As a Brit, autumnal flavours for me are typically fruits like pears, apples and blackberries, and root veggies like parsnips and carrots. Whilst the UK supermarkets do fill with pumpkins for halloween, the use of pumpkin as an autumnal staple food is not as engrained in our society as it is in the USA.
However, in the past few years, I feel like social media has declared that pumpkin is the flavour of the season, wherever you live in the world, and so I have certainly been influenced by the pumpkin recipes circulating Instagram.
The problem is, for those of us outside of the USA, tinned pumpkin is quite hard to get hold of, whereas prechopped butternut squash is easy to find in the UK, and can be steamed or microwaved, and making this recipe quick and convenient. Additionally, a quick Google revealed that most of the time, the puree in tinned pumpkin puree is actually butternut squash, so in theory, the use of butternut squash in place of pumpkin for this recipe is not too sacrilegious.
If you’re still not convinced, I’ve also opted for butternut squash over pumpkin as it has less of an impact on blood sugar, and you know that’s one of my key goals when making these recipes - I want them to support blood sugar, helping to keep inflammation low and hormones happy. However, if you want to use pumpkin, please don’t stress - it may be high glycemic, but it has a low glycemic load, which means that a normal serving of pumpkin (about a cup) shouldn’t spike blood sugar. You can learn more about the glycemic index and load here.
Now, I do aim to make my bakes sweet without spiking blood sugar, but if you’re used to very sweet pumpkin pies (I’ve never tasted a real one so I have no idea how sweet they are), you might find this needs a bit more sweetness, and I have addressed how to do that below.
This anti-inflammatory pumpkin pie is…
Better for blood sugar to stabilise hormones, reduce PMS and lower oxidative stress.
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, I have focused on the presence of healthy fats (from the ground almonds), fibre (oats, dates, pumpkin/squash and almonds) and protein (oats and ground almonds), which have all been shown to help stabilise blood sugar levels and slow down the uptake of glucose/starch from our food (dates, oats, pumpkin/squash and chocolate in this case) to our blood stream, preventing blood sugar spikes.
In fact, just one serving (1/6th) offers 7g protein and 6g of fibre.
One of the easiest ways for us to support our blood sugar is to opt for whole food carbohydrates, such as dates, 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.
Another great way to support blood sugar is with lower glycemic index foods, and every ingredient in this recipe, even the dark chocolate (because we are opting for a high percentage and low sugar version) is low to moderate on the glycemic index scale. I’ve opted for butternut squash instead of pumpkin, because whilst pumpkin is packed with nutrients, it’s high glycemic, and so combined with the other starches and sugars like the dates and chocolate, this recipe could have a great impact on blood sugar if I used pumpkin.
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.
A quick word about dates: Dates have a low to moderate glycemic index, which means they shouldn’t cause a dramatic or quick rise in blood sugar. However, research has shown that individual blood sugar responses vary from person to person, and if you eat a lot of even a low glycemic index food, it may have a greater impact on your blood sugar levels because you’re eating more in one sitting. You can learn about this here. Therefore, I’ve kept the amounts of dates to 100g total so you have 12-16g of dates per slice, which is about 1 medium date, and have deliberately ensured there is support from fat, fibre and protein, to further reduce the blood sugar impact. This isn’t because I don’t want you to enjoy dates, I just want to ensure I am catering as well as possible - including those who are more sensitive to dates!
I’ve also intentionally used almonds and uncoooked oats in this recipe to further support blood sugar.
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 (like using regular flour) for blood sugar stability.
Oats also contain something called resistant starch. Resistant starch is a type of starch that resists digestion in the small intestine. Typically, starch is broken down and absorbed very quickly by the small intestine, which is why you may hear me or other health practitioners discuss moderation or being mindful with starchy foods, because it can spike blood sugar.
But resistant starch resists digestion. It makes its way to the large intestine, where good bacteria eat it and this has some incredible benefits for the gut and endo due (more on that below).
