Microbiome nurturing and blood sugar supportive cardamom and dark chocolate pear cake (gluten and dairy free)
Chris is obviously a disloyal dessert lover, because this cake has now knocked off carrot cake from its top spot, and he is obsessed. In fact, I wasn’t even sure I was going to share it with you guys, but every time he had a slice he made such a fuss that it persuaded me! He would finish a slice, sit in silence for a moment and then mutter “beautiful” to himself. It honestly makes me so happy to be able to feed people and for them to actually find the food delicious, and I am sitting there content in the knowledge that I am caring for their bodies too!
This pear cake to me, has some of the most perfect flavour combinations of these darker months - pear, cardamom and if desired, dark chocolate. It’s also a bake that is a lot more interstitial cystitis and histamine friendly. A lot of winter spices are not well tolerated by us MCAS and IC folks, which really leaves us out of the seasonal fun, but cardamom and vanilla are usually okay, and pear is generally histamine/bladder safe too. If dark chocolate is a trigger for you, you can omit, or swap for carob (I have a recipe here, though you can sometimes buy carob bars in the shops) - I made this cake both with and without chocolate, and both times it was beautiful.
This pear cake is not like a regular cake - it’s not light and fluffy, instead it has a melt in your mouth, silky texture, somewhere between bread and butter pudding and a blondie, or maybe the kind of texture you get with a flourless chocolate cake. Velvety, basically. If you want a lighter sponge, I’ve shared some tips in the Notes section below.
You can eat it warm from the oven after about 15 minutes, and if you plan to do that, I recommend you serve it in the tin, with a big dollop of thick Greek yoghurt, or a probiotic product of some sort like crème fraîche or sour cream (dairy free if needed), or my vanilla ice cream, and allow your friends and family to tuck in, like a skillet cookie! It’s also delicious just warm (so leave it to cool for 40 mins or so), or once it’s been refrigerated. Honestly, it’s a pretty versatile cake!
This gluten free cardamom and dark chocolate pear cake is…
Made with whole foods and are rich in healthy fats, fibre and protein to stabilise blood sugar, sweetened naturally with fruit and made with olive oil for an extra blood sugar supportive boost.
Unfortunately, simple carbohydrates, like those found in baked goods such as cakes, are some of the biggest blood sugar spikers, which can pose a problem for us endo peeps.
Blood sugar spiking foods such as high sugar foods and processed foods can potentially contribute to more PMS, menstrual pain and endo pain. Blood sugar spikes increase oxidative stress, which leads to more inflammation in the body and that may trigger further pain and symptoms. In fact, oxidative stress is higher in people with endo, and it’s a key driver of endo growth.
To avoid these issues, for this cardamom pear cake, I have focused on the presence of healthy fats (from the olive oil, egg, sunflower seeds, walnuts), fibre (dates, pear, oats, sunflower seeds and walnuts) and protein (eggs, sunflower seeds, walnuts), which have all been shown to help stabilise blood sugar levels and slow down the uptake of glucose/starch from our food (oats, pears and dates in this case) to our blood stream, preventing blood sugar spikes.
One of the easiest ways for us to support our blood sugar is to opt for whole food carbohydrates, such as whole oats instead of flour, and fruit instead of sugar or maple syrup, as I have done here. Whole foods still contain their fibre, which helps slow down digestion and the resulting absorption of glucose to the blood stream, creating a steady drip rather than a flood. The added benefit is that rolled oats contain beta-glucan, a special type of fibre found in oats that offers a wide range of health benefits, including stabilising blood sugar post-meals (and as a result, makes oat-based foods more effective than wheat based foods for blood sugar stability).
