to the fridge for an hour.

• Once ready, cut into six even slices. Keep covered and refrigerated - will last for about three days. Can also be frozen and left to warm up at room temp for 15-30 minutes before eating, the texture of the yoghurt won’t be quite the same, but it’s still good!