Small batch Endo Belly Healing peanut butter hobnobs (a.k.a crunchy oat cookies)

These biscuits are:

• High in beta glucan, a soluble fibre found in oats. Oats have been shown to significantly increase propionate, a type of short chain fatty acid which has significant systemic anti-inflammatory effects and blood sugar stabilising benefits. Lowering inflammation and balancing blood sugar are two key methods for managing endo.

• A source of resistant starch, one of the only fibres to boost levels of butyrate, a short chain fatty acid that may help us fight endo and endo belly (and is often low in people with endo) by targeting toxins called LPS, which contribute to endo growth. Resistant starch is found in raw oats, and cooked and cooled oats (amongst other foods).

• Contain ground psyllium husk, a type of fibre that helps to boost all three short chain fatty acids (in varying degrees), to improve gut health, blood sugar and inflammation levels. Psyllium husk can also improve constipation, diarrhoea, bowel regularity and stool consistency - issues many with endo struggle with. Psyllium husk is slow to ferment, so is often better tolerated by those with IBS and SIBO, and is recommended as a dietary source of fibre by Monash University, however - remember everyone is different.

• Low in FODMAPs, helping to prevent bloating (a.k.a endo belly) and IBS flares. You don’t need to go full low fodmap to manage endo/endo belly - and even if you do, it shouldn’t be a long term solution - but having snacks or treats in that don’t make you feel terrible, is always a bonus, so I’ve tried to make these so that they prevent bloating in the short term whilst also helping to address the root cause long term!

• Low in sugar, rich in fibre, protein and healthy fats to prevent the blood sugar spike that often occurs with cookies and biscuits. In fact (according to AI calculations) these biscuits have a low glycemic load!

Important notes to help you tailor these biscuits to your own body and needs (and tastebuds!)

Oat bran vs. Rolled oats

This recipe uses oat bran rather than rolled oats, the reason being is that oat bran is higher in fibre than rolled oats, being less processed, and so boosts the fibre content of these biscuits, which contributes to gut health and blood sugar stability.

If you can’t find oat bran, don’t worry! Rolled oats are fine, but try to avoid the ‘quick cook’ type, which have the least amount of fibre.

For those with coeliac disease or a bad gluten sensitivity, you’ll need to look for gluten free oats (oats do not contain gluten, but are often handled in factories that also handle gluten).

Psyllium husk

This recipe specifically includes psyllium husk for its endo belly fighting benefits (see above). Psyllium husk is generally well tolerated, but it should be consumed with caution as it won’t be right for everyone (have a read or listen to my podcast about its benefits, uses and how to consume it).

The content of psyllium husk is moderate, about 2.5g for the whole recipe, so if you’re eating these across a few days, it shouldn’t cause an issue and in theory, should be beneficial. And if you’re someone who is used to high doses of psyllium (such as 6g for constipation etc), these biscuits should be more than fine, but I would be wary about having your usual amount of psyllium as well as the biscuits, maybe consider reducing your usual intake or check with your doctor first if the psyllium was prescribed.

If you’re new to psyllium husk, I definitely wouldn’t recommend you eat the entire batch in one go, to prevent a sudden jump up in psyllium husk intake, which if done out of the blue, especially without extra fluid and just in one day, could cause constipation because it’s bulking. It’s always best to build up with psyllium husk, to test your tolerance. One to two cookies per day is a good amount (esp. when we consider blood sugar levels too), however, I recommend you read or listen to my podcast before you get started with this recipe so you can decide!

If you have a bowel obstruction or adhesions/endo on the bowel, because psyllium husk is bulking (it increases the volume and consistency of stools), you should speak to your doctor first before bringing psyllium into your diet.

Bloating

Each biscuit is low FODMAP, and even two should be low FODMAP, three biscuits and you’re moving into moderate FODMAP levels.

FODMAPs are rapidly fermentable carbohydrates, which means they make gas in the gut quickly, which can trigger bloating and gastrointestinal distress and symptoms. Because so many of us with endo suffer from bloating, I’ve kept the FODMAP levels low, to try and prevent them from triggering endo belly.

However, the low FODMAP diet doesn’t work for everyone, and everyone has different triggers, and this is especially true if your bloating is caused by small intestine bacterial overgrowth, so whilst I’ve done my best to keep these endo belly friendly, it’s not a guarantee, because every gut is unique!

Blood sugar and Maple Syrup

I make my own biscuits with chicory root syrup (a.k.a inulin syrup), which is high FODMAP because inulin belongs to a group of highly fermentable dietary fibres called fructans.

