The Long Game: Living with SIBO Beyond Restrictive Diets

Colorful: Salad with Chickpeas & Tofu (aka low-FODMAP, plant-based proteins)

Recently, a reader asked how I was doing on my long-term keto diet. And I was like, what long-term keto diet?

So I'd like to make something clear.

I am not on a long-term keto diet! Yes, sometimes I eliminate carbs for a few days to get my digestion back on track, or to recover from a carbohydrate-induced IBS/SIBO flare. In cases such as these, three days of keto is a godsend.

I discuss doing a keto reset on one of the most popular Sexy Sibo blog posts to date: The Main Idea: Ketogenic Healing and a No-Bloat Food List for Meaningful SIBO Reduction, which you can read here.

That post, written in 2015 during a moment when I had been eating keto-style for 10 days, is a classic. However, please don't think for a moment that I have been following a strict ketogenic diet ever since then, nor that I think you should.

Au contraire.

Here's a fun fact. When I started Sexy Sibo back in 2015, it was one of the first blogs about SIBO in the world! Almost nobody knew what SIBO was in those days.

But things have changed. There are many SIBO blogs now, and many SIBO specialists. There is a SIBO summit here, and another SIBO summit there. There are SIBO conferences, SIBO books and SIBO protocols. And there are promises. Lots of promises. "Take this (or take that) and get cured." "Eat this (or eat that) and get cured."

I've even seen a recipe book that indicates you can clear your SIBO in 30 days.

Listen. I've been actively dealing with my SIBO for a solid 5 years now. And in that time, I've come to terms with another fun fact that, at first, was tough to accept.

It is quite possible, if not likely, that I may never 100% "clear" my SIBO. 

Once upon a time, it was very exciting to think I could figure this thing out and get permanent relief, once and for all. I no longer think this way.

I don't think the digestive tract of a middle-aged person can ever become the digestive tract of a 12-year old, or even a 25-year old person. Microbes build up over a lifetime. They move in, and they stick around—literally, inside a safe, sticky biofilm. A Biofilm of Doom, if you like.

But that's just how it is. THERE'S NO ESCAPE, MY FRIENDS!

And, as the saying goes, A man's gotta eat—(Note: by "man" here, I mean human). So, no. I am not following a lifetime diet of meat, fat and green vegetables.

Ketochrome: Short Ribs in the Slow Cooker

I've widened my scope quite a bit and regularly include many more plant-based, starchy/carby foods in my diet than I did at first. These foods include organic brown rice cakes and whole grain basmati rice, as well as Jasmine rice. They include extra-firm tofu now and then, roasted beets on a salad, winter squash several times a week, low-FODMAP fruits here and there and even, in season, a high-FODMAP fruit or two. For instance, Honeycrisp apples. Or a ripe, juicy peach on a hot summer day. (Did that peach make me bloat? Yes. Was it worth it? I think so.) I may even have some delicious medjool dates or Turkish figs with yogurt for dessert.

If you are just discovering you have SIBO, do please (with the blessing of your primary care provider or other healthcare professional) try the low-carb and SIBO-safe diets I recommend elsewhere on this blog. Consider doing a round or two of antimicrobials, herbal or allopathic. See how far you progress and pay attention to what works for you.

This last bit is the key. For a long-term approach, you'll need to find out what works best for you, and is sustainable for your body, mind and spirit.

It's important to have access to something like my 3-4 day keto reset to fall back on, because there will be times that you REALLY need relief. But it's also important to have pie once in a while. Finding the balance and learning to adapt is the journey.

One more thing.

Personal experience has taught me that if I restrict my diet too much, or for too long, I tend to binge. That is a miserable cycle. So, after 5 years of dealing quite intensively with my SIBO, I have consciously, lovingly, given myself permission to be bloated.

Today, 5 years in, my focus is on finding balance with my diet, digestion and lifestyle using an informed, intuitive eating approach. Because low-FODMAP diets are incredibly well researched for IBS, I tend to rely on low-FODMAP foods most of the time. If I flare, I drop back to keto. Day by day, I try to be aware of and honor my needs—physical, emotional, spiritual. Food has a place in all three.