Another great way to support blood sugar is with lower glycemic index foods, and every ingredient in this recipe is low to moderate on the glycemic index scale. The glycemic index is a tool that looks at foods and the impact they can have on your blood sugar, on a scale of 0-100. A high GI index would be 70 and above, a medium GI is 56-69 and a low GI index is 55 or less. High GI foods are very likely to spike your blood sugar levels and do so quickly, foods with a medium GI rating tend to cause a moderate rise and low GI foods tend to keep blood sugar levels stable and steady over time with a gentle rise. This is because low GI foods break down slowly in the gut because they are rich in fibre and slow release carbohydrates, this means that the release of glucose to the blood stream is slow and gradual.
Whilst sweeteners like sugar are high glycemic, the fruits I’ve used to sweeten this cake, pears and dates, are low to moderate (dates vary depending on the type of date you use, some are low, some are moderate).
To further slow down that moderate rise in blood sugar, I’ve added two super star ingredients; sunflower seeds and olive oil.
Research has shown that adding olive oil to meals reduces the post-prandial blood sugar levels (meaning it helps prevent blood sugar spikes from foods/meals), even in high glycemic meals (meaning meals/foods high in sugar or starch that can cause rapid blood sugar spikes).
Additionally, sunflower seeds have been shown to also have benefits for blood sugar. Adding sunflower seeds and other seeds may help lower the glycemic index of carb rich foods, like baked goods. Additionally, sunflower seeds contain compounds that have been shown to improve fasting glucose levels and show improvements in animal models as well.
Finally, the naturally occurring soluble fibre found in pears, called pectin, forms a gel in the gut, which slows down digestion and has been shown to improve post-prandial (post-meal) glucose spikes, as well as insulin sensitivity and blood sugar management generally. Whilst most studies are performed on high doses of pectin, the natural amounts of pectin in pears, combined with these other beneficial ingredients, can help to reduce the blood sugar impact of this cake overall.
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 excess or dominance and low progesterone if ovulation is interrupted or stopped entirely. Both of these imbalances can cause more PMS, heavier periods, and may also exacerbate endometriosis symptoms.
Additionally, this cake can help us out with luteal phase cravings. When we’re in our luteal phase, we often experience more blood sugar swings because oestrogen, which dominates in our follicular phase, helps us to 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, such as cookies! 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 cake, being lower in sugar and rich in fibre, can help us get our fix without the pain triggering spikes.
Finally, blood sugar swings are linked heavily with mood disorders such as depression and anxiety, so if you struggle with low moods in your luteal phase, supporting blood sugar can actually support your mental health.
Rich in prebiotics and polyphenols to help heal the endo belly and reduce systemic inflammation.
A major study of 10,000 people found that eating 30 or more plant foods a week helps to create a healthier and more diverse microbiome. This recipe offers you around 7-8 of your 30! For extra guidance on how to reach your 30 a week, check out this article by The Gut Health Doctor or this one by Zoe.
This recipe is also high in polyphenols. Polyphenols are types of antioxidants found in certain plant foods that not only reduce inflammation levels and improve overall health, but they are also an absolute favourite food for our gut microbiome, which means they can support our good gut bugs to thrive.
Polyphenols can be found in various plant foods, and are in high amounts in olive oil, dark chocolate, pears and dates.
The anti-inflammatory effects of extra virgin olive oil, thanks to its polyphenol content, are far reaching. For example, research has shown that extra virgin olive oil can decrease C-Reactive Protein levels, a marker for inflammation.
Additionally, this cake is a great source of prebiotic fibre from the whole foods, and provide special soluble fibres like beta-glucans from the oats, that are incredibly beneficial for a healthy gut microbiome.
Pears are also a rich source of both insoluble and soluble fibre, including pectin, which can benefit both constipation and diarrhoea by bulking out stools and absorbing water, with multiple studies demonstrating that pectin can help normalise bowel movements. Pectin has also been shown to raise good gut bugs like bifidobacterium and lactobacillus, and can even help inhibit the growth of harmful bacteria. It may also help to strengthen and repair the intestinal lining, preventing LPS leakage (more on that and why it matters below!).
