The ultimate endo friendly peanut butter oatmeal cookies

If the world of recipe blogs and social media is anything to go by, most of us love a peanut butter oat cookie. And I would have to say, I agree. For years, I’ve been thinking about trying to perfect my own recipe, but as I shared in my recent Double Chocolate Chip cookie recipe, a really endo supportive cookie recipe - that’s also delicious - has evaded me, despite many, many attempts.

If you follow my recipes, you know I love to keep them rich in a antioxidants, fibre, protein, healthy fats and blood sugar balancing, so even though there are lot’s of healthier cookie recipes out there, many of just didn’t hit the mark for me. Especially as I like to include functional ingredients that actually can help us manage endo.

Then, I cracked it with my recent PMS Double Chocolate Chip Cookies, and realised I could probably use this recipe as a basis for my very own Peanut Butter Oat Cookies.

And so I did, and the result was gooey, melt in the mouth PB cookies. The bonus? Peanut butter actually comes with some pretty significant health benefits for us endo peeps, so read on to learn more…

These cookies are…

• High in vitamin E which can help reduce inflammation and period pain, and support healthy progesterone levels.

Peanuts are a significant source of vitamin E, and just two tablespoons provides 2.9mg of your daily 3mg requirement. This recipe contains roughly 8 tbsps of peanut butter, meaning each single cookie provides around 1.9g of your daily 3mg (and the’s not including small amounts from the other ingredients).

Vitamin E can help us manage endo and the associated pain that comes with it. 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% - this study actually used sunflower seeds as their main vitamin E provider.

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.

• A great source of prebiotic and soluble fibre for microbiome health and bowel regularity.

People with endo have already been shown to have microbiome dysbiosis, with lower levels of some beneficial bacteria and higher levels of pathogenic (bad) bacteria, which can not only fuel IBS symptoms like bloating, but also inflammation.
These cookies are a great source of polyphenols from the peanut butter, dark chocolate and flax. Polyphenols are types of antioxidants found in certain plant foods that not only reduce inflammation levels and improve overall health, but they are also a favourite food for our gut microbiome, which means that can support our good gut bugs to thrive.

Additionally, flax seeds contain prebiotic fibre, which is fibre that resists digestion and ends up in the large intestine, where it feeds gut bugs. This in turn increases levels of short chain fatty acids (SCFA), beneficial gut compounds which are produced when good bacteria eat fibre. These guys help to keep inflammation down in the gut and the body, help to keep blood sugar levels healthy, inhibit bad bacteria and foster good bacteria growth.

Because research suggests that people with endo may have gut inflammation, high levels of unhealthy gut bacteria and low levels of beneficial bacteria, as well as blood sugar issues, and often low levels of short chain fatty acids, replenishing SCFA levels and restoring the microbiome management is essential to endo belly and endo management overall.

Finally, as we explored earlier - flax helps keep you regular. In fact, it’s an evidenced based treatment for constipation, which I know many endo peeps struggle with, especially in the luteal phase when progesterone can slow down motility.

• Blood sugar balancing and sweetened only with moderate amounts of fruit to prevent glucose spikes and inflammation.

Most cookies are laden with simple starches and sugars, and tend to cause elevated blood sugar levels. They’re also classified, when store bought, as ultra processed, which as we explored earlier, can potentially contribute to more PMS and endo pain.

I wanted to create a healthy, functional food cookie that was lower in sugar, used wholefoods to sweeten and didn’t spike blood sugar, but also tasted good. I’ve sweetened only with dates, and have kept the amount of dates to a moderate portion, so that each serving (two cookies) is only 7-9g of naturally occurring sugar (and a little from the dark chocolate).

I also added our sidekicks fat, fibre and protein in the form of peanut butter and flax. These can help slow down the release of glucose to the blood stream, creating a steadier stream of glucose vs. a big spike. In fact, peanut butter is a bit of a super hero for this. Adding 2 tbsp (32g) of peanut butter to high starchy, sugary and high carb foods has been shown to lessen the blood sugar spike that these foods would typically cause. And flax seeds also provide viscous fibre, a type of soluble fibre that forms a gel in the gut, and is particularly beneficial for blood sugar because it significantly slows down the digestion of glucose.

So why does this matter?

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. In fact, oxidative stress is higher in people with endo, and it’s a key driver of endo growth.

When we’re in our luteal phase, we often experience more blood sugar swings because oestrogen, which dominates in our follicular phase, helps us 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 low in sugar and rich in fibre, can help us get our fix without the pain triggering spikes.

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 excess or dominance and low progesterone if ovulation is interrupted or stopped entirely.

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!

• Provide a therapeutic amount of flax seed to support healthy oestrogen metabolism.