Please check out my official website www.eat2evolve.com to learn more about my work, outside of the Sexy Sibo arena. I am currently becoming certified as an Eating Disorder Recovery Coach while keeping my Certified Nutrition Specialist credential up to date and offering Nutrition Therapy sessions—both in person at my office in Hadley, MA and via phone consultation for those who live at a distance. I would love to work with you!

May you be comfortable, joyful and deeply nourished.

xo Diana

Support for Constipation & Motility

Supporting gastrointestinal motility and bowel regularity are core features of a comprehensive treatment protocol for SIBO and IBS-C.

I've been hard at work behind the scenes at my day job (Product Development Manager at Moss Nutrition) developing two new products to address these needs and I am thrilled to announce that both are now officially launched!

MMC Select™ is a prokinetic formula designed to help promote gut motility by supporting healthy function of the migrating motor complex (MMC)—the "cleansing wave" that sweeps food, bacteria and debris out of the stomach and small intestine towards the colon. As we've discussed before on Sexy Sibo, the MMC is active between meals when the digestive system is at rest, which is why practicing "meal spacing" is so important for SIBO! MMC Select™ contains a careful selection of evidence-based ingredients for motility support: organic prokinetic ginger root, a premium concentrated DGL deglycyrrhizinated licorice extract researched for motility support, 5-HTP + P-5-P to help increase gut serotonin levels, absorption-optimized anti-inflammatory curcumin phytosome and alkalinizing potassium, a traditional prokinetic nutrient.

Colon Select™ is designed to help provide safe, gentle relief from occasional constipation with meaningful levels of researched and traditional ingredients. This formula features:

• Magnesium in two forms: ascorbate (vitamin C) and hydroxide
• Triphala, the revered Ayurvedic triple herb combination for enhancing bowel tone & function
• Aloe ferox extract (Cape Aloe) in the clinically relevant potency for helping to promote elimination: minimum 18% aloin content
• A blend of 5 time-honored botanicals to help stimulate complete and comfortable bowel movements: Marshmallow, Ginger, Sweet Fennel, Barberry Bark & Turkey Rhubarb Root.

Click on the product names above to visit the Moss Nutrition website and read more about these fabulous SIBO-specific products. I am so happy to be able to offer them to the world, and to my patients and clients in particular! (If you are a new patient or client, contact me for details about ordering.)

Yours in joyful service,
Diana🌀

Salad Days

Early on in the SIBO adventure, when beginning treatment and following a gut healing diet composed of SIBO-safe foods for the very first time, we avoid raw fruits and vegetables and, basically, cook the hell out of everything we can eat.

I didn't go near a raw vegetable for, probably, three full months when I was first starting out. I always drop back to eating cooked-only veggies whenever I flare or relapse, too. Cooked, peeled and de-seeded low-FODMAP vegetables are the easiest to digest, hands down. (As a rule, discard peels and seeds because they tend to be higher in bacteria-feeding fiber than other edible plant parts.)

Once your gut has healed, however, you can begin to introduce salads and raw vegetables. Something to look forward to!

I have chives growing in my garden now. Chives and green onions are the go-to low-FODMAP allium, since onions and garlic are out. Chives and green/spring onions add color and flavor to any dish. As a bonus, sweet purple chive blossoms are also edible.

Bon appetit! ❤

The pretty salad pictured here features red romaine lettuce, grated carrot (peeled first!), Persian cucumber (also peeled!) and fresh picked chives.

About 4 ounces of pan-fried wild Alaskan salmon filet, leftover from the previous night and flaked, provides the protein. I cooked the fish in ghee: skin side up for 5 minutes, then flipped until done cooking. Near the end, I added a splash each of Nama Shoyu tamari and balsamic vinegar, and covered the pan for a few minutes while the flavors married. Yum.

The white stuff is Trader Joe's Chunky Blue Cheese Dressing & Dip. To be honest, I consider this convenient pre-made dressing a "legal cheat" as it is very low in carbohydrates (only 1 g per 2 Tbsp serving*) but contains some questionable ingredients (corn starch, non-fat milk powder).




*Rule of thumb: When reading labels, low carb/low sugar means low fermentation potential, so feel free to experiment with this principle when your belly is in a good place.

"The pain's just a program."

I’ve been watching Season 2 of Westworld, which is currently being released in single episodes on Sunday nights. The sci-fi plot is fascinating in a semi-incomprehensible, deeply philosophical kind of way, which I love. But overall, the show is so horribly violent that every week I ask myself if I even want to keep watching.

