My SIBO Diet (Hint: It's Not About the FODMAPs)

If you google "diet for SIBO," you're sure to come across the GAPs Diet, Specific Carbohydrate Diet, Paleo AIP Diet and Low-FODMAPs diet. These diets have calmed symptoms for millions of IBS sufferers and they deserve all the praise they get, but they don't cure the source of the problem, especially when it comes to SIBO methane — the constipation variety of SIBO that I have. Practitioners like Chris Kresser make the case that diet alone is not enough and, further, that a diet that starves the gut of carbs could have a deleterious effect on the large intestine biome. I certainly don't want to fix SIBO in the small intestine only to create a different problem in my large intestine. Additionally, persuaded by Paul Jaminet's argument that very low carb diets can actually cause gastrointestinal disease by depleting the gut of Mucin-2, I chose to follow the diet prescribed by his book The Perfect Health Diet — and in fact I had already started three months before I got the actual SIBO-C diagnosis, when I was merely hoping to improve my symptoms.

Diet

PHD is a whole-foods, moderate-carb diet that, similar to other ancestral diets like Paleo recommends eating a plethora of wholesome vegetables and fruits, as well as grass-fed, pastured and wild protein sources, while eliminating refined sugar, grains, legumes, and chemical additives. Jaminet is a scientist, and his site is extremely well-researched with exhaustive footnotes. The philosophy of the Perfect Health Diet (the title is aspirational) goes like this: Poor health is the result of nutrient deficiencies, food toxins, and infection. So the primary goal of any diet should be to provide optimal intake of all necessary nutrients (optimal meaning "enough to derive the biological benefits, but not enough to become toxic"); to avoid food toxins; and to address any underlying infection in the body.

To quote Jaminet: "Given two equally nourishing alternatives, say wheat or white rice, if there is evidence that one is significantly more toxic than the other (in this case, wheat more toxic than rice), we should avoid that one and get the nutrition from the safer source."

On the diet I eat grass-fed, pastured and wild protein, dairy and eggs; the rainbow of fruits and vegetables; all starchy root vegetables; white rice; and homemade gelatin-rich bone broth.

I don't eat sugar, seed oils, soy, peanuts, legumes, chemical additives, or any grains at all except white rice.

I'm not finding the diet difficult. It probably helps that I'd given up sugar many years ago. I'd also eliminated gluten six years ago, when I started getting an itchy rash on my elbows, knees and tailbone that a friend told me looked like a food reaction. Though I tested negative for celiac and for gluten antibodies, the rash does return any time I've been inadvertently "glutened." It was slightly harder to give up other grains like corn and GF oats, which so many gluten-free folks depend upon, but I've been able to adjust, experimenting with coconut flour and cassava flour. In a future post I'll share some of my favorite recipes, including a cassava pizza crust.

The toughest thing for me to give up on PHP has been legumes, including peanut butter (peanuts are actually a bean — boo!). I used to love having steamed lentils for lunch or making a big vat of chili, and I have yet to find a decent substitute for hummus, which I practically lived on in my previous life.

I'm also avoiding alcohol for now, while my liver is being taxed with cleaning up endotoxins that the SIBO is spewing into my body. I used to love visiting wineries of the Northfork in the summer. Once I've healed the leaky gut and stopped the joint flares and neuropathy, I do look forward to having a glass of wine again, which the PHP diet supports.

In addition to diet, there are a number of lifestyle changes that the PHD book encourages, such as intermittent fasting and circadian rhythm entrainment and I'm doing those as well. (See: Health Hacks.) I'm also optimizing nutrients by getting my vitamin levels up. (See: Optimizing Nutrients with Vitamins.)