In an endo-world of food fear, phobia, and conflicting approaches, it’s become a pretty challenging place to know where your own body fits in to diet + lifestyle swaps. Do you touch red meat and eggs? Do you eschew gluten? How the heck does one woman swear by vegan and another keto?? Ahhhh!

And the truth is - you’re totally right to be confused. There are a lot of different approaches because … there’s a lot of different women in your shoes! There are women with endo + gut infections, endo + autoimmune disorders, endo + chronic fatigue, endo + allergies, the list goes on.

That’s why to think one person could create a single diet plan to fit the profile of every endo-warrior out there would be overambitious to say the least. Some of you may die when you eat onions, some of you may react to 100 things (or be scared of 100 things), some of you may be addicted to sugar and white bread while others won’t touch starch. Some of you have never even considered dietary changes at all.

So here’s what I’m going to do: give you the basics on improving gut + microbial health, reversing malnutrition, and calming systemic inflammation - all of which are shown in scientific literature to directly affect the severity of endo. Then you can then make your own decisions on how to interpret and/or adjust for your own body, infections, dysbiosis, allergies, sensitivities, autoimmune, etc. (if you’re confused about this stuff make sure to buy my ebook and read it cover to cover)

Ready for the basics of good, healthy eating? Yes you are.

Goal 1: Eating to reverse dysbiosis and heal the damage in the gut lining.

The imbalance of gut bacteria can cause anything from chronic inflammation, to infections, digestive impairment, histamine or fodmap intolerance, and bloating. Addressing dysbiosis is. so. important. for you - dear endo-warrior - since we all know how microbial populations of the intestinal tract are associated with nutritional, autoimmune, and infectious diseases of all kinds. So yes, endometriosis too.

Know the most significant impact you can positively make on your gut microbiome is through diet, because the food you eat is the same food your bacteria eat. Through this method, you can change your microbiome for the better in as little as three days of eating certain ways. No joke

As for healing the gut lining, leaky gut is different than bacterial imbalance yet intricately connected. Repairing damage here includes lots of targeted  nutrients, digestive support, and removing food triggers in order to calm the immune system. We can assume most everyone with endo has a damaged gut lining since LPS - particles of gram-negative bacteria in your intestinal tract - are known to be colonized in endometriosis lesions and even in menstrual blood, fueling the endo-fire so to speak.

Goal 2: Eating to reverse malnutrition + calm systemic inflammation

One thing everyone with chronic disease has in common is a degree of malnutrition, even those who are overweight or obese. Studies show nutrient deficiency may even contribute to the development of endometriosis directly. 

Doing this takes certain ways of eating that reverse the nutrient deficiencies that are keeping your intestinal lining from repairing itself and your immune system from properly regulating. Did you know that the first thing your immune system gives the boot when you’re malnourished is its regulatory ability? That means its ability to TURN OFF THE INFLAMMATION, so if you want to put out the fire, you have to give your body the proverbial water. Not only that, your immune system is one of the biggest nutrient hogs in your body, and since we know endometriosis is an autoimmune-related disorder (meaning your immune system isn’t properly working), it’s time we gave this system a huge boost.

You might be overwhelmed at first.

Approaching these issues will require a shift in the way you eat, but I will never preach a strict diet before anything else. For many of you ladies, you may see some significant shifts by just removing some big offenders like sugar, gluten, and conventional dairy while increasing the nutrient density of your diet. If these changes aren’t helping oodles, removing some other big offenders like grains or eggs may do the trick. And then, of course, there’s nothing wrong with a strict elimination diet like the Paleo Autoimmune Protocol or lowFODMAP approach for those that need a lot of help.

To be clear, I am no fan of strict black or white diets. Do you want to be yo-yo dieting for the rest of your life, from one fad to the next? No. You don’t. You want to heal, you want to be able to eat food that makes you feel good, feel satiated, feel whole. You want to eat a diet that feeds your microbiome (which directly means as much diversity as humanly possible!). That’s the Heal Endo approach. Remember: progress before perfection. Ready? Here we go!

The Heal Endo Diet Approach

Here is the focus of your diet, no matter who you are. Fresh veggies, quality proteins, fat, flavor, and as diverse as humanely possible. Think diversity of colors, of cuts, of produce, and seasons. If you’re feeling deprived you’re doing it wrong, because you should be feeling well-fed and nourished.