Then I do.

In this week’s episode, one of the main characters needs to strap himself into a torturous device that will saw through his cranium, remove a circle of his bony skull cap and extract a small mechanism buried inside his brain, all while he is wide awake with no anesthesia.

Naturally the character is afraid of how painful this surgery will be, but it’s the only option, the world is at stake. As his head is being locked into position, he steels his resolve with these gritty words: “The pain's just a program.”

Granted this character is a Host, rather than a human. In Westworld, Hosts are extremely lifelike robots or cyborgs, who actually can think and feel. However, everything about them, including their mind, is manmade. Their flesh and blood only look, taste and smell exactly like “real” flesh and blood. Ultimately, every thought and sensation they experience is computer-generated. Even though they can feel it. The pain is just a program.

I’m thinking about this as I wake up and deal with my own pain. My gastrointestinal discomfort, which I live with every day, which goes hand in hand with my IBS and SIBO. This pain is just a program of my condition. How I respond to it, on the other hand—the story I tell myself about it, the program I assign to it—is up to me.

Pain is a hallmark of irritable bowel syndrome (aka IBS, aka the mother of SIBO). Irritable bowel syndrome is, of course, the most common gastrointestinal disorder in the developed world, “affecting 5%–27% of Western society. GI symptoms, including abdominal pain, bloating, distension, excessive wind, and altered bowel habit, characterize this condition when anatomical abnormalities and inflammation have been excluded.” [Extending Our Knowledge of Fermentable, Short-Chain Carbohydrates for Managing Gastrointestinal Symptoms. Jacqueline S. Barrett, PhD, BSc (Biomed)(Hons), MND Nutrition in Clinical Practice Volume 28 Number 3 June 2013 300–306.]

Abdominal pain. Bloating and distension. Excessive wind. Sound familiar?

In addition to pain itself, many people with IBS are known to suffer from something called chronic visceral hypersensitivity (also referred to as bowel hypersensitivity). Viscera in this case means our intestines, and hypersensitivity means we feel more sensation there, in our visceral, abdominal gut region, than normal people without IBS might tend to feel. A tiny bit of pressure feels like a great deal of pressure. A great deal of pressure feels unbearable.

I know this symptom well. It’s rare that I DON’T feel some pressure in my viscera, even after a good night of sleep and 12 or more hours of overnight fasting. To my disappointment, most days I wake up feeling not-empty. When I check my profile in the mirror, indeed my stomach is usually bloated. But often, it is not as bloated as it feels. And even if it were: Feeling bloated is just a program.

Bloating is not my first choice for a program. I’d rather have a different program. But I don’t. This is it, baby. It’s a FEELING. Feelings come and go. Some stay for longer, some for shorter. Long or short, it’s important to remember this:

I have feelings, but I am not my feelings.

And also:

This, too, shall pass.

One problem with visceral hypersensitivity is that it impairs your ability to ascertain whether the stomach is empty or full. This makes it tough to practice something like intuitive eating, a wonderful, non-dieting approach to food intake. Intuitive eating encourages tuning into and respecting the body’s natural hunger and satiety signals. But how can we respect our body’s signals when they are indistinct, if not indiscernible, due to a functional flaw in our hunger/fullness-perceiving mechanism. Can you say Catch-22?!

This problem is compounded by the fact that when a person with IBS feels bloated or in pain (which is, essentially, most of the time), the pain goes away while they are eating. Eating when in pain is never a good idea, everyone knows that. But ironically, the act of chewing and swallowing food causes the brain to release sedating serotonin and pain-killing endorphins. Therefore, eating makes a sore gut feel better, but only during the act of eating. Afterwards, it often feels way worse.

This final irony is really a challenge for anyone like me who’s ever suffered from a binge-type eating disorder and now has IBS. Your whole, viscerally hypersensitive, digestively disordered life can start to feel like one gigantic, non-stop trigger. Every. Single. Day.

So, let’s talk about IBS and eating disorders.

For a long time, researchers have recognized a strong association and even a causal relationship between IBS and disordered eating, particularly disorders of the binge eating (BE) type. Both bulimia nervosa (binge/purge cycling) and stand-alone binge eating disorder (formerly known as compulsive overeating, now simply BED) can lead to the development of irritable bowel symptomology.

