EP.311/ Butyrate and Resistance Starch - How Can They Help You Fight Endo and Endo Belly?
Last week I talked about short chain fatty acids and their benefits for endo, and why people with endo need to focus on these to help manage the disease.
Today, I want to talk about how to boost one of these types of short chain fatty acids, called butyrate.
Butyrate for us endo peeps is arguably the most helpful of the short chain fatty acids.
Firstly, it is the primary source of fuel for your intestinal cells, which keeps your intestinal lining healthy and therefore, helps heal leaky gut.
When your gut is leaky, bacteria and their toxins, called lipopolyscacharrides, can leak out into the pelvic cavity and blood stream, and can actually contribute to endo development. In fact, people with endo have higher levels of LPS in the gut, blood stream, menstrual blood, lesions and peritoneal fluid (fluid that surrounds the organs in the abdomen).
These LPS trigger an inflammatory reaction from the body, that contributes to endo development.
Butyrate actually inhibits these reactions, and was shown in mice models to reduce the growth of lesions.
Butyrate also helps to lower intestinal inflammation, and we know that intestinal inflammation can spread, triggering low grade inflammation throughout the body, but also locally (so nearby), such as the pelvic organs. Endo is an inflammatory disease, with inflammation being at the centre of its growth and pain, and people with endo have higher levels of multiple inflammatory markers, so we want to take as many steps as we can to keep inflammation levels normal, rather than excessive.
Butyrate has also been shown in multiple studies to improve insulin sensitivity and blood sugar management. Insulin is the hormone that delivers glucose from our food to our cells, we become resistant to it when we are having too many blood sugar spikes over time. Eventually, insulin resistance leads to type 2 diabetes.
But from an endo perspective, keeping blood sugar levels stable and our insulin response healthy is important because blood sugar spikes lead to a process called oxidation, which is linked to endo development, as well as a spike in prostaglandins, which can trigger pain. High insulin levels also cause significant hormone disruption. Finally, endo has been linked to metabolic issues and blood sugar instability, so we want to actively support our blood sugar to reduce the risk of developing diseases like diabetes.
If you want to learn more about blood sugar and endo, I’ve linked to some free resources in the show notes, but you can also purchase my Nutrition for Endo Advanced Masterclass, which is solely about blood sugar and endo.
Finally, butyrate promotes the growth of beneficial bacteria such as Bifidobacteria and Lactobacilli, and actually inhibits harmful bacteria by creating an environment that minimises their chances of survival, such as altering the pH. People with endo tend to be lower in beneficial bacteria, and higher in gram negative and harmful bacteria, which can increase intestinal inflammation, leaky gut, IBS symptoms and LPS levels.
So, how do we improve butyrate levels?
The answer is resistance starch.
Resistant starch is a type of fibre and it is the only type of fibre to really boost butyrate, some types, like inulin produce a little, but not as much as they produce other short chain fatty acids. And additionally, resistant starch primarily boosts butyrate, rather than the other types of short chain fatty acids.
Resistant starch is a type of starch that resists digestion in the small intestine. Typically, starch is broken down and absorbed very quickly by the small intestine, which is why you may hear me or other health practitioners discuss moderation or being mindful with starchy foods, because it can spikes blood sugar.
But resistant starch resists digestion. It makes its way to the large intestine, where good bacteria eat it, and produce butyrate.
Because it resists digestion and breaks down slower, resistant starch is better for blood sugar vs. regular starch. In fact, resistant starch has been shown to be improve insulin sensitivity and blood sugar levels in multiple studies.
It also is can be better for those of us with bloating and IBS issues, a.k.a endo belly. People with endo belly and small intestine bacterial overgrowth (which many of us with endo have), may be more reactive to types of fibre called FODMAPs, which are essentially, fermentable carbohydrates. FODMAPs ferment quickly, creating a sharp spike in gas and therefore bloating. Resistant starch ferments slowly, so is less likely (though not impossible) to cause bloating.
A huge win for those of us (like me) who struggle with bloating from carbs.
There are different types of resistance starch and so it’s helpful to try and get a variation of these, if you’re able to:
Type 1 comes from wholegrains, seeds, uncooked oats, pulses and legumes.
Type 2 comes from foods like green bananas, lentils and raw potatoes (yes, you can get this in a powder form, it’s a type of potato starch from raw potatoes and is very high in resistant starch).
Type 3 is produced when certain starchy foods are cooked, then cooled, such as rice, potatoes, oats, bread and pasta.
Obviously we want to try to go for whole foods for the most part, but if you want some pasta or bread, cooking and cooling is a great way to have these and improve their impact on your health, both from a blood sugar perspective and from a gut perspective.
With all of these, the best outcomes are when chilled in the fridge overnight, and with bread, the resistant starch is produced from freezing the bread, which you can use for toast, for example, the next day.
If you’re cooking and cooling rice, be mindful of the risk of food poisoning, so I’ve linked to a resource on how to cook, cool and reheat rice safely.