  Flax seeds are rich in a type of fibre called viscous fibre, which creates a gel-like substance in the gut, and bulks out bowel movements, improving regularity and treating constipation. This is absolutely essential for the last step in clearing out oestrogen - we want to be having at least one bowel movement a day to keep oestrogen at a healthy level. When oestrogen is hanging out in the gut, not going anywhere, it can be reabsorbed, creating higher levels of oestrogen once again.

  This is especially true if we have elevated levels of an enzyme called beta glucuronidase, that can be high in people with endo, and recirculates waste oestrogen. The good news? Eating a diet rich in fibre (which flax seed offers in great amounts) helps to lower levels.

  Flax seeds have also been shown to improve the metabolism of oestrogen through the liver, by increasing the amount of healthy oestrogen waste products (known as metabolites) and reducing the amount of the more potent, harmful ones, which can cause more oestrogenic activity.

  Finally, flax contains lignans, plant compounds that have mild oestrogen-like effects, but are no where near as potent as oestrogen. Structurally, they mimic oestrogen and so can bind to oestrogen receptors. Think of a receptor as the lock, and oestrogen as they key, when we turn the lock, it triggers an oestrogen activity like thickening of the uterine lining. This can actually reduce the impact of high oestrogen levels, but also supports low levels, in menopause, for example.

  In fact, one study showed that the participants who consumed 10g fresh, ground flax seeds (uncooked), daily for three cycles had longer luteal phases and a higher progesterone to oestrogen ratio in the luteal phase as well. You’ll be pleased to know that these cookies provide 10g of flax per serving (2 cookies).

  Now, despite what the research shows, everyone is individual, so if you find flax seeds make you feel more oestrogen dominant, please listen to your body, and I advise you listen/or read this and this, for more info on how to use flax for your body and endo.

• High in minerals magnesium and iron to support energy, PMS and menstrual health.

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. Just one cookie provides around 25%-30% of your magnesium RDA, thanks to the peanut butter, flax, dark chocolate (and a little from the oats and dates).

But we also have iron, at about 11% of your RDA per cookie. Iron deficiency is extremely common in general, 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 and low levels can cause brain fog, extreme tiredness, heart palpitations, dizziness, muscle weakness and depression to name a few.

Now, it’s worth noting that iron from plant foods is a type of iron called non-heme iron, and it’s typically harder to absorb. Pairing these cookies with a source of vitamin C, like strawberries, can actually aid absorption.

• A great source of B6 and folate for hormone health, energy and mental health.

These cookies provide just under 15% of your RDA for of both B6 and folate, per cookie!

B6 is one of the most important B vitamins for balanced hormones as it supports progesterone production and oestrogen metabolism. Many people with endo suffer with depression and anxiety, but also, if you suffer with hormonal imbalances like low progesterone, this can also cause significant mood shifts because our sex hormones support neurotransmitter production and regulation.

B6 plays a pivotal role in the production of feel good neurotransmitters serotonin and dopamine, whilst also supporting GABA production, our calming neurotransmitter.

Oestrogen regulates both serotonin and dopamine, and so when oestrogen dips in our luteal phase, some of us can feel the effects of this, especially if we’re low in progesterone. Progesterone upregulates GABA receptors (basically, makes us more sensitive to GABA so it’s more effective) and so when progesterone is low, we can really feel the lack of GABA support - in fact, low levels of GABA have been linked to PMDD.

Finally, research has shown that B6 treatment can help reduce PMS, especially the mood challenges that can come with the syndrome.

Low folate levels can cause irritability, mood swings and fatigue, whilst low B1 levels have been associated with more severe menstrual cramps, and treatment with B1 has been shown to significantly reduce period pain.

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

Sweetness and blood sugar

These won’t taste like your store bought cookies because they don’t have anywhere near the amount of sugar in them, but as you begin to reduce your sugar intake, your tastebuds should adjust! They’ll also adjust after a few bites too.

If you want to boost the sweetness, use medjool dates as they’re higher in sugar than most dates, and go for an 85% rather than a 90% chocolate, because again, it’ll have slightly more sugar. Don’t worry, the sugar content of these won’t be too different (though do check the labels of the chocolate, some brands do whack up the sugar content), and as I said, I’ve added flax, peanut butter, etc. to support blood sugar, and I’ve kept the amount of dates moderate as well.

As with all sweet snacks, they are best consumed after meals because the fibre, fat and protein from your meal helps slow down the release of glucose, or you can consume before an activity, like a walk, etc. which helps use the glucose in the cookies for fuel. This is just the ideal scenario for blood sugar - but as I’ve said, I’ve made these cookies as blood sugar supportive as possible (without making them with a sugar free alternative or keto), so in theory, you should be able to enjoy as a snack watching a movie, without having to worry!