In other words, eating massive quantities of food—not just once in a while, as on Thanksgiving, but day after day, again and again—screws up your gut.

This is not a shocking conclusion. It makes sense that chronically overloading your stomach, with or without puking afterwards, would screw up your gut, but why exactly this happens is not known for sure. An excellent research paper entitled “Binge eating, body mass index, and gastrointestinal symptoms,” posits three possible mechanisms for the observed association between bingeing and IBS. Because this is so important and so well-referenced, I’m going to quote the article verbatim, then summarize the passages underneath. Feel free to scroll down if technical jargon makes your brain hurt, otherwise, enjoy:

“The significant, positive association between BE and IBS symptoms, which persisted even after introducing potential medical and psychiatric morbidities (e.g., hypertension, Crohn’s disease, depression) and BMI, suggests that the influence of BE is particularly robust. Given the exploratory nature of the current analyses we present three potential interpretations of the underlying association between BE and IBS. First, both BE and IBS have demonstrated important relationships with psychosocial stress [29–31]. Stress is known to be a common precipitant of BE [29] and many individuals who struggle with this behavior may be prone to using BE in an effort to reduce anxiety or dysphoria [31]. In addition, stress is thought to play an important etiological role in functional GI disorders (the most common of which is IBS) [30, 32–35]. The observed association could potentially reflect a pattern that would be expected to occur if stress were a critical third variable that influenced both BE and IBS. While the current analyses do not lend themselves to mediation to assess the influence of stress, such analyses would be important to undertake in future studies.

“A second hypothesis is that the acute symptoms of IBS (e.g., nausea, diarrhea) may cause patients to either severely restrict their diets so as to avoid specific foods or to undergo prolonged periods of restriction to avoid IBS flares. Given the known association between dietary restriction and urges to binge [36], the observed association might suggest an inadvertent side effect of attempts to avoid IBS episodes via food restriction or limitation.

A third hypothesis is that individuals with concurrent BE and IBS may experience acute symptoms of IBS as a result of bingeing on foods that are not well tolerated. Symptoms of IBS are often triggered by food intolerance, particularly with foods that are high in fat content [37–39]. Macronutrient studies of those who engage in BE reveal that typical binge episodes are dense with high-fat foods and carbohydrates [40]. Thus, patients who struggle with BE may be more prone to IBS flare ups given that their binges are likely to be rich with foods that are poorly tolerated due to IBS.” [Peat CM, et al. Binge eating, body mass index, and gastrointestinal symptoms. J Psychosom Res. 2013 Nov;75(5):456-61.]

Okay, allow me to break those long paragraphs down to their essence:

Three Possible Reasons for the Association Between Binge Eating and IBS

1) Psychological Stress (causes both compensatory overeating, and cortisol-induced GI issues)

2) Restricted Diets that Eliminate IBS Foods/Triggers (dieting behaviors, rigid food plans, and restricting food intake in general causes compensatory bingeing)

3) Typical Binge Foods are IBS Triggers (the 2013 article mentions ‘foods high in fat and carbs’ as a primary culprit; if it were written today, I expect they would specify FODMAPs.)

Did someone mention Catch-22?

Now, just for fun, let’s throw visceral hypersensitivity into the mix. Feeling bloated all the time not only causes and increases stress levels, it makes it almost impossible to know, based on natural signals from your gut, if you are hungry, how full you are becoming during a meal, and when to stop eating. However, if you try to follow a portion-controlling food plan, you’re restricting. If you try to follow a SIBO-friendly or Low-FODMAP Diet, you’re restricting. And restricting leads to bingeing, and bingeing leads to IBS, and will you ever get off this merry-go-round, and if that isn’t stressful, I don’t know what is!

Talk about crazy making.

Okay. Deep breath.

It’s no surprise that stress is number one on the above list. Stress is at the root of IBS, no question. Therefore, finding ways to reduce and manage stress is of PRIME IMPORTANCE for people with IBS and SIBO. I can’t stress this enough, and it’s a big piece of what I work on with clients.

As for items 2 and 3, here’s where things get even trickier. It’s a fact that fermentable sugars and carbohydrates feed SIBO bugs, and that most fats and proteins don’t. Following a SIBO-smart diet is the most direct way to reduce the famous SIBO symptoms of gas and bloating. But if we force the diet or we restrict to tightly for too long, we risk going off the rails in a big way and really setting ourselves back.