Vegetable Based: 

“Plant based” often means a lot of grains and beans. Instead, I want to see you focus on feeding your microbial goddesses with the most nutrient dense plants of all: vegetables. Think 7-9 servings per day. Aim for local, for all the colors of the rainbow, for leafy, cruciferous, and brightly pigmented. Have fun tasting new flavors and expanding out of the norm. **Note that if you have IBS or terrible endo-belly bloat it may be worth sticking with lowFODMAP options for a while until you know what you’re reacting to.

Quality Protein: 

The most nutrient dense proteins are organ meats, shellfish, cold-water fatty fish like salmon, sardines, and mackerel, bone broth, or glycine rich cuts like roasted meat on the bone or pulled pork. Did you squeal with excitement on all of those?? No? Ok, bear with me though, because there are definitely ways to fold these slowly but surely into your diet :) Check out my recipe book here for awesome ideas

If you can afford it, all meat should be 100% grass-fed, pastured, or wild caught, which is best for you, the planet, and animal welfare! Diversity of animal proteins is just as important as plant proteins (think diversity of animals as well as cuts of the same animal). You don’t have to eat a lot to make this count - although if you end up craving a lot please eat up, as this often signals deficiency and cravings should minimize over time as you re-fill.

Ancestral fats

Fats are so important, they make up 25% of every cell in your body!! This is why it’s the place I demand kindly request you do your best to stock in your pantry with high-quality options. That’s because poor quality oils are often oxidized, and just trust me when I say this will have a direct impact on your health in a negative way. No vegetables oils pleassse, no canola, not even if it’s organic (per below). Instead cook with coconut oil, lard, tallow, avocado oil, ghee, grassfed butter, or sustainably harvested palm oil. Drizzle extra virgin olive oil on salads, veggies, or even in smoothies. Ancestral oils like these are what your ancestral cells need to refuel.

Microbiome + Diversity Focus: 

High fiber, wide diversity of foods, fermented foods (if you can tolerate), and as locally sourced as possible. Diversity plants in color and varieties (like cruciferous versus leafy greens versus brightly pigmented). Diversity means animal varieties and cuts, everything from deer to cow to fish to eggs, and an absolute focus on snout to tail eating. Diversity means fats, making sure you have high cholesterol options to support your hormone formation, antioxidant options to support your inflammation cool down, and everything in between. Eat locally, eat seasonally, eat with some adventure and gusto! When we focus on feeding our microbiome this way we have the opportunity to make significant shifts to increase our own health and vitality.

Foods that will never serve your blood sugar, dysbiosis, or nutrition needs

After focusing on the GREAT above, here are the, well, less than great. In fact, these are the foods I consider on the endo most-wanted lists, so aiming to remove them from your diet over time (while replacing them with the above!!) should be an overarching goal.

Processed Sugar + even too much “healthy” sugars

And her mean girl counterparts such as maltodextrin, corn syrup, fructose, dextrin, etc. All sugars disguised as other names. Sugar feeds all the wrong bacteria, all the wrong hormonal systems, all the wrong feedback loops. Repeat after me “not in this temple” (meaning your body).

As far as healthy sugar, when I look at some “healthy” recipe sites, they’re chock full of sweet everything! “Healthy” sweet muffins, cakes, breakfast goodies, salads, smoothies, sweet’n’savory entrees, the list goes on. Even if they’re made with good ingredients, “sweet” is still excess sugar. If you’re following your sweet obsession, you may also be binging on fruit, honey, maple syrup, and other “healthy” sweet alternatives. Please stop :) Instead, focus on cultivating your savory palette instead, and not searching meal replacements in the form of undercover dessert. **BTW sometimes sugar addiction stems from dysbiosis, as in our microbes are ordering us to eat more sugar. No joke. So your sugar craving should also start to lessen as you start to rebalance your internal ecosystem.

Gluten

I have a whole blog dedicated to this here. I know there are a lot of folk in the endo community that say they do well on gluten, but still have very deep inflammation issues. Remember, gluten intolerance doesn’t just mean digestive issues, it can mean inflammation issues. That’s why I personally recommend avoiding gluten if you have active endometriosis.

