Premenstrual prebiotic brownie bark

Find yourself struggling with endo cramps, swelling, bloating, low energy and digestive trouble pre-period? You’re not alone. High inflammation levels and hormonal imbalances can lead to all of these symptoms (and more), and can also result in higher pain levels when your period does arrive.

But what you eat can truly influence your experience of your luteal phase and your period - which is important when we consider how many of us are driven by our cravings at this time in our cycle.

That’s why I’ve created this delicious prebiotic brownie bark. Not only will it help curb cravings in a healthier way, it’ll also support endo specific gut health and give you a dose of anti-inflammatory antioxidants.

This recipe is:

• Low FODMAP to prevent bloating flare ups and IBS symptoms. People with endo often have gut microbiome alternations which can cause stomach upset, small intestine bacterial overgrowth and /or IBS. People with these gastrointestinal issues may find that foods high in fermentable carbohydrates can irritate their symptoms (because gut bugs love to eat these foods, creating gas, bloating, etc) and additionally, there is some research suggesting a low FODMAP diet may be helpful for people with endo who also have gut symptoms (more needs to be done). Does this mean you should go full blown low FODMAP? No (though some of you may benefit from it, as a short-term therapeutic diet), but to prevent triggering endo belly and worsening any pre-menstrual bloating, I wanted to keep this recipe low FODMAP so as many people as possible could enjoy it.

• Helps to curb PMS cravings and manage PMS. An association has been found in the research with processed foods/junk food (a.k.a foods high in sugar, unhealthy fats, low in nutrients, etc) and the prevalence of PMS. When we’re in our luteal phase, we often experience more blood sugar swings because oestrogen, which dominates in our follicular phase, helps us regulate our blood sugar response, but is lower in the luteal phase. As a result, we tend to get cravings for sweet foods or foods high in starch. The problem is, these foods keep us on a blood sugar rollercoaster, and raise inflammation levels, resulting in more of those inflammatory symptoms and pain that we’re trying to avoid. This sweet snack, being low in sugar and with a low glycemic load, but rich in anti-inflammatory ingredients, can help us get our fix without the pain.

• A good source of prebiotic resistant starch from the cooked and cooled rice. Resistant starch boosts levels of butyrate, a short chain fatty acid essential for helping us to fight endo and endo belly by re-establishing a healthy microbiome and inhibiting that inflammatory pathways that drive endo growth. To learn more about resistant starch and endo, head here.

• Is a rich source of gut loving polyphenols. Polyphenols are types of antioxidants found in certain plant foods that not only have a profound effect on reducing inflammation levels and improving overall health, but they are also a favourite food for our gut microbiome. Because people with endo tend to have microbiome dysbiosis, with lower levels of some beneficial bacteria and higher levels of pathogenic (bad) bacteria, feeding our gut bugs is essential to reestablishing balance.

• Is a source of antioxidant vitamin E from the hazelnut butter. Vitamin E is a powerful anti-inflammatory which has actually been shown to minimise period pain  and help manage endometriosis pain (reduced pelvic pain and inflammatory markers). Whilst this recipe doesn’t provide the same level of vitamin e used in the research, one study did show improvements in inflammatory markers when endo patients followed an antioxidant rich diet high in vitamins A, C and E.

• Is high in magnesium from the cacao and hazelnuts. Magnesium has been shown in multiple studies to help with menstrual issues including PMS and period pain. For period pain, it works by lowering prostaglandins, those inflammatory little suckers that are too high in people with endo and dysmenorrhea. Magnesium is also essential for energy production, so can help you to feel more energised when battling pre-menstrual fatigue.

• Is a good source of healthy dietary fats. Polyunsaturated fats and monounsaturated fats, like those found in hazelnuts, are associated with lower inflammation levels, whilst saturated fat (found in the coconut oil and cacao butter) is essential for building our sex hormones. Whilst we want to exercise some caution with saturated fats as excessive levels can heighten inflammation (more on that below), this brownie bark delivers a potent antioxidant punch packaged up with some of these hormone loving fats.

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

Bloating and IBS issues

I’ve tried to make this recipe as endo belly friendly as possible by keeping it low FODMAP and rich in gut loving foods, but remember, everyone is different. Some people may find the strong cacao content triggers bowel movements (which may not be a bad thing, if you’re often constipated in your luteal phase), whilst others may not do well on the naturally occurring resistant starch or higher fat foods (which can trigger motility). In general, I’ve kept to moderate serving sizes to prevent any issues, but I can’t predict your personal triggers, so you may need to adjust to tolerance.