However, the great thing about chicory root syrup/inulin syrup (it tends to be named differently depending on the location, brand, etc), is that it is naturally sweet but is very low in naturally occurring sugar, and because it’s so high in fibre, it ends up being very blood sugar friendly and can slow down the release of the other carbs you’re eating.

It also works well in biscuits because it helps to create that snap and crunch, whereas I’ve found other sugar free natural sweeteners like monk fruit and allulose don’t do this, in fact, they can make biscuits and cookies quite cake-y.

The problem is of course, these recipes are about keeping bloating down, and so for many of you reading, chicory root is not going to be a good idea for you, because it is so fermentable.

And given all my experimentation, I know the other blood sugar balancing alternatives aren’t going to cut it texture wise. I did try dates, but they made an entirely different type of biscuit and didn’t work in this recipe (despite trying several times!).

So, I resorted to maple syrup, but I kept the amount low, so that per serve, the actual amount of sugar is quite low, and I ensured that the biscuits have a good amount of fat (from the almonds, peanut butter and oil), protein (nuts, oats to a degree) and fibre (nuts, oats, psyllium husk) to slow down the reaction.

I’m pretty sure if you want to reduce the sugar content, you could go down to 15g and they would be sweet enough, but I’ve spent years reducing my sugar intake so I appreciate my taste buds have adapted, but give it a go if you’re curious!

Blood sugar and Glycemic Load

Now, even though I can’t quote this as 100% accurate, I did run this recipe through AI, and the glycemic load per biscuit is classified as low, so in theory, this is pretty blood sugar friendly - but when it comes to blood sugar, we all have unique reactions, so see how you feel on them.

If you’re unfamiliar with glycemic load, here’s a quick break down:

Firstly, we want to understand the glycemic index. The glycemic index looks at how quickly carbs in a food break down and are absorbed; high glycemic foods break down quickly and can cause a spike, and lower have less of an impact.

The glycemic load looks at both how quickly the food breaks down but also how high it is in carbohydrates. This is thought to be a better evaluation of the impact a food has on blood sugar, because sometimes a food may break down quickly, but doesn’t have a high amount of carbs per serve, so actually, eating it in a normal serving size wouldn’t necessarily cause a spike. This is also true for something that has a lower GI, but if a normal serving size is pretty high in carbs, it can actually spike blood sugar levels higher than its GI rating would indicate.

Two biscuits would likely still be a low glycemic load, but three you’re maybe moving into moderate glycemic load territory, and also moderate fodmaps, as explained above.

If you want to learn more about this topic, here’s two great resources:

https://www.betterhealth.vic.gov.au/health/healthyliving/carbohydrates-and-the-glycaemic-index#

https://glycemic-index.net/?s=goji

Boosting the resistant starch

Resistant starch is a type of starch that resists digestion in the small intestine (does what it says on the tin!) and so makes its way to the large intestine, where it is consumed by bacteria (fermentation). This process of fermentation boosts short chain fatty acids, specifically butyrate, which is really beneficial for endo (read more about that here), but it also means that the starch which would normally break down quickly and cause a spike in blood sugar, doesn’t get to do that, because it has changed chemically and has become ‘resistant’. To understand more about this, have a read or listen to this episode.

Resistant starch occurs naturally in raw oats, but is also formed when oats have been cooked and cooled. The amount of resistant starch is increased even more when left overnight or for 24 hours, and especially if refrigerated. So, these biscuits are going to be more blood sugar balancing and more gut friendly if you refrigerate them overnight or for 24 hours.

Because cookies and biscuits often need to be stored in a cool and dry place, and can go soft in the fridge, I tested this out, and tested them on my boyfriend. I stored some in a tight jar in the fridge overnight and some in the cupboard, the cupboard biscuits are a little more crisper, they just have a tad more snap, but the fridge biscuits are just as crumbly and satisfying, and if I hadn’t mentioned anything, my partner wouldn’t have noticed the difference. So, it’s up to you! Do what you’d prefer, but if you’re eating them for the health benefits, the fridge is a good choice.

The other thing to note, that whilst these biscuits are a source of resistant starch, you’d have to eat a lot to really crank up the levels, so try to get other sources throughout the day, which you can learn about here.

So are these a health food?

See these biscuits as biscuits with benefits, rather than a health food to eat every day. I mean of course, do what you want and enjoy your life, but I’m here as a health coach, so naturally I’m going to lean towards the healthier lifestyle advice.

These biscuits do contain sugar from maple syrup, so they might contribute to higher blood sugar levels (though I’ve tried to prevent that and it’s unlikely, see above), and additionally, the more sugary snacks we eat, the more likely we’ll crave sugar, and that can keep us going back for more.

