Oxidative Stress Busting, Iron Replenishing Toffee Bites

As most of us know, endometriosis is an inflammatory disease. It’s these inflammatory chemicals and pathways, that trigger endo growth and pain.

Some of the major players at the centre of this endo inflammation are prostaglandins and oxidative stress. In fact, people with endo have been shown to have higher levels of both of these (check out this and this).

But did you know, we can actually modulate these inflammatory markers and pathways through nutrition and food? Yes - really!

People with endo have been found to have lower levels and lower intake of certain antioxidants, such as vitamin C, E and A to name a few, with higher levels of circulating oxidative stress and oxidative stress markers in the peritoneal fluid (fluid in the pelvic area).

The good news is, treatment with diet and/or supplementation, actually reduced these markers significantly - even in the peritoneal fluid!

So yes, we can reduce the amount of inflammatory endo ‘fertilisers’ in our pelvic area, with food and nutrition.

Pretty incredible, huh? No it’s not the cure, but it’s a major piece of the puzzle to managing endo.

Now, I had a look at the foods they used for reducing these markers, and some of them probably wouldn’t be too realistic for you guys to munch on daily - for example, vit E was obtained with 2 tbsp peanuts and 4 tbsps of sunflowers. Fairly simple enough, but I don’t know how many people would commit to eating those every day!

So, I’ve designed this Oxidative Stress Busting, Iron Replenishing Toffee Bites to provide you with vitamins A and E in significant amounts, with a hefty serving of prostaglandin fighting magnesium on the side.

But the goodness doesn’t end there. Very few of my clients come to me with healthy iron levels, in fact, most of them are deficient. But iron is essential for energy production, mental health and cognitive function to name a few processes, so it’s imperative that we raise levels, especially in cases of chronic fatigue.

So, every single ingredient in this recipe, is a great to good source of iron! Creating these mini iron bites that pack a real punch and get you much closer to reading your (UK) RDA.

Oh, and they taste like Quality Street toffee pennies - but wrapped in chocolate and nutrition. You’re welcome.

This recipe is…

• High in vitamin A from the apricots, providing nearly a quarter or more of your RDA (AI generated).

Various studies have shown an association between low vitamin A intake and endometriosis risk. Researchers believe that low vitamin A levels may be involved in the pathogenesis (development) of endo, as the active form of vitamin A has anti-prolific and anti-oestrogenic properties, halting growth of endo tissue. Whilst there are other factors that could be affecting our levels of active vitamin A, nutritional intake is one of them and the research has shown that these levels can be altered, having a significant impact on oxidative stress markers in the body and in the pelvic area, due to vitamin A’s antioxidant properties.

• High in vitamin E thanks to the nuts and seeds, as well as the apricots!

  As you’ll come to see, there are a few versions you can make of this - and all versions provide a good dose of vitamin E, but the versions with almond butter or sunflower seeds provide the biggest bang for your buck (did you know, just 30g of almonds or sunflower seeds can provide nearly 50% of your RDA?!) - however, these versions are a bit lower in iron than the others.

So, why do we want more antioxidant vitamin E in our diet? 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%!

• A fantastic source of iron from the nuts, seeds, dark chocolate and apricot.

  Your biggest iron hit will come from the tahini version or the tahini and cashew butter blend, coming in at roughly 15% of your UK RDA (AI generated), but every seed/nut I’ve selected for the recipe contribute good doses of iron, so just go for the versions you fancy. Iron deficiency is extremely common, but even more so in people with heavy menstrual bleeding. 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 due to having SIBO, avoiding red meat, heavy periods or other reasons. Supporting healthy iron absorption and intake is a key part of beating endo fatigue and recovering from heavy blood loss.

• A significant source of period wonder 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.

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

Blood sugar considerations

The main ingredient in this recipe is dried apricots, however, dried fruit is a known blood sugar spiker, which we want to prevent. Keeping blood sugar levels stable helps to prevent oxidative stress, which leads to more inflammation in the body and that may trigger further pain and symptoms. Additionally, 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 excessor dominance and low progesterone if ovulation is interrupted or stopped entirely.

 So, to reduce the impact on blood sugar, I’ve wrapped these apricots in fat, fibre and protein from the nuts and seeds (and fat from the dark chocolate) to help lower any spike, and I’ve kept the dark chocolate percentage high, to prevent adding lots of extra sugar. You can also further prevent the blood sugar spike by sprinkling ground flax seeds on top.  Flax seeds provide viscous fibre, a type of soluble fibre that forms a gel in the gut, and is particularly beneficial for blood sugar because it slows down digestion of glucose. They’re also another great source of iron!

I also advise that you eat these after meals, as a little desert or following a snack high in protein, fat and/or fibre, to help prevent blood sugar spikes further.

Additionally, the recommended serving size of dried fruit is 30g, to prevent excessive sugar intake/blood sugar spikes, so this recipe provides four servings to keep it just under this amount. If you exceed a serving, this is very likely going to impact your blood sugar more.

Which nut or seed butter should I use? And what if I have a nut allergy?

The original version I designed of this was all tahini, because tahini provides such a high amount of iron - but I personally found it overwhelming, so I added half cashew butter, and it softened the taste whilst also still getting the benefits of iron in both the cashew butter and tahini. However, I also considered that cashews are super high fodmap, so may not agree with everyone and could cause bloating, hence why I used almond butter as another option, because almond butter is low FODMAP at this serving size. Finally, I wanted to give a purely seed version, for those who cannot tolerate/are allergic to nuts!

Alternatives for dark chocolate or cacao if you’re sensitive

If you have histamine intolerance, interstitial cystitis or dysautonomia, dark chocolate may bother you. For some with histamine issues, dark chocolate can be flare inducing, whilst for those with IC, it could irritate the bladder and finally, with dysautonomia, it might be too stimulating. However, and this is a big however, everyone has different responses and I have very few clients who can’t tolerate dark chocolate (unfortunately, I am one of the few who can’t have much).

If you’re sensitive to dark chocolate, you could swap the chocolate for a carob bar (I have a recipe here, just omit the lion’s mane).

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 gut health and blood sugar.  

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

Method:

• Melt the dark chocolate on a low heat in a double boiler.

• Once melted, add your chosen nut/seeds butters and vanilla (if using), and whisk gently or use a spatula to combine.

• Cover a chopping board with a layer of baking paper, and arrange your apricots across it. One by one, using a fork, roll the apricots in the chocolate, and then remove and place onto the paper.

• If using flax or hemp, sprinkle with these in desired amounts. Save the salt for once the chocolate is set, otherwise it dissolves.

• Freeze for at least an hour, and then sprinkle with salt if desired.

• Keep frozen, and take out of the freezer 3-5 minutes before consuming - this gives you a really good toffee chew, but without breaking your teeth!