If you want to reheat these foods, they will still contain more resistant starch than had you eaten them fresh off the stove but less than just eating them cold.
Type 4 is made by chemically modifying starch. These ingredients are normally used in processed foods as thickeners and emulsifiers.
From an overall health perspective, it’s probably not best to try and get your resistant starch from type 4, as it will mean increasing your processed food intake, which is associated with worse gut health and overall health outcomes.
So, how much resistant starch should we be getting a day?
There’s truly no agreed amount, but various studies and sources show benefits at around 15g-30g, some going higher to even 40g or 45g.
To get that much resistant starch, we need to be having a couple of sources a day as most sources come in at anywhere from 1g to 5g per serving.
I personally try to have resistant starch with every meal, and even snacks. I have uncooked oats, and seeds with my breakfast, I have cooked and cooled potatoes with lunch, and I tend to have lentils or cooled rice or grains with my dinner.
These are the forms of resistant starch that work for me, but as you heard earlier, their are a number of types, and some can get your levels up very quickly, like raw potato starch, which is flavourless and can be added to lots of foods.
Additionally, play around with which types work best for you. For example, you may find that lentils upset your stomach, but that you’re great with uncooked oats.
For me, I do really well with the foods I listed, but green bananas give me bloating and an upset stomach, which can absolutely be down to the other sources of fermentable carbs found in bananas. So, experiment until you find the ones that work for you.
If you’re not sure how to get started, head over to my Instagram, where this week I am sharing fudgy resistant starch raw brownies, and I’ll be sharing more recipes in the coming weeks!
Show notes
SCFAs/Butyrate
https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10233627/
https://www.nature.com/articles/s41598-018-30114-4#:~:text=Probiotic treatment also significantly enhanced,SCFAs in the gut48.
https://www.healthline.com/nutrition/short-chain-fatty-acids-101#TOC_TITLE_HDR_9
https://biosignaling.biomedcentral.com/articles/10.1186/s12964-023-01219-9
https://zoe.com/learn/what-are-short-chain-fatty-acids
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9577580/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10305054/
https://www.healthline.com/health/butyric-acid#bottom-line
Endo and inflammatory markers
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7956504
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5859972/
Bacteria and endo
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805679/
https://www.thelancet.com/journals/lanmic/article/PIIS2666-5247(23)00221-5/fulltext
https://www.healthline.com/health-news/endometriosis-may-be-caused-by-this-bacteria
Endometriosis and blood sugar
https://pubmed.ncbi.nlm.nih.gov/37673102/
https://pubmed.ncbi.nlm.nih.gov/7918300/
https://jamanetwork.com/journals/jama/article-abstract/202670
https://pubmed.ncbi.nlm.nih.gov/20497781/
https://pubmed.ncbi.nlm.nih.gov/19088375/
https://pubmed.ncbi.nlm.nih.gov/20537326/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7333061/
https://pubmed.ncbi.nlm.nih.gov/18508964/
https://pubmed.ncbi.nlm.nih.gov/12379575/
https://www.ncbi.nlm.nih.gov/books/NBK493173/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9783643/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC308109920
https://www.wildnutrition.com/blogs/our-blog/endometriosis-part-2-the-link-between-sugar-and-the-immune-system
https://pubmed.ncbi.nlm.nih.gov/11511861/
https://pubmed.ncbi.nlm.nih.gov/2010896/
https://endometriosis.net/living/diet-sugar
https://endometriosis.net/living/how-to-balance-your-blood-sugar-levels-to-reduce-endo-symptoms
LPS
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4519769/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5902457/
Resistant starch
https://www.researchgate.net/figure/Classification-of-types-of-resistant-starch-RS-food-sources-and-factors-affecting_tbl1_330644723
https://www.sciencedirect.com/science/article/pii/S1756464622001645
https://monashfodmap.com/blog/dietary-fibre-series-resistant-starch/
https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1464-5491.2010.02923.x
https://pubmed.ncbi.nlm.nih.gov/8092089/
https://pubmed.ncbi.nlm.nih.gov/16155268/
https://www.healthline.com/nutrition/9-foods-high-in-resistant-starch
https://www.sciencedirect.com/science/article/pii/S1756464622001645
https://www.csiro.au/en/research/health-medical/nutrition/resistant-starch
Rice safety
https://www.food.gov.uk/safety-hygiene/home-food-fact-checker
Processed food
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6835660/
https://zoe.com/learn/what-is-ultra-processed-food
https://zoe.com/post/processed-food-gut-health
Free resources:
This podcast!
Ways to work with me:
This EndoLife, It Starts with Breakfast digital cookbook
Masterclasses in endo nutrition, surgery prep and recovery and pain relief
Live and Thrive with Endo: The Foundations DIY course
One to one coaching info and application
This episode is sponsored by BeYou Cramp Relief Patches. Soothe period cramps the natural way with these 100% natural and discreet menthol and eucalyptus oil stick on patches. Click here to find out more and to shop: https://beyouonline.co.uk/pages/how-it-works
Produced by Chris Robson