Because this type of starch resists digestion and breaks down slower, resistant starch is better for blood sugar vs. regular starch. In fact, resistant starch has been shown to be improve insulin sensitivity and blood sugar levels in multiple studies, and has even been shown to improve postprandial glucose levels when paired with a high sugar meal (in this study, it was 500g of syrup) in contrast to regular starch.
Uncooked oats, as we’re using here, are rich in resistant starch - when they’re cooked, that resistant starch turns into regular starch, which has the potential to affect blood sugar levels, which is why I always recommend pairing cooked oats with plenty of fat, fibre and healthy fats.
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.
Nuts have been shown to have a positive effect on blood sugar, and whilst less attention has been focused on cashews in the research, they are rich in healthy fats, fibre and protein, which have all been shown to help stabilise blood sugar levels and slow down the uptake of glucose from our food to our blood stream, preventing blood sugar spikes.
Almonds have been shown in the research to be one of the most beneficial nuts. One study showed that almonds significantly reduced the increase in glucose levels following a high glycemic food like white bread (high glycemic means this food tends to spike blood sugar levels, learn more here). Another study found that 28g almonds (which is about a serving of almonds/handful) reduced the blood sugar spike in healthy individuals from a high glycemic meal of a bagel, juice and butter.
Additionally, this pumpkin pie can help us out with luteal phase or period 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. 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. These cookies, being lower in sugar and rich in fibre, can help us get our fix without the pain and PMS 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.
Now, let’s be clear before we wrap up this section. I am not saying you have to avoid sugar or refined carbs for the rest of your life, but if like me, you enjoy a sweet treat as a snack or after dinner, it can help to make these regular goodies a bit more blood sugar balancing, so that we’re looking after ourselves on a day to day basis.
Rich in prebiotics and polyphenols to help heal the endo belly and reduce systemic inflammation.
The latest data shows that 96% of UK adults are getting less than the recommended 30g fibre a day. That’s not great for our guts, which rely on fibre to thrive, and people with endo need extra gut support already (as you’ll come to learn shortly) so a lack of fibre isn’t going to help the situation (though you may find you need to tailor your fibre sources if you have IBS or SIBO).
A serving of this recipe (1/6th) provides around 9g of fibre!
Additionally, 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 5 of your 30 already, and with herbs, spices, olive oil, fruits, veggies, beans/legumes, teas and coffee and whole grains all counting, you can easily top up your levels further. 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.
And thanks to our specific ingredients of dates, almonds, chocolate/cacao and butternut squash this recipe is also a good source of 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 (prebiotic) for our gut microbiome, which means they can support our good gut bugs to thrive.
But why does this matter for us endo folk?
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.
These prebiotic fibres help us to increase our production of gut friendly fats, called short chain fatty acids, which are made when good bacteria consume fibre. Research shows that people with endo may be low in short chain fatty acids and that this may be linked to endo pathogenesis, so by improving our fibre levels, we may actually be improving some of our defences against endo.
A good source of hormone and endo supportive vitamins and minerals.
Amongst several other micronutrients, this pie is a good source of vit E, magnesium, and iron to name a few.
Vit E
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%!
Magnesium
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.
Iron
Iron deficiency is extremely common in general, but even more so in people with heavy menstrual bleeding and even more so in endo, with a recent major study of over 43,000 endo patients finding that we have a six-fold higher odds of iron deficiency.
Iron plays a major role in preventing fatigue, and yet many of the clients who I work with, come to me with significantly low levels. Supporting healthy iron absorption and intake is a key part of beating endo fatigue and recovering from heavy blood loss and low levels can cause brain fog, extreme tiredness, heart palpitations, dizziness, muscle weakness and depression to name a few.
Healthy iron levels are also essential for ovarian function, which is key to producing healthy amounts of sex hormones and low levels are associated with menstrual irregularities and fertility problems. Additionally, low iron levels are linked to ADHD development and can worsen ADHD symptoms, and ADHD is a condition which many people with endo struggle with.
