Iron replenishing salted chocolate tahini caramel bar
So I am maybe a little embarrassed to admit that I really don’t like tahini-based sweet treats. Don’t get me wrong - I love tahini - but I love tahini in savoury foods like salads, or drizzled over baked potatoes. But I know so many of you love a tahini goodie, so I sacrificed my taste buds… And actually, I really like this bar. So much so, that I can’t stop thinking about when to eat the rest of it (probably in a minute, as I have no will power).
So, if I really like this salty, chocolatey, tahini caramel laden bar, then you tahini fans out there? You’re going to love this.
And what’s even better is that it looks and tastes like it’s just come out of a fancy chocolate shop - but it’s easy to make, requires just a few healthy ingredients and packs a nutritional punch that can help improve our energy levels with endo.
So, what are we waiting for? Let’s get to it.
This salted chocolate tahini caramel bar is…
Rich in iron to support ovarian function, reduce chronic fatigue and improve ADHD symptoms.
Iron deficiency is extremely common, but did you know that low iron is a pretty big problem for us endo folk?
A recent major study of over 43,000 endo patients found that we have a six-fold increased risk of iron deficiency. SIBO could be a player here, as it inhibits iron absorption but it could also be from heavy menstrual bleeding, restricting red meat and other factors.
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. Dates, cacao and sesame seeds are all rich sources of non-heme iron, making this chocolate bar a delicious addition to your daily iron intake.
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.
High in vitamin E which can help reduce inflammation, oxidative stress levels and period pain, and support healthy progesterone levels.
Sesame seeds are a significant source of vitamin E, vitamin E can help us manage endo and the associated pain that comes with it.
For example, 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 and vit E rich diet, and oxidation levels reduced by 20%!
Vitamin E can also help raise progesterone levels, and whilst we’re not using as high a dose as used in the studies, ensuring you’re getting enough vit E can support a healthy corpus luteum and progesterone production.
Better for blood sugar to stabilise hormones, reduce PMS and lower oxidative stress.
Whilst a good candy bar/chocolate bar are for many of us the go-to luteal or menstrual phase comfort foods, the typical ingredients, like sugar and refined carbohydrates 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, yet also deliver a chocolate bar that rivals any store bought version, I have focused on the presence of healthy fats (from the tahini), fibre (cacao powder, tahini and dates) and protein (tahini), which have all been shown to help stabilise blood sugar levels and slow down the uptake of glucose/starch from our food (dates, and the chocolate, in this case) to our blood stream, preventing blood sugar spikes.
In fact, just 1/4 of this bar offers 6g protein and 7g 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. 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 low 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 tahini and cacao in this recipe to further support blood sugar.
A recent systematic review and meta-analysis found that in multiple studies, tahini improves fasting blood sugar levels and HbA1C (average blood sugar levels) and also has been shown to improve post-prandial (after meal) blood sugar too!
And what may surprise you is that cacao can also improve our blood sugar response! A high cacao content chocolate eaten before a glucose challenge (when people drink a large amount of glucose to test blood sugar responses) was shown to significantly decrease the blood sugar spike following glucose ingestion. Additionally, cacao has been shown to improve insulin sensitivity and diabetes markers.
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 dessert 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. This banana bread, 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).
Thanks to the addition of dates, tahini and cacao powder, this chocolate bar offers 7g of your recommended 30g, with just a 1/4 of the bar.
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 3 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 dark chocolate, dates and tahini, 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 (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, especially one called butyrate. Butyrate is a short-chain fatty acid produced by our gut microbiome, and has been found to be low in people with endo. Butyrate has a range of benefits for endometriosis and gut health (so therefore, can help us tackle endo belly) such as reducing intestinal inflammation, improving insulin sensitivity, preventing leaky gut, promoting the growth of beneficial bacteria and inhibiting the growth of harmful bacteria. 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, so by improving our fibre levels, we may actually be improving some of our defences against endo.
Rich with hormone and endo beneficial nutrients, including magnesium, zinc, B vitamins and calcium.
Tahini, cacao and dates contain so many key nutrients for hormone health. Now of course, we covered all the incredible benefits of vitamin E above, but now let’s look at some of the other nutrients…
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.
B vitamins play a major role in hormone and period health.
Folate is crucial to ovarian function and ovulation, and low folate levels can cause irritability, mood swings and fatigue, and fertility problems.
B6 is one of the most important B vitamins for balanced hormones as it supports progesterone production and oestrogen metabolism. Additionally, research has shown that B6 treatment can help reduce PMS, especially the mood challenges that can come with the syndrome.
Low levels of calcium have been repeatedly associated with increased PMS symptoms and research has shown that treatment with calcium supplements can reduce the syndrome and even period pain because low levels of calcium can cause more contractions. Calcium may also be a supportive option for PMDD.