Everyone’s blood sugar is different, so judge how you feel after the cookies or measure your glucose levels if you’re really curious, to see how you respond. If you feel (or see on a glucose monitor) that these spike you, try eating the two cookies one by one, at separate times, so you still get the therapeutic amount of flax across the day, but you’re not having as much sugar in one go (even though it’s not a lot!).

Nut butter swaps

If you can’t eat peanut butter due to an allergy, sunflower seed butter is a good swap here, as flavour wise, it’s fairly close!

Endo belly and FOMDAPS

All the ingredients in this recipe come in as low FODMAPS per two cookies, so this means they are less likely to trigger bloating and endo belly because they are low in fermentable carbohydrates. But remember, everyone is different, and tolerance to foods and fibres can vary dramatically, especially if you have SIBO, so if you find two cookies at one sitting triggers bloating or any gut discomfort, try eating one at a time at separate sittings, and you may find you tolerate them better.

Oil separation

Creating an egg free, dairy free and gluten free cookie, without regular sugar, and making it chewy, is no easy task! One of the biggest problems I’ve had is oil separation from the nut butter due to the lack of flour. This final version is oily, but the oil isn’t spilling out whilst baking, which was happening with previous batches of the PMS cookie. I’ve added very specific instructions to the method to prevent the oil separation from happening too much - not soaking the dates, not adding liquid, folding the flax gel into the dry ingredients first before adding the but butter, and not over folding/mixing. Follow the method to the letter, and your dough will be fine - it’ll still be oily to handle (hence why I say shape with wet hands), but you shouldn’t have oil leaking out of the cookies during the baking time, which creates a dry cookie and affects the texture! These are oily, but they hold their oil, if that makes any sense?!

Claggy?

A big disclaimer here. I am currently on the elemental diet, and so I had to make three recipes in one week, to get them all ready for my two weeks of not being able to eat anything at all (except of course, the elemental diet!). Now, making three recipes when you see clients daily is no easy feat, and because I’d literally tested the Double Chocolate Chip Cookie recipe 10 times, I felt reasonably confident that I didn’t have to recipe test this one more than once (I aways recipe test my recipes three times minimum) because I was so up against the clock. I loved these cookies and so did Chris, but I felt that some bites were a little claggy occasionally (this can happen with PB), so in an ideal world, I’d perfect them more. But Chris loved them, and found them more melt in the mouth, and thought I was being a perfectionist, so, see what you think. As I said, I still loved them, but I feel I could make them even better, so maybe they’ll be a Peanut Butter Oat Cookie 2.0.

If you find them a little claggy, I would suggest first starting with the type of peanut butter you’re using - try to go for a really runny and smooth one. You could also, very carefully, add 1-2 tbsp of milk of choice to the mix, I would do this when you add the flax to the dry ingredients - be cautious here as my experience with the PMS Cookie recipe was that extra liquid caused oil separation.

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.

The ultimate endo friendly peanut butter oatmeal cookies

Method:

• Preheat the oven to 160°C (fan) / 180°C (conventional). If you find after making these you want them firmer, go for 170/190°C next time, but you may need to remove a minute or two early as they may start to catch.

• In a small bowl, combine the water and flax and stir well. Leave to gel whilst you work on the following steps.

• Pulse and then blend the dates, vanilla and the peanut butter in a food processor until you get a smooth paste or dough like texture (depending on the thickness of your nut/seed butter and the type of dates you have, you could get one of the other, both are fine!). You might not be able to get it perfectly smooth because we’re not using a liquid, don’t stress about that - just get it as smooth as you can. Don’t soak dates first or be tempted to add liquid, as the oil from the nuts and the water will separate.

• In a separate bowl, add the oats, baking soda and salt and stir to combine.

• Chop your dark chocolate into fairly big chunks and set aside.

• Add the flax egg to the dry ingredients, and stir and fold well until a dough forms.

• Add the nut butter blend and then fold in again until a dough forms. Work fairly quickly here.

• Fold in the chocolate chips.

• Divide into 6 equal balls and place on the baking tray, evenly spaced.

• Press down with the back of a wooden spoon or with your hands.

• Bake for 12-13 minutes until golden brown. They’ll be soft to touch still, but will firm up when cooling.

• Leave on the tray for 5-10 minutes to cool before transferring to a wire cooling wrack, you could eat them now, and they’ll be very gooey. Or leave to cool for another 20-25, they’ll be firmer but still very melt in the mouth.

• Sprinkle with sea salt flakes before consuming, if desired.

• I store these in an airtight container in the fridge for up to three days.