Research is finding a strong correlation between microbiome disturbances and endometriosis development, such as reduced levels and variety of good gut bugs and higher levels of pathogenic (bad, infectious), opportunistic (in high numbers, can cause problems like inflammation) gut bugs, as well as gut bugs linked to elevated oestrogen levels. These microbiome differences have also been associated with higher IL-8 levels, a type of inflammatory cytokine shown to be involved in the development of endometriosis.
Polyphenols and prebiotic fibre are like gut bug boosters - the more we provide to our good gut bugs, the more they grow and outnumber the bad guys. This helps to bring the gut back into harmony, which can improve gut symptoms and intestinal inflammation and whilst we need to do more research, could even help us fight endo.
Both beta-glucans and pectin also raise short chain fatty acid levels, including acetate and propionate and even butyrate.
Research shows that people with endo may be low in short chain fatty acids. Acetate and propionate play an incredible role in reducing systemic inflammation, immune regulation and helping to stabilise blood sugar, but butyrate is the highlight here. Butyrate has a range of benefits for endometriosis and gut health such as reducing intestinal inflammation, improving insulin sensitivity, preventing leaky gut, promoting the growth of beneficial bacteria and inhibiting the growth of harmful bacteria. But here’s what I find most interesting. Butyrate inhibits our inflammatory immune response to lipopolysaccharides (LPS) - LPS are toxins that come from certain bacteria that can escape into the blood stream and local area via a weakened intestinal lining, and have been shown to be heavily involved in endo pathogenesis.
Gluten free to help minimise symptoms and reactions in certain endo folk.
Whilst not everyone with endometriosis needs to go gluten free or entirely gluten free (some people feel better just not eating it that often), reducing gluten may help some of us manage our pain and endo belly symptoms.
In a major and recent survey study of 2388 endometriosis patients, out of those who removed or reduced gluten, 45% experienced a reduction in pain. In another study, 75% of patients had a significant reduction in painful symptoms after eliminating gluten for 12 months. There is also a significant association between endometriosis and coeliac disease. And whilst the research on endometriosis and gluten has limitations, I myself experienced improvements by reducing gluten in my diet (in fact, it was one of the key players for helping me live a normal life again no longer ruled by pain and my periods), as have many of my clients (though not all, it’s very individual).
If you’d like to learn more about why gluten may impact some of us with endo and how, I recently did a huge deep dive into all the research on my podcast, here.
Is a great source of anti-inflammatory and hormone supportive micronutrients, including vit E, magnesium, zinc and folate.
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%!
Research has shown magnesium to be an effective treatment in preventing dysmenorrhea (period pain) because it reduces inflammatory prostaglandins that are the drivers of both endo and period pain. One study showed that six months of magnesium treatment reduced prostaglandin F2a by over half! In fact, in recent research, magnesium is being explored as a dietary treatment for endo and a higher intake of magnesium rich foods was associated with a lower risk of endo. Additionally, magnesium helps to regulate our sex hormones, and as result, is a recognised treatment for preventing PMS.
Low levels of zinc have been linked to endo, and research has shown it can significantly reduce period pain thanks to its anti-inflammatory benefits. It additionally supports follicle development and ovulation, while deficiency has been linked to infertility.
Folate is crucial to ovarian function and ovulation, and low folate levels can cause irritability, mood swings and fatigue, and fertility problems.
Important notes to help you tailor this recipe to your own body and needs (and tastebuds!)
Making this dairy free
Research shows that about half of people with endo may experience improvements in pain and symptoms with the removal of dairy. However, dairy is nuanced so it’s worth reading or listening to this series to help you work out if it’s right for you and how much you can tolerate (you may not need to cut it out entirely!).
If you know you can’t tolerate milk, use a good quality dairy free milk like an almond that just has simple ingredients (almonds, water, salt) and no added gums, starches or preservatives. I used almond milk with one test and goat’s milk with another (as I don’t do well on cow’s milk) and they both came out great.
