Gluten free, whole food and blood sugar balancing english muffins
Something you probably know about me by now, is that I take an anti-inflammatory approach to nutrition and managing my endometriosis symptoms. This means being more mindful with processed and packaged foods, and whilst I absolutely have flexibility and enjoy an 80/20 approach (meaning most of the time, my diet is rooted in anti-inflammatory nutrition, and 20% time I enjoy some treats and indulgences), if I can make something a bit more anti-inflammatory and avoid having to buy it from a store, I will, not because it’s better for my health, but because I actually enjoy doing! I am always up for a good recipe challenge.
Which leads me to this week’s recipe. I love English muffins (who doesn’t), and something about the colder months calls me to them. I love nothing more than getting cosy with a hot drink and a toasted English muffin on a chilly autumn day.
But whilst we travel, they’re not always easy to come by, and when we do find them, I am not always a fan of the ingredients. Sure, we could make our own quite simply with some gluten based flour, but with my high risk of developing coeliac disease, if I can make something gluten free and therefore be able to enjoy it more often, of course I will! Plus, the gluten free English muffins on the market are pretty awful so far and I know many of you struggle with gluten as I do.
Not satisfied with just making these gluten free, I’ve also gone for a fibre rich, whole food approach with a little special ingredient to further stabilise blood sugar.
So let’s get to it.
These gluten free English muffins are…
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, my Nutrition Masterclass dives into all the science, and you can also check out my podcast episodes like this one.
Made with whole foods and are rich in healthy fats, fibre and protein to stabilise blood sugar, plus a psyllium husk for an extra blood sugar supportive boost!
Unfortunately, simple carbohydrates, like those found in refined flours and baked goods such as English muffins, are some of the biggest blood sugar spikers, which can pose a problem for us endo gals. And whilst we might think gluten free is a better option, that's not always the case from a blood sugar perspective. Most gluten free recipes will use gluten free flours, but here’s the thing - though they are fantastic for baking, flours (gluten free or gluten-based) are more likely to spike blood sugar, because they provide a lot of starch and carbohydrates, with very little fibre, so all that starch can get digested and absorbed quickly, which is what makes a lot of baked products more blood sugar spiking (and any added sugar of course).
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, fibre and protein, which have all been shown to help stabilise blood sugar levels and slow down the uptake of glucose/starch from our food (oats, 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, over refined carbohydrates, such as flour, 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) .
I’ve also included yoghurt which provides the fat and protein, and can help to make this recipe both blood sugar stabilising and satisfying, curbing those luteal phase cravings. Additionally, fermented dairy, like yoghurt, has been associated with lower rates of type 2 diabetes and insulin levels, as well as lower glucose and insulin levels. See the notes for Greek yoghurt alternatives if you can’t eat dairy.
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.
Overall, these English muffins are on the lower end of a moderate glycemic index and load.
But the real start here is the psyllium husk powder. Multiple studies have shown that taking psyllium husk daily, normally before a meal, can improve blood sugar levels over time. And adding psyllium husk to meals or immediately before meals has also been shown to improve the postprandial (after meal) glucose response, blunting spikes, and one study found these effects were even better when combined with a meal high in protein (such as Greek yoghurt!).
How does this magic ingredient work? Thanks to its high viscous and soluble fibre content. Psyllium creates a gel-like texture by absorbing water (either added water or liquid in our gut) and slows down digestion and transit time, reducing the uptake and slowing down the uptake of glucose and carbohydrates.
High protein to help stabilise blood sugar and satisfy luteal cravings.
You might find yourself experiencing more cravings in your luteal phase, especially for high carb or sugary foods.
This is because progesterone can increase hunger and oestrogen, which is lower in the luteal phase, improves insulin sensitivity, therefore in the follicular phase when oestrogen reigns supreme, our blood sugar is more stable and we are less prone to cravings.
As oestrogen declines in the luteal phase, we can become more vulnerable to blood sugar fluctuations, especially if our blood sugar is already not very well balanced people with endometriosis may be prone to blood sugar instability and metabolic issues). Add to the progesterones tendency to increase hunger, and we have a recipe for cravings - especially if we’re also experiencing PMS, PMDD or nutrient deficiencies (all of which can intensify cravings).
Now, satisfying these cravings is not a bad thing - but how we satisfy them can influence our hormones and our periods for better or for worse.
As we chatted about above, processed foods like store-bought baked goods can potentially contribute to more PMS, menstrual pain and endo pain, but battling off those sweet and carby cravings is not often realistic (or needed!), so I always endeavour to create better-for-you versions of those comforting foods we tend to reach for.