This is the dance, finding the sweet spot between SIBO-smart eating and ease. Learning how to make intelligent boundaries around our food, eating inside those boundaries, allowing ourselves to eat outside those boundaries, and noticing the consequences of both. Living with it, and circling around, consciously.

As a clinical nutritionist specializing in SIBO, people expect me to practice what I preach, so I want to be clear: I don’t just preach “Eat this, don’t eat that.” I also preach tolerance. I also preach self-love. And what is very important for me, and for all of you to understand, is that everyone is ALLOWED TO GO OUTSIDE THE BOUNDARIES. Eating outside the SIBO-safe box doesn’t make you bad, wrong or undeserving in any way. It may make your tummy sore, it may make you gain weight, it may make you bloated, or constipated, or give you the runs. But at the end of the day, it’s just food. Food, and your body. How your body responds to food. And whatever you are feeling today, this too shall pass.

The important question is: How do you want to feel? How do you want to feel today? And not only today, but tomorrow? Because what you eat today is going to affect tomorrow. In fact, it may affect the entire next two weeks if you really go outside the boundary of what your gut handles best. We’ve all been there, and it’s not fun.

It’s not fun, but it’s okay. The pain is just a program. The program is in your mind.

Which brings me to a fresh idea: How about moving beyond the program? How about creating more ease around all this pressure to “be good” and “stay on plan” by dropping out of the program, out of your mind, and into the moment. Ask your body what it wants and needs right now? Slow down and check in. Cultivate an attitude of loving presence by practicing mindfulness and compassionate self-love.

The longer I am on this path, the longer I cycle through struggle and resistance and surrender and letting go, the more I am convinced that BEING SWEETLY PRESENT WITH MYSELF is the answer.

Being sweetly present with myself means non-judgmental checking in. Pausing and connecting. Looking at everything I know as tools, not rules. Asking my body how it’s feeling in this moment. Engaging playfully in an ongoing conversation with my body.

“Hello, my body! How are we feeling right now? What would you like to do today?”

My body is not the enemy. My body is my friend. It responds to whatever I provide as input—movement, stillness, food, no food, water, no water—it just responds. And by responding, it speaks. My body always does the best it can, and it is very forgiving, very resilient. Most importantly, it’s always there. Talk about a loyal companion!

Here’s a sweet exercise you can try right now.  Wrap your arms around yourself. Give your own shoulders a little squeeze or a rub. Now, rock yourself gently side to side, and say, “I love you, my body. Thank you for being there for me. Thank you for always supporting me. Let’s keep talking!” After you’re done hugging yourself, try putting one hand on your belly, and one hand on your heart, and saying kind words to yourself again. “Thank you, my body, for always being there for me. I appreciate you, and I love you.”

Make friends with your body. Continue the conversation. Be curious. Keep listening. Enjoy a full, deep breath together. Ask it what it wants. Maybe it wants to eat something delicious. Maybe it wants to go outside and play. Maybe it wants to rest. Whatever it is, and wherever you are, however you are feeling, just try to be with it. Be here.

And be kind to yourself, even when you hurt. The pain is just a program. Ditto for cravings, and compulsions. You can manage them, with knowledge and with kindness, returning to yourself again and again as you journey along your own, unique path of healing.

Chubby Checkers™ - The Fun & Easy SIBO Treat

In search of the ultimate, easy-to-make SIBO-safe sweet treat? This is it. I call them Chubby Checkers™ because of their shape, and also, it makes me think of the great Chubby Checker himself, not to mention his big hit The Twist. Who doesn't love to TWIST?

Anyway, to make Chubby Checkers™ all you need is a silicone mini-muffin mold*. I got my red, 1-dozen count mold, pictured here, for $10 at Bed, Bath & Beyond. Later, I ordered a double batch 2-dozen mold, pictured further below, from Amazon. Generally, I'm not a fan of using synthetic materials for food preparation or food storage, but silicone does have its advantages when making something special such as these candy-like, SIBO-safe treats!

Besides a mold, the main ingredients needed to make Chubby Checkers™ are raw cacao butter and whey protein powder.

