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The Diet

July 27, 2009

Even though I made promises to update the blog, I’ve failed at many attempts. I’m having a couple of issues.

I prefer discussion over a monologue. Obviously this is why I do tend to give a little more attention to my yahoo group, because we can bounce ideas off one another, and address specific and targeted issues that people are having. Here too, however, I can be slow/late/negligent when it comes to writing and responding to group discussions because Outside of work I spend very little time sitting down. I had a knitting blog once. I used to like movies. But as a cursory glance at this blog will tell you, I am not one of those SIBO’ers who has trouble keeping weight on; quite the opposite, I have trouble losing, and I haven’t lost nearly 40 lbs in the last 2 years or so by blogging or knitting or watching movies. I run, I use the elliptical and crosstrainer, I lift weights, I play wii sports and wii active and I go dancing whenever I can. So blogging is just once thing that’s slipped out of my grasp a little in an effort to hit my weight loss goal (about 10 – 15 more  lbs to go btw. Lastly, I’m learning something about myself lately and it’s that I’m uncomfortable with the amount of knowledge I have about this condition. I have yet to meet/cross paths with anyone who knows more about SIBO than I. Bloggers, forum posters, doctors, you name it. I value expertise very highly and I do not think it comes easily. All this time I have been avoiding telling people how they should deal with their own overgrowth, what they should eat, what they should take, etc. But a few things are becoming clear in my group. There are only a handful but I want to discuss them a post at a time. So for starters, lets talk about diet.

1) A Low carb, high fat diet helps most everyone with SIBO to manage their symptoms and feel a little more normal. The people who aren’t helped by low carb generally fall into two categories: A) People who either think they have issues with fat digestion or people who really have issues with fat digestion and B) People who won’t even bother trying. A group discussion recently brought me enormous frustration when it went something like this:

“I am very sick.” “what’s your diet like?” “I eat pretty much nothing but fruits and oats.” “Try low carb.” “Oh that doesn’t work for me. I need lots of fiber to keep me regular. I put psyllium husks in my fruit smoothie.” “Okay, well maybe you should stop that and try to drop the carbs and up the fat.” “Oh no, I’ve tried a high protein diet before and I have issues with C.””Okay well protein isn’t going to help you go to the bathroom but fat is.” “Oh I can’t eat a high protein diet.”

I haven’t done a ton of research on high protein diets. I eat what some might consider high protein, at between 110 – 150 grams per day. I also run 3 miles a day most days, or go dancing for 3 hours at a time with no breaks. I need the protein I consume. I remember the hair loss that used to occur all the time in my vegan years; I don’t have to deal with that anymore. When you look at my macronutrient breakdown, however, my diet is really high fat. Always my fat intake is at least 60% of my total intake. That leaves less room for protein and even less room for carbs. There are a few reasons for that. First of all, when you have SIBO, fiber becomes fairly indigestible. If you can easily digest fiber, I’ve got news for you – you probably don’t have SIBO. Secondly, most sugars aren’t digestible either, so if you have no sugar, and you have no fiber, all you’re left with is starch. And guess what? While Dr. Pimentel says you can eat all the potatoes, pasta, rice, and bread that you want, (and I hope for your sake he’s right) you may be like me, and those foods may bother you about as much as low GI carbs do. Generally, we with SIBO have two modes of operating – Playing It Safe, and Life Experimentation. Playing it Safe occurs when we feel worst, when we’re trying to figure out what is wrong, when we have an important event coming up and we don’t want to pop out of our party dress or spend the evening in the restroom missing out. Life Experimentation is what we’re doing when we’re not Playing it Safe. Playing it Safe means neither of us are eating rice or oatmeal or buckwheat, if we’re smart. Unless we know for a fact that those foods aren’t feeding the SIBO, and I doubt I can find one person who doesn’t know that. But if you are them, by all means, eat those oats! During Life Experimentation, very few rules apply, except that there is no reason to think you can go overboard on fruit and fiber with no consequence. The important thing, however, is that Life Experimentation gives you something you didn’t have before – knowledge. Of how a food gets on with your digestive tract. During a certain time of the day. During a certain length of time out from your treatment. During your period. All the time. Whatever you can grasp.

High fat and high protein are not the same thing. Okay, now that we are clear there, I will need a person to tell me that they ate a lamb chop cooked in coconut oil (or something less chemically offensive if they are FCI) or a broiled steak or a piece of baked cod and then tell me that they experienced bloating and gas and cramping or some other symptom due to their meal before I will change my tune from the simple gospel that if you have SIBO, meat will not make you sick. I get so tired of reading blog after blog and discussion post after discussion post about people eating ramen noodles while their family dines on turkey or ham. If you have SIBO, there is no mechanism by which the bacteria living in your small bowel can digest or even attempt to digest meat. Meat is probably the safest food you can eat, followed by eggs if you are not allergic (most people aren’t) and dairy if you are not intolerant to that. You can add green veggies to your diet as long as tolerated – the fiber can get you though so be careful with that one.