Sugar feeds the bad gut bugs that we’re trying to inhibit (people with endo may have higher levels of certain pathogenic and opportunistic bacteria and low levels of good ones), but I’ve counteracted that by adding lots of plant ingredients and fibre, which our good gut bugs love, and ingredients that specifically support a healthy microbiome. I’ve also kept the amount of maple syrup pretty damn low for a biscuit recipe, so again, unlikely to be much of an issue because the research points to high sugar intake, but overall, we know a diet low in processed, sugary foods is better for our health and our gut.

Finally, one of the reasons processed foods and processed meats are unhealthy for us is because of their levels of advanced glycation end products. Advanced glycation end products are harmful compounds that are produced when proteins and fats react with sugar molecules, and this can occur during cooking (they can also be produced naturally in our body from blood sugar spikes). AGES cause oxidation in the body, an inflammatory process linked to endo. If you want a 101 on AGES, this is a great easy-to-digest article.

Baked goods, even healthier ones like these, are higher in AGES than say, my no bake brownies or no bake cookie dough bars, because the cooking is what causes the molecules to bond. High temperatures, dry cooking methods and long cooking methods, as well as browning of food (called the Maillard reaction) increases the production of AGES.

Lower cooking levels (under 180c), moist cooking methods (so say stewing over grilling), and shorter temps, with less browning, lowers the AGE formation. There’s also some great hacks, like adding certain herbs and spices, that can further prevent their formation - but that’s a podcast to come!

By keeping these cookies lower in sugar than the typical biscuit or cookie, this helps to keep the AGE formation lower and prevents blood sugar spiking (a major contributor to AGE formation in the body). However, the fat/protein in the almonds and peanut butter (which help support blood sugar) contribute to the AGE formation process when being cooked. I’ve kept the temp lower at 175c, and the cooking time short, to try and minimise the AGE formation. Overall, these biscuits probably have a moderate AGE level per serve. You could take them out two minutes earlier, which would lessen the browning effect - I’ve done this, and they’re still very good, just not as crisp.

The other thing is, that a diet rich in antioxidants helps counteract the effects of AGES, so if your diet is rich in plant foods, lots of herbs and spices, veggies and fruits, then snacking on these biscuits really is not going to be a significant issue. High AGES come from foods like fast food, fried food, processed foods, bacon, processed meat or high heat cooked meat, blood sugar spikes, etc. As you can see, a few healthier cookies in the context of an overall healthy diet, is not the problem, so please don’t worry. I’m just giving you all the info because to me, it’s important you’re informed so you can make educated decisions about your health.

Overall, these are a healthier choice than your standard hobnob biscuits (or general cookie) etc. due to the added fibre, added gut boosters, low sugar, etc. Like I said, if you fancy some biscuits and want some added endo benefits, these are the ones. But if you want a daily endo belly booster with less AGES, then my brownies, mousses, cookie bars, etc. are a better bet, in my opinion. With that being said, you shouldn’t (really shouldn’t!) feel guilty or worried about these. I want you to have your cake (biscuit) and eat it - and I’ve done everything in my power to help you to feel good about that choice! Every bite is helping in the fight against endo, so enjoy. :)

Further resources

If you’re struggling with your 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, plus, you might find these article helpful in terms of how to manage your blood sugar levels and why:

https://endometriosis.net/living/diet-sugar

https://endometriosis.net/living/how-to-balance-your-blood-sugar-levels-to-reduce-endo-symptoms

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

Method:

• Preheat the oven to 175c and line a baking tray with baking paper.

• Add all the dry ingredients into a medium sized bowl and whisk with a fork to incorporate.

• Add the peanut butter, oil, water, vanilla and maple syrup, and mix with a spoon or spatula until it forms a dough.

• Refrigerate for 10 minutes to firm up.

• Divide into six even balls, using a tablespoon if needed.

• Space out evenly onto the baking paper, and squash down with your hands or a spatula, until about 2.5 - 3 inches in diameter. I pressed them down inside a biscuit mould to keep them neat, you could roll the dough and cut, but I didn’t feel this dough would take well to that - it’s not strong enough and I think would keep breaking as you rolled it.

• Bake for 14 minutes until just browning around the edges.

• Remove from the oven, they’re quite hardy so can be moved to a cooling rack pretty much immediately, but they’re hot, so maybe wait a minute or two to save your fingers!

• Leave to cool for 15 minutes before tucking in, but ideally, once totally cool, store in a tight jar and leave overnight or in the fridge, to build resistant starch.

• These cookies will keep in a seal container for about three days.