Making this egg free
Whilst I haven’t tried it, you could sub the eggs for two flax eggs. There’s already some flax in this recipe for structure, so you may only need one flax egg - I would experiment and see what works best. I do think flax would probably work as an egg alternative in this recipe, but I can’t guarantee it.
Making this nut free
Sub the ground almonds for sunflower seeds, as well as the walnuts too. I actually always made this cake with ground sunflower seeds, but ground almonds are much easier for most people to get hold of.
Are oats gluten free?
Oats do not contain any gluten, but most factories that handle oats, also handle gluten, which means there are often trace amounts of gluten on the oats. If you have coeliac disease or an allergy, you need to avoid all traces of gluten, so go for gluten free oats. The same may be said if you have a very reactive intolerance. However, if you just generally avoid or minimise gluten, regular oars should be just fine.
Is this low FODMAP?
Unfortunately, pears are not low FODMAP, so this is one of my few bakes that isn’t low FODMAP - but I have plenty that are!
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 endometriosis and SIBO.
Microbiome nurturing and blood sugar supportive cardamom and dark chocolate pear cake (gluten and dairy free)
Ingredients:
For the cake
150g ground almonds
90g soft dates, pitted
70ml extra virgin olive oil
60g rolled oats or oat flour (if using whole oats, pulse in a food processor/spice grinder until a flour is achieved)
50ml milk of choice (listen/read this is you’re not sure whether you tolerate diary or not)
50g 90% dark chocolate (or 85% if you prefer sweeter)
15g ground flaxseed
2 ripe pears
2 eggs
1 tsp baking powder (6g)
1/4 tsp baking soda
Pinch of salt
1 tsp vanilla extract or scraping from one pod
1 tsp ground cardamom
For the crumble topping (optional, but recommended)
1 soft date
1 tbsp olive oil
30g walnuts
30g rolled oats
1/2 tsp cardamom powder
1/2 tsp vanilla extract
makes: 6-8 serves in an 8-9 inch cake tin or 8X8 brownie pan
prep time: 30 mins (inc crumble topping)
bake time: 45 mins
cool time: 15-45 mins
Method:
Preheat the oven to 175c (fan assisted) and line either a standard 8-9 inch cake tin or an 8x8 deep brownie dish (I used a casserole dish as that’s all we have in our current Airbnb) with baking paper.
Core one pear and chop into chunks, keeping the skin on (the key polyphenols are in the skin!).
Blend together the milk, oil, eggs, pear chunks, vanilla extract and dates until smooth. Set aside.
If you’re using whole rolled oats, pulse to a flour.
Whisk together the ground almonds, oat flour, flaxseed, baking powder, baking soda, salt and cardamom.
Core and slice the second pear, skin on and set aside.
Pour the liquid mix into the dry and whisk to combine and remove any lumps.
Chop the dark chocolate into chunks and stir though.
Pour into the cake tin/brownie pan and arrange the pear slices as desired (I arranged the slices in quarters, so a 1/4 of the pear was grouped together in each corner), bake on the middle shelf for 45 minutes.
Whilst the cake is baking, make the crumble topping by pulsing all the ingredients in a food processor until a crumb is formed. In the last 12 minutes of baking (not earlier, otherwise the rise on the cake will sink), very quickly sprinkle the cake with the crumble and close the oven to finish cooking. You can add the crumble from the beginning, but it tends to cook much quicker and can burn - if you try this method, cover the cake after about two thirds of the way through cooking to prevent further burning/browning.
Remove the cake from the oven, and leave for 10 minutes in the pan to firm up, before moving to a cooling rack to finish cooling. You can eat warm at 15 minutes with thick yoghurt, or leave to cool for 40-45 minutes. Also is great refrigerated, so eating the next day is fine!
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Need more help or want to learn how to work with me?
Ways to work with me:
One to one coaching info and application
Live and Thrive with Endo 2.0 DIY online course
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This EndoLife, It Starts with Breakfast digital cookbook
Free resources:
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