Sugar content

When I make chocolate recipes for myself, I use my carob recipe, that has no added sugar at all - there is naturally occurring sugar in the carob, which adds a subtle sweetness, but due to the high fibre content, the release of this naturally occurring glucose is slowed which makes carob a great choice for blood sugar balancing. Having said that, there are lots of low sugar chocolates out there, I just can’t eat chocolate regularly because of my histamine issues, and because I have a COMT snp, which means I don’t do well with lots of cacao, green tea, coffee, black tea, etc.

However, I know most people don’t like carob and you may not want to make a whole two carob bars every time you want to make this recipe, so I’ve opted for a combination of 85% dark chocolate and 90% dark chocolate with this recipe. I used Lindt, and so the nutritional content of  this recipe is based on Lindt’s sugar and carb content of their 85% (15g sugar, 22g carbs per 100g) and 90% bars (7g sugar, 14g carbs). With all the other ingredients, each serve is 3.6g sugar and 10.5g carbohydrates.

When we look at this on the GI index and GI Load scale (learn about that here), each serve should be low glycemic, especially when we consider the resistant starch that has developed overnight, which has less of an affect on blood sugar.

So, in theory, this recipe, when eaten in the recommended serving sizes, shouldn’t spike blood sugar - but when it comes to blood sugar, individual responses vary, so see how you feel personally.

This is good news for managing endo, as blood sugar spikes can raise inflammation and pain.

If you want to lower the sugar content of this recipe even more, go for a darker chocolate like 90% or 95%, or try my carob recipe, which has no added sugar at all!

Fat content

Saturated fat is essential for making our sex hormones, because it is the precursor to cholesterol (in short, it makes cholesterol) and cholesterol is the key component of our sex hormones. This is why low fat diets or restrictive dieting can result in missing periods annovulation or low hormone levels.

However, we do want to be mindful of our intake. Saturated fats truly aren’t the enemy they’ve been made out to be in the media and are crucial for various processes in the body, but high levels (the key here being high), have been associated with negative microbiome changes, pain with endo, and endometriosis risk. Of course, the data and research on fats is ongoing, but these are the general trends.

In contrast, other fats, like monounsaturated fats and polyunsaturated fats, found in the hazelnut butter in this recipe, are associated with reduced inflammation, less PMS, healthier gut microbiome, reduced pain with endo and menstruation - especially in the context of a diet rich in plant foods like veggies, fruits, nuts, seeds, whole grains, etc.

Before you throw saturated fat out of the window, remember we need all fats - including saturated, not just for hormone production, but for many functions in the body.

The key is being mindful of intake with saturated fat, and keeping other healthy monounsaturated fats and polyunsaturated fats, found in fatty fish, avocados, nuts, seeds, olive oil etc. at the heart of your fat consumption. It’s also especially important to focus on lots of plant foods, as the data shows that high fibre and plant diversity equals a happy gut.

All that to say, that this recipe, being largely made from chocolate, is on the higher side in saturated fat at about 10g per serve (in the UK, general guidelines for women is 20g saturated fat per day, though individual fat requirements vary). However, one serve is considered a moderate amount of total fat and so if you’re sticking to the serving sizes and also ensuring you’re eating a healthy diet in general, not only can this delicious luteal phase treat fit into an anti-inflammatory diet, it’s actually beneficial for your hormones, gut health and inflammation levels.

If you’d still like to reduce the fat serving further, split the brownie bark into twelve pieces rather than six - but please remember, we don’t need to demonise saturated fat or go super low with it! We just want to be mindful of our intake and consume it in the context of a healthy diet.

Further resources

If you’re struggling with your 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, plus, you might find these article helpful in terms of how to manage your blood sugar levels and why:

https://endometriosis.net/living/diet-sugar

https://endometriosis.net/living/how-to-balance-your-blood-sugar-levels-to-reduce-endo-symptoms

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

Method:

Cook your rice according to the instructions.

Whilst the rice cooks, melt the chocolate and coconut oil in a medium bowl over a pan of simmering water, or in short 10 second bursts in the microwave (be careful it doesn’t burn).

Once melted, add the salt and hazelnut butter and stir well to combine.

Take off the heat and allow to cool slightly and also let the rice cool for 5-10 minutes (but no longer).

Add the rice to your food processor and pour over the melted chocolate mixture, then pulse a few times until blending until combined. The chocolate may seize and the blend will look grainy, a bit like clumps of wet sand, but don’t worry!

Press into a small rectangular container (I used one that is 8cm x 15cm) and refrigerated for two hours.

Once set, melt your other chocolate (as above) and pour over the brownie tray, and place back in the fridge, ideally overnight, to allow the resistant starch to develop. If you want your bark to have more snap, store in the freezer.

Divide into 6 slices.