If using, sprinkle the sesame seeds in the bottom of your chocolate bar mould, and then drizzle or flick the tahini over, so it creates abstract streaks of tahini on the chocolate once set. Don’t leave large globs of tahini as it’ll just stay stuck to the mould - you just want thin amounts that can set within the chocolate. Leave aside.
Break up the chocolate and melt gently over a double boiler.
Once silky and smooth, remove from the heat, and pour 1/3 into the base of the chocolate bar mould, ensuring the base is well covered in chocolate. Refrigerate for 15 mins whilst you make the caramel. Leave the remaining chocolate over the sauce pan but off the heat, to keep it liquid.
Remove the stones from the dates and blend with the tahini and milk until a smooth caramel forms, add the cacao powder and a pinch of salt and blend again until well incorporated. Add more salt if needed.
Spoon into the chocolate bar mould on top of the partially set chocolate. If possible, try to leave a slight border around the edge to allow for chocolate to seal it all in, but don’t worry if you can’t quite manage it.
Take the remainder of the chocolate and pour evenly over the top to encase the centre.
Refrigerate for one hour until solid, and if preferred (I always prefer!), stick in the freezer for 10-15 minutes before eating, it just elevates that chunky bite.
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!
Not sweet enough?
I don’t use a lot of added sugar in my recipes to keep inflammation levels and blood sugar spikes at bay, and I am very used to using lower sugar amounts and natural alternatives like dates, bananas or apple puree, so for me, my tastebuds have adjusted. If something is not sweet enough for you, give it a few bites and some time, and you may surprise yourself as your palate starts to change. However, if you do want some more sweetness to this recipe, trying using an extra date or two.
Is this low FODMAP?
Yes, but there’s nuances…
A low FODMAP serving of tahini is 20g, with a moderate serving being 184g - each 1/4 bar gives you 25g, so this should be well within a low FODMAP serving size for tahini.
85% dark chocolate is low FODMAP at 20g. A 1/4 of this bar would give you 25g of chocolate, and there’s no information about whether above 20g would be amber (moderate) or red (high). However, if we look at dark chocolate in general, we have more specific information: 80g would be considered moderate in FODMAPs, but only for lactose, and if you’re going for an 85% dark chocolate or higher, it’s actually very unlikely that there will be much, if any dairy/lactose in the bar at all, so I think this should be well within a low FODMAP serving.
A tablespoon of cacao powder is low FODMAP, and each 1/4 gives you 1/2 tbsp, so you should be well within your low FODMAP serving sizes.
Why do you make so many recipes low FODMAP?
The low FODMAP diet is being shown in the research to be one of the most effective dietary interventions we have for symptom relief in endo (esp. for those with IBS issues). That doesn’t mean you have to do it, and if you do, it should be done under supervision of a doctor or low FODMAP trained professional, but some people may be on the diet already, so I like to tailor to as many people as possible. It also means this recipe is less likely to trigger bloating (though that’s not guaranteed, because everyone is different).
Is this recipe suitable for SIBO?
Everyone’s triggers vary with SIBO, but this recipe is low FODMAP so can help reduce bloating and flares.
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.
Iron replenishing salted chocolate tahini caramel bar
Ingredients:
1/2 tsp sesame seeds (optional, for decoration)
Tsp tahini (optional, for decoration)
5 tbsps tahini
2 tbsp cacao powder
5 medjool dates (100g)
100g 85% or higher dark chocolate
2 tbsps almond milk (or milk of choice)
serves: 4
prep time: 15-20 mins
chill time: 1 hour
Method:
If using, sprinkle the sesame seeds in the bottom of your chocolate bar mould, and then drizzle or flick the tahini over, so it creates abstract streaks of tahini on the chocolate once set. Don’t leave large globs of tahini as it’ll just stay stuck to the mould - you just want thin amounts that can set within the chocolate. Leave aside.
Break up the chocolate and melt gently over a double boiler.
Once silky and smooth, remove from the heat, and pour 1/3 into the base of the chocolate bar mould, ensuring the base is well covered in chocolate. Refrigerate for 15 mins whilst you make the caramel. Leave the remaining chocolate over the sauce pan but off the heat, to keep it liquid.
Remove the stones from the dates and blend with the tahini and milk until a smooth caramel forms, add the cacao powder and a pinch of salt and blend again until well incorporated. Add more salt if needed.
Spoon into the chocolate bar mould on top of the partially set chocolate. If possible, try to leave a slight border around the edge to allow for chocolate to seal it all in, but don’t worry if you can’t quite manage it.
Take the remainder of the chocolate and pour evenly over the top to encase the centre.
Refrigerate for one hour until solid, and if preferred (I always prefer!), stick in the freezer for 10-15 minutes before eating, it just elevates that chunky bite.
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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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Masterclasses in endo nutrition, surgery prep and recovery and pain relief
This EndoLife, It Starts with Breakfast digital cookbook
Free resources:
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