I prefer Select Whey® from Moss Nutrition—the super high quality, practitioner-only supplement brand where I just happen to be the Product Development Manager (which is how I KNOW the quality is top notch).

Select Whey® is an awesome product. First of all, the whey itself is sourced from New Zealand grass-fed cows—producers of, arguably, the cleanest cow dairy on the planet.

Second, Select Whey® Chocolate and Vanilla flavors, are sweetened with SIBO-safe monk fruit extract, a natural, non-fermenting sweetener that, unlike stevia, actually tastes delicious! Other monk fruit bonuses are: zero calories and zero impact on blood sugar. Love it!

Once they are made, it's best to store Chubby Checkers in the fridge, in or out of the mold. You can store them at room temperature in an airtight container, too. Cacao butter is solid at room temperature, so these won't melt like those fat bombs made with coconut oil. However, I find refrigeration is ideal for preserving the freshest flavor and texture.

*Please note, if you don't have a silicone mini-muffin mold, you can still make these treats—they just won't look like checkers. Use a shallow flat dish lined with waxed paper, and after the batter cools, cut into squares with a knife. On the other hand, I'd say the silicone mini-muffin mold is worth the $10 investment. Those checkers are awfully cute.

INGREDIENTS 

Each recipe below makes 1 dozen Chubby Checkers™.

Chocolate Chubby Checkers™

2 oz raw cacao butter

1/3 cup Select Whey Chocolate protein powder

pinch of Himalayan pink salt

1 Tbs cacao nibs (optional)

Vanilla Chubby Checkers™

2 oz raw cacao butter

1/3 cup Select Whey Vanilla protein powder

pinch of Himalayan pink salt

1 Tbs ground vanilla bean (optional)

Variations: To make Mint-Chocolate Chubby Checkers, add 12 drops peppermint essential oil to the melted cacao butter. For Lemon-Vanilla Chubby Checkers, add 12 drops lemon essential oil to melted cacao butter. Or try Orange-Vanilla, by adding 12 drops orange essential oil. You can also experiment with lavender and rose. Have fun making up your own flavors! ❤︎


DIRECTIONS

Start by weighing out 2 ounces of raw cacao butter. You don't need a fancy digital scale with pinpoint accuracy, you just need to be in the ballpark.

Put the cacao butter in a pyrex bowl, place it in a low oven or toaster oven set to 200 degrees and allow the cacao butter to melt. Keep your eye on it—no need to overheat!

As soon as the cacao butter is melted, remove from oven and let the liquid cacao butter cool down a little, say, 10 minutes or so. This is important because you don't want to scorch the whey protein when you stir it in.

If you are doing a flavor variation with essential oils, add them into the cooled but still liquid cacao butter. Then add your Select Whey® protein powder. I generally use a miniature wire wisk for this part, but a fork works too. Stir well until the mixture of melted cacao and whey is smooth and uniform.

Finally, add pinch of salt and any optional ingredient you are using, again stirring well to combine. Alternately the optional ingredients can be sprinkled on top after completing the next step, transfer.

Use a clean tablespoon to transfer batter into the silicone mold cups, distributing evenly. Place filled mold in refrigerator and wait an hour to set the Chubby Checkers™. Then pop 'em out—so fun!

 

Body Ecology and the 80/20 Rule

I've been rereading The Body Ecology Diet by Donna Gates, a classic.

I am fortunate to own a 1993 first edition of the book, which came out before Donna had a bunch of products to sell (not that there's anything wrong with that), but I appreciate how in my copy, her diet and principles are outlined in a very pure form.

The Body Ecology Diet (or BED) grew out of Donna Gates' extensive research and experience. It incorporates elements of Ayurvedic medicine, macrobiotics and natural hygiene with the goal of providing a real food, plant-based, nutritional method for eradicating Candida overgrowth and rebalancing the gut microbiome. Many BED principles can be applied or adapted to SIBO, and the current, up-to-date Body Ecology website, unlike my vintage paperback, addresses IBS and SIBO specifically.

One of the seven main principles in the BED is "The 80/20 rule". This is applied to three distinct categories:

1) In terms of maintaining proper pH balance, the 80/20 rule is to eat 80% alkaline foods and 20% acidifying foods.