These English muffins do just that with their high protein content. One English muffin provides a around 10g protein, when it comes to luteal phase cravings, protein is your bestie because it improves satiety more than carbohydrates or fats, which means it keeps you fuller for longer. Pair your muffin with some peanut butter and chia seeds, or avocado and egg, and you’ve got yourself a real power house of a snack. If you opt for a dairy free or vegan version, it may be lower, but I’ve given you some options in the notes on how to push protein up.
Boosts the gut microbiome and can ease IBS symptoms, to improve endo belly.
Both oats and psyllium husk offer incredible benefits for our gut microbiome. Psyllium husk is a prebiotic soluble plant fibre, which means it helps to feed our good gut bugs, whilst oats also contain a prebiotic soluble fibre, called beta-glucan.
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.
Prebiotics 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.
But that’s not where the benefits of prebiotics end. Both beta-glucans and psyllium husk both help to boost 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, and have been shown to be heavily involved in endo pathogenesis.
Now you might think that without its prebiotic benefits, that psyllium may worsen endo belly by causing gas and bloating. However, psyllium ferments at a slower pace than some other types of fermentable carbohydrates, which means that it’s less likely to trigger a quick and excessive increase in gas, which results in bloating and other IBS symptoms like cramps, or diarrhoea, etc.
Having said that, it is worth noting that everyone has their own unique triggers, especially if small intestine bacterial overgrowth is present, so just because it’s generally deemed as better tolerated, doesn’t mean it will be, and Monash University, the creators of the Low FODMAP diet, acknowledge that psyllium husk may be one of those fibres which can exacerbate symptoms for some people, despite it being recommended for people with IBS.
Despite the word of warning, psyllium also has other benefits for us endo belly gals and folks. Psyllium is classified as a bulking type of fibre, this means that it increases volume and mass of stools, which in turn, improves consistency and form, and the extra bulk can increase the frequency of bowel movements and increase colonic transit time, which is the time it takes for food to pass through the gastrointestinal tract. This makes psyllium husk a great evidenced based option for people with constipation, and in fact, it has been studied for this purpose multiple times, hence why you will find it in prescription and over the counter laxatives. Additionally, thanks to its gel-forming properties (by absorbing water), psyllium can help reduce diarrhoea and loose stools.
Important notes to help you tailor this recipe to your own body and needs (and tastebuds!)
Making these 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 Greek yoghurt, then we want to replace it with ideally, a high fat and high protein alternative (for structure, as well as benefits).
Good dairy free brands in the UK are Nush, which have a high protein option, and Coyo, which are high fat. Alternatively, you could try sheep or goat’s yoghurt, which may be better tolerated due to contain A2 casein rather than A1, found in regular cow’s dairy products.
You could also try canned coconut milk.
I haven’t tried any of these alternative options, but I’d love to hear how you get on.
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.
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.
Gluten Free whole food english muffins
Ingredients:
225g Greek yoghurt or yoghurt of choice (see notes above)
160g rolled oats
1 tbsp psyllium husk powder (not husks, grind if you only have husks)
1 tbsp water or milk of choice
1 tsp baking powder
Pinch of salt (optional)
Dusting of polenta (optional)
makes: 4 muffins
prep time: 10 mins
bake time: 25-30 mins
cool time: 30-45 mins
Method:
Slowly heat a cast iron pan or any frying pan/skillet you have over a low-moderate heat on the stove (I have found when I don’t start with a preheated skillet/pan, the muffins don’t rise or cook as well).
In a food processor, pulse and blitz the oats and baking powder until there are no whole oats left intact. You won’t have a smooth flour etc the end of it, you’re more so aiming for a course flour, a bit like oat bran.
Next, add the yoghurt and blitz until the dough resembles a thick oatmeal.
Then, add your psyllium husk and 1 tbsp water, and blitz once more until a very thick dough forms - this won’t take long.
Scrape out the dough and divide into four equal pieces. Using either a mould or your hands, shape the dough into muffins and if desired, dust each side with a little polenta (optional).
Preheat the oven to 175c and line a baking tray with baking paper.
Place your muffins onto the skillet/pan and cover with a cast iron pot or saucepan/metal bowl (make sure you don’t have plastic handles that could melt) and cook for 10-12 minutes either side with the lid remaining covered throughout.* They should be a deep golden brown on the outside, a little darker than regular muffins just because we’re using different ingredients and need to cook a little longer.
Once risen, place in the oven for 5-10 minutes to finish cooking through.
Remove from the oven and place on a cooling rack for 30-45 minutes until cool. This is important because the psyllium husk sets whilst cooling, if you slice beforehand, you risk the muffins being a bit doughy.
When ready to eat, slice and toast, and top with desired toppings!
* If you don’t have the right equipment, you can try baking the muffins in the oven for 25-30 minutes, but I haven’t tried this method.