These past few months, I'd been excitedly anticipating my travel to Portland to attend the 3rd annual SIBO Symposium. Dr. Allison Siebecker, a highly regarded SIBO specialist, presented a SIBO diet update to her eager audience. Many of her keen listeners consisted of MDs, NDs, Nutritionists, Dietitians, Health and Wellness Coaches and Chiropractors. I attended as patient and a CHC (Certified Health Coach).
I would like to share with you some of the highlights and key take aways from Dr. Siebecker's lecture this past weekend. Please keep in mind that her data is based off challenging SIBO patients. This information may not apply to simple SIBO cases. However, it may be very useful during a flare.
Things to keep in mind:
1. Individuals vary greatly- What may be tolerable for one person may not be tolerable for the other. Everybody is different. Tolerances may change over time with treatment. Experiment to find tolerances. Variations of fruits and vegetables may vary (softer is better). Its important to test foods and amounts of foods. If you reacted badly to something, try it again another day before you rule it out.
2. Amounts matter- Some people can tolerate small amounts of certain foods but if they eat too much of it, they may have issues. For example, I do well when I eat 3-4 bites of asparagus (the tips), but if I eat more than that or eat the whole spear, I feel terrible. If you would like some guidance, follow Dr. Siebecker's SIBO diet food guide which includes amount suggestions. She informed us that she will be updating this very soon to provide the latest information based on her more recent data.
3. The SIBO Diet is to be used during treatment, for symptom control and prevention support. It will not cure SIBO. The main take away here is that SIBO is a secondary issue. For me, my goal has been to investigate what is causing my SIBO to return after several rounds of treatment.
4. Trust your body over any list or diet. If you feel that if you can eat something that is High Fodmap and you can tolerate it well, don't stop eating it. For example, avocado oil is listed as a tolerable oil, but it you can't tolerate it, do not eat it.
Food that is Tolerated with SIBO
Sucrose- table sugar (intolerable to those who may have a yeast problem)
Cocoa- small amounts of dark chocolate
Lactose free dairy- According to Dr. Seibecker, about 75% of people can tolerate dairy and can be helpful for underweight patients. However, probiotics in yogurt might not be tolerated by some.
Clover Honey- She tested this with her patients who have fructose malabsorption and saw good results with absorption.
Starch- White Rice or white potatoes as tolerated starches. According to her, most of her patients could do one or the other, but were not able to tolerate both. These starches are good for underweight patients.
Fruits & Veggies- pick soft, Low Fodmap fruits and veggies.
Food that is NOT Tolerated with SIBO
Resistant starches- reheated foods (leftovers) like rice and potatoes.
Skins and seeds from fruits and vegetables- consider removing & peeling them during a flare
Coconut/Coconut oil- very fibrous and not tolerated well with the majority of her SIBO patients.
Winter squash - this one makes me sad because I love winter squash. I do notice that I feel bad after eating butternut and acorn squash. The ones that I may keep in my diet repertoire will be delicata and kabocha. These I can tolerate in small to medium amounts.
Raw & Unripe foods are not tolerated - pick the softest foods, not hard. For example, I bought some collard greens and I did have a bad reaction. Looking back I realize now that these greens were very tough to the touch. I can tolerate softer greens like spinach and chard.
Don't eat the stalks of greens (chard, kale, broccoli, etc)
Don't eat the fibrous white parts of citrus- pulp is okay to eat.