2) In terms of eating proper volume, the 80/20 rule is to fill your stomach only until it is about 80% full, and leave 20% empty space. This tip can help improve digestion and sleep quality in all people. Traditional Japanese culture has a phrase for this: Hara hachi bu

3) In terms of menu planning, the 80/20 rule is to eat 80% vegetables (land and ocean source) at every meal, and 20% of proteins or BED starches (root vegetables other than sweet potatoes and potatoes*, or the 4 seedlike grains - amaranth, quinoa, millet and buckwheat). *As an exception to the no potato rule, red potatoes in their jackets are allowed.

Because animal protein is non-fermentable, it's one of the safest foods to eat on the SIBO diet, but relying too heavily on eggs, aged cheese, fish, chicken and meat at the expense of veggies can lead to gut heaviness, mineral deficiencies and other imbalances.

Not eating enough fresh veggies is especially a problem in winter when salads can lose their appeal. However, I feel best when I base my diet on vegetables and use animal food as an addition to, not instead of plant food. I am grateful for being reminded of the 80/20 rule by rereading The Body Ecology Diet.

Here's how I put the 80/20 rule in action for my tasty lunch today:

What you are looking at up there: A big pile of room temperature greens (chopped romaine, spinach and cilantro) under one, over easy organic egg. Diced orange heirloom tomato also in hiding. Two slices of sugar free, Paleo-approved bacon and a couple black olives. Bragg's Healthy Vinaigrette with a little extra balsamic vinegar.

If I think of it, I'll add more 80/20 meal pictures to this post in the future, to give you more ideas on how to apply this principle to your SIBO safe diet.

March 2019 Photos Update: Examples of what 80/20 looks like on the plate. Body Ecology principles suggest it's helpful to eat your animal protein meal at lunchtime, when digestive fire is strongest, and to have a starch-based, vegetarian meal at dinner time. As always, see what works best for you.

80% Veg (Braised Mixed Veg + cultured carrots + avocado); 20% Starch (soaked and boiled Millet)

80% Veg (Zucchini Noodles with Red Peppers and Tomato Sauce); 20% Protein (Grass Fed Ground Beef)

Snack: Turkey Breast Roll-Up in Nori Seaweed, with Cultured Veg and Avocado filling

80% Vegetables (cabbage, parsley, Coastal Blend, braised in broth); 20% Protein (pastured hard boiled eggs)

80% Veggies (spinach salad, steamed broccoli & carrots); 20% Protein (baked tempeh + pumpkin seed sprinkle)

80% Veg (Sauteed Greens + soaked Hijiki Seaweed + Cultured Carrots); 20% Starch (Millet and Carrots)

FODMAPS WTH?

SIBO loves high FODMAP apples.

It was recently brought to my attention that I've mentioned FODMAPs and the importance of eating low FODMAP foods for controlling SIBO many, many times on this blog without every actually explaining what the hell a FODMAP is.

In case you were wondering...

FODMAP is an acronym that stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols.

These mysterious Os, Ds, Ms and Ps are compounds found in specific carbohydrate-containing foods, namely starches (oligosaccharides), sugars (mono and disaccharides) and sugar alcohols (polyols).

Being fermentable means the compounds are consumed by microbes such as yeast and bacteria—organisms which produce gasses as a byproduct of digestion. The more of these organisms you have in your gut (enter SIBO), the more your belly will fill up with gas when you eat FODMAPs.


 A few examples of different high FODMAP foods are:

• Fermentable....
• Oligosaccharides: wheat & rye, beans, onions, garlic, cashew, pistachio
• Disaccharides: Lactose (liquid milk, ice cream, soft unripened cheese)
• Monosaccharides: Fructose in fruits (esp apple, pear, mango), HFCS, agave & honey, asparagus, jerusalem artichokes,
• Polyols: Xylitol/sorbitol/mannitol, celery, mushroom, snow pea, stone fruits including avocado

The best place to learn more about FODMAPS is the Monash University website. Monash  has done most of the research in this field, notably by testing thousands of different foods for FODMAP content, and they have an awesome app you can buy for about ten bucks.

I also love registered dietitian Kate Scarlata's website and blog, dedicated to the low FODMAP diet. Kate also has created the best, free downloadable charts I've seen anywhere, plus she posts great recipes and wonderful articles that are informative and fun to read. Thank you, Kate!