I have heard a lot of excuses for not going low carb. Especially distubing is the SIBO sufferer who is having trouble keeping weight on; he or she is afraid to eat a low carb diet because then won’t they just lose tons more weight? Maybe I just love food too much, but my answer would be “not if you eat enough of it,” which might be easier to do once you begin to eat food that your body is capable of digesting.

What’s your experience with low carb, high fat? Did it help your SIBO? If not, please share your thoughts and help me understand why I’m being a douche.

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151 comments

  1. […] First of all, when you have SIBO, fiber becomes fairly indigestible. If you can easily digest fiber,… […]


  2. Just wanted to mention that another instance in which people may have issues with trying a low-carb diet is if they have a GI motility disorder. SIBO occurs frequently in people with gastroparesis, a serious motility disorder in which the stomach does not emptying properly. Eating fat exacerbates the problem since fat further slows gastric emptying — this can worsen the already debiliting nausea, vomiting, pain and fullness caused by the disease.

    It’s a very difficult balancing act for those who are dealing with both GP and SIBO, so in that case being hesitant or even unable to follow a low-carb diet initially is completely legitimate.


  3. I know this is an older post, but I just came across it and found it riveting! I’m not on a special diet, and only starting to learn about SIBO, but it really hit home. I have such a hard time with fiber, and have a much easier time with high protein meals. If you’d be willing to share, I’d love to know what a typical day looks like for you, foodwise. Also, sorry if I missed it – do you take any probiotics? Mine worked great for me – until SIBO. They didn’t work anymore and once I stopped taking them I didn’t even feel worse. I suppose I already felt bad enough, ha! I’m still holding out hope that there’s a supplement out there that will help. Love your blog!


  4. Sarah, I think the problem with probiotics is the prebiotics added to them. I was happily having them and have only now realised, months later, that they were making me feel bad. I also discovered the FODMAP diet which I’m somehow trying to combine with SCD diet and that olive leaf extract, which I’ve been taking high doses of is high in FOS.
    Praying to feel well again, may we all be blessed with excellent health,
    Esther


  5. Hi there. I am trying a low carb diet, crossed with fodmap and specific carbohydrate. Seems like a very natural diet for the most part, and seems to be doing the trick in combo with digestive enzymes and glutamine. Its getting me into alot of research though, figuring out everything thats in food! complex!

    The only issues that might exist (no real strong evidence though) long term for low carb, seem related to overly low fruit and particularly vege intake – perhaps based on anti-oxidants and vitamins.

    But i eat lots of non-starchy low fodmap veges, and small amounts of low sugar low fodmap fruits like berries and even occasional nuts. I have the occasional bit of glucose as a mild sweetner, which is easier to absorb than sugar or carbs anyway. And I take digestive enzymes to help break anything down than might not be easy to break down.

    I may look into vitamin levels or anti-oxidant supplementation, or just eat more varied veges and berries later (missing mushrooms and brocolli). But my diet seems very healthy I think anyway in the mean time.

    Will see how it goes long term, but I am happy not eating carbs, they seem pointless nutrient wise, plus carbs are just long acting/ hard to break down sugars.

    I am liking where this may be leading for my overall health, and optimistic it will help me get control again of my life. A new lifestyle can fill one with optimism, even if it comes from a hard place.

    I am also replacing more sweet with more tart, which is interesting. Lemon, lime, cranberry diluted in water, or lemon in cooking, or hard aged cheese, and berries which are also more tart. Makes things tasty without the overwhelming sweet and saliva u get from sugar.

    I was pretty damn bad (burping for hours, felt like i would drown), so I want to make sure its good and treated before I worry too much about nutrional deficiencies (not that my current diet seems all that lacking anyway)

    No its an old post, but thought id comment anyway.

    And yes, high carb proponents, and the traditional food pyramid thinking is very ingrained, and not all that supported by science either. (high carb is associated with lots of diseases). People balk at the idea of higher protein diets, and getting rid of the staple bread, rice, whatever. Seems strange now to me. How did our anscestors live? certainly not on bread and rice. Theres so many health risks.

    Interestingly IBS is much higher in all countries with high carb intake, like italy (highest IBS rate) and mexico (next highest), moderately high in china and the UK with slightly lower carb intakes, and quite low in france with even less carbs and higher fat (they also have less heart disease), lowest in places like spain and germany, where they eat loads of meat, and not that much carb at all.

    Youd think someone could add 1 and 1 and make 2, but no researcher seems to have gotten through the food pyramid mentality to make the link.


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