Processed refined foods:

Breads, pastas, cakes, pastries, cookies, crackers - Even if they’re gluten free or organic, consider these foods a healthier junk food option. They are fillers without the nutrition your body so desperately wants, so if you’re filling up on these you’re missing out on key nutrients. In addition, most gluten-free processed foods have been shown to be contaminated with gluten so, yah, well, not great.

Soy, corn, and processed dairy

Soy and corn products are basically nutritionally void fillers, soy with the added benefit of having endocrine disrupting affects if not properly prepared, while conventional dairy is widely agreed upon to cause inflammation. All three also work to feed dysbiosis when eaten in excess, and you can assume most all processed and prep-packaged foods are full to the brim with these guys. That’s why they’re often easier to avoid when you cut out processed foods.

Vegetable Oils

Even if organic, no soy, corn, canola, rapeseed, grapeseed, sunflower, or safflower. I have a big article on it here if you want more info. These are big-time Endo-no-no’s

Gray Area Foods, consider cutting out short-term if your symptoms persist

These are what I consider healthy foods that you may be secretly reacting to, or not at all. If you don’t feel better just increasing the good guys above while decreasing the no-nos, you may need to really pay closer attention to this list. The best way to find out if you’re reacting to one of these categories is to do a one month removal with reintroductions being your goal to see if you react. Keep diligent track of your symptoms if you choose to do this!

Grains + Beans

These foods have certain factors that both promote leaky gut and feed dysbiosis, which is why I recommend cutting them out at least short term and replace them with nutrient dense alternatives, a la veggies. When you reintroduce them after a period of not eating them, look for symptoms of bloat, brain fog, cravings, or blood sugar issues. If you decide to eat them after all, make sure they are properly prepared by soaking and sprouting beforehand.

Raw or Cultured Dairy

Processed dairy should probably be off limits to most everyone, but raw, grass-fed, and/or fermented dairy may be another story for some ladies depending on your gut, your ancestry, and more. In fact, I even consider grass-fed butter and/or ghee a superfood it’s so nutrient dense. Yet, dairy like this is still another item that’s worth cutting out for a while to see if you improve - many of you will. Also, some women will feel great with butter or ghee, but not with cheese or milk, so it’s worth experimenting not just with dairy overall, but with many different types (including different animals, as you may be able to tolerate sheep cheese but not cow).

Eggs

If you’re not improving the way you hoped via diet shifts and are still eating eggs, give them a one month boot to see if you feel better. Egg allergies are on the rise, and if you’re reacting to the proteins in eggs it won’t matter how nutrient dense they are if you’re reacting. It’s estimated that 1 in 3 people with chronic diseases may be reacting to eggs in some way, and it may not be digestively - think eczema, headaches, ovulation pain, etc. Like dairy, you may find you react differently to egg whites and egg yolks (which are much easier to tolerate), so when reintroducing try the yolks first before the entire egg.

Nuts and Seeds

Honestly, I have so many clients react to these that I have to mention them. We know that nuts and seeds are very hard to digest in large amounts, can be damaging to the gut lining, and contain anti-nutrients, yet many endo-recipes include copious amounts of nuts and seeds for healthy fats and fiber. So confusing. But truly I have many clients suffering from pretty bad cases of endo-belly remove nuts and seeds and they often quickly feel a lot better (and their bloat’s cut in half), so worth a try if this rings true for you as well.

Alcohol and Caffeine

In excess, neither of these are great for any body, but some of you endo-ladies will be able to tolerate these in moderation while others of you may need to look deep inside to break up with the nightly wine unwind or morning coffee ritual in order to feel your best. All fun things to consider :)

what about other gray areas like FODMAPS, AIP, and histamines?

HahahHAHahahAHahahha, yes there are lots of gray areas!!! Oh sorry, not funny, that was more of a stress laugh because it’s sometimes stressful as a practitioner working with so many women who literally have very different triggers, from onions to black pepper to apples to sweet potatoes to tomatoes to coconut oil. My point? Don’t give up here if you’re in the “more serious” level of endo suffering. You honestly may have huge triggers you could discover through a lowFODMAP, lowHistamine, or Paleo AIP approach. Work with a practitioner, and remember that it’s not in your head if you’re experiencing terrible symptoms no matter what you do, there are real reasons why - sometimes it just takes some professional guidance to figure it all out.