Whilst heme iron (found in animal products and spirulina) is the easiest form of iron to absorb, we can also top up our iron levels with non-heme iron rich foods, found in plants. Chocolate, dates, and chickpeas are all great sources of non-heme iron, making these blondies surprisingly high in iron. Ideally, pair with a vitamin C food like berries, to aid absorption, as non-heme iron can be difficult for our body to absorb, but vit C has been shown to aid this process.
IMPORTANT NOTES TO HELP YOU TAILOR THIS RECIPE TO YOUR OWN BODY AND NEEDS (AND TASTEBUDS!)
Everything you’ve said about blood sugar and processed foods, does that mean I can never have my favourite treats again?
Absolutely not. I am all for ‘worth it moments’. Enjoy our fav foods, whatever they are, in moments when we really desire them. But I am a health coach, and my goal is to minimise your symptoms and lower things like oxidative stress and inflammation that could contribute them, so I am going to encourage snacking smarter and leaning on healthier treats on a day to day basis, and that’s way these recipes are for. So you can have your cake, and eat it!
Is this pie low FODMAP?
Yes, if you have 1/8th of the pie instead of 1/6th per serve, then this will come in as a green serving.
Is this recipe suitable for SIBO?
Everyone’s triggers vary with SIBO, but this recipe is low FODMAP, so may be better tolerated.
Can I make it nut free?
Yes, use ground sunflower seeds.
Are oats gluten free?
Oats are naturally gluten free, but are often handled in factories that also handle gluten, so if you need to avoid any traces of gluten, you can go for gluten free oats.
Further resources
If you’re struggling with your endo symptoms 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.
How do I make the filling sweeter?
My preference would be to add one to two medjool dates into the blend, as that will add fibre and more nutrients. However, if you’d rather not do that, you could go for 80% dark chocolate (but there are less polyphenol benefits and more sugar the lower you go) or one tablespoon of maple syrup.
high antioxidant, low fodmap sweet potato pecan brownies
Ingredients:
Ingredients
For the crust
100g ground almonds
100g medjool dates
60g ground oats
1-2 tsps olive oil
For the filling
300g cooked butternut squash (about 400g-450g uncooked) or 300g tinned pumpkin
200g 85% dark chocolate
Optional flavourings: cinnamon, vanilla extract, pumpkin spice, etc (I skipped this step as I can’t tolerate most spices due to IC)
Serves: 6-8
Prep time: 20 mins
chill time: overnight
Method
In a food processor, pulse and then blend the oats, ground almonds, dates and one tsp of olive oil until a crumbly dough forms. Press the dough between your fingers, if it holds together, it’s ready to go - if it crumbles, add 1 more tsp of olive oil, blend again to combine.
Line a standard pie or tart dish with baking paper, and then press the dough into the dish to form a crust, taking care with building up the edges. Pop into the freezer whilst you make the filling.
If you have tinned pumpkin, skip the next step: Steam the butternut squash over a double boiler for about 10-15 minutes until soft, and then allow to drain or dab with a kitchen towel to mop up any excess moisture. Alternatively, you can microwave according to the instructions (normally I would just put in a microwave safe dish with a splash of water and cover, cooking for 4-5 minutes until soft).
Whilst the squash drains, melt the chocolate over a double boiler.
Once melted, take off the heat and blend in a blender or food processor with 300g of cooked squash, until completely smooth. If you want it sweeter, see the above instructions. Add flavourings if desired i.e. cinnamon, vanilla or pumpkin spice.
Remove the crust from the freezer and pour the mix into the centre, spreading out to create an even surface.
Pop into the fridge and leave to chill overnight.
Serve with Greek yoghurt for extra probiotic and protein points and a sprinkle of flaky sea salt.
Endo of summer special offer - if you’ve got half way through the year and endo has taken much of that time from you, I’m offering £500 off my 12 session 1:1 coaching or £250 off the six session coaching. Learn more about coaching here.
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These are some of my favourite brands…
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Need more help or want to learn how to work with me?
Ways to work with me:
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This EndoLife, It Starts with Breakfast digital cookbook
Free resources:
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